Become a Producer
To become a new Keller & Co. Producer:
1) Click on the Broker Agreement Packet below for your state
2) Fill in the forms completely and print a copy
3) Sign the forms and fax or email to Keller & Co. with the required attachments
FAX COMPLETED FORMS TO: (716) 874-4920 or EMAIL TO: marketing@kellerandco.com
Questions? Call or Email:
Andrew Coric
Ext. 229
Commercial Lines Assistant Manager
John T. Barton, Vice President
Ext. 241Commercial & Personal Lines Manager, Market & Producer Relations
Broker Agreement Packet - New York - (Fillable PDF)
Broker Agreement Packet - Pennsylvania - (Fillable PDF)
Broker Application - Commercial/Personal Lines - (Fillable PDF)
Broker Application - Motorcycle - (Fillable PDF)
FAX / EMAIL CONSENT FORM
Broker Agreement Packet - Pennsylvania - (Fillable PDF)
Broker Application - Commercial/Personal Lines - (Fillable PDF)
Broker Application - Motorcycle - (Fillable PDF)
FAX / EMAIL CONSENT FORM