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New Business Submission Fast Start Sheet
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* Indicates required question
Email
*
Your email
Date
MM
/
DD
/
YYYY
Prospect Name
*
Your answer
Prospect Address
Your answer
The Following Items are in 360
Complete Acord Applications (Must include sales, payroll, FEIN, etc.)
Digital Photos
Loss Runs and/or Loss Letter
Status of Loss Runs
Your answer
Additional Information
(optional)
Your answer
Class/Type of Business
Your answer
Number of Employees
Your answer
Annual Sales
Your answer
Possible Coastal Issues
Yes
No
If yes, Explain
Location, construction, losses, etc.
Your answer
Source of Lead
Your answer
Effective Date
MM
/
DD
/
YYYY
Desired Proposal Date
MM
/
DD
/
YYYY
Current Carrier
Your answer
Expiring Premium
Your answer
Target Premium
Your answer
Desired Carriers for Quote
Your answer
Carriers to Avoid
Your answer
Why?
Your answer
Sales Opportunity
What does Prospect want? What do we have to do to Make the SALE? What commitment has Prospect made to you?
Your answer
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