Become An Agent

In order to write new business or to receive a new quotation within UBIC – Get Comp!, please complete the new agent agreement.

Please complete the following forms (click to download):

1. Agency Agreement
2. Brokerage Agreement
3. Agency Profile
4. Authorization for EFT Commission
5. W-9 Form
6. Copy of your E & O Coverage

Please contact Stacey Scott at 678-766-8242 ext. 210, or email [email protected] for more information.

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