Home Premium Payment – The Agency Network LLC

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Agency Information

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Payment Information

For the convenience of our clients, we have partnered with The Agency Network, LLC, a third-party Billing Agent who specifically operates with credit card payments and collections for the Insurance Industry. No refunds are given unless required by law.

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Attestation and eSignature

The Agency Network, LLC is a third-party Billing Agent. No refunds are given unless required by law.

Attestation *

The Undersigned allows The Agency Network, LLC to act as a third party Billing Agent on behalf of the named Agency to collect the specified Premium Payment. All Premiums generated by the Agency shall be earned, in their entirety, upon the production of such services. At NO time after the execution of such services provided shall the premium(s) enumerated become refundable unless otherwise denoted by the respective state laws governing such transaction.

eSignature *

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