The following form is provided to you for making changes or requests on your existing policies. By submitting this form you understand that no coverage or premium adjustment of any kind is bound until you receive written notice from us.
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Insurance products are offered through the following insurers: The Travelers Indemnity Company (Hartford, CT); Encompass (Chicago, IL); Bolt Access (Irvine, CA); The Progressive Corporation (Mayfield Village, OH); Safeco Insurance Company of America (Boston, MA); National General Insurance Company (Winston-Salem, NC); Main Street America (Keene, NH); Mid-Hudson Co-Operative (MHC) (Montgomery, NY); Mercury Insurance (Santa Ana, CA); and other unaffiliated insurers.
Insurance services are provided by an independent insurance agency. Bermudez Insurance Agency and its producers are licensed in the states where services are offered. License numbers are available upon request. Availability, eligibility, and coverages may vary by state. Not all products are available in all states.
