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Contact Person: Agency Name (required): Street Address: City (required): State: ZIP: Phone (required): Fax: Agency Email Address: Select the Auto companies you represent. To select multiple companies, hold down the Ctrl key as you click.
AAA** Affirmative Insurance Company of Michigan AIG Allied PC American Fellowship AutoOwners* Bristol West (Reliance) CHUBB Cincinnati* Citizens Dairyland Employers / Hamilton Mutual Encompass (CNA) Fireman's Fund Founders Frankenmuth Fremont General Accident GMAC (Integon) Grange Great Lakes Hartford Hastings Mutual Infinity Property & Casualty (Great American) Lake States / Harleysville Leader National Merchants Mutual Mercury Insurance Michigan Automobile Placement Facility (MAIPF) Michigan Insurance Company Michigan Millers Mutual Services Casualty Insurance (MSCI / MIC) Northern Mutual Northpointe Ohio Casualty / West American OMNI Partners Insurance Pioneer Progressive* Safeco Secura Southern Michigan State Auto Titan Titan Affinity Travelers Westfield / Ohio Farmers / American Select Wolverine Mutual
Select the Home companies you represent. To select multiple companies, hold down the Ctrl key as you click.
AAA** Allied PC American Fellowship AutoOwners / Homeowners (HOIC)* Badger Mutual Brotherhood Mutual Chubb / Great Northern / Federal Pacific Indemnity Cincinnati Citizens Employers Encompass (CNA) Farmers / CIVIC P&C* Farmers and Merchants* Farmers Mutual Fireman's Fund Foremost Frankenmuth Fremont Mutual Grange Hartford Hastings Mutual Infinity Property & Casualty (Great American) Lake States / Harleysville Merchants Mutual Michigan Basic Property (MBPIA) Michigan Insurance Company Michigan Millers Northern Mutual Ohio Casualty / West American / American Fire Partners Insurance Pioneer State Mutual Safeco Secura State Auto Travelers / AETNA Westfield / Ohio Farmers / American Select Wolverine
Select the Fire companies you represent. To select multiple companies, hold down the Ctrl key as you click.
AutoOwners* Citizens Farmers & Merchants* Fremont Mutual Hastings Mutual Michigan Basic Property (MBPIA) Michigan Insurance Company Northern Pioneer State Mutual Wolverine
Agency Management System (if any): Version: Current Pricing Software: Annual Cost:
Please send the demo software: on CD via Internet.