PRODUCER PROFILEProducer Profile • April 29th, 2014
Contract Type FiledApril 29th, 2014Please complete this form in its entirety. Please remember to include: Signed Lucantha Marine Insurance Producer Agreement, Producer Profile, W-9 form and a Dec Page copy of your current E&O insurance coverage. Return the completed information to Jennifer Morrissey at jen@lucantha.com.