Stop: This form is only used for Personal Lines, You can select Commercial Lines EOI if needed.
Producer & Agency Info:
STOP: Do not release this EOI. You must first bind the policy with the carrier then comeback to complete this EOI.
Client Info:
Carrier / Policy Info:
Note: Since most lenders/mortgage companies require there be at least 6 months remaining on the Policy, especially for a loan closing transaction. Therefore, the expiration date of the Policy will be extended for another 12 months.
Please remember to bill for the renewal premium when completing the invoice. Since we do not have the actual renewal premium then we simply take the current term premium plus an additional 10%. Any extra premium will simply be refunded to the customer.
Building Info:
What is the adddress of Building No. 1?
What is the adddress of Building No. 2?
What is the adddress of Building No. 3?
What is the adddress of Building No. 4?
Coverage Info:
Remarks:
Additional Interest Info:
What is the Address of the Additional Insured