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In order to write new business or to receive a new quotation within United Business Partner's programs, please complete the brokerage agreement and information sheet.

Agency Contract Checklist

  1. Agency Agreement
  2. Brokerage Agreement
  3. Agency Profile
  4. Copy of E & Coverage
  5. Copy of W-9 Form

Please contact Matt Harpin at 678-766-8242 ext. 203, or email mharpin@united-business.us for more information.

Thank you, we look foward to working with you and your agency!

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