Producer Closing

PRODUCER INFORMATION

PRODUCER*

Did Another Team Member Assist In Winning This Account?*

Yes
No

Co-Producer

Set Primary Location*

LEAD TYPE | LINES OF BUSINESS

What Type Of Insurance Are We Writing?*

Personal
Business

Is This For A New Real Estate Closing?*

Yes
No

Do You Want To Start The Current Client PL - XDate Campaign?*

Yes
No

Do You Want To Start The Commercial To Personal Cross Sell?

Yes
No

Select if you want to cross-sell personal lines (home, auto, umbrella) for a Commercial Client

INSURED | CONTACT INFORMATION

Insured Name

First Last

Business Name

Primary Business Contact

First Last

Mobile Phone

Email

SALES INFORMATION

Lead Type*

Effective Date (NEW Sold Date)

PL NEW Premium - Sold

CL NEW Premium - Sold

Effective Date (Account Round Date)

PL Account Round Premium - Sold

CL Account Round Premium - Sold

POLICY INFORMATION

Please Write Policy Types Sold

Example: Personal Auto & Homeowners Example: Business Owners & Workers Compensation

Total Number Of Policies Sold

Personal Policy Type(s)

Business Policy Type(s)

NEW REAL ESTATE PURCHASE

New Purchase Street Address

Loan Closing Date

Loan Officer (First Name Only)

Loan Officer (Full Name)

Loan Officer Email

Loan Officer Phone

Loan Processor (First Name)

Loan Processor Email

Real Estate Agent (First Name)

Real Estate Agent (Full Name)

Real Estate Agent Email

Real Estate Agent Phone

Closing Attorney (First Name)

Closing Attorney (Full Name)

Closing Attorney Email

SETUP CURRENT CLIENT PL X-DATE

How Many Policies Are You Following Up On?

Policies To Cross Sell

Use Formal Capitalization as this will merge to email communication)

Anticipated PL X-Date

SALES REPORTING DATA

Home Insurance - Metallic Selection

HOME - Platinum
HOME - Gold
HOME - Silver
HOME - Bronze

Home Insurance - Limit Selection

Same Limits
Increased Policy Form

Auto Insurance - Metallic Selection

AUTO - Platinum
AUTO - Gold
AUTO - Silver
AUTO - Bronze

Auto Insurance - Limit Selection

Same Limits
Increased Liability Limits

Personal Insurance Add'l Policies

Select All That Apply

POLICY | ACCOUNT ISSUANCE INFORMATION

Pay Plan

Provide Pay Plan Selected

Pay Plan | Payment Information

Example - enter Routing & Account Number

Coverage Limit(s) & Options Confirmation & Notes

Please make sure we know what coverages or options are needed (if multiple options were presented)

Carrier / Brokerage Notes

Provide any relevant info if you spoke with an Underwriter about risk (example - % credit authorized by underwrite)

Policy Weakness | Coverage Rejection

Please use "number" for order and Policy Type - then weakness/rejection (Ex 1. HOME - Scheduled Jewelry Declined)

All Other Notes

Put anything else you want here

PROCESSOR TO DO'S

Please check ALL Items that need to be done

Check What Needs To Be Done!

Enter Underwriting Link

Enter Underwriting Link if not an available in selection above

Carrier Requirements

Erie - Esignature Needed
State Auto - Esignature Needed

Policy Info For Agency Bill

When entering the policy information below, please remember that this data will be MERGED into the email requests. Please use proper Capitalization. When possible, enter Policy Number & Policy Type (ex. Q09-123456 | Business Auto).

Agency Bill Premium Due

1. This is a CURRENCY Field ($'s aren't required) 2. Please enter the entire amount due (including taxes & fees)

Post Issuance Notes

Do we need to do anything special for the customer after issuance (send cancellation request | immediate COI needs | etc)

Attach Relevant Files

Drop files here or

Max. file size: 60 MB.

Includes Proposals, Other Carrier Decs, any file that you want in the management system