Complete the application below for firm terms.
The quote you receive after submitting the application to underwriting will not bind coverage until you submit an online request to bind.

United Farmers Agents Association
Insurance Agents Professional Liability Application
Insurance Agents Errors and Omissions*

1
Quick Quote
2
Application
3
Bind Request
AGENCY:
Kevin Dahlke Insurance Brokerage, Inc.
COVERAGE:
Insurance Agents Errors and Omissions
Premiums below are an indication only and subject to change with a completed application.

LIMIT OF COVERAGE AND ESTIMATED PREMIUM AMOUNT:

Limits of Coverage Annual Policy Premium Monthly Premium Estimated Down Payment
$1M / $2M $2,874 $222 $709
$2M / $2M $4,459 $350 $1,002
$3M / $3M $5,128 $404 $1,126
$4M / $4M $5,487 $433 $1,192
$5M / $5M $5,908 $467 $1,270
Active Farmers agents who are NOT association memberS: add $26 to the down payment and $13 to each monthly payment.