SERVICE FEE AGREEMENTService Fee Agreement • March 30th, 2016
Contract Type FiledMarch 30th, 2016As indicated by the signature(s) on this form, I (we) have been advised and have full knowledge that in applying for insurance with Faller Insurance Agency, Inc. in Niles, IL, I (we) are paying to Faller Insurance Agency a non-refundable service fee ( defined below), as authorized by Sec. 500-80 of the Illinois Insurance Code: