Fillable SURETY AGENCY PROFILE Return to Nathan Miller at (Philadelphia Insurance Companies)

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SURETY AGENCY PROFILE Return to Nathan Miller at (Philadelphia Insurance Companies)

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SURETY AGENCY PROFILE Return to Nathan Miller at Nathan.Miller@phly.com
Name of Firm:
Principal Address:
City:
State:
Zip:
Telephone:
Email:
BACKGROUND
1.
Year Surety operation established:
2.
Is the Agency engaged in, owned by, associated, affiliated, or controlled by any other business
interest?
No
If yes, please describe:
SURETY PERSONNEL
Name
Title or Position
Number of Years in Surety
OPERATIONS
1.
Does your Agency write business outside your state of domicile?
No
2.
Please indicate all the states in which your Agency holds a valid license:
3.
Total Surety Volume:
$
Contract – Account:
$
Contract – Application Based / Transactional:
$
Commercial – Account:
$
Commercial – Application Based / Transactional:
$
Subdivision:
$
Distribution of Bonded Programs Size
$0 to $1M
%
$1M to 5M
%
$5M to $15M
%
$15M to $20M
%
$25M to 50M
%
$50M and Above
%
4.
List major carriers in order of premium volume:
Name
Years
Represented
Annual Volume
Loss
Ratio
Reference (Name)
$
%
$
%
$
%
$
%
$
%
Surety Agency Profile
Page 1 of 1
© 2016 Philadelphia Consolidated Holding Corp.
09/2016
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Completed 7 November 2020

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