COMPLETE and RETURN TO:
Part I: Agency Resume
Agency Name: Phone:
Street Address: Fax:
City:
Agency is a: Corporation Individual Partnership
IRS Corporate Name:
Mailing Address:
City: State: Zip:
Agency Established (year):
Any Other Locations? Yes No How Many:
E&O Carrier: Policy #: Exp Date:
List all Agency Owners and Officers:
(√ If Owner) Name: (First, MI, Last) Officer Title: (PR, VP, etc) E-mail:
Primary Owner:
Home address: Phone:
Agency Bank: Contact: Phone:
Insurance Reference: of Phone:
Part II: Current Company Analysis
PERSONAL LINES: How many Homeowner policies sold per month:______
Homeowners Carriers (if applicable, which MGA) Annual Volume Est Loss Ratio
1. $ %
2. $ %
3. $ %
4. $ %
5. $ %
6. $ %
PART III: Additional questions to get to know your agency better
Personal Lines Manager (if applicable):______
Email address for main contact: ______
Number of agents writing Personal Lines in the office and to be trained on the Florida
Peninsula quoting website: ______
What day of the week is best for Agency training? ______
What other lines of business does your agency write? ______
What is your Homeowners retention rate?
What is your commitment/goal on a monthly basis for Florida Peninsula? ______
Will Florida Peninsula be one of the top 3 companies for Homeowner quotes in your
Agency? ______
Does the agency quote both with wind and ex-wind business? ______
Has any carrier terminated the agency in the past 3 years for production and/or adverse
Loss ratio? ______
Any judgments or suits pending against the agency? ______
Any account current or unearned commission balances past due to any company? ____
______
Is the agency affiliated with a national or regional brokerage firm? ______
Is the agency a member of PIA? ______Is the agency a member of IIAA? ______
Is the agency a member of LAAIA? ______
Is the agency a member of FAIA? ______
Who do you currently write Flood Insurance with? ______
Additional Agency Comments:
FPI Managers 12-09 ver3