Insurance Agent/Broker Initial Application

SBCA provides an Approved Broker Program to a select group of insurance brokers who have experience and qualification in providing property and casualty insurance to companies that manufacture structural building components (trusses, wall panels and related components). If you are a broker interested in being part of this program, please review the program requirements and submit the following application.

Name of Agency/Brokerage *

Contact Name *

Address *

Phone *

Email *

Component Manufacturing, Manufacturing and Construction Experience

How many years have you worked in the role of an insurance agent/broker? *

How many years have you been with the agency named above? *

How many years has the agency named above been in business? *

How many structural building component (trusses, wall panels and related component) manufacturers do you have as clients? (You must serve at least one per the program requirements linked above.) *

What is the total sales volume of your combined structural building component manufacturing clients? (The aggregate annual sales for component manufacturers must total no less than $25 million per the program requirements linked above.) *

Do you regularly provide these lines of coverage per the program requirements linked above: Commercial Property, Commercial General Liability, Automobile Liability, Excess/Umbrella coverage, and Workers’ Compensation? *

Yes

Please describe your experience in analyzing the types of exposure facing structural building component manufacturers and the coverage that is needed. *

List any manufacturing or construction industry associations you are a member/participate in (including SBCA).

We hereby apply for the Approved Broker Program provided by the Structural Building Components Association (SBCA). If admitted, we will observe all of the program requirements, and will actively support its policies and goals.

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