Please note that submitting the request does not guarantee appointment with UPC Insurance.

Appointment type requested

UPC Insurance is currently not accepting appointments for agents located in Broward, Collier, Hillsborough, Lee, Miami-Dade, Orange, Osceola, Palm Beach, Pinellas, and Seminole counties.
Select company/companies with whom you are interested in an appointment

UPC Insurance Commercial Residential Lines appointments are currently available only in Florida.

Agency profile
Does your agency have a DBA name that differs from the legal name?

Agency principal name
Primary contact information same as agency principal?

Primary contact name
Have you ever been contracted with UPC Insurance?

Have you ever been contracted with Interboro Insurance?

Are or were you a captive agency?

Is your agency part of

Are you a member of any insurance associations?

Written premium distribution
Would the agency consider a Flood rollover?

Names of licensed commercial habitational producers
Upload your agency premium and profitability reports - New York

This field is required

Upload your agency premium and profitablity reports - Florida

This field is required

Are you a new agency without an established book of business?

List your top 3 homeowner's insurance carriers

If you are a new agency, please enter 0.

List your top 3 NEW BUSINESS Homeowner's insurance carriers

If you are a new agency, please enter 0.

List your top 3 Commercial Residential insurance carriers

If you are a new agency, please enter 0.

List your top 3 NEW BUSINESS Commercial Residential insurance carriers

If you are a new agency, please enter 0.

Mark top 3 sources of your leads