Agreement NumberProducer Agreement • February 9th, 2015 • Florida
Contract Type FiledFebruary 9th, 2015 JurisdictionThis 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: