The following information will help us best serve your needs and assign an associate.

Name *

Phone *

Email *

BOB Gross Commissions

Target Buying Price

Funds Available

Bank Financing Yes No

Bank's Pre approved Yes No

Florida Licensed Yes No

Currently Owns an Agency in Florida Yes No

Auto 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Commercial Lines 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

General Liablility 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Workers' Comp 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Homeowners 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Standard BOB 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Private lines 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Non Standard BOB 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

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