Protection Review and Discount Checklist Please provide the following to help ensure you are properly covered and maximizing discounts! Name* First Last Email* We want to make your insurance experience smooth and enjoyable so we’d like to tailor our communication to you. Please let us know your preferred method of contact for ongoing communication:*EmailTextPhoneMailI currently have the following policies with Forest Park Insurance:* Auto Insurance Home or Condo Insurance Renters Insurance Umbrella Insurance Boat Insurance Life Insurance Landlord Insurance Recreational Vehicle (travel trailer, motorhome) Insurance Motorcycle Insurance ATV Insurance Other Do you have any insurance policies not written through Forest Park Insurance?*YesNoPlease indicate the type of policy(s) that is not insured with Forest Park Insurance:Do you drive your vehicle(s) less than 8,000 miles per year?*YesNoIf so, how many miles do you drive each vehicle per year:Do you carry AAA for towing?*YesNoPlease provide your AAA member #:Do you use your vehicle(s) for business or delivery?*YesNoDo you use your vehicle(s) for ride-sharing purposes, such as Uber, Lyft, SideCar, etc?*YesNoDoes your vehicle(s) have any aftermarket parts?*YesNoDoes your vehicle(s) have a totaled / salvaged title?*YesNoHave you purchased or sold a vehicle recently?*YesNoDo you own a boat, motorcycle, RV, travel trailer or ATV?*YesNoWe may be able to add an OEM endorsement which will allow the insurance company to repair your vehicle with Original Manufactured parts rather than aftermarket parts. Would you like a quote for this endorsement, if available?*YesNoHave you updated remodeled your home recently?*YesNoDo you have a burglar alarm?*YesNoIf so, is it monitored?*YesNoDo you have any dogs?*YesNoWhat breed(s):*Has your dog ever bitten someone?*YesNoDo you have a pool or trampoline?*PoolTrampolineBothNeitherDo you have an in-home business or daycare?*In-home BusinessDaycareBothNeitherDo you have a woodstove?*YesNoDo you have a sump pump?*YesNoWhat is your home's heating source?*EX: electric, gas, oil, etcDo you have a golf cart, electric bike (e-bike), electric scooter, Segway or tractor?*Golf CartElectric BikeElectric ScooterSegwayTractorMultipleNoneAll home policies have low coverage limitations for valuable items such as jewelry, fine art, antiques, collectibles, rare items, watches, furs, business property and silver. Do you have any of these items?*YesNoAll home policies exclude earthquake, flood, landslide/mudslide damage. Please let us know if you would like a quote for:*EarthquakeFloodLandslide / MudslideAll of the aboveNoneMost home policies exclude damage to the water & sewer lines running from your house to the street. The cost to repair or replace these lines can easily cost thousands however the cost to insure these lines is minimal. Please let us know if you would like a quote to cover the water and sewer lines:*YesNoHave you had more than 1 prior water leak?*YesNoHave you had more than 1 prior sewer line blockage or backup?*YesNoIs the water line longer than 250' from your house to the property line?*YesNoIs the sewer line longer than 250' from your house to the property line?*YesNoDo you share a water or sewer line with a neighbor?*YesNoIs there an oil tank on your property?*YesNoDo you have a pollution liability policy?*YesNoDo you use your home for home-sharing (Airbnb, VRBO, etc)?*YesNoWould you like a quote for term life insurance?*YesNoHave you placed your home or vehicles in a Trust or LLC?*YesNoPlease provide the name of the Trust or LLC:*Would you like a quote for a personal umbrella?*YesNo Liability is what protects you, your assets, property, income, savings, retirement and future earnings from a lawsuit. Without sufficient liability protection your wages could be garnished, a lien placed on your home or be personally sued. Ideally your limit of liability should be sufficient to protect the sum of your assets plus 5 years of household income. What's the best way to protect all that you’ve worked so hard for? With an umbrella policy! But what is an umbrella policy? Simply put, it’s an affordable way to protect yourself if someone sues you for more than what’s covered on your basic insurance policies. An umbrella policy may even cover defense costs of frivolous lawsuits. Defense attorneys charge between $200 - $800 per hour, an umbrella policy could cover this. Who needs an umbrella policy? Because anyone can be sued, everyone needs an umbrella policy. A single judgment can exceed your savings, the value of your home and other assets… risking your FUTURE earnings. Renters are especially vulnerable to judgments that garnish wages. The best news, the average monthly premium for an umbrella is only $20!If so, would you like to include a quote for excess uninsured motorist coverage?*YesNoHave you updated or remodeled your rental property recently?*YesNoDo you allow tenants to have dogs?*YesNoIf so, do you restrict certain breeds?*YesNoDoes your rental property have a pool or trampoline?*PoolTrampolineBothNeitherDoes your tenant have an in-home business or daycare?*In-home businessDaycareBothNeitherDo you store personal belongings at the rental property?*YesNoIs there a woodstove in the house?*YesNoAll landlord policies exclude earthquake, flood and landslide/mudslide. Please let us know if you would like a quote for either of these:*EarthquakeFloodLandslide / MudslideAll of the aboveNoneAll landlord policies exclude damage to the water & sewer lines running from your house to the street. The cost to repair or replace these lines can easily cost thousands however the cost to insure these lines is minimal. Please let us know if you would like a quote to cover the water and sewer lines:*YesNoHave you had more than 1 prior water line leak?*YesNoHave you had more than 1 prior sewer blockage or backup?*YesNoIs the sewer line longer than 250' from your house to the property line?*YesNoIs the water line longer than 250' from your house to the property line?*YesNoIs your rental property used for short term rentals or home-sharing / vacation rentals such as Airbnb, VRBO, etc?*YesNoHave you placed your rental property in a Trust or LLC?*YesNoDo you have a sump pump?*YesNoIs there an oil tank on your property?*YesNoDo you have a pollution liability policy?*YesNoDo you use a property management company?*YesNoDo you require a rental application screening (background, credit and past eviction)?*YesNoDo you require your tenant to carry renter’s insurance and keep a copy on file?*YesNoDo you perform regular property inspections?*YesNoAre smokers prohibited in the lease?*YesNoDoes the house have a fire sprinkler*YesNoPlease provide information on other life changes that may impact your insurance:*Wedding, new baby, new vehicle, etc
