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FirstMark Checklist

FirstMark - Coverage Checklist

Coverage Checklist - FirstMark

Step 1 of 16

6%
Client Name
Policy(ies) Sold

Auto

PIP or Medical

Driver Information

Primary Driver(Required)
Driver #2
Driver #3
Driver #4
Driver #5
Additional Drivers
First Name
Last Name
 

Vehicle #1

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Vehicle #2

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Vehicle #3

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Vehicle #4

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Vehicle #5

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Classic Auto

Liability same as primary auto coverage
Towing
Trailer
Modifications
(Tint, Rims, Electronics)
Photos or Appraisal Required?
PIP or Medical Payments
$0 Glass Deductible
Stated Amount/Agreed Value
Spare Parts
Added to Umbrella Coverage
Vehicle under restoration

Primary Home

Mortgage/Escrow
Earthquake Coverage
Landslide Coverage
Extended Dwelling Limits
Special Personal Property
Loss of Use/Additional Living Expenses
Extended Limits/Matching Roof & Siding
Flood
Water Backup Sewer and Drain
Hidden Water Damage/Leak and Seepage
Cyber Protection/ID Fraud
Equipment Breakdown Coverage
Service Line Enhancement Coverage
Alarm System (fire and police) or Cameras
Interior Sprinkler System
Automatic Shut Off; water and/or gas
Short-Term Rental (VRBO, AirBnb)
Dog(s)
Additional Animal(s)
Trampoline
Pool
Golf Cart?
Increased Limit - Jewelry
Increased Limit - Art (Agreed Value)
Increased Limit - Firearms
Increased Limit - Collections (Agreed Value)

Secondary Home

Mortgage/Escrow
Earthquake Coverage
Landslide Coverage
Flood Coverage
Short-Term Rental (VRBO, AirBnb)
Water Backup Sewer and Drain
Trampoline
Pool
Does the property have a wood stove?

Condominium Info

Mortgage/Escrow
Interior Building Limit
Special Personal Property
Loss of Use/Additional Living Expenses
Loss Assessments
Master HOA Deductible Coverage
Earthquake Coverage
Flood
Water Backup Sewer and Drain
Hidden Water Damage/Leak and Seepage
Cyber Protection/ID Fraud
Equipment Breakdown Coverage
Service Line Enhancement Coverage
Alarm System (fire and police) or Cameras
Interior Sprinkler System
Automatic Shut Off; water and/or gas
Short-Term Rental (VRBO, AirBnb)
Dog(s)
Additional Animal(s)
Golf Cart?
Does the property have a wood stove?
Increased Limit - Jewelry (Theft)
Increased Limit - Art (Agreed Value)
Increased Limit - Firearms (Theft)
Increased Limit - Collections (Agreed Value)

Renters

Policy Deductible
Personal Property
Special Personal Property Coverage
Loss of Use/Additional Living Expenses
Earthquake Coverage
Cyber Protetion/ID Fraud
Flood
Water/Sewer Back Up
Trampoline
Does the property have a wood stove?
Pool
Alarm System, Auto Shut Off/Sprinkler
Dogs(s)
Additional Animal(s)
Increased Limit - Jewelry (Theft)
Increased Limit - Art (Agreed Value)
Increased Limit - Firearms (Theft)
Increased Limit - Collections (Agreed Value)

Landlord

Property Address
Mortgage present/Escrow Pay?
Extended Limits - Dwelling
Landlords Contents (With Replacement Cost)
Extended Limits/Matching - Roof And Siding
Loss of Rents
Earthquake Coverage
Flood
Water/Sewer Back up
Limited Hidden Water or Seepage/Leakage
Equipment Breakdown Coverage
Service Line Enhancement Coverage
Alarm System (fire and police) or Cameras
Interior Sprinkler System
Automatic Shut Off; water and/or gas
Short-Term Rental (VRBO, AirBnb)
Dog(s)
Additional Animal(s)
Does the property have a wood stove?
Trampoline
Pool
Short- Term Rental (VRBO, AirBnb)

Motorcycle

PIP or Medical
Primary Driver(Required)
Motorcycle Driver #2
Motorcycle Driver #3
Motorcycle Driver #4
Motorcycle Driver #5

Motorcycle #1

Licensed For Street Use
Towing/Roadside
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Accident Forgiveness
New Vehicle Replacement
Modifications
Loan/Lease "Gap" Coverage
Leinholder/Lease

