(Please note: If you are already doing business with Burns & Wilcox Brokerage or Burns & Wilcox you do not need to apply again. If you are looking to receive login information, please contact your producer.)

Burns & Wilcox is dedicated to working with agents with integrity, and an excellent record of service. We enjoy innovation and flexibility. We are strong partners with reliable insurance carriers and together we promise to have competitive pricing and fair claims handling.

Before you can become a credentialed Burns & Wilcox Brokerage agent, you must first complete the following forms and attach them to your Burns & Wilcox Brokerage Appointment Application.

Download: Producer Agreement Form

Download: W-9 Form

New agents are also required to attach the following documents to the Burns & Wilcox Brokerage Appointment Application.

  • Licenses for all states
  • Agency E&O policy
  • Employee directory (including name, position and e-mail address)
  • Agency brochure (if available)

Download: Burns & Wilcox Appointment Application

Thank you for taking the time to apply for an Appointment with Burns & Wilcox Brokerage. Please submit your completed Burns & Wilcox Brokerage Appointment Application and all supporting documents to:

BWBAppointment@Burns-Wilcox.com