Common Contracts

Agreement Number

Agreement Number • February 9th, 2015 • Florida

• Contract Type
  Agreement Number
• Filed
  February 9th, 2015
• Jurisdiction
  Florida

This Agreement is made this day of, , (“Effective Date”) by and between: FAIR of New Jersey, LLC, its subsidiaries and/or affiliates (“Company”), and (“Producer”), an Independent Agent, which can be a Retail Agent, Retail Broker and/or Surplus Lines Broker, provided however, that the Producer must disclose the role(s) that the Producer is acting in for the insured to the Company on the date of execution of this Agreement: