Northern Insurance Service, LTD Keeping You Secure and Financially Strong Since 1927!
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Customer Service

We at Northern Insurance understand the need for swift and efficient handling of our insured's requirements. The following forms can be used to Request Quotes, Bonds, or to Report a Claim, 24 Hours a Day, 7 Days a Week.

Bid Bond Request Form

Add an Auto, Driver, or
Request a Quote

Homeowners Questionnaire

Insurance Renewal Checklist

Report A Claim


Bid Bond Request Form

From (Contractor):
Requested By: Phone #
Bid Date: Time:
Obligee:
Address:
City: State:
Job Description:
Invitation:
Location City: State:
Estimated Contract Amount Percentage Subcontracted:
Bid Bond Amount Percentage of Bid Bond
Final Bond Requirements
Performance: Labor & Material:
Time to Complete: Start Date:
Completion Date: Length of Warranty:
Uncompleted Work on Hand:
Bid Form Required: Surety     AIA     Obligee
Special Instructions:

Auto Worksheet

Name: Date:
Address:
City: State:
Phone #:
Prior Insurance: Exp. Date::
Occupation: Premium:
Driver #1
Name:
DOB: SS#:
DL#: Miles Driven to Work (one way)
Driver #2
Name:
DOB: SS#:
DL#: Miles Driven to Work (one way)
Driver #3
Name:
DOB: SS#:
DL#: Miles Driven to Work (one way)

Auto #1
Make: Model:
Year: VIN #:
Alarm System: Yes    No

   
Coverage: Liability Only Full Coverage
Auto #2
Make: Model:
Year: VIN #:
Alarm System: Yes    No

   
Coverage: Liability Only Full Coverage
Auto #3
Make: Model:
Year: VIN #:
Alarm System: Yes    No

   
Coverage: Liability Only Full Coverage
Liability Limits: 20/40
25/50
50/100
100/300
500/500

Homeowners Questionnaire

Name: Date:
Address:
City: State:
Phone:    
Prior Insurance: Exp. Date:
Occupation: Premium:
Year Constructed: Type of Construction:
Sq. Ft. Number of Stories:
Basement: Finished
Unfinished
No Basement
Sewer & Sump Pump? Yes
No
Garage: Attached
Detrached
No Garage
   
Dog: Yes
No
Breed:
Pool: Yes
No
Fence: Yes
No
Current Deductible: Current Liability Amount:
Umbrella Amount: Billing Plan:

Report a Claim

Name: Date:
Address:
City: State:
Phone:    
Insurance Company: Date of Loss:
Explanation of Loss:

Annual Client Review Checklist

Name:
Email:
Address:
City: State:
Home Phone: Business Phone:
Mobile Phone: Emergency:

Personal Client Updates
Changed Job/Occupation Purchased a New Home
Purchased a New Car Purchased a New Recreational Vehicle
Changed Primary Address Updated Will/Trust Beneficiary
Caring for Loved One Aded to my Family
Expecting a Child   Changed Marital Status:
      Married
      Divorced
      Seperated
      Widowed
Business Client Updates
Started New Business Sold/Looking to Sell Business
Expanding Business Hiring Key Employees
Changed Employee Benefits Altered Company Retirement Plan
Purchased New Property Purchased New Equipment
Purchased New Business Autos    
Personal Topics in my next Review
Auto Insurance Disability Insurance
Homeowners Insurance Insurance Needs for a Loved One
Insurance Needs for my Children Insurance Needs for my Spouse
Long-term Care Insurance Medicare Options
Personal Life Insurance Portfolio   Other:
Business Topics in my next Review
Buy-Sell Agreement Employee Benefits
Flexible Spending Arrangements Health Savings Accounts
Key Person Life Insurance Property & Casualty
Voluntary Benefits Workers Compensation
  Other:    
Family Memebers that may benefit from a complimentary Insurance
Name:
Name:
Name:

Please update my file and contact me next year
Please contact me to review current coverages via telephone
Please contact me to schedule an insurance review appointment
Joliet Illinois

Joliet Location

Phone: (815) 744-0111
Fax: (815) 744-0999

350 Houbolt Road
Joliet, IL 60431

 

Morris Illinois

Borens Insurance

Main Phone: (815) 942-0017
Fax: (815) 942-9035

114 W. North St.
Morris, IL 60450