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Our offices will be closed Monday for the holiday. We will reopen Tuesday at 8:30AM. Even though we are closed you can submit a request, pay your bill, or get information for reporting a claim through the Service Center.

Insurance Protection Review Survey


from Bailey Place Insurance

Homeowner Insurance Policy Review

Please complete the form below to help us understand your evolving insurance needs.

Contact Information
Are you the policy holder? ✶

Property Information
Property Deed
Are you the only deeded owner of your home? ✶
Detached Structures
Do you have any detached structures? ✶
(shed, garage, carport, barn, etc)
Swimming Pool
Is there a swimming pool on your property? ✶
Type
Pool features
Trampoline
Do you own a trampoline? ✶
Home Changes
Have you made, or do you plan to make any changes, cosmetic or otherwise, to your home? ✶
Home Security
Do you have a security system in your home? ✶
Rental Property
Is any portion of your premises rented to anyone? ✶

Business & Commercial Usage
Business Actitivies
Are there any business activities conducted at your home, or in or on any property that you own? ✶
(daycare (adults or children), home based business, lawn mower repair, etc.)
Business property
Do you have any business property at or away from your home? ✶
Recreational Vehicles
Do you or a resident family member own a motorcycle, moped, mini-bike, snowmobile, ATV, go-kart, dune buggy, motorboat, yacht, sailboat, jet-ski or golf cart? ✶
Other Real Estate
Do you own or have any interest in any other real estate? ✶
(timeshare, vacation property, vacant land, camp, farm land, etc.)

Farm & Agricultural Usage
Farming Business
Are you in the farming business? ✶
(incidental farming, custom farming, or livestock, etc.)
Farm Equipment
Do you own a farm-type tractor or other farm equipment? ✶
Livestock
Do you have any horses, cows, goats, chickens etc? ✶

Coverage Options
Domestic Employees
Do you have any employees or domestic help at your residence? ✶
(nanny, care giver, cleaning person, etc.)
Identity Theft Coverage
Would you like information on Identity Theft coverage? ✶
Increasing Policy Limits
Would you consider increasing your liability limit and/or your policy deductible? ✶
Excess Liability Coverage
Would you like information on Umbrella or Excess Liability coverage? ✶
Earth Movement Coverage
Would you be interested in having coverage for earth movement? ✶
(earthquake, landslide, etc.)
Flood Insurance
Do you want coverage for flood damage to your home or personal belongings? ✶
Belongings Coverage
Do you feel the coverage amount on your personal belongings is adequate to replace them in the event of a total loss? ✶
Water Backup / Sewer
Do you want coverage for backup of water from the sewer or drains? ✶
Rebuild Coverage
Do you feel the coverage on your home and other structures is adequate to rebuild them? ✶
Firearms
Do you want coverage for theft of firearms? ✶
Jewelry
Do you want any coverage for jewelry, watches, precious or semi-precious stones if they are lost or stolen? ✶
Antiques & Collectibles
Do you want any coverage for antiques & collectibles? ✶
(stamps, coins, memorabilia, etc)
Silverware & Tableware
Do you want any coverage for silver, gold or pewter plated ware or tableware? ✶
Secure form

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