Bind Submission Submission Type* New Renewal Rewrite Cancellation Date of Prior Policy* MM slash DD slash YYYY Submission Details This account has been entered into EPIC. The contact information (name, email, address, license) is the same as last year. I have already requested binding from the carrier. Rush additional insured certificates are included with submission. Supporting Documentation InsuredInsured* Phone*EPIC Code* Business Contact DetailsMain Contact* First Last Business Name* License Number* FEIN* Email* Fax SIC Code*- Select Classification -111 Wheat112 Rice115 Corn116 Soybeans119 Cash Grains, Not Elsewhere Classified131 Cotton132 Tobacco133 Sugarcane and Sugar Beets134 Irish Potatoes139 Field Crops, Except Cash Grains, Not Elsewhere Classified161 Vegetables and Melons171 Berry Crops172 Grapes173 Tree Nuts174 Citrus Fruits175 Deciduous Tree Fruits179 Fruits and Tree Nuts, Not Elsewhere Classified181 Ornamental Floriculture and Nursery Products182 Food Crops Grown Under Cover191 General Farms, Primarily Crop211 Beef Cattle Feedlots212 Beef Cattle, Except Feedlots213 Hogs214 Sheep and Goats219 General Livestock, Except Dairy and Poultry241 Dairy Farms251 Broiler, Fryer, and Roaster Chickens252 Chicken Eggs253 Turkeys and Turkey Eggs254 Poultry Hatcheries259 Poultry and Eggs, Not Elsewhere Classified271 Fur-Bearing Animals and Rabbits272 Horses and Other Equines273 Animal Aquaculture279 Animal Specialties, Not Elsewhere Classified291 General Farms, Primarily Livestock and Animal Specialties711 Soil Preparation Services721 Crop Planting, Cultivating, and Protecting722 Crop Harvesting, Primarily by Machine723 Crop Preparation Services for Market, Except Cotton Ginning724 Cotton Ginning741 Veterinary Services for Livestock742 Veterinary Services for Animal Specialties751 Livestock Services, Except Veterinary752 Animal Specialty Services, Except Veterinary761 Farm Labor Contractors and Crew Leaders762 Farm Management Services781 Landscape Counseling and Planning782 Lawn and Garden Services783 Ornamental Shrub and Tree Services811 Timber Tracts831 Forest Nurseries and Gathering of Forest Products851 Forestry Services912 Finfish913 Shellfish919 Miscellaneous Marine Products921 Fish Hatcheries and Preserves971 Hunting and Trapping, and Game Propagation1011 Iron Ores1021 Copper Ores1031 Lead and Zinc Ores1041 Gold Ores1044 Silver Ores1061 Ferroalloy Ores, Except Vanadium1081 Metal Mining Services1094 Uranium-Radium-Vanadium Ores1099 Miscellaneous Metal Ores, Not Elsewhere Classified1221 Bituminous Coal and Lignite Surface Mining1222 Bituminous Coal Underground Mining1231 Anthracite Mining1241 Coal Mining Services1311 Crude Petroleum and Natural Gas1321 Natural Gas Liquids1381 Drilling Oil and Gas Wells1382 Oil and Gas Field Exploration Services1389 Oil and Gas Field Services, Not Elsewhere Classified1411 Dimension Stone1422 Crushed and Broken Limestone1423 Crushed and Broken Granite1429 Crushed and Broken Stone, Not Elsewhere Classified1442 Construction Sand and Gravel1446 Industrial Sand1455 Kaolin and Ball Clay1459 Clay, Ceramic, and Refractory Minerals, Not Elsewhere Classified1474 Potash, Soda, and Borate Minerals1475 Phosphate Rock1479 Chemical and Fertilizer Mineral Mining, Not Elsewhere Classified1481 Nonmetallic Minerals Services, Except Fuels1499 Miscellaneous Nonmetallic Minerals, Except Fuels1521 General Contractors-Single-Family Houses1522 General Contractors-Residential Buildings, Other Than Single-Family1531 Operative Builders1541 General Contractors-Industrial Buildings and Warehouses1542 General Contractors-Nonresidential Buildings, Other than Industrial Buildings and Warehouses1611 Highway and Street Construction, Except Elevated Highways1622 Bridge, Tunnel, and Elevated Highway Construction1623 Water, Sewer, Pipeline, and Communications and Power Line Construction1629 Heavy Construction, Not Elsewhere Classified1711 Plumbing, Heating and Air-Conditioning1721 Painting and Paper Hanging1731 Electrical Work1741 Masonry, Stone Setting, and Other Stone Work1742 Plastering, Drywall, Acoustical, and Insulation Work1743 Terrazzo, Tile, Marble, and Mosaic Work1751 Carpentry Work1752 Floor Laying and Other Floor Work, Not Elsewhere Classified1761 Roofing, Siding, and Sheet Metal Work1771 Concrete Work1781 Water Well Drilling1791 Structural Steel Erection1793 Glass and Glazing Work1794 Excavation Work1795 Wrecking and Demolition Work1796 Installation or Erection of Building Equipment, Not Elsewhere1799 Special Trade Contractors, Not Elsewhere Classified2011 Meat Packing Plants2013 Sausages and Other Prepared Meat Products2015 Poultry Slaughtering and Processing2021 Creamery Butter2022 Natural, Processed, and Imitation Cheese2023 Dry, Condensed, and Evaporated Dairy Products2024 Ice Cream and Frozen Desserts2026 Fluid Milk2032 Canned Specialties2033 Canned Fruits, Vegetables, Preserves, Jams, and Jellies2034 Dried and Dehydrated Fruits, Vegetables, and Soup Mixes2035 Pickled Fruits and Vegetables, Vegetable Sauces and Seasonings, and Salad Dressings2037 Frozen Fruits, Fruit Juices, and Vegetables2038 Frozen Specialties, Not Elsewhere Classified2041 Flour and Other Grain Mill Products2043 Cereal Breakfast Foods2044 Rice Milling2045 Prepared Flour Mixes and Doughs2046 Wet Corn Milling2047 Dog and Cat Food2048 Prepared Feed and Feed Ingredients for Animals and Fowls, Except Dogs and Cats2051 Bread and Other Bakery Products, Except Cookies and Crackers2052 Cookies and Crackers2053 Frozen Bakery Products, Except Bread2061 Cane Sugar, Except Refining2062 Cane Sugar Refining2063 Beet Sugar2064 Candy and Other Confectionery Products2066 Chocolate and Cocoa Products2067 Chewing Gum2068 Salted and Roasted Nuts and Seeds2074 Cottonseed Oil Mills2075 Soybean Oil Mills2076 Vegetable Oil Mills, Except Corn, Cottonseed, and Soybean2077 Animal and Marine Fats and Oils2079 Shortening, Table Oils, Margarine, and Other Edible Fats and Oils, Not Elsewhere Classified2082 Malt Beverages2083 