Automated Ordering Options
Completed reports may be retrieved from:
*Account Code: Company Name: *Policy Number: Agency: Agency Phone:
Send Report to: E-mail Address: ------------Coverage Amounts------------ Building: $ Contents: $ Type of Business:
Contact Person Placing This Order - Your Telephone # & Ext. (in case we have a question):
Insured / Mailing Address
*Name (Last Name, First): Contact/DBA: *Address: *City: *State: *Zip Code: Phone:
Survey Address (If Different from Mailing Address) Address: City: State: Zip Code: Phone:
Vehicle & Driver Information (vehicle surveys only)
Veh #1 Description: Veh #2 Description: Veh #3 Description:
Veh #1 Class: Veh #2 Class: Veh #3 Class:
Driver's Name
Birth Date (Date Format MM/DD/YY)
Driver's License Number
Insurance Survey(s) Requested
If you need something which is not listed, please give us a call 800.451.5621 and we will be happy to help!
Global Telephone Surveys Commercial Lines Surveys - Hourly Abbreviated Commercial Lines Surveys - Published Rates Limited Commercial Lines Surveys - Flat Rates (appropriate for Surplus Lines) Farm Surveys - Hourly & Published Rates Personal Lines Surveys Premium Audit Services
Global Telephone Surveys NONE ACS - Abbreviated Contractors ACSS - Abbreviated Contractors Short Form ACST - Auto Classification Short Form ACT - Auto Classification AGCY - Agency Report BOPT - Business Owners Package CSRQ - Cooking Supplement Restaurant Questionnaire CVAC - Commercial Vehicle / Abbreviated Contractors Combo. CVCT - Commercial Vehicle FAR1 - Retail Business Survey FAR2 - Restaurant Survey FAR3 - Auto Trades Survey FAR4 - Commercial Real Estate Survey FAR5 - Habitational Survey FTS - Farm Telephone Survey GLST - Garage Liability HRS - Home Renovation IMT - Inland Marine - Telephone MKT - Marketing - Retention Survey MRS - Mold Remediation Supplement TRC - Telephone Residential Replacement Cost UOTS - Uses & Operators VBTS - Vacant Bldg Phone Survey WCAC - Workers' Comp & Abbrev. Contractor's Survey WCEX - Worker's Comp Extended WCP - Workers' Comp, Telephone CFCE - Country Estate Phone Survey "Clean Up Project" CFAF - Auto Farm Use Survey
Commercial Lines Surveys - Hourly
NONE BOPB - Business Owners Package B CFS - Commercial Fire CGL - Comprehensive General Liability (Completed Operations) CPP - Commercial Package Policy / MPS (Multi-Peril) CVS - Commercial Vehicle FFS - Farm Fire GLS - Garage Liability / GKLL (Garage Keepers Legal Liability) IMC - Inland Marine - Contractors Equipment MTSC - Midwest Technical Safety Consultants (available by agreement only) OLT - Public Liability / OL&T (Premises Operations) PLS - Products Liability RCC - Replacement Cost Commercial (Only) RES - Resurvey / Recommendations Check (please fax original survey info) RETA - Restaurant / Tavern Rider (with another survey) WCS - Workers Compensation WD - Wind Survey FFB - Farm Family Business Owners Package
Abbreviated Commercial Lines Surveys - Published Rates
NONE BOPA - Business Owners Package A CFEX - Commercial Fire Exterior CFSS - Commercial Fire Short Form CPP - Commercial Package Policy / MPSS (Multi-Peril Short Form) CRFS - Care Facility CSJS - Contractors Short Form Job Site CVSS - Commercial Vehicle Short Form (1-4 Vehicles) GLSS - Garage Liability Short Form / GKLL (Garage Keepers Legal Liability) LLS - Liquor Liability OLTS - Premises Liability / Public Liability Short Form RETA - Restaurant / Tavern Rider (with another survey) RETO - Restaurant / Tavern Survey (Only) SPEC - Special Survey (available by agreement only) WCSS - Workers Compensation Short Form WD - Wind Survey
Limited Commercial Lines Surveys - Flat Rates
NONE CFEX - Commercial Fire Exterior SRS - Small Risk Survey BVSC - Building Valuation Survey Commercial DIAG - Diagram
Farm Surveys - Hourly & Published Rates
NONE FFS - Farm Fire DOS - Dwelling Observation Survey DS - Dwelling Survey HFR - Horse Farm Report OCS - Outbuilding Condition Survey MTSC - Midwest Technical Safety Consultants (available by agreement only) CFSF - Special Farm Package CFCE - Country Estate Supplemental Questionnaire CFH - Horse CGL Form FFF - Farm Family Farm Survey
Personal Lines Surveys
NONE ACF - Auto Classification, Field DCP - Homeowners / Day Care Residential DOS - Dwelling Observation DS - Dwelling (with Replacement Cost Valuation) EH - Electrical & Heating EHS - E&H Short Form HS - Homeowners (with Replacement Cost Valuation) HSH - Homeowners Survey - Hurricane/Wind with Replacement Cost Valuation HVD - High Value Dwelling MHS - Mobile Home OCS - Outbuilding Condition Survey PO - Photo Only POD - Photos with Diagram RCP - Replacement Cost - Residential (Only) THS - Tenant Homeowners VIP - Abbreviated High Value Dwelling VPR - Vacant Property - Residential WBS - Woodburning Stove WBS3 - WBS Short Form
Premium Audit Services
NONE TAUD - Telephone Audit MAUD - Voluntary Mail Audit
Photographs Requested
Rear / Side View
Comments / Special Instructions
(Maximum 800 Characters)
Please "Send Order" after each request.
