Broker Application

As a broker with us, you will have access to competitive programs and valuable online sales tools. Our knowledgeable staff is standing by to help you place the risks you currently control as well as the risks you didn't know you could write. Our service team is ready to help keep your insureds needs met while answering any questions you may have. We provide solutions for your clients’ needs and can be an active partner in developing your business.

Give Us a Call Today   516.543.0411

Broker Application

If you are interested in placing your insured's insurance needs with us, please complete our appointment application, and return it via email or fax, along with the following:

  • Completed Broker Questionnaire
  • Copy of Agency and Individual License(s) for all states
  • Copy of Errors & Omission declarations page
  • Limited Broker Agreement
  • Read & Understood the Terms & Conditions of the Limited Broker Agreement

Via Email:

Via Fax: 516.385.8855