Malt2084 Wines, Brandy, and Brandy Spirits2085 Distilled and Blended Liquors2086 Bottled and Canned Soft Drinks and Carbonated Waters2087 Flavoring Extracts and Flavoring Syrups, Not Elsewhere Classified2091 Canned and Cured Fish and Seafoods2092 Prepared Fresh or Frozen Fish and Seafoods2095 Roasted Coffee2096 Potato Chips, Corn Chips, and Similar Snacks2097 Manufactured Ice2098 Macaroni, Spaghetti, Vermicelli, and Noodles2099 Food Preparations, Not Elsewhere Classified2111 Cigarettes2121 Cigars2131 Chewing and Smoking Tobacco and Snuff2141 Tobacco Stemming and Redrying2211 Broadwoven Fabric Mills, Cotton2221 Broadwoven Fabric Mills, Manmade Fiber and Silk2231 Broadwoven Fabric Mills, Wool (Including Dyeing and Finishing)2241 Narrow Fabric and Other Smallware Mills: Cotton, Wool, Silk, and Manmade Fiber2251 Women's Full-Length and Knee-Length Hosiery, Except Socks2252 Hosiery, Not Elsewhere Classified2253 Knit Outerwear Mills2254 Knit Underwear and Nightwear Mills2257 Weft Knit Fabric Mills2258 Lace and Warp Knit Fabric Mills2259 Knitting Mills, Not Elsewhere Classified2261 Finishers of Broadwoven Fabrics of Cotton2262 Finishers of Broadwoven Fabrics of Manmade Fiber and Silk2269 Finishers of Textiles, Not elsewhere Classified2273 Carpets and Rugs2281 Yarn Spinning Mills2282 Yarn Texturizing, Throwing, Twisting, and Winding Mills2284 Thread Mills2295 Coated Fabrics, Not Rubberized2296 Tire Cord and Fabrics2297 Non-woven Fabrics2298 Cordage and Twine2299 Textile goods, Not Elsewhere Classified2311 Men's and Boys' Suits, Coats, and Overcoats2321 Men's and Boys' Shirts, Except Work Shirts2322 Men's and Boys' Underwear and Nightwear2323 Men's and Boys' Neckwear2325 Men's and Boys' Separate Trousers and Slacks2326 Men's and Boys' Work Clothing2329 Men's and Boys' Clothing, Not Elsewhere Classified2331 Women's, Misses', and Juniors' Blouses and Shirts2335 Women's, Misses', and Juniors' Dresses2337 Women's, Misses', and Juniors' Suits, Skirts, and Coats2339 Women's, Misses', and Juniors' Outerwear, Not Elsewhere Classified2341 Women's, Misses', Children's, and Infants' Underwear and Nightwear2342 Brassieres, Girdles, and Allied Garments2353 Hats, Caps, and Millinery2361 Girls', Children's, and Infants' Dresses, Blouses, and Shirts2369 Girls', Children's, and Infants' Outerwear, Not Elsewhere Classified2371 Fur Goods2381 Dress and Work Gloves, Except Knit and All-Leather2384 Robes and Dressing Gowns2385 Waterproof Outerwear2386 Leather and Sheep-Lined Clothing2387 Apparel belts2389 Apparel and Accessories, Not Elsewhere Classified2391 Curtains and Draperies2392 House furnishing, Except Curtains and Draperies2393 Textile Bags2394 Canvas and Related Products2395 Pleating, Decorative and Novelty Stitching, and Tucking for the Trade2396 Automotive Trimmings, Apparel Findings, and Related Products2397 Schiffli Machine Embroideries2399 Fabricated Textile Products, Not Elsewhere Classified2411 Logging2421 Sawmills and Planing Mills, General2426 Hardwood Dimension and Flooring Mills2429 Special Product Sawmills, Not Elsewhere Classified2431 Millwork2434 Wood Kitchen Cabinets2435 Hardwood Veneer and Plywood2436 Softwood Veneer and Plywood2439 Structural Wood Members, Not Elsewhere Classified2441 Nailed and Lock Corner Wood Boxes and Shook2448 Wood Pallets and Skids2449 Wood Containers, Not Elsewhere Classified2451 Mobile Homes2452 Prefabricated Wood Buildings and Components2491 Wood Preserving2493 Reconstituted Wood Products2499 Wood Products, Not Elsewhere Classified2511 Wood Household Furniture, Except Upholstered2512 Wood Household Furniture, Upholstered2514 Metal Household Furniture2515 Mattresses, Foundations, and Convertible Beds2517 Wood Television, Radio, Phonograph, and Sewing Machine Cabinets2519 Household Furniture, Not Elsewhere Classified2521 Wood Office Furniture2522 Office Furniture, Except Wood2531 Public Building and Related Furniture2541 Wood Office and Store Fixtures, Partitions, Shelving, and Lockers2542 Office and Store Fixtures, Partitions, Shelving, and Lockers, Except Wood2591 Drapery Hardware and Window Blinds and Shades2599 Furniture and Fixtures, Not Elsewhere Classified2611 Pulp Mills2621 Paper Mills2631 Paperboard Mills2652 Setup Paperboard Boxes2653 Corrugated and Solid Fiber Boxes2655 Fiber Cans, Tubes, Drums, and Similar Products2656 Sanitary Food Containers, Except Folding2657 Folding Paperboard Boxes, Including Sanitary2671 Packaging Paper and Plastics Film, Coated and Laminated2672 Coated and Laminated Paper, Not Elsewhere Classified2673 Plastics, Foil, and Coated Paper Bags2674 Uncoated Paper and Multiwall Bags2675 Die-Cut Paper and Paperboard and Cardboard2676 Sanitary Paper Products2677 Envelopes2678 Stationery, Tablets, and Related Products2679 Converted Paper and Paperboard Products, Not Elsewhere Classified2711 Newspapers: Publishing, or Publishing and Printing2721 Periodicals: Publishing, or Publishing and Printing2731 Books: Publishing, or Publishing and Printing2732 Book Printing2741 Miscellaneous Publishing2752 Commercial Printing, Lithographic2754 Commercial Printing, Gravure2759 Commercial Printing, Not Elsewhere Classified2761 Manifold Business Forms2771 Greeting Cards2782 Blankbooks, Looseleaf Binders and Devices2789 Bookbinding and Related Work2791 Typesetting2796 Platemaking and Related Services2812 Alkalies and Chlorine2813 Industrial Gases2816 Inorganic Pigments2819 Industrial Inorganic Chemicals, Not Elsewhere Classified2821 Plastics Materials, Synthetic Resins, and Nonvulcanizable Elastomers2822 Synthetic Rubber (Vulcanizable Elastomers)2823 Cellulosic Manmade Fibers2824 Manmade Organic Fibers, Except Cellulosic2833 Medicinal Chemicals and Botanical Products2834 Pharmaceutical Preparations2835 In Vitro and In Vivo Diagnostic Substances2836 Biological Products, Except Diagnostic Substances2841 Soap and Other Detergents, Except Specialty Cleaners2842 Specialty Cleaning, Polishing, and Sanitation Preparations2843 Surface Active