Producer Forms
If you are already appointed with our parent company, DUAL North America, please contact producer@dualinsurance.com to learn more about how to become appointed with our programs.
Not appointed yet? Please click here to apply to become a producer.
CONTACT INFORMATION
- For questions regarding appointment: producer@dualinsurance.com
- For ACORD and Supplemental: submissions@nbis.com
- For Endorsement requests: endorsements@nbis.com
- For Filings request: filings@nbis.com
- For Loss Run requests: lossruns@nbis.com
- For Audit Inquiries: audits@nbis.com
- For all other inquiries: contactus@nbis.com
SUPPLEMENTAL APPLICATION FORMS - fillable forms
- Crane, Rigging and Heavy Equipment Supplemental Application
- Equipment Inspection Services - Prof. Liability Supplemental Application
- Specialized Transportation Supplemental Application
- Oilfield Operations/Rig Mover Supplemental - ALSO Required with the above Transportation Supplemental
- Concrete Pumping Supplemental Application
- Equipment Dealer Supplemental Application
- Workers' Compensation Supplemental Application
ACORD FORMS - fillable forms
- Producer Information Form - Acord
- Acord 876 - Background Check Authorization
- ACORD 125
- ACORD 125 - Florida
- ACORD 126 - Commercial General Liability
- ACORD 127 - Commercial Auto
- ACORD 129 - Vehicle Schedule
- ACORD 130 - Workers' Compensation
- ACORD 130 - California WC
- ACORD 131 - Umbrella/Excess
- ACORD 132 - Truckers - Motor Carriers
- ACORD 140 - Property
- ACORD 143 - Transportation Section
- ACORD 152 - Commercial Inland Marine
- ACORD 155 - Equipment Breakdown
- ACORD 163 - Commercial Auto Driver Info Schedule
INDUSTRY INFORMATION