Motorcycle #2

Licensed For Street Use
Towing/Roadside
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Accident Forgiveness
New Vehicle Replacement
Modifications
Loan/Lease
Leinholder/Lease

Motorcycle #3

Licensed For Street Use
Towing/Roadside
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Accident Forgiveness
New Vehicle Replacement
Modifications
Loan/Lease
Leinholder/Lease

Motorcycle #4

Licensed For Street Use
Towing/Roadside
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Accident Forgiveness
New Vehicle Replacement
Modifications
Loan/Lease
Leinholder/Lease

Motorcycle #5

Licensed For Street Use
Towing/Roadside
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Accident Forgiveness
New Vehicle Replacement
Modifications
Loan/Lease
Leinholder/Lease

Motorhome/RV

Vacation Liability
Contents Coverage
Full Timer Coverage

Driver Information

Primary Motorhome/RV Driver
Motorhome/RV Driver #2
Motorhome/RV Driver #3
Motorhome/RV Driver #4
Motorhome/RV Driver #5

Motorhome/RV #1

Towing/Roadside
Rental Car
Commercial Use
Glass with $0 deductible
OEM Parts
Vehicle in storage
Loan/Lease (GAP Coverage)
Motorhome/RV Modifications
New Vehicle Replacement
Leinholder/Lease

Motorhome/RV #2

Towing/Roadside
Rental Car
Commercial Use
Glass with $0 deductible
OEM Parts
Vehicle in storage
Loan/Lease (GAP Coverage)
Motorhome/RV Modifications
New Vehicle Replacement
Leinholder/Lease

Motorhome/RV #3

Towing/Roadside
Rental Car
Commercial Use
Glass with $0 deductible
OEM Parts
Vehicle in storage
Loan/Lease (GAP Coverage)
Motorhome/RV Modifications
New Vehicle Replacement
Leinholder/Lease

Motorhome/RV #4

Towing/Roadside
Rental Car
Commercial Use
Glass with $0 deductible
OEM Parts
Vehicle in storage
Loan/Lease (GAP Coverage)
Motorhome/RV Modifications
New Vehicle Replacement
Leinholder/Lease

Motorhome/RV #5

Towing/Roadside
Rental Car
Commercial Use
Glass with $0 deductible
OEM Parts
Vehicle in storage
Loan/Lease (GAP Coverage)
Motorhome/RV Modifications
New Vehicle Replacement
Leinholder/Lease

Boat/Jet Ski

Driver Information

Primary Driver(Required)
Driver #2
Driver #3
Driver #4
Driver #5

Boat/Jet Ski #1

Insured Item
Uninsured Boater
Liability
Medical Payments
Hull Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #1

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Boat/Jet Ski #2

Insured Item
Uninsured Boater
Liability
Medical Payments
Hull Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #2

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Boat/Jet Ski #3

Insured Item
Uninsured Boater
Liability
Medical Payments
Hull Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #3

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Boat/Jet Ski #4

Insured Item
Uninsured Boater
Liability
Medical Payments
Hull Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #4

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Boat/Jet Ski #5

Insured Item
Uninsured Boater
Liability
Medical Payments
Hull Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #5

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

ATV/Snowmobile

Driver Information

Primary Driver(Required)
Driver #2
Driver #3
Driver #4
Driver #5

ATV/Snowmobile #1

Insured Item
UM/UIIM
Liability
Medical Payments
Physical Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #1

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

ATV/Snowmobile #2

Insured Item
UM/UIIM
Liability
Medical Payments
Physical Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #2

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

ATV/Snowmobile #3

Insured Item
UM/UIIM
Liability
Medical Payments
Physical Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #3

Towing/Roadside
Rental Car
Does the property have a wood stove?
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

ATV/Snowmobile #4

Insured Item
UM/UIIM
Liability
Medical Payments
Physical Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #4

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

ATV/Snowmobile #5

Insured Item
UM/UIIM
Liability
Medical Payments
Physical Damage/Deductible
Trailer Damage/Deductible
Personal Effects
Additional Equipment
Emergency Services

Vehicle #5

Towing/Roadside
Rental Car
Ride Share or Delivery (Uber, Lyft, etc.)
Commercial Use
$0 Glass Deductible
OEM Parts
Vehicle in storage
Telematics
Accident Forgiveness
Modifications
New Vehicle Replacement
Loan/Lease (GAP Coverage)
Leinholder/Lease

Umbrella

Policy(ies) covered by Umbrella policy

Life Insurance

Life Insurance

Life Insurance(Required)

Customer Signature

Name

Company

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