SDL Brokerage

Commercial Insurance Questionnaire

The following information we’ll ask you to provide is typical of the underwriting information we will need to collect pricing from carriers so they can accurately assess your operations and potential risks and hazards for your Property and Liability (Casualty). We wouldn’t ask if it wasn’t necessary.

There is a “Save” option at the bottom of form if needed. Make sure to copy & save the unique URL to revisit your form in progress.

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Client Information

Mailing Address:
Give us an elevator pitch on what your organization does and how it generates revenue.

Business Information

Only necessary if applying for Worker's Compensation Insurance.
Current payroll annualized estimate, some carriers use this as part of their General Liability pricing and Workers Compensation is based on payroll.
Use current sales year estimate annualized or provide last verifiable fiscal year-end total gross sales. Carriers use sales as the foundation for their General Liability pricing.

Location Information

Physical locations of your office or business. Please get in touch with the landlord or property manager to confirm if not known.

Is your business 100% remote/virtual with no physical locations?
If 100% remote/virtual, provide a home address.
Do you own the building at this location?
Sprinklered:
What type of roof does the building have?
Please contact the landlord or property manager to confirm if not known.
Does your business utilize any of the following?
What amount do you need to insure the building for a total loss?
Have you put extra investment into the physical interior of leased space that is not contents? If so, what amount needs to be insured?
Business personal property (BPP) insurance covers the equipment, furniture, fixtures, and inventory you own, use, or rent inside your workspace. It covers almost everything except the physical structure of the building itself.
Click or drag a file to this area to upload.
Does your organization own any work vehicles that need to be insured? If so, upload the vehicle registrations and copies of an owner(s) or employee Drivers Licenses that need to be insured.

Please provide a separate list of vehicles and drivers (.pdf, .doc, .jpg, .png)
General liability insurance policies typically cover you and your company for claims involving bodily injuries and property damage resulting from your products, services or operations. It may also cover you if you are liable for damages to your landlord's property. Landlords and clients you work with require minimum limits in your leases or contracts.
Liability Excess or Umbrella extends the underlying coverage limits of General Liability and can also extend limits for Commercial Auto and Workers Compensation If applicable.
Miscellaneous Coverage Needed (D&O, EPLI, Crime, Fiduciary, etc.)
Do you need any of the following or would like to know more about these asset protections? Additional underwriting information will be required.

• Professional liability insurance is a type of business insurance that provides coverage for professionals and businesses to protect against negligence claims from clients or customers. Professional liability insurance typically covers negligence, copyright infringement, personal injury, and more.

• Cybersecurity insurance typically includes first-party Coverage of losses incurred through data destruction, hacking, data extortion, and data theft. Policies may also provide coverage for legal expenses and related costs, as well as 3rd party coverage, depending on the business's operation.

• Employment practices liability insurance (EPLI) "helps protect your business from employment-related claims, like wrongful termination, discrimination, and harassment.

• Directors & officers insurance (D&O) is liability insurance that covers the directors and officers of the company against lawsuits alleging a breach of fiduciary duty. A company pays for this Coverage so executives can serve confidently as their organization's leaders without fear of personal financial loss.

• Crime insurance typically covers dishonest acts like petty theft, and funds transfer fraud committed by part-time staff, volunteers or contractors, property damage, and burglary.

Prior Losses

Have you had any losses reported to insurance carriers in the last 5 years?
Click or drag a file to this area to upload.
Contact current carrier or broker and ask for loss runs for the entirety of policy existence.

(.pdf, .doc, .jpg, .png)
Click or drag a file to this area to upload.
(.pdf, .doc, .jpg, .png)
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