Grimes Insurance » Commercial Insurance Renewal Form

Name of the business *

Have there been any major changes in your operations? *

Please list the changes as best as possible *

Do you have any of the following as part of your business insurance?

What is your estimated gross sales in the upcoming year? *

What is your estimated payroll for the upcoming year? *

Do you use subcontractors?

If yes, what percentage of your work is done by subcontractors? *

What is your best guess of what the replacement cost of your building(s)? *

What is the value of your business personal property? *

If you rent your building out, what is the monthly rent amount? *

When was the roof last updated? *

When was the electrical wiring last updated? *

When was the plumbing last updated? *

When was the HVAC last updated? *

Are there additional vehicles that should be on your policy that you do not see on your coverage outline? *

If yes, please list year, make, and model of the vehicle(s) *

Are all drivers listed on your policy correctly? *

If no, please list the name, Driver's License #, and Date of Birth for each additional driver *

What is your estimated payroll for the upcoming year? *

Have you added any employees in the last year? *