Independent 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 agency as well as agent's 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 with G.J. Sullivan Co. 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.
