Bicycle Shop Insurance Questionnaire

7. Please provide receipts ($) for the following: (Non-motorized watercraft only - canoe, kayak, paddleboat, or similar)

	Retail Sales	Service and Repair	Used Sales	Consignment Sales*	Used Parts Sales*	Tours	Rides
a. Bicycle
b. E-Bike
c. Segway
d. Watercraft*
e. Cross-country ski
f. Fitness Equipment
g. Clothing
h. Shoes
i. Other - Describe below
Total Gross Sales

7di. Please list the types of non-motorized watercraft you sell:

7fi. Please list the types of fitness equipment you sell:

7ii. Please describe "Other" sales:

7j. Please describe consignment operation.

7k. Please describe used equipment and parts you sell.

8. What percentage of equipment sales is:

	Residential	Commercial
Equipment Sales

9. What kind of warranty is provided? (Attach copy of checklist to verify viability of parts.)

BICYCLE INFORMATION

1. Do you use a bike assembly checklist?

YesNo

2. Is a torque wrench available and in use?

YesNo

3. Do you offer bicycle repairs away from premises?

YesNo

BICYCLE AND EQUIPMENT RENTAL OPERATIONS

1. What equipment do you allow test rides?

BicycleE-BikeSegwayOther

1a. Describe "Other" test ride equipment:

2. Bicycle, E-Bike, and Segway Testing Area

	Yes	No
a. Is the outdoor area on your premises for test riding bicycles free of potholes and cracks?
b. Are parents required to supervise younger children while they test ride?
c. Do you always require helmets for test rides of bicycles, E-bikes and Segways?
d. Do you require protective shoes (i.e. sneakers or athletic footwear) for bicycle, E-bike, and Segway testers?
e. Do you require the test rider or parent of test rider sign a hold harmless agreement? (Copy please.)

3. Do you rent bicycles, E-bikes, Segways, Cross Country Skis, Skates or Skateboards?

YesNo

4. Please provide the following information (Provide copy of each type of rental agreement.)

	Rental Receipts	Required Age to Rent
a. Bicycle
b. E-bike
c. Segway
d. Cross Country Skis
e. Skates
f. Skateboards

5. Please describe rental procedures and safety instruction for equipment (bicycle, E-bike, Segway, cross country skis, skate, and skateboard):

6. Please answer the following. (Provide copy of each type of hold harmless agreement.)

	Yes	No
a. Do you always require helmets and protective shoes (i.e. sneakers or athletic footwear) for bicycle, E-bike, Segway, skate, and skateboard rentals?
b. Do you have the renter or parent sign a hold harmless agreement for bicycle, E-bike, Segway, cross country ski, skate, and skateboard rentals?

6. When the equipment (bicycle, E-bike, Segway, cross country skis, skates, skateboards) comes back from rental, is each item checked by an employee and updated in a written maintenance log before it is rented again?

YesNo

6a. If yes, what checks are made?

7. If you offer sales, service or repair of skates/skateboards, please describe below including gross receipts ($).

8. Do you guide rock climbing?

YesNo

8a. If yes, provide details:

	Enter Number Below
Concession Receipts ($)
Number of Stands
Square Footage

	Enter Number Below
Ranges
Ovens
Deep Fryers
Grills
Broilers
Griddles

	Building Age	Building Construction	Building Limit ($)	Content Limit ($)
Building 1
Building 2
Building 3

	Year	Make	Model	Value to Insure For ($)
Item 1
Item 2
Item 3

	Vehicle Make	Vehicle Model	Cost New ($)	Year
Vehicle 1
Vehicle 2
Vehicle 3

	Amount ($)
Limit of Liability
Comprehensive Deductible
Collision Deductible