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Business Account Review


By reviewing the checklist and submitting it to R&A Insurance, I understand that each area has been reviewed by me. I further understand that if there is an exposure or coverage change, it is my responsibility notify R&A Insurance as soon as possible. 

A record of this completed review will be kept on file at R&A Insurance. 

By submitting this form, I declare that this review was completed to my satisfaction.   



Important Notice
Any submissions or payments made via this website do not constitute a binding agreement to your policy or coverages. Changes and payments to policies are not effective or binding until you, or any party involved, receive official notice from either your insurance agent, or your insurance company. If you have any questions, please feel free to contact us.

Per the terms of our online privacy policy we will not resell your information to any third-party.
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