Agents, Finishing Agents, Sulfonated Oils, and Assistants2844 Perfumes, Cosmetics, and Other Toilet Preparations2851 Paints, Varnishes, Lacquers, Enamels, and Allied Products2861 Gum and Wood Chemicals2865 Cyclic Organic Crudes and Intermediates, and Organic Dyes and Pigments2869 Industrial Organic Chemicals, Not Elsewhere Classified2873 Nitrogenous Fertilizers2874 Phosphatic Fertilizers2875 Fertilizers, Mixing Only2879 Pesticides and Agricultural Chemicals, Not Elsewhere Classified2891 Adhesives and Sealants2892 Explosives2893 Printing Ink2895 Carbon Black2899 Chemicals and Chemical Preparations, Not Elsewhere Classified2911 Petroleum Refining2951 Asphalt Paving Mixtures and Blocks2952 Asphalt Felts and Coatings2992 Lubricating Oils and Greases2999 Products of Petroleum and Coal, Not Elsewhere Classified3011 Tires and Inner Tubes3021 Rubber and Plastics Footwear3052 Rubber and Plastics Hose and Belting3053 Gaskets, Packing, and Sealing Devices3061 Molded, Extruded, and Lathe-Cut Mechanical Rubber Goods3069 Fabricated Rubber Products, Not Elsewhere Classified3081 Unsupported Plastics Film and Sheet3082 Unsupported Plastics Profile Shapes3083 Laminated Plastics Plate, Sheet, and Profile Shapes3084 Plastics Pipe3085 Plastics Bottles3086 Plastics Foam Products3087 Custom Compounding of Purchased Plastics Resins3088 Plastics Plumbing Fixtures3089 Plastics Products, Not Elsewhere Classified3111 Leather Tanning and Finishing3131 Boot and Shoe Cut Stock and Findings3142 House Slippers3143 Men's Footwear, Except Athletic3144 Women's Footwear, Except Athletic3149 Footwear, Except Rubber, Not Elsewhere Classified3151 Leather Gloves and Mittens3161 Luggage3171 Women's Handbags and Purses3172 Personal Leather Goods, Except Women's Handbags and Purses3199 Leather Goods, Not Elsewhere Classified3211 Flat Glass3221 Glass Containers3229 Pressed and Blown Glass and Glassware, Not Elsewhere Classified3231 Glass Products, Made of Purchased Glass3241 Cement, Hydraulic3251 Brick and Structural Clay Tile3253 Ceramic Wall and Floor Tile3255 Clay Refractories3259 Structural Clay Products, Not Elsewhere Classified3261 Vitreous China Plumbing Fixtures and China and Earthenware Fittings and Bathroom Accessories3262 Vitreous China Table and Kitchen Articles3263 Fine Earthenware (Whiteware) Table and Kitchen Articles3264 Porcelain Electrical Supplies3269 Pottery Products, Not Elsewhere Classified3271 Concrete Block and Brick3272 Concrete Products, Except Block and Brick3273 Ready-Mixed Concrete3274 Lime3275 Gypsum Products3281 Cut Stone and Stone Products3291 Abrasive Products3292 Asbestos Products3295 Minerals and Earths, Ground or Otherwise Treated3296 Mineral Wool3297 Nonclay Refractories3299 Nonmetallic Mineral Products, Not Elsewhere Classified3312 Steel Works, Blast Furnaces (Including Coke Ovens), and Rolling Mills3313 Electrometallurgical Products, Except Steel3315 Steel Wiredrawing and Steel Nails and Spikes3316 Cold-Rolled Steel Sheet, Strip, and Bars3317 Steel Pipe and Tubes3321 Gray and Ductile Iron Foundries3322 Malleable Iron Foundries3324 Steel Investment Foundries3325 Steel Foundries, Not Elsewhere Classified3331 Primary Smelting and Refining of Copper3334 Primary Production of Aluminum3339 Primary Smelting and Refining of Nonferrous Metals, Except Copper and Aluminum3341 Secondary Smelting and Refining of Nonferrous Metals3351 Rolling, Drawing, and Extruding Of Copper3353 Aluminum Sheet, Plate, and Foil3354 Aluminum Extruded Products3355 Aluminum Rolling and Drawing, Not Elsewhere Classified3356 Rolling, Drawing, and Extruding of Nonferrous Metals, Except Copper and Aluminum3357 Drawing and Insulating of Nonferrous Wire3363 Aluminum Die-Castings3364 Nonferrous Die-Castings, Except Aluminum3365 Aluminum Foundries3366 Copper Foundries3369 Nonferrous Foundries, Except Aluminum and Copper3398 Metal Heat Treating3399 Primary Metal Products, Not Elsewhere Classified3411 Metal Cans3412 Metal Shipping Barrels, Drums, Kegs, and Pails3421 Cutlery3423 Hand and Edge Tools, Except Machine Tools and Handsaws3425 Saw Blades and Handsaws3429 Hardware, Not Elsewhere Classified3431 Enameled Iron and Metal Sanitary Ware3432 Plumbing Fixture Fittings and Trim3433 Heating Equipment, Except Electric and Warm Air Furnaces3441 Fabricated Structural Metal3442 Metal Doors, Sash, Frames, Molding, and Trim Manufacturing3443 Fabricated Plate Work (Boiler Shops)3444 Sheet Metal Work3446 Architectural and Ornamental Metal Work3448 Prefabricated Metal Buildings and Components3449 Miscellaneous Structural Metal Work3451 Screw Machine Products3452 Bolts, Nuts, Screws, Rivets, and Washers3462 Iron and Steel Forgings3463 Nonferrous Forgings3465 Automotive Stampings3466 Crowns and Closures3469 Metal Stampings, Not Elsewhere Classified3471 Electroplating, Plating, Polishing, Anodizing, and Coloring3479 Coating, Engraving, and Allied Services, Not Elsewhere Classified3482 Small Arms Ammunition3483 Ammunition, Except for Small Arms3484 Small Arms3489 Ordnance and Accessories, Not Elsewhere Classified3491 Industrial Valves3492 Fluid Power Valves and Hose Fittings3493 Steel Springs, Except Wire3494 Valves and Pipe Fittings, Not Elsewhere Classified3495 Wire Springs3496 Miscellaneous Fabricated Wire Products3497 Metal Foil and Leaf3498 Fabricated Pipe and Pipe Fittings3499 Fabricated Metal Products, Not Elsewhere Classified3511 Steam, Gas, and Hydraulic Turbines, and Turbine Generator Set Units3519 Internal Combustion Engines, Not Elsewhere Classified3523 Farm Machinery and Equipment3524 Lawn and Garden Tractors and Home Lawn and Garden Equipment3531 Construction Machinery and Equipment3532 Mining Machinery and Equipment, Except Oil and Gas Field Machinery and Equipment3533 Oil and Gas Field Machinery and Equipment3534 Elevators and Moving Stairways3535 Conveyors and Conveying Equipment3536 Overhead Traveling Cranes, Hoists, and Monorail Systems3537 Industrial Trucks, Tractors, Trailers, and Stackers3541 Machine Tools, Metal