Become an Agent

We’re excited to learn of your interest to partner with us.

Before we begin placing business together your agency must complete the steps listed below. To access our services, you must be a licensed insurance agent/producer in your state of domicile and licensed in the state the business to be insured is located. If at any time you have questions, please contact us at (847) 705-5805 or E-mail us at

  1. Complete Agency Profile
  2. Complete Producer Agreement
  3. Complete W-9 Form
  4. Provide a copy of your Agency’s Producer’s License(s)
  5. Provide a copy of your Agency’s E&O Policy showing limits and policy period

Completed documentation and copies may be E-mailed or Faxed (847) 705-5808

Thank you for your interest and we look forward to hearing from you soon!


  • application downloads image
  • Navigate



  • Active Members in Surplus Lines Industry Organizations

    American Association of Managing General Agents


    National Association of Professional Surplus Lines Offices, Ltd.

  • Customer Service

    Phone: 847.705.5805
    Fax: 847.705.5808

    Office Hours:
    Monday - Friday : 8am to 5pm CST

Copyright © 2011 The Jack Nebel Companies. All rights reserved.       Tel: 847.705.5805   Fax: 847.705.5808     101 S Wynstone Park Dr., No. Barrington, IL 60010