The intake sheet.
This is the full sheet behind a Preliminary Risk Review. It is longer than a contact form on purpose: an underwriter prices a risk from your operations, your buildings and your loss history, and a short form only moves that work to a phone call.
Take it in sections and come back to any of them. If you would rather start with a conversation, the short form is there — nothing here commits you to anything, and submitting it does not bind coverage.
Fields marked with an asterisk are required. Everything else is optional — tell us what you know and we will ask about the rest.
A. Engagement basics
Who we are speaking with, and when you need cover to start.
What we never ask for
No Social Security numbers, no driver license numbers, and no credit-consent answers — not on this sheet and not by anything automated. Where a carrier genuinely needs one, Andrew collects it directly, at the carrier’s own portal.
Why the loss question is strict
We ask you to state plainly whether there have been losses. A blank is not a “no”. A file that says the wrong thing about losses is the most common way a claim later gets denied, and that is not a risk worth taking to save a click.
- Phone
- (728) 219-9463