Broker of Record ProcedureIf you wish to have our agency take over the servicing of an existing policy please copy and paste the
letter below to your company letterhead. If individual policies, please enter your name, address, city, state and ZIP code. Please
note to replace date and list insurance companies and policy numbers you wish to have us assume. Once completed and signed, mail or
fax the form to us as indicated in our contact page.
(FOR BUSINESS PLACE THE LETTER ON YOUR LETTERHEAD
— OR —
FOR INDIVIDUALS PLEASE ENTER
NAME
ADDRESS
CITY, STATE. ZIP)
(DATE)
RE: Appointment of GarageGuys as our Agent/Broker of Record
To Whom it May Concern:
This will confirm that we have appointed GarageGuysas our exclusive insurance agent/broker of record for the following policies
1. (COMPANY) - Policy #:
2. (COMPANY) - Policy #:
3. (COMPANY) - Policy #:
The appointment of GarageGuysrescinds all previous appointments and the authority contained herein shall remain in force until canceled by
us in writing.
This letter also constitutes your authority to furnish GarageGuys’s representative with all information they may request as it pertains to
our insurance contracts, rates, reserves, retention, and all other financial data they may wish to obtain for their study of our present and
future requirements in connection with our insurance policies.
Sincerely,
(NAME)
(COMPANY / INDIVIDUAL NAME)
(TITLE, IF APPLICABLE) |
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