In order to become a producer with us, you must submit the following documents for approval:

• Please complete and sign the attached Broker Profile & Brokerage Agreement

• Provide us with a copy of your E&O Declarations page.

• Provide a copy of your Agency License and certificate.

• Provide us with copies of the state licenses for your agency staff.

• A completed and signed W-9 form

• ACH authorization – return premiums and commissions

 

You may fax or email the aforementioned documents to:

Fax: (904) 432-1124 

Email: Marketing@ameliaunderwriters.com.

 

Please feel free to contact our office if you have any questions.