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Colonial Surety Company
Phone: 1-800-221-3662 Fax: 1-800-743-1062 
Email us
 
    www.colonialsurety.com
 

 

Enrollment Application For Insurance Professionals Affiliate Plan
 
 

We are a market for the insurance agent or agency who does not have a primary source for the placement of their surety and fidelity business. Our facility does not accommodate the specialty surety agency or insurance agency who requires a secondary source for contract surety.
 

 

Enrollments are not available in following states:
HI, ME, MI, OH, VT, WA

 

 
Name of Agency
Agency Address
City
State
Zip Code
Owner Name
Contact Name
License Number
Telephone
Fax
Tax ID
SS #
Email
Web Address

Number of offices

 
Number of
agency employees

 
Number of
agency producers
 
Total agency
premium volume
 
Total agency
surety premium volume
 
Are you a member of any insurance or surety association?
Yes No
 
If yes, please list them:
 
Does your agency represent any association that may have a requirement for non-contract surety or fidelity bonds?
Yes No
 
If so please list them:
 
 
 

 
 
 
              
 
 

 

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