FORMS

Broker of Record Change Request
    (Copy this page onto your company letterhead and fax or mail it to DSIS)

General Insurance Application Checklist
    (Use this form to gather most of the information necessary to get an Insurance Quote)

Workers'Compensation Insurance Application Checklist
    (Use this form to gather most of the information necessary to get an Insurance Quote)

Insurance Change Request
    (Use this form to Add/Remove Vehicle, request change in coverage, etc.)

What Insurance Should My Business Have
    (Excerpt from an article be the "Insurance Information Institute")

Please note that completion of the following request for information does not constitute the purchase of insurance. No coverage may be added, changed or bound as a result of submitting this request for information or quotation of insurance. All coverage must be confirmed by the agency in writing subject to an acceptable signed application meeting the underwriting guidelines of the Insurance Company.

Dynamic Solutions Insurance Services is licensed in the state of California. No solicitation of insurance is being made outside of this state.