Common Contracts
1 similar Service Fee Agreement contracts
SERVICE FEE AGREEMENTService Fee Agreement • September 24th, 2020
As indicated by the signature(s) on this form, I (we) have been advised and have full knowledge that in applying for insurance with XYZ Agency of ABC, Illinois providing insurance coverage, I (we) are paying to XYZ Agency a one-time, non-refundable service charge of $ , dollars, as authorized by Sec. 500-80 of the Illinois Insurance Code. I (we) further understand and agree that should the application for insurance be rejected, postponed, canceled, rated up, or should I (we) elect for any reason to withdraw or cancel the application for insurance or request the coverage be canceled or the application voided, the service charge is fully earned and that no portion of the service charge will be refunded or returned.
