Name: Ken Rozich Insurance Agency, LLC
Address: 113 West Liberty Street, Suite 203, Charles Town, WV, 25414, US
Telephone: 304-728-3888
Price range: $
Rating: 5

Client Information
Your Name*
First Last
Your Email*
Your Phone Number
What insurance do you currently have with us?*
- Personal Insurance
- Business Insurance
Home Address*
Street Address Address Line 2 City State ZIP Code
Company Name*
Company Address*
Street Address Address Line 2 City State ZIP Code
Total Annual Sales*
Total Number of Employees*

Your Business Structure
Please think back over the last year when answering these questions.
Have you changed the ownership structure of your business?*
- Yes
- No
Have you added new or changed your existing operations and/or products?*
- Yes
- No
Have you begun to buy supplies or sell your products overseas?*
- Yes
- No
Are you operating out of any new locations or have you closed locations?*
- Yes
- No
Please explain any changes to your business structure.

Your Personal Liability
Please think back over the last year when answering these questions.
Have you acquired, leased or sold a building, business property and/or equipment?*
- Yes
- No
Have there been any improvements and/or significant alterations to your building?*
- Yes
- No
Has your Inventory level changed significantly?*
- Yes
- No
Have you purchased, leased or sold any Vehicles?*
- Yes
- No
Please explain any changes to your personal liability.

Your Income Protection
Please think back over the last year when answering these questions.
Have your Businesses revenues changed by more than 10% since last year?*
- Yes
- No
Do you rely on a single supplier for more than 50% of your materials?*
- Yes
- No
Do you rely on a single buyer for more than 50% of your sales?*
- Yes
- No
Please explain any changes to your income protection.

Additional Protection
Would you like to discuss any additional insurance protection with us?*
- Yes
- No
Confirmation
Your initials*
Coverage will not be bound or changed until confirmed by a licensed agent.
This field is for validation purposes and should be left unchanged.
This field is for validation purposes and should be left unchanged.

Policy Review

Let’s ensure you have the right insurance in place.

It’s time to review your insurance.

There’s one guarantee in life and business. Things change. Our annual review is an opportunity to compare your existing coverage against your current needs to ensure your insurance remains appropriate to your situation.

Policy Review

Step 1 of 9

Client Information

Your Home(s)

Your Automobiles and other “Vehicles”

Your Other Life Events

Your Business Structure

Your Personal Liability

Your Income Protection

Your Employees & Professional Liability Exposure

Additional Protection

Confirmation

Contact Information

About Ken Rozich Insurance Agency, LLC

Personal Insurance

Business Insurance

Our Service Areas

Charles Town, WV