# General Liability Checklist

**Named Insured:** [Name]

**Insurance Company:** [Company Name]

**Best's Rating:** [Rating]

**Policy Number:** [Policy Number]

**Policy Period:** [Policy Period]

## Policy Form

### 1. Occurrence:
- **a. ISO Form:** [X]
- **b. Other:** [ ]

### 2. Claims Made:
- **a. ISO Form:** [ ]
- **b. Other:** [ ]
- **c. Claims Trigger:**
  - Claims made in writing?
  - Reported incidents?
- **d. Retroactive Date:** [ ]
- **e. Extended Reporting Period:**
  - Automatic
  - Basic
  - Supplemental
  - Available if cancelled or non-renewed by insured?
- **f. If first year CM, has explanatory letter been furnished insured?**
- **g. If renewal/replacement CM, is original retro date used?**
- **h. If original retro date is not used, are files documented that extended reporting option has been offered the insured, if available?**

**Remarks:** [Remarks]

**Term:** [Term]
**Term:** [Term]
**Term:** [Term]
**Cost:** [Cost]

**MM 009795**