Commercial Lines Exposure Checklist For:

Commercial Lines Exposure Checklist For:Client NameCoverageHas CoverageMiscellaneous PolicicesAircraft Products LiabilityAviationBondsBreach of PrivacyCredit InsuranceCyber/E-Commerce LiabilityDirectors & OfficersDiscontinued Products LiabilityEmployment Practices LiabilityEnvironmental Liability (1st and 3rd party coverage)Excess Flood Insurance (over Federal Flood Program maximum limits)Extended Reporting Period Endorsement (Tail Coverage)Fiduciary LiabilityFlood InsuranceFood ContaminationIntellectual Property (Patents, Copyrights, Unauthorized Disclosure)Kidnap & RansomLead Paint Liability (Landlord)Mergers & AcquisitionsPolitical Risks, Terrorism, Trade Disruption, etcProduct RecallTravel AccidentUmbrella/Excess LiabilityOtherProperty – Direct DamageAgreed ValueBlanket LimitsBuilder’s RiskBuilding Ordinance or Law CoveragesCo-Insurance (proper percentages for each coverage)Demolition CostEarthquakeFloodInflation GuardMold RemediationMultiple LocationsPeak Season ChangesPersonal Property of InsuredPersonal Property of OthersPersonal Property at Other Locations (Domestic & Foreign)Pollution CleanupProperty Damage Legal Liability (excess over Fire Legal Liability)Property Limited (Jewelry, Furs, Molds, Dies, Precious Metals, etc)Real Property (All Locations Domestic & Foreign)Sewer or Drain BackupTemperature Change (re: Food Spoilage,etc)Page 1 of 5DateNeed CoverageNot Applicable/Not Interested

CoverageValuationReplacement CostActual Cash ValueFunctional Replacement CostSelling PriceValue Reporting FormOtherProperty – Indirect DamageAgreed ValueBuilders’ RiskBuilding Ordinance or Law CoveragesCo-Insurance (proper percentages for each coverage)Dependant Properties (Domestic & Foreign)Extended Period of IndemnityExtra ExpenseLeasehold InterestLoss of Business IncomeOff Premises:Power/Water Supply PropertiesPower/Communication LinesCommunication PropertiesOverhead Transmission LinesOrdinary Payroll ExclusionOrdinary Payroll LimitationRental IncomeTuition and FeesOtherHas CoverageInland MarineAccounts ReceivableBailee CoverageCamerasEDP EquipmentComputer & Data Processing EquipmentMedia & SoftwareBusiness Income/Extra ExpenseBreakdownEquipment FloaterFine ArtsGlassInstallation FloaterMusical InstrumentsPrecious MetalsSignsTerritoryTransportation (Domestic)Common/Contract CarrierRailOwned VehiclesUS MailValuation (Replacement Cost, Selling Price)Valuable PapersOtherPage 2 of 5Need CoverageNot Applicable/Not Interested

CoverageOcean MarineAircraft LimitConcealed DamageContainer ShortageContingencyDutyFOB/FASUnpaid Vendor InterestValuationCost Plus (state percentage)Selling PriceVessel LimitWar Risks including SRCCOtherAutomobileVehicle #1 (owned, leased, other)Vehicle #2 (owned, leased, other)Vehicle #3 (owned, leased, other)Vehicle #4 (owned, leased, other)Driver #1 Driver #2 Driver #3 Driver #4 Liability PIP (Basic)Extended/AdditionalWork Loss Exclusion Coordination MilitaryDeductible: Name InsuredName Insured Dep. Rel.Medical PaymentsUninsured Motorists Bodily InjuryStacked Non-stacked Lower LimitsUnderinsured Motorists Bodily InjuryStacked Non-Stacked Lower LimitsUninsured Motorist Property DamageComprehensive – Deductible Limited CollisionCollision – Deductible Waiver of DeductibleCustomized, Electronic, Sound Equipment Towing & LaborRental Reimbursement Per day/TotalHired AutoLiabilityPhysical DamagePrimaryExcessNon-Owned Automobile LiabilityDrive Other Car (Name of Individual)LiabilityMedical PaymentsComprehensiveCollisionUninsured MotoristBroadened PIPFellow Employee Coverage (include or exclude)Mexican AutomobileOut of Territory (USA & Canada)Page 3 of 5Has CoverageNeed CoverageNot Applicable/Not Interested

CoverageGarage CoveragesGarage LiabilityGarage Uninsured MotoristsGarage Auto Medical PaymentsGaragekeepers LiabilityLegal LiabilityDirect PrimaryDealers Open Lot ComprehensiveDealers Open Lot CollisionFalse PretenseDrive-Away CollisionOtherWorkers’ CompensationBuilding Owner (if same ownership) added as Additional InsuredDefense Base ActFederal Employees Liability ActIncreased Employers LiabilityJones ActOfficers Excluded? If yes, have proper DWC11 forms filed with state?Other States EndorsementSole Proprietors, Partners IncludedStatutory CoverageUSL&HVoluntary CompensationOtherGeneral LiabilityAdditional InsuredsAircraft (owned & non-owned), Aircraft ProductsEnvironmental (1st party & 3rd party)FormOccurrenceClaims MadeHost Liquor LiabilityLiquor Law LiabilityPer Project AggregatePersonal Injury including Libel, Slander and False ArrestPrior Acts CoverageProfessional Liability, Errors & OmissionsProperty Damage Legal Liability (basic 50,000 limit)Property Damage Legal Liability - Increased LimitsTerritoryWatercraft (owned & non-owned)OtherForeign LiabilityAutomobile Liability (including Hired & Non-Owned)Difference in ConditionsEmployers LiabilityExcess RepatriationForeign Voluntary Workers CompensationPremises LiabilityProducts & Completed OperationsProperty Damage Legal Liability (basic 50,000 limit)Property Damage Legal Liability - Increased LimitsOtherPage 4 of 5Has CoverageNeed CoverageNot Applicable/Not Interested

CoverageComputer FraudDepositors ForgeryEmployee DishonestyERISAInnkeepers LiabilityMoney Order/Counterfeit PaperTheft Disappearance & DestructionInsideOutsideThird Party CoverageOtherHas CoverageNeed CoverageNot Applicable/Not InterestedEquipment BreakdownBusiness IncomeExtended Business IncomeHazardous SubstancesOff Premises Services InterruptionOrdinance or LawProduction EquipmentProperty DamageSpoilageOtherLife, Health, DisabilityBuy-Sell InsuranceGroup Disability (short or long term)Group LifeGroup Long Term CareGroup Medical PlansMandatory State DisabilityVoluntary BenefitsOtherInsured’s Name (print)Insured’s SignatureTitleDatedProducer’s Name (print)Producer’s SignatureTitleDatedPage 5 of 5

Credit Insurance Cyber/E-Commerce Liability Directors & Officers Discontinued Products Liability Employment Practices Liability Environmental Liability (1st and 3rd party coverage) Excess Flood Insurance (over Federal Flood Program maximum limits) . THE EGIS GROUP Commercial Lines Coverage Checklist For: Author: