SureTec - Agent Profile

Your first name:*

Your last name:*

Your email address:*

Agency Name with DBA:*

Agency FEIN no.:*

Web address:

Agency street address:*

City:*

State:*

Zip code: *

Agency principal first name:*

Agency principal last name:*

Principal email address:*

Principal license no.:

Agency phone no.:*

Agency license no.:*

Years in business:

No. of locations:

No. of producers:

Does your agency have Errors & Omissions Insurance?*

E&O Insurance is required for appointing with SureTec.

How would you describe your agency's book of bond business? Choose one:*

Contract Bonds are bid, performance & payment bonds for construction projects.

Commercial bonds are those that fall outside of the construction sector and include License & Permit Bonds, Motor Vehicle Dealer/DMV, Notary, Lost Instrument, Tax Bonds, etc. Court Bonds are tied to litigation and include appeal bonds, supersedeas bonds, garnishment bonds, etc.

Visit the "Products" tab of our home page for further explanation of the different types of bonds.

Does your agency specialize in a particular type of bond or bond class? If so, please describe:

Commercial bond premium per yr.:*

Choose the range of total premium your agency writes for commercial bonds each year.

Contract bond premium per yr.:*

Choose the range of total premium your agency writes for bid, performance and payment bonds each year.

What are the goals for your agency's bond business?*

Does your agency prefer Agency Bill or Direct Bill?*

How are your accounts invoiced? Do companies send invoices to your agency for remittance? (Agency Bill)

Or do they send invoices directly to your accounts for remitance? (Direct Bill.)

Are you interested in our CA Contractor's License Bond program?*

Does your agency have a dedicated bond person or bond department?*

Is there an immediate bond need?

Has anyone at your agency had his/her license suspended/otherwise disciplined by insurance regulators in the last ten years?

Leave the following field blank so that we know you're a human:

Thank You for Choosing SureTec.