You can open the Broker Of Record Letter Template in multiple formats, including PDF, Word, and Google Docs.
Broker Of Record Letter Template Printable | Editable FormSample
Examples
[Name of the Broker]
[Broker’s License Number]
[Broker’s Address]
[Broker’s Phone]
[Broker’s Email]
[Name of the Client]
[Client’s Address]
[Client’s Phone]
This letter serves to formally designate [Name of the Broker] as the Broker of Record for the insurance policy effective [Start Date].
The Broker is authorized to act on behalf of the Client regarding all matters related to the procurement and management of insurance coverage.
The Client hereby appoints the Broker as their exclusive representative for all insurance-related matters for a period of [Duration].
The Broker will receive a commission of [Percentage/Amount] for services rendered, payable upon the policy renewal or issuance.
The Client acknowledges that the Broker is responsible for the existing policies specified as follows: [List of Policies].
The Client agrees to provide all necessary information and documentation required by the Broker to effectively represent their interests.
This letter shall be governed by the laws of [Jurisdiction].
[Signature of the Broker]
[Name of the Broker]
[Signature of the Client]
[Name of the Client]
[Name of the Broker]
[Broker’s License Number]
[Broker’s Address]
[Broker’s Phone]
[Broker’s Email]
[Name of the Client]
[Client’s Address]
[Client’s Phone]
This Broker of Record letter outlines the engagement of [Name of the Broker] to serve as the official Broker for the Client effective as of [Start Date].
The Broker agrees to provide comprehensive services including but not limited to: [List specific duties].
The Client agrees to compensate the Broker via a commission of [Percentage/Amount] for the duration of this engagement.
The Broker will ensure that there is no lapse in coverage for existing policies held by the Client.
This agreement may be terminated under the following conditions: [Specify conditions].
Both parties agree to limit liability as follows: [Specify terms].
The Broker agrees to comply with all relevant regulations governing the insurance industry.
[Signature of the Broker]
[Name of the Broker]
[Signature of the Client]
[Name of the Client]
Format
Please complete the form below to create the Broker Of Record Letter Template. All fields must be filled out to ensure a clear and comprehensive agreement. We provide examples to guide you through each step. Broker Of Record Letter Template 1. Broker Information 2. Client Information 3. Authorization Details 4. Scope of Services 5. Broker’s Obligations 6. Client’s Obligations 7. Confidentiality Agreement 8. Termination Terms 9. Signatures and Acceptance 10. Declaration and Signatures
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WORD
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Broker Of Record Letter Template Printable | Editable FormPrintable
