P.O. Box 1508, Sonoma, CA 95476 • License # 0606980 • Phone # 800-624-5829 • Fax # 707-996-7912

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NEW BROKERS WELCOME!

Please review our various programs! If you do business in any of these areas
please sign on with our agency as one of our preferred producers.

Please mail the following completed items, with wet signatures, to our agency.
Attn: Jerilee Lewis

Producers kit

· Producer Agreement Cover Letter
· Questionnaire
· W9 Form
· Current copy of your E&O or binder
· Current copy of your agency license
· Producer Agreement for the appropriate state, listed below:

Alabama Alaska Arizona Arkansas
California Colorado Connecticut Delaware
Florida Georgia Hawaii Idaho
Illinois Indiana Iowa Kansas
Kentucky Louisiana Maine Maryland
Massachusetts Michigan Minnesota Mississippi
Missouri Montana Nebraska Nevada
New Hampshire New Jersey New Mexico New York
North Carolina North Dakota Ohio Oklahoma
Oregon Pennsylvania Rhode Island S. Carolina
South Dakota Tennessee Texas Utah
Vermont Virginia Washington West Virginia
Wisconsin Wyoming

If binding of an account does not allow for mail time of these documents, you may fax them to us with the originals to immediately follow by mail.

Please direct inquiries to:
Jerilee Lewis
Apollo General Insurance Agency, Inc.
P.O. box 1508 , Sonoma, CA 95476
Phone: 707-996-2912 x18 or 800-624-5829
Fax: 707-996-7912
Contact Us Via E-mail
CA license # 0606980

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