Cutting Types3542 Machine Tools, Metal Forming Types3543 Industrial Patterns3544 Special Dies and Tools, Die Sets, Jigs and Fixtures, and Industrial Molds3545 Cutting Tools, Machine Tool Accessories, and Machinists' Precision Measuring Devices3546 Power-Driven Handtools3547 Rolling Mill Machinery and Equipment3548 Electric and Gas Welding and Soldering Equipment3549 Metalworking Machinery, Not Elsewhere Classified3552 Textile Machinery3553 Woodworking Machinery3554 Paper Industries Machinery3555 Printing Trades Machinery and Equipment3556 Food Products Machinery3559 Special Industry Machinery, Not Elsewhere Classified3561 Pumps and Pumping Equipment3562 Ball and Roller Bearings3563 Air and Gas Compressors3564 Industrial and Commercial Fans and Blowers and Air Purification Equipment3565 Packaging Machinery3566 Speed Changers, Industrial High-Speed Drives, and Gears3567 Industrial Process Furnaces and Ovens3568 Mechanical Power Transmission Equipment, Not Elsewhere Classified3569 General Industrial Machinery and Equipment, Not Elsewhere3571 Electronic Computers3572 Computer Storage Devices3575 Computer Terminals3577 Computer Peripheral Equipment, Not Elsewhere Classified3578 Calculating and Accounting Machines, Except Electronic Computers3579 Office Machines, Not Elsewhere Classified3581 Automatic Vending Machines3582 Commercial Laundry, Drycleaning, and Pressing Machines3585 Air-Conditioning and Warm Air Heating Equipment and Commercial and Industrial Refrigeration Equipment3586 Measuring and Dispensing Pumps3589 Service Industry Machinery, Not Elsewhere Classified3592 Carburetors, Pistons, Piston Rings, and Valves3593 Fluid Power Cylinders and Actuators3594 Fluid Power Pumps and Motors3596 Scales and Balances, Except Laboratory3599 Industrial and Commercial Machinery and Equipment, Not Elsewhere Classified3612 Power, Distribution, and Specialty Transformers3613 Switchgear and Switchboard Apparatus3621 Motors and Generators3624 Carbon and Graphite Products3625 Relays and Industrial Controls3629 Electrical Industrial Apparatus, Not Elsewhere Classified3631 Household Cooking Equipment3632 Household Refrigerators and HOme and Farm Freezers3633 Household Laundry Equipment3634 Electric Housewares and Fans3635 Household Vacuum Cleaners3639 Household Appliances, Not Elsewhere Classified3641 Electric Lamp Bulbs and Tubes3643 Current-Carrying Wiring Devices3644 Noncurrent-Carrying Wiring Devices3645 Residential Electric Lighting Fixtures3646 Commercial, Industrial, and Institutional Electric Lighting Fixtures3647 Vehicular Lighting Equipment3648 Lighting Equipment, Not Elsewhere Classified3651 Household Audio and Video Equipment3652 Phonograph Records and Prerecorded Audio Tapes and Disks3661 Telephone and Telegraph Apparatus3663 Radio and Television Broadcasting and Communications Equipment3669 Communications Equipment, Not Elsewhere Classified3671 Electron Tubes3672 Printed Circuit Boards3674 Semiconductors and Related Devices3675 Electronic Capacitors3676 Electronic Resistors3677 Electronic Coils, Transformers, and Other Inductors3678 Electronic Connectors3679 Electronic Components, Not Elsewhere Classified3691 Storage Batteries3692 Primary Batteries, Dry and Wet3694 Electrical Equipment for Internal Combustion Engines3695 Magnetic And Optical Recording Media3699 Electrical Machinery, Equipment, and Supplies, Not Elsewhere3711 Motor Vehicles and Passenger Car Bodies3713 Truck and Bus Bodies3714 Motor Vehicle Parts and Accessories3715 Truck Trailers3716 Motor Homes3721 Aircraft3724 Aircraft Engines and Engine Parts3728 Aircraft Parts and Auxiliary Equipment, Not Elsewhere Classified3731 Ship Building and Repairing3732 Boat Building and Repairing3743 Railroad Equipment3751 Motorcycles, Bicycles, and Parts3761 Guided Missiles and Space Vehicles3764 Guided Missile and Space Vehicle Propulsion Units and Propulsion Unit Parts3769 Guided Missile Space Vehicle Parts and Auxiliary Equipment, Not Elsewhere Classified3792 Travel Trailers and Campers3795 Tanks and Tank Components3799 Transportation Equipment, Not Elsewhere Classified3812 Search, Detection, Navigation, Guidance, Aeronautical, and Nautical Systems and Instruments3821 Laboratory Apparatus and Furniture3822 Automatic Controls for Regulating Residential and Commercial Environments and Appliances3823 Industrial Instruments for Measurement, Display, and Control of Process Variables; and Related Products3824 Totalizing Fluid Meters and Counting Devices3825 Instruments for Measuring and Testing of Electricity and Electrical Signals3826 Laboratory Analytical Instruments3827 Optical Instruments and Lenses3829 Measuring and Controlling Devices, Not Elsewhere Classified3841 Surgical and Medical Instruments and Apparatus3842 Orthopedic, Prosthetic, and Surgical Appliances and Supplies3843 Dental Equipment and Supplies3844 X-Ray Apparatus and Tubes and Related Irradiation Apparatus3845 Electromedical and Electrotherapeutic Apparatus3851 Ophthalmic Goods3861 Photographic Equipment and Supplies3873 Watches, Clocks, Clockwork Operated Devices, and Parts3911 Jewelry, Precious Metal3914 Silverware, Plated Ware, and Stainless Steel Ware3915 Jewelers' Findings and Materials, and Lapidary Work3931 Musical Instruments3942 Dolls and Stuffed Toys3944 Games, Toys, and Children's Vehicles, Except Dolls and Bicycles3949 Sporting and Athletic Goods, Not Elsewhere Classified3951 Pens, Mechanical Pencils, and Parts3952 Lead Pencils, Crayons, and Artists' Materials3953 Marking Devices3955 Carbon Paper and Inked Ribbons3961 Costume Jewelry and Costume Novelties, Except Precious Metal3965 Fasteners, Buttons, Needles, and Pins3991 Brooms and Brushes3993 Signs and Advertising Specialties3995 Burial Caskets3996 Linoleum, Asphalted-Felt-Base, and Other Hard Surface Floor Coverings, Not Elsewhere Classified3999 Manufacturing Industries, Not Elsewhere Classified4011 Railroads, Line-Haul Operating4013 Railroad Switching and Terminal Establishments4111 Local and