BusinessLink ™

BusinessLink™ is a confidential database created and maintained by PIA to facilitate partnerships between agents, companies, general agents and managing general agents.

MGA/GA seeking agent/broker

Please complete the Appointment Access Program form identifying appointment criteria.

MGA/GA information

MGA/GA name *

Contact *

Address *

P.O. Box

City *

State *

ZIP *

Phone *

Fax *

Email *

Website *

E&O coverage information:

Carrier *

Limit ($) *

Expiration date *

Please check regions/states available for appointment:

Region(s)

Click here for a breakdown of all regions.

NY-1

NY-2

NY-3

NJ-4

NJ-5

CT-6

CT-7

Check markets available for appointment:

List companies you represent: *

General parameters for potential agents:

Agency size (written premium) $ *

Mix of business (%) Personal lines *

Mix of business (%) Commercial lines *

Mix of business (%) Other

E&O insurance required?

Yes

Accept start-up agency(ies):

Yes

Agency experience/training:

Additional comments/requirements: