Personal Umbrella Protection Review | Bailey Place Insurance in Cortland, New York

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607-756-2805
2 N. Main Street
Cortland, NY 13045
607-844-8626
78 North Street
Dryden, NY 13053
607-319-0094
2428 N. Triphammer Rd
Ithaca, NY 14850

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Personal Umbrella Protection Review

Bailey Place Insurance

Please fill out the information below.

Personal Information

Your name ✶

Are you the policy holder? ✶

Yes No

Relationship to policy holder

Address include city, state, & ZIP ✶

E-mail ✶

Phone ✶

Checklist

Besides your auto, do you or a resident family member own any other motorized vehicles like a motorcycle, moped, mini-bike, snowmobile, ATV, go-kart, dune buggy, motorboat, yacht, sailboat, jet-ski or golf cart? ✶

Yes No

Additional Information

Are you in the farming business? (incidental farming, custom farming, own or care for livestock, etc.) ✶

Yes No

Additional Information

Do you have any employees or domestic help at your residence? (nanny, care giver, cleaning person, etc.) ✶

Yes No

Additional Information

Are you caring for any property that is not your own and it exceeds $1,000? ✶

Yes No

Additional Information

Are there any business activities conducted at your home, or in or on any property that you own? (daycare, home based business, lawn mower repair, etc.) ✶

Yes No

Additional Information

Is any portion of your premises rented to anyone? ✶

Yes No

Additional Information

Do you own or have any interest in any other real estate? (timeshare, vacation property, vacant land, camp, farm land, etc.) ✶

Yes No

Additional Information

Are there any drivers in your household under the age of 25? ✶

Yes No

Additional Information

Do you own, lease, or charter an aircraft, or have a pilot license? ✶

Yes No

Additional Information

Do you use your property, vehicles, watercraft, or aircraft for business purposes? ✶

Yes No

Additional Information

Do you have any vehicles, watercraft, aircraft, or property that are owned, hired, leased, rented, or used on a regular basis that are not covered by insurance? ✶

Yes No

Additional Information

Is there a swimming pool on your property? ✶

Yes No

Above ground, in ground, diving board, or slide?

Is it fenced?

Yes No

Are there any other “attractive nuisances”? (trampoline, pond, unregistered vehicles, etc.) ✶

Yes No

Additional Information

Do you, any household resident, or any tenant have any animals or exotic pets? (dogs, cats, reptiles, birds, farm animals, etc.) ✶

Yes No

Additional Information

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About Us

Bailey Place Insurance is an independent insurance agency with offices in Cortland, Dryden, and Ithaca, New York.

Give us a call or request a quote online to find out how much we can save you on your insurance.

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Cortland Office

2 N. Main Street
Cortland, NY 13045

607-756-2805

Dryden Office

78 North Street
Dryden, NY 13053

607-844-8626

Ithaca Office

2428 N. Triphammer Rd
Ithaca, NY 14850

607-319-0094

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