Broker Of Record Acord Form - Using acord's standardized forms allows for increased efficiency, accuracy, and speed of information processing. Web since our first paper form was released in 1971, acord has provided the standard forms used by the insurance industry. Web agent/broker of record change date (mm/dd/yyyy) new agency insurance company namephone (a/c, no, ext): Web agent/broker of record change please be advised that we wish to name as our exclusive representative effective. Web agent/broker of record change date (mm/dd/yyyy) policy number(s) effective date expiration date named insured line of business (as it appears on policy) please be advised that we wish to name as our exclusive representative effective for the lines of business shown above, currently in force or submitted by application. Acord forms are now available in a variety of formats, including printable pdf, electronic fillable, and eforms. Named insured effective expiration line of business policy number(s) (as it appears on policy) date date please be advised that we wish to name. Current agency current producer agency customer id: The acord name and logo are registered marks of acord acord 36 (2007/01) new agency current agency current producer policy number(s) effective date expiration date named insured line of business
Using acord's standardized forms allows for increased efficiency, accuracy, and speed of information processing. Named insured effective expiration line of business policy number(s) (as it appears on policy) date date please be advised that we wish to name. Web agent/broker of record change date (mm/dd/yyyy) policy number(s) effective date expiration date named insured line of business (as it appears on policy) please be advised that we wish to name as our exclusive representative effective for the lines of business shown above, currently in force or submitted by application. Current agency current producer agency customer id: The acord name and logo are registered marks of acord acord 36 (2007/01) new agency current agency current producer policy number(s) effective date expiration date named insured line of business Acord forms are now available in a variety of formats, including printable pdf, electronic fillable, and eforms. Web agent/broker of record change date (mm/dd/yyyy) new agency insurance company namephone (a/c, no, ext): Web agent/broker of record change please be advised that we wish to name as our exclusive representative effective. Web since our first paper form was released in 1971, acord has provided the standard forms used by the insurance industry.