Change of Address Notification
Your Firm Name:
Your Name:
Date of Change:
New Address:  
Address:
City:
State:
Zip Code:
New Phone # :
New Fax # :
Email:

If we insure your Office, please complete the following questions:
Is this new office location a commercial condominium unit? YES NO
Is there a change in coverage needed? For example, have you purchased new or additional equipment or furnishings for the new office or does your new lease require that you insure improvements or betterments to the space? If so, you may need to increase your Business Personal Property limit.
Please Describe:
Year Building Built :
NOTE— that if the building is more than 30 years old, please let us know when the following were updated:
Heating: Wiring: Plumbing: Roof:
Construction:
Office Square Footage:
No. of Stories :
Sprinklered? YES NO
Add landlord as additional insured? YES NO
Name & Address of Landlord:
Name:
Address:
City:
State:
Zip Code:
Phone # :
Fax # :
Email:
 

 

 

 

  
     
 

Euclid Insurance I 234 Spring Lake Drive I Itasca, IL 60143 I Phone: 630-694-3700 (ask for a member of the A/E Team) I Fax: 630-773-4075 I E-Mail: ae@euclidinsurance.com
Designed by Image Perspective © 2006 Euclid Insurance. All rights reserved.