or Mail:Producer Agreement • February 13th, 2012 • Arizona
Contract Type FiledFebruary 13th, 2012 JurisdictionThis authorizes Pivot Health Holdings, LLC or Allied National on behalf of Pivot Health Holdings, LLC to send credit entries (and appropriate debit and adjustment entries) electronically, or by any other commercially accepted method, to my (our) account indicated below and to other accounts I (we) identify in the future (the "Account"). This authorizes the financial institution holding the Account to post all such entries.