Create a BOR Form (P-Lines)

What is an BOR or AOR

A change in Agent/Broker is known as a AOR or BOR. Which means instead of writing a new policy, a client can sign a form to change from one agency to another. If your client wishes to change their broker, then you must execute a “Broker of Record Change”. In order to move forward with the change, the client must sign the BOR confirmation his decision to change to new agent/broker. The BOR is then presented to the Insurance Carrier for the change to occur. The BOR assures the underwriter that the new broker has the authority to bind coverage on behalf of the client.

Today's Date*

Date

Producer Name*

The completed PDF form will be emailed to the email address associated with this person

Completed By (For Email Subject Line)*

Agency Info:

What is the Agency Name

Wish to Name Producer

Agency Street Address*

City*

State

Zip

What is the Phone Number*

(A/C, No., Ext)

What is the Fax Number

(A/C, No.)

What is the Email Adddress:

Information for the Policies:

How many Policies do you intend to put on this form to create a BOR*

Are all the policies with the same Insurance Carrier.*

Stop: We cannot use 1 bor form for several different insurance carriers. You do a BOR for each carrier you plan to send the BOR form to for the transfer.

Are all the Policies Personal Lines since this is only a P-Lines BOR*

Stop: This form is only used for Personal Lines

Named Insured on the 1st Policy*

As it Appears on Policy

1st Policy Number*

1st Policy

1st Policy Premium

What is the Effective Date*

What is the Expiration Date*

Choose the Line of Business*

What is the Named Insured on the 2nd Policy*

As it Appears on Policy

2nd Policy Number*

2nd Policy

2nd Policy Premium

What is the Effective Date*

What is the Expiration Date*

Choose the Line of Business*

What is the Named Insured on the 3rd Policy*

As it Appears on Policy

3rd Policy Number*

3rd Policy

3rd Policy Premium

What is the Effective Date*

What is the Expiration Date*

Choose the Line of Business*

What is the Named Insured on the 4th Policy*

As it Appears on Policy

4th Policy Number*

4th Policy

4th Policy Premium

What is the Effective Date*

What is the Expiration Date*

Choose the Line of Business*

What is the Named Insured on the 5th Policy*

As it Appears on Policy

5th Policy Number*

5th Policy

5th Policy Premium

What is the Effective Date*

What is the Expiration Date*

Choose the Line of Business*

What is the Named Insured on the 6th Policy*

As it Appears on Policy

6th Policy Number*

6th Policy

6th Policy Premium

What is the Effective Date*

What is the Expiration Date*

Choose the Line of Business*

Which Carrier is the BOR for*

Agency Code

* Aegis requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* American Collectors Insurance requires at least 30 days prior to renewal for the policy to be
successfully transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

American Modern does not allow BOR in California.
The policy must be written with a new business application
as to move to another agency.

Aon Edge requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

ASI requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

Assurant (NFIP) requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

AU Gold requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

Bamboo requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

Bluewater requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

Bridge Specialty requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

CATcoverage requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

Collect Insure requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* CSE requires at least 60 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Delos requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Distinguished requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* ePremium requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Fair Plan requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* First Cap requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Flood Risk Solution requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

(Bristol West)

* Bristol West requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time for
the renewal and will be effective the following next year/term.

(Foremost Specialty)

* Foremost Specialty requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Guard requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Geovera requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Hartford requires at least 20 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Hagerty requires at least 21 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Heritage requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Hippo requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Honeycomb requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Hudson requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* ICAT requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Infinity requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Ins Helper requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* ISC requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* JC Taylor requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Jewelers Mutual requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* JIBNA requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Kemper Auto requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Kemper requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* KW Specialty requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Lightspeed requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Mapfre requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

(California Auto Insurance)

California Auto does not allow BOR in California.
The policy must be written with a new business application
as to move to another agency.

* Metlife requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Mile Auto requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Nat Gen requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Nationwide requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Neptune requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Obie requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Pacific Specialty requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Palomar requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Progressive requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Personal Umbrella requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* REInsure Pro requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* RLI Corp requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* RVNA requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Safeco requires at least 15 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Sagesure requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Selective Flood requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* SES requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Special Ins. requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Steadily requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Sterling requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Stillwater requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Travelers requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* US Assure requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* USLI requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* WOWs requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Vacant Express requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Veracity requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

* Wright Flood requires at least 30 days prior to renewal for the policy to be successfully
transferred to the new agency code. Otherwise the BOR may not be processed in time
for the renewal and will be effective the following next year/term.

What is going to be the effective date of the change in Agency*

When will we become the new agent