Trinity Insurance Services, Inc.

Agency Appointment

In order to obtain or maintain a current appointment with
Trinity E&S Insurance Services, Inc.,
who does business in the 3 states of:

CA / AZ / NV

You or your company:

Must be a currently licensed & bonded Agent (resident / non-resident) in the state in which you wish to do business:
Must submit a current and in force copy of each state license in which you wish to do business with Trinity
Must submit a current in force copy of your E&O policy declarations page
Must submit a completed Trinity Broker's Questionnaire *

* Following review and approval of Questionnaire, an agreement would follow

All documents meeting the above mentioned criteria are to be
submitted along with the SIGNED Questionnaire
to our Corporate office,
via FAX, Email, (if urgent) or U. S. Mail.
Trinity E&S Insurance Services, Inc.
79-301 Country Club Dr, Suite 200
Bermuda Dunes, CA 92203
ATTN: Linda Moore
FAX: (760) 423-1064
Email: LMoore@trinityinsurance.com

Choose one of the following to obtain a copy of:
Trinity's Broker's Questionnaire

NOTE: Both types require a signature on the last page
Instructions are included with each file.

WORD Format File	To Fill Out Electronically (preferred for readability)
PDF Format File	To Fill Out Manually

To Download a copy of Acrobat Reader Click On The Button

IMC Inc.