NEW AGENTS AGREEMENT
We want to be your professional liability insurance partner.
We understand your clients’ demands and unique requests, we can assess each situation to provide customized options. We’ve made it convenient to partner with ExecutivePerils — just follow the steps below.
How to become an appointed insurance agent with ExecutivePerils
- Step 1: Complete and sign our producer agreement Download the agreement >
- Step 2: Complete W-9 form Download the form >
- Step 3: Send us a copy of your current agency license in the state you write business
- Step 4: Send us a current copy of your E&O policy declaration page or a certificate confirming insurance coverage. Please send the items above by one of the following methods:
- Email to firstname.lastname@example.org
- Fax to 310-444-9355