Woodhouse

Please fill out the form completely:

1. Name of Insured: *

2. Have there been any changes in your home during the past year? Examples: additions, pools, trampoline, remodel, updating heating or cooling system, etc.

3. Did you purchase, lease, or dispose of any motor vehicles during the last 12 months? Examples: private passenger cars, trucks, commercial vehicles, recreational vehicles, tractors, golf carts, watercraft, aircraft, ATV’s, motorhomes, trailers, etc.

4. Have you purchased, leased, or disposed of any real property or locations, including vacant land or buildings during the past year?

5. Have you purchased or disposed of any additional jewelry, furs, firearms, camera equipment, fine arts, musical instruments, or collectibles? Would you like additional information on these risks and insurance to provide protection?

6. Are there any new drivers living in your household?

7. Are there any vehicles used to deliver newspapers, pizza, or other deliveries for business purposes?

8. Do you have a child who will be attending college and living outside the home?

9. Do you conduct business from your home and want a quote for a business policy?

10. Have you acquired any new animals?

11. Do you employ either full-time or part-time employees in your home?

12. You may have an exposure to damage from a flood, sewer backup, or earthquake, which is not covered by your homeowner’s policy. Would you like additional information on these risks and insurance to provide protection?

13. Are you satisfied that the replacement value of your home is adequate? We are pleased to assist you with your final determination of values.

14. Your exposure to a liability loss may exceed your policy limits. Would you like a quote for an umbrella policy to provide additional limits of liability?

15. Have you acquired any of the following motorized vehicles: watercraft, including jet skis, snowmobiles, ATV’s, motor homes, or golf carts? If so, would you like a quote to ensure proper coverage?

16. Is there anything else that could affect your current insurance coverage of which we should be aware?

17. Save up to an additional 20% on your current policy by obtaining two or more policies. Request a quote on one or more of these additional lines of coverage:

Home or Auto

Watercraft

Motorcycle

RV or Camper

Life or Umbrella

18. If there are no changes to your insurance needs from your current policy(s), please check here.

Contact Information:

Your Name *

Email Address *

Phone Number *

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Insurance Renewal Questionnaire