Farmers Insurance Agent
Producer Agreement Instructions

Please submit the following paperwork. We will respond as soon as possible.

• »  Completed Producer Profile Questionnaire >> available here.
• »  Signed & Completed Producer Data Form >> available here.
• »  Signed Producer Agreement >> available here.
• »  Current copy of E&O insurance declarations page.
• »  Current copy of Producers license.
• »  Payment Terms >> available here.
• »  Completed W-9 >> available here.

All completed paperwork must be faxed to 714-876-2252. Providing all of the above information does not guarantee a producer agreement approval. Should you have any questions, please contact Marlies Erickson at 714-621-2300 or via email.

Again, thank you for your interest in G.J. Sullivan Co.