Harbor Insurance Company

Agency Name*
Phone*
Business Type
- Street Address Same As Mailing
Mailing Address
Mailing Address City State ZIP Code
Street Address
Street Address County City State ZIP Code
Fax
Email
Date Agency Established
MM slash DD slash YYYY
How long has agency been under the current ownership?
List all Names and Titles of Corporate Officers, Partners, Owners, Key Personnel*
Name Title Email
Person in charge of the following departments:
Personal Lines Commercial Lines Accounting Agency Manager
Agency Volume
Personal Lines ($) Commercial Lines ($)
List Non Standard Auto Companies and General Agencies Represented
Company Name Volume ($) Loss Ratio (%)
Estimated first year volume with Statewide
Personal Lines ($) Commercial Lines ($)
List all company contracts cancelled in the last 3 years and reason
Company Name Cancellation Reason

Name	Title	Email

Company Name	Volume ($)	Loss Ratio (%)

Company Name	Cancellation Reason