1. A completed Agency Questionnaire and an IRS W-9 form

2. Copies of your agency license, and producer licenses

3. Copy of the E & O Declarations Page (Minimum Limits $1,000,000 per occ.)

4. A signed copy of the Producer Agreement

First, open and print the Agency Questionnaire and W-9 form, fill in the required information (where designated with an X).

Second, open the Producer Agreement.
Complete the required information, print, and sign (where designated with an X).
Don't forget to sign the Accounting Basis page also. 

Third, produce copies of your agency license, producer license and a copy of your E&O declarations page.

For Commercial Lines please fax completed information forms and documents to compliance at(913)663-2014. For Non-Standard Auto contracts, please fax completed information forms and documents to Lindsay Sun at (913)663-2014.



NOTICE: By submitting to us the requested documents by fax or electronically, you agree that they and copies thereof may be used by us as if they were the originals thereof in any professional, administrative or legal proceeding.

After the above information has been reviewed and approved, a signed copy of the Producer Agreement will be sent back to you for your records. Our Compliance Department will assign your agency a producer code which will be indicated on the front page of your copy of the Producer Agreement and you may then begin submitting business. We look forward to working with you. Again, welcome to the growing list of producers that look to us for solutions to their client’s needs.