Suburban Transit4119 Local Passenger Transportation, Not Elsewhere Classified4121 Taxicabs4131 Intercity and Rural Bus Transportation4141 Local Bus Charter Service4142 Bus Charter Service, Except Local4151 School Buses4173 Terminal and Service Facilities for Motor Vehicle Passenger Transportation4212 Local Trucking Without Storage4213 Trucking, Except Local4214 Local Trucking With Storage4215 Courier Services, Except by Air4221 Farm Product Warehousing and Storage4222 Refrigerated Warehousing and Storage4225 General Warehousing and Storage4226 Special Warehousing and Storage, Not Elsewhere Classified4231 Terminal and Joint Terminal Maintenance Facilities for Motor Freight Transportation4311 United States Postal Service4412 Deep Sea Foreign Transportation of Freight4424 Deep Sea Domestic Transportation of Freight4432 Freight Transportation on the Great Lakes-St. Lawrence Seaway4449 Water Transportation of Freight, Not Elsewhere Classified4481 Deep Sea Transportation of Passengers, Except by Ferry4482 Ferries4489 Water Transportation of Passengers, Not Elsewhere Classified4491 Marine Cargo Handling4492 Towing and Tugboat Services4493 Marinas4499 Water Transportation Services, Not Elsewhere Classified4512 Air Transportation, Scheduled4513 Air Courier Services4522 Air Transportation, Nonscheduled4581 Airports, Flying Fields, and Airport Terminal Services4612 Crude Petroleum Pipelines4613 Refined Petroleum Pipelines4619 Pipelines, Not Elsewhere Classified4724 Travel Agencies4725 Tour Operators4729 Arrangement of Passenger Transportation, Not Elsewhere Classified4731 Arrangement of Transportation of Freight and Cargo4741 Rental of Railroad Cars4783 Packing and Crating4785 Fixed Facilities and Inspection and Weighing Services for Motor Vehicle Transportation4789 Transportation Services, Not Elsewhere Classified4812 Radiotelephone Communications4813 Telephone Communications, Except Radiotelephone4822 Telegraph and Other Message Communications4832 Radio Broadcasting Stations4833 Television Broadcasting Stations4841 Cable and Other Pay Television Services4899 Communications Services, Not Elsewhere Classified4911 Electric Services4922 Natural Gas Transmission4923 Natural Gas Transmission and Distribution4924 Natural Gas Distribution4925 Mixed, Manufactured, or Liquefied Petroleum Gas Production and/or4931 Electric and Other Services Combined4932 Gas and Other Services Combined4939 Combination Utilities, Not Elsewhere Classified4941 Water Supply4952 Sewerage Systems4953 Refuse Systems4959 Sanitary Services, Not Elsewhere Classified4961 Steam and Air-Conditioning Supply4971 Irrigation Systems5012 Automobiles and Other Motor Vehicles5013 Motor Vehicle Supplies and New Parts5014 Tires and Tubes5015 Motor Vehicle Parts, Used5021 Furniture5023 Home furnishings5031 Lumber, Plywood, Millwork, and Wood Panels5032 Brick, Stone, and Related Construction Materials5033 Roofing, Siding, and Insulation Materials5039 Construction Materials, Not Elsewhere Classified5043 Photographic Equipment and Supplies5044 Office Equipment5045 Computers and Computer Peripheral Equipment and Software5046 Commercial Equipment, Not Elsewhere Classified5047 Medical, Dental, and Hospital Equipment and Supplies5048 Ophthalmic Goods5049 Professional Equipment and Supplies, Not Elsewhere Classified5051 Metals Service Centers and Offices5052 Coal and Other Minerals and Ores5063 Electrical Apparatus and Equipment Wiring Supplies, and Construction Materials5064 Electrical Appliances, Television and Radio Sets5065 Electronic Parts and Equipment, Not Elsewhere Classified5072 Hardware5074 Plumbing and Heating Equipment and Supplies (Hydronics)5075 Warm Air Heating and Air-Conditioning Equipment and Supplies5078 Refrigeration Equipment and Supplies5082 Construction and Mining (Except Petroleum) Machinery and Equipment5083 Farm and Garden Machinery and Equipment5084 Industrial Machinery and Equipment5085 Industrial Supplies5087 Service Establishment Equipment and Supplies5088 Transportation Equipment and Supplies, Except Motor Vehicles5091 Sporting and Recreational Goods and Supplies5092 Toys and Hobby Goods and Supplies5093 Scrap and Waste Materials5094 Jewelry, Watches, Precious Stones, and Precious Metals5099 Durable Goods, Not Elsewhere Classified5111 Printing and Writing Paper5112 Stationery and Office Supplies5113 Industrial and Personal Service Paper5122 Drugs, Drug Proprietaries, and Druggists' Sundries5131 Piece Goods, Notions, and Other Dry Good5136 Men's and Boy's Clothing and Furnishings5137 Women's, Children's, and Infants' Clothing and Accessories5139 Footwear5141 Groceries, General Line5142 Packaged Frozen Foods5143 Dairy Products, Except Dried or Canned5144 Poultry and Poultry Products5145 Confectionery5146 Fish and Seafoods5147 Meats and Meat Products5148 Fresh Fruits and Vegetables5149 Groceries and Related Products, Not Elsewhere Classified5153 Grain and Field Beans5154 Livestock5159 Farm-Product Raw Materials, Not Elsewhere Classified5162 Plastics Materials and Basic Forms and Shapes5169 Chemicals and Allied Products, Not Elsewhere Classified5171 Petroleum Bulk stations and Terminals5172 Petroleum and Petroleum Products Wholesalers, Except Bulk Stations and Terminals5181 Beer and Ale5182 Wine and Distilled Alcoholic Beverages5191 Farm Supplies5192 Books, Periodicals, and Newspapers5193 Flowers, Nursery Stock, and Florists' Supplies5194 Tobacco and Tobacco Products5198 Paints, Varnishes, and Supplies5199 Nondurable Goods, Not Elsewhere Classified5211 Lumber and Other Building Materials Dealers5231 Paint, Glass, and Wallpaper Stores5251 Hardware Stores5261 Retail Nurseries, Lawn and Garden Supply Stores5271 Mobile Home Dealers5311 Department Stores5331 Variety Stores5399 Miscellaneous General Merchandise Stores5411 Grocery Stores5421 Meat and Fish (Seafood) Markets, Including Freezer Provisioners5431 Fruit and Vegetable Markets5441 Candy, Nut, and Confectionery Stores5451 Dairy Products Stores5461 Retail Bakeries5499 