Agent/Broker of Record Letter
Dual appointment BOR letter generator.
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Date
Date Signed
Letter Type
Agent / Broker of Record (Dual Appointment)
Agent of Record (No Broker)
Insurance Company Name
Carrier Address
Insured Name (Company)
Policy Number(s)
Agent Name (Saved Profiles)
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Agent Name (Representing Agency)
Agency Name (Retail / Primary)
Agency Address
Broker/Wholesaler Name
Broker/Wholesaler Address
Insured Representative Name
Insured Representative Title
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