Insurance Auto Acord

INSURANCE AUTO ACORD — SERVICE AGREEMENT

Parties

Recitals

WHEREAS, Producer is duly licensed and authorized to prepare, submit and facilitate ACORD automobile insurance applications and related policy documents on behalf of clients and insurers; and

WHEREAS, Client desires to retain Producer to prepare and submit ACORD automobile forms, to procure and procure placement of automobile insurance and to assist with endorsements, renewals and claims documentation for the vehicle(s) listed in this Agreement; and

WHEREAS, the parties wish to set forth the terms, scope and payment for such services effective as of .

Scope of Work

Producer will perform the following services in a professional manner consistent with industry standards and applicable law:

Typical tasks include preparation and submission of ACORD Auto forms, collection of underwriting requirements, placement negotiation with carriers, issuance of policy evidence and endorsements, and coordination of renewal submissions and claims support. Producer is not responsible for coverage determinations made by insurers.

Policy Information — ACORD-style Schedule

Carrier:     Policy No.:

Effective Date:     Expiration Date:

Coverages Requested

Payment Terms

Client shall pay Producer the fees set forth below for services rendered. Fees are earned when services are performed and are non-refundable except as expressly provided in this Agreement.

Payments are due within days of invoice. Late payments shall incur interest at the rate of per month (or the maximum allowed by law), plus collection costs.

Term and Termination

This Agreement shall commence on and shall continue until unless earlier terminated in accordance with this section.

Either party may terminate this Agreement without cause by providing the other party with days' prior written notice. Either party may terminate for material breach if the breach is not cured within 15 days after written notice specifying the breach. Termination does not relieve Client of obligation to pay fees earned through the effective date of termination.

Confidentiality

Each party shall keep confidential all non-public business, financial and personal information (including insured data and underwriting materials) received from the other party in connection with this Agreement and shall use such information solely for performance under this Agreement. Confidential information shall not include information that is or becomes publicly available other than by breach of this Agreement, or that is rightfully obtained from a third party without restriction. The obligations of confidentiality survive termination for a period of three (3) years.

Insurance, Indemnity and Warranties

Producer represents that it maintains professional errors and omissions insurance and general commercial liability insurance in amounts appropriate to its operations. Producer shall indemnify and hold harmless Client from third-party claims arising out of Producer's gross negligence or willful misconduct in performing services under this Agreement. Client shall indemnify Producer for claims arising from Client's misrepresentations to carriers or Client's failure to disclose material information.

Governing Law and Jurisdiction

This Agreement shall be governed by and construed in accordance with the laws of the State of , without regard to conflict of law principles. The parties submit to the exclusive jurisdiction of the state and federal courts located in that State for any dispute arising out of or relating to this Agreement.

Entire Agreement; Amendment

This Agreement, together with any schedules and exhibits executed by the parties, constitutes the entire agreement between the parties with respect to its subject matter and supersedes all prior and contemporaneous agreements, representations and understandings. Any amendment must be in writing and signed by both parties.

Notices

Notices required under this Agreement shall be in writing and delivered to the contact information set forth above or to such other address as a party designates in writing. Notice is effective upon receipt.

Acknowledgment

The parties acknowledge that they have read and understand this Agreement, that they have the authority to enter into this Agreement, and that they executed this Agreement voluntarily.

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