Miscellaneous Food Stores5511 Motor Vehicle Dealers (New and Used)5521 Motor Vehicle Dealers (Used Only)5531 Auto and Home Supply Stores5541 Gasoline Service Stations5551 Boat Dealers5561 Recreational Vehicle Dealers5571 Motorcycle Dealers5599 Automotive Dealers, Not Elsewhere Classified5611 Men's and Boys' Clothing and Accessory Stores5621 Women's Clothing Stores5632 Women's Accessory and Specialty Stores5641 Children's and Infants' Wear Stores5651 Family Clothing Stores5661 Shoe Stores5699 Miscellaneous Apparel and Accessory Stores5712 Furniture Stores5713 Floor Covering Stores5714 Drapery, Curtain, and Upholstery Stores5719 Miscellaneous home furnishings Stores5722 Household Appliance Stores5731 Radio, Television, and Consumer Electronics Stores5734 Computer and Computer Software Stores5735 Record and Prerecorded Tape Stores5736 Musical Instrument Stores5812 Eating Places5813 Drinking Places (alcoholic Beverages)5912 Drug Stores and Proprietary Stores5921 Liquor Stores5932 Used Merchandise Stores5941 Sporting Goods Stores and Bicycle Shops5942 Book Stores5943 Stationery Stores5944 Jewelry Stores5945 Hobby, Toy, and Game Shops5946 Camera and Photographic Supply Stores5947 Gift, Novelty, and Souvenir Shops5948 Luggage and Leather Goods Stores5949 Sewing, Needlework, and Piece Goods Stores5961 Catalog and Mail-Order Houses5962 Automatic Merchandising Machine Operators5963 Direct Selling Establishments5983 Fuel Oil Dealers5984 Liquefied Petroleum Gas (Bottled Gas) Dealers5989 Fuel Dealers, Not Elsewhere Classified5992 Florists5993 Tobacco Stores and Stands5994 News Dealers and Newsstands5995 Optical Goods Stores5999 Miscellaneous Retail Stores, Not Elsewhere Classified6011 Federal Reserve Banks6019 Central Reserve Depository Institutions, Not Elsewhere Classified6021 National Commercial Banks6022 State Commercial Banks6029 Commercial Banks, Not Elsewhere Classified6035 Savings Institutions, Federally Chartered6036 Savings Institutions, Not Federally Chartered6061 Credit Unions, Federally Chartered6062 Credit Unions, Not Federally Chartered6081 Branches and Agencies of Foreign Banks6082 Foreign Trade and International Banking Institutions6091 Non-deposit Trust Facilities,6099 Functions Related to Depository Banking, Not Elsewhere Classified6111 Federal and Federally-Sponsored Credit Agencies6141 Personal Credit Institutions6153 Short-Term Business Credit Institutions, Except Agricultural6159 Miscellaneous business Credit Institutions6162 Mortgage Bankers and Loan Correspondents6163 Loan Brokers6211 Security Brokers, Dealers, and Flotation Companies6221 Commodity Contracts Brokers and Dealers6231 Security and Commodity Exchanges6282 Investment Advice6289 Services Allied With the Exchange of Securities or Commodities, Not Elsewhere Classified6311 Life Insurance6321 Accident and Health Insurance6324 Hospital and Medical Service Plans6331 Fire, Marine, and Casualty Insurance6351 Surety Insurance6361 Title Insurance6371 Pension, Health, and Welfare Funds6399 Insurance Carriers, Not Elsewhere Classified6411 Insurance Agents, Brokers, and Service6512 Operators of Nonresidential Buildings6513 Operators of Apartment Buildings6514 Operators of Dwellings Other Than Apartment Buildings6515 Operators of Residential Mobile Home Sites6517 Lessors of Railroad Property6519 Lessors of Real Property, Not Elsewhere Classified6531 Real Estate Agents and Managers6541 Title Abstract Offices6552 Land Subdividers and Developers, Except Cemeteries6553 Cemetery Subdividers and Developers6712 Offices of Bank Holding Companies6719 Offices of Holding Companies, Not Elsewhere Classified6722 Management Investment Offices, Open-End6726 Unit Investment Trusts, Face-Amount Certificate Offices, and Closed-End Management Investment Offices6732 Educational, Religious, and Charitable Trusts6733 Trusts, Except Educational, Religious, and Charitable6792 Oil Royalty Traders6794 Patent Owners and Lessors6798 Real Estate Investment Trusts6799 Investors, Not Elsewhere Classified7011 Hotels and Motels7021 Rooming and Boarding Houses7032 Sporting and Recreational Camps7033 Recreational Vehicle Parks and Campsites7041 Organization Hotels and Lodging Houses, on Membership Basis7211 Power Laundries, Family and Commercial7212 Garment Pressing, and Agents for Laundries and Drycleaners7213 Linen Supply7215 Coin-Operated Laundries and Drycleaning7216 Drycleaning Plants, Except Rug Cleaning7217 Carpet and Upholstery Cleaning7218 Industrial Launderers7219 Laundry and Garment Services, Not Elsewhere Classified7221 Photographic Studios, Portrait7231 Beauty Shops7241 Barber Shops7251 Shoe Repair Shops and Shoeshine Parlors7261 Funeral Service and Crematories7291 Tax Return Preparation Services7299 Miscellaneous Personal Services, Not Elsewhere Classified7311 Advertising Agencies7312 Outdoor Advertising Services7313 Radio, Television, and Publishers' Advertising Representatives7319 Advertising, Not Elsewhere Classified7322 Adjustment and Collection Services7323 Credit Reporting Services7331 Direct Mail Advertising Services7334 Photocopying and Duplicating Services7335 Commercial Photography7336 Commercial Art and Graphic Design7338 Secretarial and Court Reporting Services7342 Disinfecting and Pest Control Services7349 Building Cleaning and Maintenance Services, Not Elsewhere7352 Medical Equipment Rental and Leasing7353 Heavy Construction Equipment Rental and Leasing7359 Equipment Rental and Leasing, Not Elsewhere Classified7361 Employment Agencies7363 Help Supply Services7371 Computer Programming Services7372 Prepackaged Software7373 Computer Integrated Systems Design7374 Computer Processing and Data Preparation and Processing Services7375 Information Retrieval Services7376 Computer Facilities Management Services7377 Computer Rental and Leasing7378 Computer Maintenance and Repair7379 Computer Related Services, Not Elsewhere Classified7381 Detective, Guard, and Armored Car Services7382 Security Systems Services7383 News Syndicates7384 