Become a Cardinal Agent

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Agency name *

Locations

Name *

First

Last

Phone number *

Email *

Target industries

Target states

Amount of worker’s compensation written by agency by class (top 5 classes)

Amount written by carrier (top 5 and amounts with each)

Average worker’s compensation account size

Experience with deductibles and loss sensitive programs

Does your agency have in-house claims?

Does your agency have in-house loss prevention personnel?

Number of commercial property and casualty/worker’s compensation producers

Agency needs

Other Comments