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Agency Appointment – Step 2surewebadmin2023-08-14T09:53:43+00:00

Agency Appointment

Contact Information

Agency Name(Required)

Address(Required)

Contact Person’s Full Name(Required)

Phone(Required)

Email(Required)

How many BOP policies do you have in your existing book of business?(Required)

Agency License Information

National Producer Number(Required)

State Where Licensed(Required)

License Category(Required)

License Number(Required)

License Expiry Date(Required)

License Status(Required)

Lines of Business Licensed For(Required)

Copy of Agency License(Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB.

Agency E&O Policy for a Limit not less than $ 1M(Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB.

Completed W-9 Form(Required)

Accepted file types: jpg, gif, png, pdf, Max. file size: 1 GB.

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AskAlex@wesuregroup.com
(929) 909-6262

WeSure Digital Insurance Services, Inc.

220 East 42nd Street, Floor 24
New York, NY, 10017

Issuance of coverage is subject to underwriting. Not available in all states. Please see the policy for full terms, conditions and exclusions. Coverage is dependent on actual facts and circumstances giving rise to a claim. WeSure Digital Insurance Services, Inc. is an insurance agency licensed to sell certain insurance products and may receive compensation from insurance companies for such sales. Policy obligations are the sole responsibility of the issuing insurance company. Refer to Terms of Service and Privacy Policy for more information.

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