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Home > Additional Insurance Services > Small Business Questionnaire (SBQ) - Austin
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Small Business Questionnaire (SBQ) - Austin


The renewal date of your insurance coverage with our office is fast approaching, and it is important that we keep our information current.  By taking a few minutes to fill out and return this questionnaire, you can help us keep your coverage up-to-date and prevent gaps in coverage. If we do not hear back from you, we will assume that there have been no changes.

Thank you in advance for taking the time to review and complete this questionnaire! If you have requested a quote on any of the items below or have made changes or corrections, we will contact you for further discussion.

**If you would prefer to access the SBQ via hardcopy please click the PDF link. Otherwise, you may begin the SBQ below.

Small Business Questionnaire (SBQ) Small Business Questionnaire (SBQ) - Austin.pdf

Compensation Disclaimer Compensation Disclaimer - Austin.pdf



Personal Information
First Name *
Last Name *
Company Name *
Company Street Address *
City *
State *
ZIP / Postal Code *
Phone Number *
E-Mail Address *
Small Business Questions
Is the named insured listed above correct?

Are all entities identified above correct?

Any new corporations, partnerships, limited partnerships or joint ventures?

Have you started, changed or discontinued any activities or operations during the past year?

Any products to be sold, added or discontinued in the coming year?

Have you entered into any new contractual arrangements, including leased property?

Please provide your Projected Sales *
Please provide your Projected Payroll *
Please provide your Projected Number of Employees *
Have you purchased, leased, or acquired any real property or locations (including vacant land)?

Are all owned and leased locations listed on your current policy?

Do you own the buildings at any of your locations?

Is the building in the Business name or a Personal name?

Please provide the name if Personal
If a tenant, have you made improvement to the building you lease?

Do you need coverage for personal property of others that is in your care, custody or control?

Would you like to discuss increasing the limit on your building/contents?

Should the following be covered on your policy: Fences, signs, light poles, antennas, awnings, glass, carports?

Is your computer equipment/software limit adequate?

Have you had any changes to Contractor's Equipment?

If yes, please explain
Have you had any changes to Contractor's Patterns?

If yes, please explain
Have you had any changes to Contractor's Tools?

If yes, please explain
Have you had any changes to permanently installed equipment?

If yes, please explain
Any change needed to coverage for accounts receivable, valuable papers, stocks, blue prints?

Do you have machinery/equipment that is critical to your business not included in your current policy?

Are you interested in a quote for Wind, Hail, Flood or Earthquake coverage for contents and/or building?

If you have a Wind, Hail, Flood or Earthquake policy, your limits may or may not match your contents/building coverage. Would you be interested in a quote for higher limits?

Is your Business Income/Extra Expense/Rental Income limit adequate?

Do you have an exposure for loss of Business Income due to Off Premises Power Failure/Service Interruption?

Any changes to fire, sprinkler or security systems?

Do you have any changes to business-owned items: Autos, Trucks, Boats, Yachts, Aircraft?

If yes, please explain
Do your employees rent vehicles or use their own cars for company business?

Any vehicle / driver changes?

Are you interested in higher limits of liability?

Are you doing any business outside of the US?

Do you have any employee payroll in states not currently listed on your policy?

Are you sponsoring any teams or conducting any unusual promotional activities?

Have there been any unreported legal actions brought against you during the past year?

Are you required to carry liquor liability coverage?

Do you have a pollution liability exposure? (Above/below ground storage tanks, etc.)

Are you interested in discussing various forms of crime coverage, e.g. employee dishonesty, robbery, credit card fraud, funds transfer fraud, ID Theft?

Are you interested in discussing protection for allegations of discrimination, harassment, etc?

Would you like a quote for Internet / Cyber Liability coverage?

Would you like a quote for Professional Liability or Directors & Officers Liability?

Are there any new employee benefits programs?

Do you sponsor employee benefit plans that require an ERISA bond?

Any additional changes in your operation that may expose you to a potential loss?
Additional Comments/Concerns
Submission Validation
Required

Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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