Klein I S D Proposer Questionnaire

Klein I S D Proposer Questionnaire

<p> Hallsville ISD Property & Casualty Insurance Proposer Questionnaire</p><p>Agency/Co. Name Office Head Address City, State, Zip Phone Fax 800 #</p><p>Are you HUB qualified? Web Site: Identify whether agency, direct writer or TPA: Date Founded/Opened Total Number of Local Employees Number of Texas School Clients Number of Commercial Clients</p><p>In-House Services – Contact Employee In-House Services – Contact Employee Service Rep - Loss Control - Claim - Other -</p><p>Account Executive Backup Executive Name Direct Office Phone E-Mail Address Home Phone Cell Phone Assistant Assistant Direct Phone Assistant E-Mail Address Number School Clients Number Commercial Clients Years with Firm Years in Insurance Designations Previous Experience</p><p>References Contact Phone</p><p>Agency Name ______Property & Casualty Insurance Companies Requested Service Office Choice Insurance Coverage MGA Premium Loss Ratio (1, 2, 3) Company s</p><p>Casualty Only Insurance Companies Requested Service Office Choice Insurance Coverage MGA Premium Loss Ratio (1, 2, 3) Company s</p><p>Property Only Insurance Companies Requested Service Office Choice Insurance Coverage MGA Premium Loss Ratio (1, 2, 3) Company s</p><p>All premiums shown must be for the servicing office only.</p>

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