The Colorado Division of Insurance is conducting a survey to collect the information required by Colo. Rev. Stat. § 24-33.5-1619 and Bulletin No. B-1.36. This survey is required for all non-surplus lines carriers who have written policies in the State of Colorado covering any of the Property and Casualty lines 1, 2.1, 2.4, 3, 4, and 5.1 during the previous business year. Non-response to this survey will result in a penalty and additional request until all companies are in compliance. Due to the timing of the survey the initial list of companies required to respond is based on the previous year's financial annual statements but will be updated as the current financial statements are filed. If your company did not write last year but did write the year before and is therefore on the list a response will still be required.

This survey is due February 1, 2026.

*1.NAIC#:(Required.)

*2.Company Name(Required.)

*3.Respondent Name(Required.)

*4.Respondent Phone Number(Required.)

*5.Respondent Email(Required.)

The following questions are for the Number of Policies that were issued or renewed from January 1, 2025 through December 31, 2025 in Colorado. An answer is required for each line of business below. If your company had no policies for a particular line of business enter 0.

For policies that may cover multiple lines of business such as a homeowner policy that also has a separate dwelling fire component how they should be handled depends on how your company files that information with the NAIC.

If it is being treated as a single policy with all of the information being reported under a single line then it is one policy.

If it is being treated as two policies and policy number information is reported on both lines with your annual financial statement then the $2 fee would be applied twice.

If it is being treated as a combined policy and being reported fractionally across both lines to the NAIC then the fee should be allocated to the line of business with the majority percentage of premium and counted as one policy.

*6.Line 1 - Fire(Required.)

*7.Line 2.1 - Allied Lines(Required.)

*8.Line 2.4 - Private Crop(Required.)

*9.Line 3 - Farmers Multiple Peril(Required.)

*10.Line 4 - Homeowners Multiple Peril(Required.)

*11.Line 5.1 - Commercial Multiple Peril (non-liability portion)(Required.)

The following information will be used for sending out the Hazard Mitigation Invoice per §24-33.5-1619 C.R.S. 

*12.Invoice Contact Name(Required.)

*13.Invoice Contact Email(Required.)

*14.Invoice Contact Phone(Required.)

*15.Invoice Contact Address Line 1(Required.)

16.Invoice Contact Address Line 2

*17.Invoice Contact City(Required.)

*18.Invoice Contact State (2 digit)(Required.)

*19.Invoice Contact Zipcode (5 digit)(Required.)

20.Survey Comments:

Send me a copy of my responses via email