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Commercial New Business Intake
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If you're on the phone with a commercial client, this is the information you need.
Fill what applies.
You don't need every field to start a quote. Use estimates where exact numbers aren't handy and note them in Producer Notes.
START HERE
What Do You Do?
"What do you do?"
The most important question we can ask. Let them tell you in their own words. It uncovers needs well beyond "I need general liability."
In their own words, what does the business do? (the operation, who they serve, anything unusual)
LOSS RUNS
Required to Quote
"Do you have loss runs?"
Most carriers will not release a commercial quote without 3 to 5 years of current loss runs. If the business has carried coverage, we need them. If not: "We can help get those ordered for you." (we order them via Loss Runs Pro)
Loss runs status
Client has them
We'll order them (Loss Runs Pro)
New venture / none yet
Date loss runs requested
Order from (prior carrier)
1
Business & Applicant Information
Legal Business Name
DBA / Trade Name
Contact Name
Title
Phone
Email
Mailing Address
City
State
ZIP
Website
FEIN / Tax ID
Years in Business
Entity Type
Sole Proprietor
Partnership
LLC
Corporation
S-Corp
Non-Profit
2
Current Insurance & Reason for Shopping
Current Carrier
Policy Expiration Date
Current Premium
What's prompting the quote?
Renewal / shopping price
New venture / startup
New requirement (contract, lease, loan)
Coverage gap / claim issue
Lost / non-renewed by carrier
Date coverage needed
Who referred / lead source
3
Operations -What the Business Does
You captured the plain-language description up top. Use this section to pin down the class and territory.
Industry / Class of Business
NAICS / SIC (if known)
States / Territory of Operation
% Work Subcontracted Out
% Commercial vs Residential
Who do they serve?
General public
Other businesses (B2B)
Government / municipal
Residential homeowners
Online / e-commerce
4
Size & Exposure -The Rating Numbers
These drive the price on most commercial lines. Get a good estimate and keep moving.
Annual Gross Sales / Revenue
Projected Next 12 Mo.
Annual Payroll
# Full-Time Employees
# Part-Time Employees
# 1099 / Subcontractors
Annual Sub Cost
Total Square Footage Occupied
# of Locations
# of Owned Vehicles
5
Coverages Requested
Check all the client is asking about (or that the operation needs):
General Liability / BOP
Commercial Property
Workers Compensation
Commercial Auto
Umbrella / Excess
Inland Marine / Equipment
Liquor Liability
Garage / Dealers
Professional / E&O
Cyber Liability
Employment Practices (EPLI)
Other (note below)
Desired GL Limits
Desired Umbrella Limit
Other coverage notes
6
Locations & Property
Complete one block per location. Add a sheet for additional locations.
Add Another Location
Total Building Value
$0
Total Contents (BPP)
$0
Total Business Income
$0
Total Square Footage
0
7
Commercial Auto
List each vehicle. Add a sheet if more than three.
# Vehicles
# Drivers
Operating Radius
Hired / Non-Owned Needed?
--
Yes
No
Add Another Vehicle
Vehicles Listed
0
Total Vehicle Value
$0
Drivers
Add Another Driver
8
Workers Compensation
Field labor counts as employee payroll. Uninsured subs are treated as employees at audit and can trigger an additional premium bill, so capture what is paid to them.
Payroll by job duty / class (e.g. clerical $X, drivers $Y, field labor $Z)
# Employees Covered
Owners Included or Excluded
--
Included
Excluded
Experience Mod (loss-history factor, if known)
Owners / Partners / Members (name, ownership %, salary, DOB for each, for WC inclusion and audit)
Any work subbed out?
--
Yes
No
Subs Insured or Uninsured?
--
Insured
Uninsured
Mix
$ Paid to UNINSURED Subs (annual)
Prior WC Carrier
Any work performed out of state? (where)
9
Contractors Supplement
Complete if the business does any construction, trade, or field work.
Suggested
Primary Trade(s)
Contractor's License #
License State
% New Construction
% Repair / Remodel
% Residential
% Commercial
Largest Single Job ($)
Work above 3 stories?
--
Yes
No
Operations involved
Roofing
Excavation / grading
Electrical
Plumbing / HVAC
Framing / carpentry
Concrete / masonry
Demolition
Crane / hoisting
Do you collect subcontractor COIs?
--
Yes
No
Value of Tools / Equipment
Mobile Equipment?
--
Yes
No
10
Liquor, Restaurant & Bar Supplement
Complete if the business serves food or sells alcohol.
Suggested
Liquor Sales as % of Total Sales
On-Premise / Off-Premise
--
On-Premise
Off-Premise
Both
Seating Capacity
Hours of Operation
Live Entertainment?
--
Yes
No
Server Training (TIPS)?
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Yes
No
Restaurant / Kitchen
Fire Suppression System Type
Service Contract?
--
Yes
No
Hood / Duct Cleaned How Often
# of Deep Fryers
Raw Food Served?
--
Yes
No
All-You-Can-Eat?
--
Yes
No
Bar / Tavern
Drink Specials? (describe)
Type of Entertainment
Games / activities on premise
Darts
Cornhole
Pool / billiards
Dance floor
Live music / DJ
Mechanical amusement
Axe throwing
Other
11
Garage & Dealers Supplement
Complete for auto service, repair, or sales operations.
Suggested
Operations
Repair / service
Body / paint
Used car sales
New car sales
Towing
Detailing
Tire / parts
Quick lube
# of Lifts / Bays
# Dealer Plates
Max # Customer Autos on Lot
Garagekeepers Limit Wanted
Garagekeepers covers customers' vehicles in your care. We need the values to set the right limit.
Highest Value of Any One Vehicle
Max Value of All Vehicles on Lot at One Time
12
Loss History & Risk Picture
Years Continuously Insured
# Claims Last 5 Years
Total Incurred ($)
Describe any losses, lapses, prior cancellations, or non-renewals
Any of the following apply?
Lapse in coverage
Prior cancellation / non-renewal
Open claim
Bankruptcy / lien
None of these
13
Producer Notes & Next Steps
Producer / Associate Name
Date Taken
Follow-Up By Date
Markets to approach, missing items to circle back on, and any handoff notes
Exposure Summary
$0
Total Insured Value (property + autos). Updates as you add locations and vehicles.
Property TIV
$0
Auto Values
$0
Annual Sales
$0
Annual Payroll
$0
Total Employees
0
Total Sq Ft
0
Sizemore Insurance
· Commercial New Business Intake · Internal Use Only
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