ROCKWOOD PROGRAMS INC SENIOR PRODUCTION MANAGER
SUPPLEMENTAL QUESTIONNAIRE
GENERAL INFORMATION
Applicant Name
E-Mail Address
example@example.com
Telephone
Format: (000) 000-0000.
PRODUCT EXPERTISE
Which Management / Professional Liability insurance products do you have experience placing (check all that apply):
Employment Practices
Directors & Officers
Miscellaneous Professional
Cyber Liability
Fiduciary Liability
Excess
Other
Do/did you specialize in certain business classes/segments?
Yes
No
If "Yes", please describe:
OWNED PORTFOLIO / DISTRIBUTION NETWORK
Do you currently own a book of business?
Yes
No
If "Yes" provide the following:
Product description
Annual Gross Written Premium
Do you own the expirations of the portfolio?
Yes
No
Are there any encumbrances on this book (non-competes, non-solicitations, purchase rights etc.)?
Yes
No
If "Yes" provide more information as an attachment.
Do you possess a network of sub-producers?
Yes
No
If "Yes" provide the following:
How many agents?
Are they:
National
Regional
State-specific
Does your network require any unique compensation requirements?
Yes
No
If "Yes" please describe:
REQUIRED ATTACHMENTS
Resume
1-2 Page business plan outlining strategies for developing a $2 million portfolio of
business within the first year of employment at Rockwood.
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