Indium AOR/BOR

To BOR/AOR a policy, we require a completed and signed Acord 36. For small business and personal lines, Acord 36 is accepted. For large and middle market or insurance accounts, we also recommend a letter from the insured requesting the AOR on the insured's letterhead, although it is not always required. Rules below regarding the BOR process MUST be followed. Deviation from these guidelines will result in the delay or rejection of your BOR request.

Indium will be the agency of record, so the Acord and any letter MUST reflect our agency name and address in all locations where you would input the producer or agency name. That information is as follows:

Indium Holding Company LLC
6620 Mooney Street, Suite 360
Dublin, Ohio 43017 USA

The agency code slot must be left blank so that Indium can provide our agency code.
If electronically signed, the electronic signature confirmation packet must be included.
For business insurance, the insured signing must include their title on the Acord. Titles that do not reflect an owner or partner in the business, or someone with authority to request the change will likely be rejected by the carrier.

An AOR/BOR template can be found here - you are able to utilize this and return a signed copy meeting the above.

PersonalCommercial

Upload a Signed AOR/BOR here

Your Name

First NameLast Name

Your Phone Number*

Please enter a number we can call and text as neededFormat: (000) 000-0000.

Your Email*

example@example.com

Your Agency*

Insured Name/Company*

Next Expiration Date*

Date

Carrier*

Insured Street Address*

Insured City*

Insured State*

Insured Zipcode*