Annual Insurance Checklist

First Name*
Last Name*
Phone*
Email*
Which type of insurance do you have with us? Select all that apply.*
- Personal Insurance
- Business Insurance
Personal Insurance
Home Address
Street Address Address Line 2 City State ZIP Code
Have you renovated, remodeled, added on to, or otherwise updated your home(s)?
- Yes
- No
Have you started a business based out of your home?
- Yes
- No
Do you protect your home with a professional security system?
- Yes
- No
Have you added a permanent swimming pool?
- Yes
- No
Do you or any family members perform babysitting services in your home?
- Yes
- No
Do you employ any part-time or full-time domestic help, including nannies, housekeepers, or landscapers?
- Yes
- No
Have you purchased any additional residences such as condos, timeshares, or second houses?
- Yes
- No
Do you rent out your home as part of the home-sharing economy?
- Yes
- No
If you’ve started renting out your home or any other property, do you have renters insurance?
- Yes
- No
Are all of your vehicles, including recreational vehicles and watercraft, insured with this agency?
- Yes
- No
Have you recently purchased any additional automobiles, recreational vehicles, or watercraft?
- Yes
- No
Have you upgraded any of your vehicles with new equipment?
- Yes
- No
Do you need to add any new drivers to your policy?
- Yes
- No
Do you drive any employer-sponsored vehicles?
- Yes
- No
Do you own any older vehicles that may be classic or collector cars?
- Yes
- No
Do you provide ride services as part of the ridesharing economy?
- Yes
- No
Do you have any children who no longer live at home and can no longer be considered dependents?
- Yes
- No
Have you purchased any jewelry, electronics, or other valuables that you would like to add to your policy?
- Yes
- No
Are there any such items that you would like to change or remove from your policy?
- Yes
- No
Do you insure your personal possessions for their full replacement value?
- Yes
- No
Have you recently added or otherwise changed ownership of assets such as trusts, titles, or LLCs?
- Yes
- No
Are there any other insurance coverage issues you would like to discuss?
- Yes
- No
Business Insurance
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Total Number of Employees
Are there any business properties or pieces of equipment that you have recently acquired, leased, or sold?
- Yes
- No
Have you closed or opened any business locations?
- Yes
- No
Has your company building undergone any renovations, additions, or other significant changes?
- Yes
- No
Have you added, changed, or removed any company products?
- Yes
- No
Has your inventory level experienced any significant shifts or fluctuations?
- Yes
- No
Do you either purchase supplies from or sell your products to foreign countries?
- Yes
- No
Has the ownership structure of your business changed?
- Yes
- No
Has there been a 10% or greater change in your business's revenue in the last year?
- Yes
- No
Do 50% or more of your materials come from a single supplier?
- Yes
- No
Do 50% or more of your sales come from a single buyer?
- Yes
- No
Do any of your employees regularly work from home or from another state?
- Yes
- No
Do any of your employees regularly travel to other states or countries for business?
- Yes
- No
Do any of your employees travel for business in their personal vehicles?
- Yes
- No
Has your company leased, purchased, or sold any automobiles or other vehicles?
- Yes
- No
Do you require all vendors, subcontractors, and 1099 workers to provide certificates of insurance?
- Yes
- No
Are there any other insurance coverage issues you would like to discuss today?
- Yes
- No

Your Local Agent

Customer Reviews

Five stars!!!Jennifer H., Illinois

JH

5 stars!Jamie H., Roscoe, Illinois

5 starsScott S., Rockford, Illinois

Five stars!!!!!!!!Roy R., Illinois

Five stars!Nancy L., Charleston, Illinois

See All Reviews See All Reviews

About

About Us
Meet Our Staff
Customer Reviews
Our Insurance Carriers
Insurance Blog

Insurance

Auto, Home, & Personal Insurance
Business Insurance
Life & Health Insurance
Group / Employee Benefits

Policy Service

Support
Online Billing & Payments
File A Claim
Policy Change Request
Annual Insurance Checklist

Contact

Vision Insurance Group

7214 N. Alpine Rd.
Loves Park, Illinois 61111

Phone: (815) 282-3480

Fax: (815) 282-3309

Mon-Fri: 9:00am-5:00pm
Sat-Sun: Closed

Google Maps Yelp Facebook

Vision Insurance Group specializes in auto, home, life, business, and workers' compensation insurance for all of Illinois, Washington, Wisconsin, Tennessee, and Kentucky.

Insurance Website Designers

Annual Insurance Checklist

Personal Insurance

Business Insurance