<%@ page contentType="text/html; charset=iso-8859-1" language="java" import="java.sql.*" errorPage="" %> Get Appointed with Fredricksen Insurance Services, Inc.
  
Home | Farm/Ranch | Mortality | Homeowners | State Info | Forms | FAQ | Contact

Get appointed with
Fredricksen Insurance Services, Inc.

If you are a new broker to Fredricksen Insurance Services, Inc. you must complete the following before we can quote or bind coverage. If you have any questions regarding any of the steps, please do not hesitate to call us at (800) 669-4347.
Step 1
Adobe
Word
Brokerage Application    

All States
PDF
DOC

Viewers if you don't have them already.
Word Viewer
 
Answer all questions completely.
If a question does not apply, please write none in the space provided.
Step 2    
We also need a copy of the following items:    

Copy of Errors & Omissions Coverage
Copy of Agency License
Copy of Broker's Bond (California Only)
     
Step 3    

Fax completed applications and forms to (951) 929-3574. Thank you for your interest in Fredricksen Insurance Services, Inc.

Please note that on July 17, 2004, the 909 area code was split.
Our new area code is 951.
Please be sure to change autodials on fax machines.