Newport Beach Insurance Center

Name *

First Name

Last Name

Phone

(###)

###

####

Do you collect more than one collection category? (Ex. Fine Art, Jewelry and Rare Coins)

Yes

No

Do you maintain an inventory of the collection? *

Yes

No

Are the pieces documented, graded, appraised or authenticated?

Yes

No

Do you have any single pieces valued at $25,000 or more? *

Yes

No

Unknown

Is the collection stored in a safe? (If applicable) *

Yes

No

Do you store the collection in a safety deposit box (Bank vault)? *

Yes

No

Premise Security Features (Select All That Apply) *

Central Alarm System

Video Surveillance

Deadbolt

24-hour Security Guard

Gated Community

Is the collection currently insured?

Yes

No

Have you filed a claim on your collection in the last 5 years? *

Yes

No

Is the building protected by a fire and/or smoke detection alarm system? *

Yes

No

Is the premises within 1,000 ft. of a public fire hydrant and 5 miles of a fire station? *

Yes

No