To find out if your agency qualifies as an Accord Partner Agency, please fill out the form below then click submit.  We will contact you within 24 hours.  To contact our national marketing department, please call Art Simms at 954-567-5755.

General Information

Your Name

Partners Names (if applicable)

Name of your agency

Physical address

City

   

State

Zip

Mailing address if different

Agency Phone

    

Best phone number to contact you

Agency Fax

Email

Do you have a web page?
(please provide)
Brief description of your agency (primary lines of business written, approximate annual sales, key markets you have and markets/products you need, number of employees and goals for your business:

Have you every had any E&0 claims, if so please explain

Do you have an agency management system? (please provide name of system)

 
 

 

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