Insurance agents licensed in Indiana, Illinois and Ohio can submit applications for quotation. Quotations may not conform to the application or specifications submitted. Requirements for binding will be listed on the quotation. Agents have no binding authority for any line of business. Binder requests must be submitted in writing to Roush Insurance Services, Inc. The following documents are required to be on file before we will bind coverage:
- Producer Agreement/Questionnaire (must be signed and dated by agency principal)
- Errors & Omissions Policy Declarations or Certificate of Insurance
- Agency License
- Producer License
Click the above underlined link to download the producer agreement/questionnaire. The completed document can be mailed, faxed or emailed to firstname.lastname@example.org. Please be sure to include the required attachments.