Broker Appointment

Contractors Managing General Insurance Agency, Inc. is the Managing General Underwriter (MGU) for National Contractors Insurance Company, Inc., A Risk Retention Group (NCIC).

The following documents along with Brokers Agreement will be required to become appointed to represent the programs offered though CMGIA:

1. W-9
2. Current copy of your License
3. Current E & O Verification
4. Current copy of your firms brokers bond

Please be advised, Part II: Certification on the W-9 form requires that you certify the taxpayer identification number you show on this form to be accurate. In the event you provide inaccurate information you may be subject to a monetary penalty charge. This monetary penalty charge will be the same amount as the Fine that is imposed on Contractor Managing General Insurance Agency, Inc. by the IRS when inaccurate information is supplied.

If your agency has separate offices that would like to be appointed with Contractor Managing General Insurance Agency, Inc. and/or is already appointed with our firm, please indicate on the enclosed Agreement or separate sheet of paper.

20350 VENTURA BLVD, SUITE 205 WOODLAND HILLS, CA 91364
Telephone Number: 866-363- CMGA (2642) FAX Number: 866-234-0415