Become an Appointed Broker With Blink

Thank you for your interest in partnering with Blink Specialty Insurance Services. To be considered for appointment,
please download and complete the required documents below, then upload everything using the Appointment Application form.

Step 1: Download & Complete the Required Documents

Please download and fully complete the following items:

  • Completed and signed Producer Agreement
  • Fully completed Producer Appointment Questionnaire
  • Completed W-9 Form
  • Copies of licenses for all states you currently write business in
  • Copy of your E&O Declarations page

Please ensure all documents are completed and signed where required before uploading. Incomplete submissions may delay review.

Step 2: Upload & Submit Your Application

Once your documents are ready, upload them using the Appointment Application form below.
Your submission will be emailed to our team for review, and we’ll reach out if anything additional is needed.

Appointment Application

List all owners of the entity (partners, officers, etc)

date established, marketing efforts, branches, ets.

List all the Brokers, Solicitors, Producers, Sales Persons, etc., who are placing business through the Brokerage/ Agency

Provide names of the current Agencies and Insurance Carriers you place business with

Percentage of the gross income that originates from these lines of business

Bank References

Click or drag a file to this area to upload.

Please sign and submit the documents below with your appointment application.

Please sign and submit the documents below with your appointment application.