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Important: Please read before you begin
Website (“Domain Name”)
- Your Agency / Brokerage will need to have a unique website address (“www.yourcompany.com”) that it owns or controls. You will not be able to register without this.
Email Address
– We strongly recommend that your email (“you@yourcompany.com”) should match your corporate website “domain name”.
The use of non – corporate / third party email providers (“@gmail”, “@yahoo”, etc ) may cause technical issues outside of our control. This could affect your ability to receive important emails from UmbrellaPro such as Quotes, Binders and Policies.
Home Office
– We define a "Home Office” as the legal entity that is the “Corporate Parent” of all other entities / offices that it owns and/or controls. These other entities / offices, generally located in different cities and/or states, are what we consider "Branch Offices”. See below. It is critical that you first provide us with your Home Office (“Corporate Parent”) information, separately and distinctly, from any "Branch Office".
Branch Office
– If the company you work for is (1) legally owned or controlled by another company ("Corporate Parent”), (2) has more than one location and/or (3) owns 50% or more of a subsidiary or affiliate company then your company either is, or has, a “Branch Office”. You will be asked to select whether you work out of the Home Office (Corporate Parent) or an “Other” location. A response of “Other” will present you with an opportunity to input your Branch Office information.
*
Indicates required field.
Home Office (“Corporate Parent”) Information
♣
Home Office Name (DBA)
*
✝
Website
*
(example: www.yourcompany.com)
Street
*
Suite
Zip
*
City
*
State
*
Select a State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Other
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Your Contact Information
Your Name
*
Title
*
Select a Title
Account Executive
Account Manager
Account Representative
Accounting Department
Accounting Supervisor
Administrative Assistant
Administrative Manager
Affidavit Clerk
Assistant Underwriter
Assistant Vice President
Associate Broker
Bookkeeper
Branch Manager
Broker
Chairman
Chief Executive Officer
Chief Financial Officer
Chief Operating Officer
Claims Adjustor
Claims Examiner
Claims Supervisor
Commercial Lines Manager
Comptroller
Contract Administrator
Controller
Corporate Vice President
Customer Service Representative
Executive Vice President
Human Resources Manager
IT Department
IT Supervisor
Junior Underwriter
Licensing & Compliance
Managing Director
Managing Partner
Managing Vice President
Marketing Executive
Marketing Manager
Office Manager
Operations Manager
Other
Partner
Personal Lines Assistant Underwriter
Personal Lines Underwriter
Policy Services Manager
President
Principal
Producer
Receptionist
Sales & Marketing Director
Senior Underwriter
Senior Vice President
Underwriter
Vice President
Telephone
*
✦
Email Address
*
Confirm Email
*
Does your Home Office (“Corporate Parent”) have more than one location (“Branch Office”) and/or own 50% or more of any other subsidiary or affiliate insurance agency/brokerage companies?
*
No
Yes
Submit
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