Dear Producer,

Thank you for your interest in doing business with Evergreen Insurance Managers Inc! 

To be considered for an appointment, the following should be completed:
     1.  Completed Application for Agency Appointment  (click here)
     2.  Copy of current agency license(s)
     3.  Copy of current E&O and E&O umbrella declarations page, if applicable
     4.  Completed Request for Taxpayer Identification Number and Certification (Form W-9)  (click here)

Note:  If you are applying under a business name, that entity must be licensed with the Department of Insurance otherwise you must apply under your personal name.

Please email the above mentioned documents to the attention of Nancy Schultz, nschultz@evergreeninsmgrs.com
Incomplete documents will delay the approval process and be returned to your agency.

For additional information on the appointment process, please contact Nancy Schultz for assistance.

We look forward to working with you!!

Thank you

5293 NE Elam Young Pkwy Ste 160
Hillsboro, Oregon  97124-7563

Tel 503-259-3060
Fax 503-259-3065
Email mail@evergreeninsmgrs.com

2006-2011  Evergreen Insurance Managers Inc

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Territory:
     California
     Idaho
     Oregon
     Washington

 

EVERGREEN INSURANCE MANAGERS INC

 

 
 
 
 
 

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