Partner With Us

Become a Broker

Join the Chenango Brokers family. Get access to 26+ state markets, admitted and surplus lines carriers, online raters, and real brokerage support from a team that knows how to get submissions bound.

Download Screening Form (PDF)Call 800-403-3738

Market Access

Admitted and surplus lines carriers across 26 states

Fast Turnaround

Get started with real-time online rating tools for faster quoting

Binding Authority

Real binding authority with technical underwriting support

Broker Appointment Application

Complete all sections below. Required fields are marked with *. Your information is kept confidential and used only for appointment consideration.

Agency Information

Agency Name*

Primary Contact*

Phone*

Email*

City

State

ZIP

How did you hear about us?

Years in Business

Number of Locations

Number of Employees

States You Write In

Production Profile

We write Personal Lines

We write Commercial Lines

Total Annual Premium (all lines)

Business Mix & Market Access

Primary Classes of Business

Specializations / Niche Markets

Current Wholesale Partners

Direct Carrier Appointments

Markets You're Seeking

Monthly Submission Volume

Account Types You Handle

Market Types (check all that apply)

Submission Familiarity

ACORD Applications

Carrier Supplemental Applications

SOV (Schedule of Values)

Loss Runs

Additional Comments on Familiarity

Current Challenges & Relationship Fit

Current Challenges (check all that apply)

Opportunities You're Pursuing

What Do You Value in a Wholesale Partner? (check all that apply)

Why Would This Be a Mutual Fit?

Timeline for Appointment

Document Uploads

Upload your documents below. License and E&O are required. You can also download the screening form PDF and upload the completed version.

License*

Click to upload

E&O Insurance*

Click to upload

Broker Appointment Application

Click to upload

W-9

Click to upload

Commission Form

Click to upload

Schedule an Introductory Call

Pick a preferred date and time for our team to call you back and discuss your application.

Preferred Date

Preferred Time

Your information is kept confidential and used only for appointment consideration.