Real Estate Agents Quote Request

The response to statements 1- 9 below must all be checked to be eligible for the Easy Enrollment program and the premiums indicated. If none of the statements below can be checked, please select the “None of the above” statement to download a standard application and request a quote.


No owner, agent or member of the applicant has been subject to a criminal conviction, any investigation, license revocation or suspension or other disciplinary action by any licensing board, real estate association or other regulatory body within the last 5 years nor has anyone agreed to surrender any license.

No owner, agent or member of the applicant has been cancelled, refused insurance, been subject to nonrenewal or declination by another insurance company during the last 5 years (except due to loss of market or nonpayment of premium).

During the past three years and the current fiscal year, all services provided and 100% of gross revenue was derived from residential real estate transactions.

No owner, agent or member of the applicant is involved in appraisal services, property management, property development, property rehabilitation or construction.

No owner, agent or member of the applicant has any exclusive listing agreements with any builder or developer.

No owner, agent or member of the applicant has provided services related to preforeclosed or bank owned properties that included involvement in any eviction procedures, delivering or negotiating cash for keys offers or property rehabilitation.

The applicant’s total gross revenue for the past three (3) fiscal years combined did not exceed $600,000.

(Gross revenues are defined as all fees and commissions received before the payment of any expenses and before the payment of any fee or commission splits with employees or independent contractors)

No owner, agent or member of the applicant is aware of any errors and omissions claim(s) made against them within the past five (5) years nor are they aware of any circumstance, situation, act, error, omission or Personal Injury which could reasonably be expected to be the basis of a claim being made against them or the applicant.

None of the above

1-866-795-9613 • 8 AM-5:00 PM CST • MONDAY - FRIDAY

INSURANCE PRODUCTS:

Agents/Brokers
Appraisers

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