Once your agency is approved, you will be signed up to sell both Vacant Express and Collectibles Insurance products.
NOTE: Agents may only sell in the state(s) in which they are licensed.

Producer Information

Please Complete the following in regards to the producer information.

  • select
  • select

Contact Information

Please Complete the following about the contact for this producer.

Billing Contact Information

Complete if different from the above contact.

Billing Contact Address

 Check if address is same as above, if different please complete:

  • select

Documentation Section

Please Upload Files (e.g. PDF, GIF, JPG etc.) containing the following documents: Your Agency and/or prodcuer license(s); E&O policy declaration; and a completed W9. if you prefer to email or fax us your documentation, you may fax us at 773-897-5381 or email at NewProducerSignup@global-indemnity.com, please include a license for each state in which you are licensed to sell.

Check if you are licensed in multiple states



* denotes a required field.