American Integrity Insurance Company is dedicated to an exceptional level of policyholder experience. In order to achieve this goal, we must contract with only the most ethical, experienced and customer service-focused agencies. Through this type of collaborative partnership, we are confident in our success.

If you would like to be considered for a voluntary appointment please complete the required information below.
products
homeowner's insurance
Agency name:

Agency code:
IRS Corporate Name: Tax ID:
please check one:



   
Location address: Mailing Address:
City/State:
City/State:
Zipcode: Zipcode:
County: County:
       
Agency main phone: fax:
Agency Principle: email:
PL Contact 1: PL Contact 2:
phone: phone:
check preferred method of contact:



   
Producers: CSR:
Licensing:    
Do you have more than one location:



If yes, please list locations:
What year was the agency founded? Total number of employees:
Book of Business Volume: Agency Total:
    Homeowners:
       
Agency / Group Main HO carriers (list all):

   
Citizens' Volume: How many homes do you write per month?
Mobile Home Volume: How many mobile-homes do you write per month?
True new business growth per year: Commercial Volume:
Agency / Group Main carriers
(list all):

Agency Management System:
Do you use comparative raters?



If yes, which ones:
 


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