BROKERAGE
AGREEMENT
THIS
AGREEMENT, made and entered into this __________________day
of ____________, by and between McCloskey Surplus
& Excess, Inc. T/A METCOM EXCESS:
In
consideration for METCOM EXCESS placing risks
hereinafter for __________________________________________
(hereinafter referred to as BROKER) with an insurer,
or insurers, and for the mutual promises and covenants
set out, it is agreed that:
- BROKER
warrants that he is properly licensed to solicit
business, and employees that may be contracted
for or hired by BROKER to service the accounts
are licensed, in accordance with the rules and
regulations of the Department of Insurance in
the state in which the Broker does business.
- BROKER
warrants that Errors & Omissions coverage will
be maintained during the term of this agreement;
BROKER further agrees to hold METCOM EXCESS
harmless with regard to any disagreement or
litigation that may arise as a result of BROKER'S
error or omissions.
- BROKER
is considered by METCOM to be an Independent
Contractor, and as such is solely responsible
for reporting and paying any and all taxes relative
to income which may be derived from this Agreement
to any legal government body.
- BROKER
shall be primarily liable to METCOM for the
full amount of premium and any applicable surcharges,
taxes and fees (less commission) including additional
premiums developed as a result of inspection
after binding of risks, audits at expiration
of coverage, and retrospective penalties on
every insurance contract placed by METCOM for
the BROKER.
-
In the event that an additional premium develops
as a result of an audit (either during the term
of the policy or after expiration of same) premiums
are due and payable upon receipt of the audit.
Should METCOM be notified within thirty (30)
days of the date of invoice that the audit premium
is uncollectible, BROKER will be relieved of
the responsibility of collection. The Carrier
will attempt to collect the premium directly,
and the BROKER will forfeit all commissions
on that premium.
- BROKER
will remit premiums plus any taxes and fees
immediately upon presentation of an invoice
from METCOM. For the convenience of METCOM and
BROKER, a statement of account will be furnished
monthly to the BROKER'S place of business, and
any accounts that are more than forty-five (45)
days in arrears will be subject to cancellation
without further notice.
- Coverage
cannot be bound without payment of a deposit
of at least 25% of the GROSS premium indicated;
if the account is to be financed, the name and
the account number of the finance company must
be noted on the completed application and request
to bind. All financed premiums must be sent
directly to METCOM by the finance company, and
all financed return premiums will be sent to
the finance company by METCOM. If a BROKER receives
a financed premium and remits his net check
to METCOM, any net return premiums will be returned
to the producer.
- In
consideration of the commission allowed to BROKER
on all premiums and additional premiums, BROKER
agrees to return to METCOM any unearned commission
on canceled accounts at the same rate such commissions
were retained.
- No
insurance contract may be returned to METCOM
by BROKER for flat cancellation unless returned
prior to inception date of contract. Earned
premiums shall be computed and charged on every
contract canceled after inception in accordance
with provisions of the insurance contract.
- BROKER
is not the agent of, and has no authority to
bind METCOM or any other of its principals or
companies. BROKER is not authorized to issue
any binder or Certificate of Insurance for any
insurance policy or contract placed for BROKER
by METCOM.
- BROKER
is considered the only representative of the
insured or insureds from whom business is placed;
in the event of a change of BROKER for the coverage
already in place, an Authorization for Change
of Broker Representative must be completed and
forwarded to METCOM.
TAX
I.D. # ________________________________ Corp _______
Ind _______ Partnership _________________________________
TELEPHONE
NUMBER _____________________
FAX
NUMBER _____________________________
THIS
AGREEMENT shall apply to current policies already
placed and in force, and all future policies which
may be placed by METCOM for the BROKER. This agreement
may be canceled at any time by written notice
of either party to the other, but cancellation
of this contract will not affect continued application
of this agreement to any insurance policies in
effect prior to the date of cancellation of this
agreement.
__________________________________
witness
for Broker Signature of Broker
__________________________________
Print
name of Broker dated this ______day of ______________
__________________________________
__________________________________
witness
for METCOM
Signature,
authorized representative for METCOM