Photofinishing Laboratories7389 Business Services, Not Elsewhere Classified7513 Truck Rental and Leasing, Without Drivers7514 Passenger Car Rental7515 Passenger Car Leasing7519 Utility Trailer and Recreational Vehicle Rental7521 Automobile Parking7532 Top, Body, and Upholstery Repair Shops and Paint Shops7533 Automotive Exhaust System Repair Shops7534 Tire Retreading and Repair Shops7536 Automotive Glass Replacement Shops7537 Automotive Transmission Repair Shops7538 General Automotive Repair Shops7539 Automotive Repair Shops, Not Elsewhere Classified7542 Carwashes7549 Automotive Services, Except Repair and Carwashes7622 Radio and Television Repair Shops7623 Refrigeration and Air-Conditioning Service and Repair Shops7629 Electrical and Electronic Repair Shops, Not Elsewhere Classified7631 Watch, Clock, and Jewelry Repair7641 Reupholstery and Furniture Repair7692 Welding Repair7694 Armature Rewinding Shops7699 Repair Shops and Related Services, Not Elsewhere Classified7812 Motion Picture and Video Tape Production7819 Services Allied to Motion Picture Production7822 Motion Picture and Video Tape Distribution7829 Services Allied to Motion Picture Distribution7832 Motion Picture Theaters, Except Drive-In7833 Drive-In Motion Picture Theaters7841 Video Tape Rental7911 Dance Studios, Schools, and Halls7922 Theatrical Producers (Except Motion Picture) and Miscellaneous Theatrical Services7929 Bands, Orchestras, Actors, and Other Entertainers and Entertainment Groups7933 Bowling Centers7941 Professional Sports Clubs and Promoters7948 Racing, Including Track Operation7991 Physical Fitness Facilities7992 Public Golf Courses7993 Coin-Operated Amusement Devices7996 Amusement Parks7997 Membership Sports and Recreation Clubs7999 Amusement and Recreation Services, Not Elsewhere Classified8011 Offices and Clinics of Doctors of Medicine8021 Offices and Clinics of Dentists8031 Offices and Clinics of Doctors of Osteopathy8041 Offices and Clinics of Chiropractors8042 Offices and Clinics of Optometrists8043 Offices and Clinics of Podiatrists8049 Offices and Clinics of Health Practitioners, Not Elsewhere Classified8051 Skilled Nursing Care Facilities8052 Intermediate Care Facilities8059 Nursing and Personal Care Facilities, Not Elsewhere Classified8062 General Medical and Surgical Hospitals8063 Psychiatric Hospitals8069 Specialty Hospitals, Except Psychiatric8071 Medical Laboratories8072 Dental Laboratories8082 Home Health Care Services8092 Kidney Dialysis Centers8093 Specialty Outpatient Facilities, Not Elsewhere Classified8099 Health and Allied Services, Not Elsewhere Classified8111 Legal Services8211 Elementary and Secondary Schools8221 Colleges, Universities, and Professional Schools8222 Junior Colleges and Technical Institutes8231 Libraries8243 Data Processing Schools8244 Business and Secretarial Schools8249 Vocational Schools, Not Elsewhere Classified8299 Schools and Educational Services, Not Elsewhere Classified8322 Individual and Family Social Services8331 Job Training and Vocational Rehabilitation Services8351 Child Day Care Services8361 Residential Care8399 Social Services, Not Elsewhere Classified8412 Museums and Art Galleries8422 Arboreta and Botanical or Zoological Gardens8611 Business Associations8621 Professional Membership Organizations8631 Labor Unions and Similar Labor Organizations8641 Civic, Social, and Fraternal Associations8651 Political Organizations8661 Religious Organizations8699 Membership Organizations, Not Elsewhere Classified8711 Engineering Services8712 Architectural Services8713 Surveying Services8721 Accounting, Auditing, and Bookkeeping Services8731 Commercial Physical and Biological Research8732 Commercial Economic, Sociological, and Educational Research8733 Noncommercial Research Organizations8734 Testing Laboratories8741 Management Services8742 Management Consulting Services8743 Public Relations Services8744 Facilities Support Management Services8748 Business Consulting Services, Not Elsewhere Classified8811 Private Households8999 Services, Not Elsewhere Classified9111 Executive Offices9121 Legislative Bodies9131 Executive and Legislative Offices Combined9199 General Government, Not Elsewhere Classified9211 Courts9221 Police Protection9222 Legal Counsel and Prosecution9223 Correctional Institutions9224 Fire Protection9229 Public Order and Safety, Not Elsewhere Classified9311 Public Finance, Taxation, and Monetary Policy9411 Administration of Educational Programs9431 Administration of Public Health Programs9441 Administration of Social, Human Resource and Income Maintenance Programs9451 Administration of Veterans' Affairs, Except Health and Insurance9511 Air and Water Resource and Solid Waste Management9512 Land, Mineral, Wildlife, and Forest Conservation9531 Administration of Housing Programs9532 Administration of Urban Planning and Community and Rural Development9611 Administration of General Economic Programs9621 Regulation and Administration of Transportation Programs9631 Regulation and Administration of Communications, Electric, Gas, and Other Utilities9641 Regulation of Agricultural Marketing and Commodities9651 Regulation, Licensing, and Inspection of Miscellaneous Commercial Sectors9661 Space and Research and Technology9711 National Security9721 International Affairs9999 Nonclassifiable EstablishmentsEntity Type*- Select Entity Type -Limited Liability CompanyLimited Liability PartnershipCorporationIndividualPartnershipJoint VentureNot For Profit OrgTrustAddressLocation Address* Street Address City State / Province / Region ZIP / Postal Code Mailing Address* Same as Location Address Street Address City State / Province / Region ZIP / Postal Code PolicyCoverage* (e.g. General Liability, Commercial Auto, etc.)Billing* Agency Bill Direct Bill Effective Date* MM slash DD slash YYYY Expiration Date* MM slash DD slash YYYY General Agent* Carrier* Premium, Taxes and FeesPure Premium*Tax*Fully Earned Endorsements*Carrier Fees*Broker Fee*Please verify that