Agent to accept funds as fiduciary. It is agreed between company and agent as follows: 1. Agent has full power and authority to receive and accept proposals for insurance covering the classes of risks as company may, from time to time, authorize to be insured; to collect, receive and receipt for premiums on insurance tendered by agent to and accepted by company and to retain out of the premiums collected, as full compensation on business placed with company, commissions as may be from time to time mutually agreed upon. It is a condition of this agreement that agent shall refund ratably to company, on business written, commissions on canceled liability and on reductions in premiums at the same rate at which the commissions were originally retained. 2. In the event of the termination of this agreement, agent having promptly accounted for and paid over premiums for which he or she may be liable, agent's records, use and control of expirations shall remain the property of agent and be left in his or her undisputed possession; otherwise the records, use and control of expirations shall be vested in company. 3. Agent agrees to hold all premiums and return premiums collected as a fiduciary trust, until payment has been made to company, or in case of return premiums, to the insured. Accounts of money due company on the business placed by agent with company are to be rendered monthly so as to reach company's office not later than the 15th day of the following month; the balance shown to be due to company shall be paid not later than 45 days after the end of the month for which the account is rendered.
Signed on this _____day of _____________(month) __________(year) at ________________________(place).
__________________ AGENT
_______________________ COMPANY