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American Millennium Insurance Company (AMIC)
Home
Products
Taxis & Limousines
Trucking
General Liability
Where we do business
Claims
Claims Reporting Form
Underwriting
Accident Checklist
New Opportunities
Contact Us
Management Team
Full Personnel List
Office Locations
New Opportunities
Home
New Opportunities Form
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(required)
Contact Title
Agency/Company Name
(required)
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(required)
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(required)
State
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(required)
Phone
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Email address
(required)
Primary Location of Program
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Policy Limits
Type of Program (check all that apply)
Trucking
Taxi
Limo
General Liability
WC
Other
If other, please enter type
Coverage Types (check all that apply)
Full coverage
Liability only
Physical damage
Cargo
Other
Current or New Opportunity/Program
Current or New Opportunity/Program
Existing Program
New Opportunity
Age of Current Program
Loss History
Claims Handling
AMIC
TPA
Policy Issuance
AMIC
MGA
Other
If other, please enter
Policy Management System Used
Distribution System Used
Filings Needed
Projected Value of Opportunity
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