Annual Insurance Checklist

Name: Charles Roach Insurance
Address: 2 E National Avenue, West Terre Haute, IN, 47885, US
Telephone: (812) 233-3636

First Name*
Last Name*
Phone*
Email*
Which type of insurance do you have with us? Select all that apply.*
- Personal Insurance
- Business Insurance
Personal Insurance
Home Address
Street Address Address Line 2 City State ZIP Code
Have you renovated, remodeled, added on to, or otherwise updated your home(s)?
- Yes
- No
Have you started a business based out of your home?
- Yes
- No
Do you protect your home with a professional security system?
- Yes
- No
Have you added a permanent swimming pool?
- Yes
- No
Do you or any family members perform babysitting services in your home?
- Yes
- No
Do you employ any part-time or full-time domestic help, including nannies, housekeepers, or landscapers?
- Yes
- No
Have you purchased any additional residences such as condos, timeshares, or second houses?
- Yes
- No
Do you rent out your home as part of the home-sharing economy?
- Yes
- No
If you’ve started renting out your home or any other property, do you have renters insurance?
- Yes
- No
Are all of your vehicles, including recreational vehicles and watercraft, insured with this agency?
- Yes
- No
Have you recently purchased any additional automobiles, recreational vehicles, or watercraft?
- Yes
- No
Have you upgraded any of your vehicles with new equipment?
- Yes
- No
Do you need to add any new drivers to your policy?
- Yes
- No
Do you drive any employer-sponsored vehicles?
- Yes
- No
Do you own any older vehicles that may be classic or collector cars?
- Yes
- No
Do you provide ride services as part of the ridesharing economy?
- Yes
- No
Do you have any children who no longer live at home and can no longer be considered dependents?
- Yes
- No
Have you purchased any jewelry, electronics, or other valuables that you would like to add to your policy?
- Yes
- No
Are there any such items that you would like to change or remove from your policy?
- Yes
- No
Do you insure your personal possessions for their full replacement value?
- Yes
- No
Have you recently added or otherwise changed ownership of assets such as trusts, titles, or LLCs?
- Yes
- No
Are there any other insurance coverage issues you would like to discuss?
- Yes
- No
Business Insurance
Company Name
Company Address
Street Address Address Line 2 City State ZIP Code
Total Number of Employees
Are there any business properties or pieces of equipment that you have recently acquired, leased, or sold?
- Yes
- No
Have you closed or opened any business locations?
- Yes
- No
Has your company building undergone any renovations, additions, or other significant changes?
- Yes
- No
Have you added, changed, or removed any company products?
- Yes
- No
Has your inventory level experienced any significant shifts or fluctuations?
- Yes
- No
Do you either purchase supplies from or sell your products to foreign countries?
- Yes
- No
Has the ownership structure of your business changed?
- Yes
- No
Has there been a 10% or greater change in your business's revenue in the last year?
- Yes
- No
Do 50% or more of your materials come from a single supplier?
- Yes
- No
Do 50% or more of your sales come from a single buyer?
- Yes
- No
Do any of your employees regularly work from home or from another state?
- Yes
- No
Do any of your employees regularly travel to other states or countries for business?
- Yes
- No
Do any of your employees travel for business in their personal vehicles?
- Yes
- No
Has your company leased, purchased, or sold any automobiles or other vehicles?
- Yes
- No
Do you require all vendors, subcontractors, and 1099 workers to provide certificates of insurance?
- Yes
- No
Are there any other insurance coverage issues you would like to discuss today?
- Yes
- No

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Customer Reviews

NT

Five stars!Nicole T., West Terre Haute, Indiana

NT

Charlie has been amazing in helping me when I had my accidentNicole T., Indianapolis, IN

AC

Love our insurance rates, and customer service with insurance brokers is scary!!Albert C., West Terre Haute, Indiana

BL

Very professional, knowledgeable and courteous! Highly recommend!Brandi L., West Terre Haute, Indiana

DM

A true professional.Diane M., West Terre Haute, Indiana

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West Terre Haute Office

Charles Roach Insurance

2 E National Avenue
West Terre Haute, Indiana 47885

Phone: (812) 233-3636

Fax: (888) 791-8560

Mon-Fri: 9:00am-5:00pm
Sat: By appointment
Sun: Closed

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Clinton Office

Charles Roach Insurance

2449 E State Road 163
Clinton, Indiana 47842

Phone: (765) 832-2440

Mon-Fri: 9:00am-5:00pm
Sat-Sun: Closed

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Charles Roach Insurance specializes in Auto/Car Insurance, Home Insurance, and Business/Commercial Insurance for all of Indiana, including West Terre Haute, Terre Haute, and Clinton.

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