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In conducting due diligence for an acquisition, it’s important to understand the risks of a target company business by obtaining information about insurance policies and other programs in place to manage those risks. This sample checklist aids the acquiror in assessing such risk management issues and should be part of a comprehensive inquiry into insurance and liability coverage of the target company. *** SAMPLE CHECKLIST *** To: Target Company From: ______________________ Re: Insurance Related Due Diligence Following is a list of certain documents, items and information which we will require in order to complete our due diligence investigation with respect to the Company’s risk management procedures. At your earliest convenience, please forward to us copies of each of the following, along with any explanatory or other information which you believe may be useful to our developing a full understanding of the Company’s risk management regime. If you have any questions about this request list or if you believe that any items are not appropriate for our review, please contact _________________ at __________________. I. Basic Insurance Documentation (a) Schedule of insurance detailing all types of insurance carried, including carriers, renewal dates, premiums, limits, deductibles and other relevant information.1 (b) Loss triangulation and actuarial studies. (c) Historical General Liability and Umbrella/Excess program information for each of the last five years. Please include retention limits, structure and insurers. II. Property Insurance (a) Schedule of locations, detailing address, construction, square footage, values for building, contents, etc. (b) Five-year loss information showing amount of loss, cause, date and location (current locations only). (c) Inspection reports. (d) Security system, sprinklers and related relevant information. III. Casualty Loss information by claim for each of the last five years with open/paid amounts, date of loss, date or report (if possible) and description of any loss over $25,000, along with a located code index, for all comprehensive, automotive, general, products liability and other coverages. IV. Automotive (a) A schedule of all autos by type, location and driver, owned or leased, Vehicle Identification Numbers, etc. (b) A schedule of vehicles owned over the last five years, by year. V. Workers’ Compensation (a) Payroll by class code, by state, with number of employees, if possible. Please include monopolistic states. (b) Five-year historical total payroll. VI. General and Products Liability (a) Five-year total historical sales and estimate for coming twelve months, broken down, if possible, into product groups. (b) Please list products you manufacture or that have made it to your space. (c) Please describe the services that you perform.

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