New Coverholder Agreement

*Coverholder Agreement Name

*Coverholder Name

*Coverholder Domicile

*Pin

*Coverholder Team

*Class Underwriter

*Broker Company Name

*Brokerage %

Enter a percentage between 0 and 100

*Brokerage Calculation

*Type

*Inception Date

*Expiry Date

*Year of Account

Not set, please select inception date

*UMR

*Agreement Number

*Coverholder Commission

*Bordereau Format

Select the format that will be used for bordereau data

Total Capacity: 0%

*Max Advance Inception

Must be a positive number

*Max Policy Period

*Underwriters

*Settlement Currency

*Max Limit in USD

Must be a positive number

*Max Brokerage to Placing Broker

*Maximum Gross Premium Income

Please select at least one product