Insurance Discussion Form

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 Insurance Discussion Form

Insurance

Open for Business Worksheet

Insurance Coverage Discussion Form

Use this form to discuss your insurance coverage with your agent. Having adequate coverage now willhelp you recover more rapidly from a catastrophe.

Insurance Agent:Address:Phone:___________________Fax: _______________________ Email: ____________________

INSURANCE POLICY INFORMATION

Type of Insurance

Policy No.

Deductibles

Policy Limits

Coverage (General Description)

Do you need Flood Insurance?Yes

__No __Do you need Earthquake Insurance?Yes __No __Do you need Business Income and Extra Expense Insurance?Yes __No __Other disaster-related insurance questions: