Day Care & Preschool Insurance Quote

Legal Business Name *

Doing Business As (if different) (not required)

Business Type (not required)

Website (optional) (not required)

Day Care Location Address *

Is your mailing address the same as the location address? (not required)

Yes No

Mailing Address (not required)

Do you operate any other locations? (list the addresses) (not required)

Description of operations (check everything that applies) *

Is the day care part of a larger organization (church, school, employer, franchise)? (not required)

Yes No

Which organization is it part of? (not required)

How long has the applicant been in business? (not required)

Is this a new venture? (not required)

Yes No

Is overnight care provided? (not required)

Yes No

Is care provided for autistic or special needs children (mentally or physically impaired)? (not required)

Yes No

Is the facility open twenty-four (24) hours a day? (not required)

Yes No

Is the drop-off center located at a shopping mall or other retail establishment? (not required)

Yes No

Do you provide nannies or similar services away from the address above? (not required)

Yes No

Sexual and/or physical abuse coverage limit you want quoted (not required)

Are you licensed, registered and/or in compliance with state regulations? *

Yes No

License number (not required)

Maximum number of children permitted by your license / state regulations (not required)

Maximum number of children on the premises at any one time (not required)

Average daily attendance (not required)

Total number of employees (including part-time) (not required)

Are criminal background checks completed on all employees? (not required)

Yes No

Any previous or pending allegations of sexual or physical abuse? *

Yes No

Please explain the allegation(s) (not required)

Do you own or rent the building? (not required)

Own Rent / lease

In what year was the building constructed? (not required)

Construction type (not required)

Total square footage occupied by the day care (not required)

Number of exits (not required)

Is the building sprinklered? (not required)

Yes No

Is there a monitored fire alarm? (not required)

Yes No

Anything else about the building we should know (age, layout, recent updates)? (not required)

Are there any bottle warmers and/or cooking appliances in areas children could reach? (not required)

Yes No

Are there trampolines? (not required)

Yes No

Are there inflatables, such as moon bounces or slides, rented or owned? (not required)

Yes No

Is the play area fully fenced? (not required)

Yes No

Are there swimming or wading pools? (not required)

Yes No

Number of pools over eighteen inches (18") deep (not required)

Number of wading pools eighteen inches (18") or less (not required)

Are the swimming pools above-ground or in-ground? (not required)

Are there swimming pool slides or diving boards? (not required)

Yes No

How high is the slide or diving board? (not required)

Is life safety equipment kept at poolside? (not required)

Yes No

Is the pool area fenced with a self-latching gate? (not required)

Yes No

Are pool rules posted? (not required)

Yes No

Is a certified lifeguard or CPR-certified attendant present at all times? (not required)

Yes No

Ratio of attendants to children while swimming (e.g. 1 to 6) (not required)

Are all pools, wading pools, hot tubs and spas compliant with the federal Virginia Graeme Baker Pool and Spa Safety Act? (not required)

Yes No

Are there any natural bodies of water (lakes, rivers, streams) on the property? (not required)

Yes No

Are there animals on the premises? (not required)

Yes No

What animals? (not required)

Are dogs kept away from the children? (not required)

Yes No

Any other play equipment or facilities (climbing structures, ball pits, splash pads)? (not required)

Describe how injuries and illnesses are handled (not required)

Are any special classes taught (dance, gymnastics, martial arts, etc.)? (not required)

Yes No

Describe the special classes and who teaches them (not required)

Do you transport children to and from home and/or school? (not required)

Yes No

Who is your auto liability insurance carrier? (not required)

Are any vehicles with a seating capacity of more than fifteen (15) passengers used? (not required)

Yes No

Please explain (not required)

Do you take the children on field trips? (not required)

Yes No

Describe the field trips (how many a year, where, who transports the children) (not required)

Do you require the drivers to carry auto liability insurance? (not required)

Yes No

Is any medication dispensed? (not required)

Yes No

Who dispenses it, and how is it authorized and recorded? (not required)

Do you have an accident and health policy covering the children? (not required)

Yes No

Accident & health carrier (not required)

Accident & health policy number (not required)

Accident & health policy term (not required)

Are children released only to the custodial parent or guardian? (not required)

Yes No

Describe your authorization procedure for releasing a child to anyone else (not required)

Do you generate power, other than emergency back-up power, for your own use or for sale to a power company? (not required)

Yes No

Please describe (not required)

Do you have any other business ventures for which coverage is not being requested? (not required)

Yes No

Please explain, and tell us where those are insured (not required)

Estimated annual gross receipts / tuition revenue *

General Liability limit requested (not required)

Requested effective date (not required)

What else should we quote? (check all that apply) (not required)

What limit do you need on contents / equipment? (not required)

Does your lease or a contract require Additional Insureds? (not required)

Yes No

List any Additional Insureds required (name + address - e.g. your landlord) (not required)

Is a Waiver of Subrogation required? (not required)

Yes No

Do you have coverage for this now? *

Yes No

Current carrier (not required)

When does that policy expire? (not required)

What are you paying now? (not required)

Have you had continuous liability coverage since the business opened? (not required)

Yes No

What was the gap in coverage due to? (not required)

In the past 5 years, has coverage been cancelled or non-renewed? (not required)

Yes No

Please explain the cancellation or non-renewal (not required)

Any liability or property claims in the past 3 years, including claims that closed with no payment? (not required)

Yes No

Claim details (date, what happened, amount paid) (not required)

Name and phone number of the person the carrier should contact for an inspection/audit (not required)

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📋 Day Care & Preschool Insurance Quote Details

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