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 Sponsored Programs 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)
 
Payroll at new location:
(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 2017 Marsh LLC. All rigts reserved.
Marsh Sponsored Programs, a division of Marsh USA Inc.
In CA, dba Marsh Risk & Insurance Services
CA Insurance License #0437153