Insurance Broker Fee Agreement
It is understood and agreed by the applicant (insured) that in consideration of marketing,
underwriting and placing this insurance with
_____________________________________________ the carrier,
ABK Brokerage, Inc.
shall earn a service fee in the amount of $ ___________.
This fee may or may not be in addition to a commission paid by the insurer.
This is for services rendered for the full term of the policy and is part of any annual
installment. This fee is not part of the premium and has been charged with my consent
I understand that this amount is fully earned at inception.
PRINT NAME (of Person Signing)
SIGNATURE (of Insured)