Location Change/Addition Form

Need to report a new or additional office location? If you are a current policy holder, use our simple form below. Completion of this form does not bind or alter your coverage. A representative from Marsh USA, Inc. will contact you.


Building Specifications
Are you the tenant or owner of the building?
If owned, please provide name of building owner.
If the building is over 30 years old, please provide year of updates:
Do you occupy the entire building?
How many square feet do you occupy?
If owned, please provide sq ft of entire building.
Coverages (please provide replacement cost limits)
(Excluding computer hardware, media, data, phones, faxes and copiers)

(Equipment taken more than 1000ft. off insured premises that is owned, leased, borrowed or rented)

(Including data, phones, faxes and copiers)

Other buildings or storage locations?
Landlord/Mortgagee on property?
Special Instructions and Requirements
* Required
Copyright 2012 by Marsh U.S. Consumer
AR Ins. Lic. #245544
CA Ins. Lic. #0633005
d/b/a in CA Seabury & Smith Insurance Program Management