Brokerage Agreement
Requirements
The following items are required before we can place
any business for you. Please fully complete and return all information.
-
Completed Producer Profile
(See below)
-
Completed Broker Agreement (See
below)
-
Completed W-9 Form
(See below)
-
Copies of Broker Licenses (if you are insuring a
location outside the state of New Jersey, you must send a copy of your
non-residence license for that state)
-
Copy of the Dec Page for your E&O Policy
-
Proper N.J. Non-Resident license if you are an out of
state broker
-
A 30% deposit is payable at the time of binding
Please fax all of the above listed items to our office
at (201) 641-6566. If you have any questions, please email
kamundson@metcomexcess.com
Thank you for your cooperation in this matter.