the correct broker fee amount is clearly displayed on your proposalTotal Cost*Please verify that the total cost matches your proposalDown Payment*Please verify that you have collected at least the minimum earned and all feesFinanced Amount*Payment Method* Check (draft form attached) Credit Card (draft form attached) ACH / Credit Card (already processed - attach receipt) Other Credit Card FeeO&A Commission*-0%1.0%1.5%2.0%2.5%3.0%3.5%4.0%4.5%5.0%5.5%6.0%6.5%7.0%7.5%8.0%8.5%9.0%9.5%10.0%10.5%11.0%11.5%12.0%12.5%13.0%13.5%14.0%14.5%15.0%15.5%16.0%16.5%17.0%17.5%18.0%18.5%19.0%19.5%20.0%20.5%21.0%21.5%22.0%22.5%23.0%23.5%24.0%24.5%25.0%25.5%26.0%26.5%27.0%27.5%28.0%28.5%29.0%29.5%30.0%30.5%31.0%31.5%32.0%32.5%33.0%33.5%34.0%34.5%35.0%35.5%36.0%36.5%37.0%37.5%38.0%38.5%39.0%39.5%40.0%Estimated Agency Income*Direct BillDirect Bill Options Carrier Collects Draft Form Attached ACH / Credit Card (already processed - attach receipt) The down payment was made directly to the carrier This policy is set up for agency sweep Auto pay form is included Broker fee only Payment attached (for carrier only) Payment attached (for broker fee only) Payment Plan*- Select Plan -AnnualSemi-AnnualQuarterlyMonthly10-Pay9-PayOtherAgency Bill - FinancingFinancing Options Orr Finance This policy is financed through the MGA Do not finance. Balance will be paid in 21 days or less. Auto-pay form is included. Payment Options 9-Pay (recommended) 10-Pay Other Other Payment Option* DocumentsUpload Files Drop files here or Select files Accepted file types: png, gif, pdf, doc, docx, jpg, Max. file size: 30 MB, Max. files: 10. Please attach all necessary documents including: proposal, carrier quote, signed applications, and any other documents associated with writing this policy.NotesNotes for Customer ServiceAgentsWriting Agent*- Select Agent - NATHAN ABRAHAM ANDREA ALVARADOMONICA ANGEL SAMANTHA ANGUIANO MIKE APRIL CARL ARRECHEA JESSICA BANUELOS CHANTELLE BARONI CHRIS BATTENSCHLAG ERIC BAXLEY DARLENE BAXTER AUSTIN BELL LEE BENHAM LUKE BRICKER KATHERINE CALERO LORI CALKINS CHRIS CALVI CHADD CASILLASSales Center MIKE CHOATE KEVIN CLARK KATIE COLLINS VICTORIA COSSEY SCOTT COYLE CIERA CRUBEL DAVE CUMMINS NICOLE DALEY JODY DYER TODD ELKINS JUSTIN ESSERJACOB FREDERICKS JAMES GAMERO JONATHAN GARCIA ED GARDINER ALAN GOLDMAN PATRICIA GONZALEZ LANDEN GOODNIGHT NICK GRAEBNER MICHAEL GRANT TARAH GRUBER ADAM GUSTAVSON BRANDON HAIRSTON MARK HALL DON HALLWORTH JESSICA HALLWORTH JERRY HANGEN JACOB HAZEL MEGHAN HEITFELD ANTHONY HERNANDEZ CHRIS HILLIARD KERRY HOLMES ALLASIA HOLMES-HYETT JORDAN HUDSON TIM HUFFMAN TOD HUNNICUTT BECKY JENNER MITCHELL JOHNSON IAN JOHNSTON JULIE KALISIAK STEVEN KARLHARRIS LACIE VINNIE LAFLER GREG LIEWALDPERSONAL LINES DIAMOND LOPEZ JERRY LOVERIN ERIC MANESE LTA Marketing PRYCE MILLER TONY MILLER BILL MITCHELL GREYSON MOORE JOLENE MOORE ZACHARY MOSBYJIM MUMPER JOSH O'ROURKE GREG ORRMIKE ORR SAN DIEGO ORR STEVE ORRStephanie Orr STEVE ORR-BERNIER STEVE ORR-LucknerSTEVE ORR-Morr STEVE ORR-SANDMAN TERI PAGEL AMY PALUSO SAMANTHA PALUSO VINNY PALUSO MATT PAULSON JONATHAN PENA TOBIAH PETTUS CLAUDE PLANT DEAN POWELLDebbie Pucciarelli KIERAN QUINN CHANTAL REES KIM REICH KATRINA REICHARDT TRAVIS RUNYAN SERGIO SALAS STEVE SALOMON MAURICIO SANCHEZSabrina SantosLori SchiavoneLori Schiavone-HEN DAN SEMENCAR DAN SEMENCAR- Feduniw STACEY SHADLEY STACEY SHADLEY-SS1ST1 LAURA SHELTON WALLY SIMPKINS VANESSA SISEMORE MEG SMITH MARK SMITH MELLISA SPIVEY ANDRIA TALLMANBRIAN TALLMAN NOAH THOMASON TOM VAUGHN ELIAS VELEZ ERIC VERKOUTEREN MARK WAGENER DAVE WAGNER DARRESE WEBB CATHIE WEEKS DAVID WEEKS RICH WIERSMA NIK WINN GRANT WONACOTT MISSY WONACOTTWriting Agent Commission*- Select Commission -15.017.520.022.525.027.530.032.535.037.540.042.545.047.550.0HiddenWriting Agent Name First Last HiddenWriting Agent EPIC ID HiddenControlling Agent Base Commission NewHiddenControlling Agent Base Commission RenewalControlling Agent*- Select Agent - NATHAN ABRAHAM ANDREA ALVARADOMONICA ANGEL SAMANTHA ANGUIANO MIKE APRIL CARL ARRECHEA JESSICA BANUELOS CHANTELLE BARONI CHRIS BATTENSCHLAG ERIC BAXLEY DARLENE BAXTER AUSTIN BELL LEE BENHAM LUKE BRICKER KATHERINE CALERO LORI CALKINS CHRIS CALVI CHADD CASILLASSales Center MIKE CHOATE KEVIN CLARK KATIE COLLINS VICTORIA COSSEY SCOTT COYLE CIERA CRUBEL DAVE CUMMINS NICOLE DALEY JODY DYER TODD ELKINS JUSTIN ESSERJACOB FREDERICKS JAMES GAMERO JONATHAN GARCIA ED GARDINER ALAN GOLDMAN PATRICIA GONZALEZ LANDEN GOODNIGHT NICK GRAEBNER MICHAEL GRANT TARAH GRUBER ADAM GUSTAVSON BRANDON HAIRSTON MARK HALL DON HALLWORTH JESSICA HALLWORTH JERRY HANGEN JACOB HAZEL MEGHAN HEITFELD ANTHONY HERNANDEZ CHRIS HILLIARD KERRY HOLMES ALLASIA HOLMES-HYETT JORDAN HUDSON TIM HUFFMAN TOD HUNNICUTT BECKY JENNER MITCHELL JOHNSON IAN JOHNSTON JULIE KALISIAK STEVEN KARLHARRIS LACIE VINNIE LAFLER GREG LIEWALDPERSONAL LINES DIAMOND LOPEZ JERRY LOVERIN ERIC MANESE LTA Marketing PRYCE MILLER TONY MILLER BILL MITCHELL GREYSON MOORE JOLENE MOORE ZACHARY MOSBYJIM MUMPER JOSH O'ROURKE GREG ORRMIKE ORR SAN DIEGO ORR STEVE ORRStephanie Orr STEVE ORR-BERNIER STEVE ORR-LucknerSTEVE ORR-Morr STEVE ORR-SANDMAN TERI PAGEL AMY PALUSO SAMANTHA PALUSO VINNY PALUSO MATT PAULSON JONATHAN PENA TOBIAH PETTUS CLAUDE PLANT DEAN POWELLDebbie Pucciarelli KIERAN QUINN CHANTAL REES KIM REICH KATRINA REICHARDT TRAVIS RUNYAN SERGIO SALAS STEVE SALOMON MAURICIO SANCHEZSabrina SantosLori SchiavoneLori Schiavone-HEN DAN SEMENCAR DAN SEMENCAR- Feduniw STACEY SHADLEY STACEY SHADLEY-SS1ST1 LAURA SHELTON WALLY SIMPKINS VANESSA SISEMORE MEG SMITH MARK SMITH MELLISA SPIVEY ANDRIA TALLMANBRIAN TALLMAN NOAH THOMASON TOM VAUGHN ELIAS VELEZ ERIC VERKOUTEREN MARK WAGENER DAVE WAGNER DARRESE WEBB CATHIE WEEKS DAVID WEEKS RICH WIERSMA NIK WINN GRANT WONACOTT MISSY WONACOTTControlling Agent Commission*Controlling Agent Commission*HiddenControlling Agent Name First Last HiddenControlling Agent EPIC ID Don't forget to upload your documents in the attachments section in EPIC.