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Personal Lines Application

1 of 4

What would you like to quote?

Homeowners(Required)
Collections(Required)

Collections

Fill any applicable columns.

Itemized
Jewelry
Fine Arts
Fur
Silver
Wine
Guns
Collections
Other
No. of Items
Jewelry
Fine Arts
Fur
Silver
Wine
Guns
Collections
Other
Blanket
Jewelry
Fine Arts
Fur
Silver
Wine
Guns
Collections
Other
Umbrella(Required)

Umbrella

Fill any applicable fields.

EPLI
Not For Profit D&O
Auto(Required)

Auto

Driver(Required)
Driver Name
Date of Birth
License Number
State
Usage
 

Vehicles

Fill one row for each vehicle.

Vehicle(Required)
Year
Make/Model
Value of Vehicle
VN#
State
Assigned To
 

Drivers

Fill one row for each driver.

Show MVR/CLUE?

MVR/CLUE:

MVR/CLUE
Type
Date
Driver
Details
 

General Information

Homeowners

Has the current policy been cancelled, non-renewed or is location for sale?
Is this a new purchase?
Is this the same location as listed above?(Required)

Rentals

LLC/Trust

Is home owned in an LLC or trust?

Personal Lines Application

2 of 4

Pool/Hot Tub(Required)
Losses within last 5 years

Losses

Losses(Required)
Date of Loss
Type of Loss
Details
Amount Paid
Open? (Yes/No)
 

Coverage Amounts

Homeowner Credits (check all that apply)

Homeowner Credits

Fire Protection

Fire Protection

Personal Lines Application

3 of 4

Wind Mitigation Credits(Required)
Reinforced Concrete Roof Deck(Required)
SWR(Required)

Personal Lines Application

4 of 4

Drop files here or
Accepted file types: doc, docx, pdf, Max. file size: 50 MB.

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    Small Commercial
    Insurance

    Florist Insurance

    Target Markets (under $20k premium)

    View Carrier Listing

    Class of Business (Not all Inclusive)

    Artisan/Trade Contractors (NO GC's)
    Auto Repair/Garages
    Bakeries
    Beauty Salons/Barber Shops
    Builder's Risk - Commercial & Residential
    Delicatessens
    Distributors/Wholesalers
    Doctors/Physicians Offices
    Electrical Contractors
    Florists
    Landscape/Lawn Maintenance
    Law Firms (excluding Professional)
    Lessors Risk — Building Owners
    Manufacturers
    Offices
    Restaurants
    Retail / Stores / Chains
    Religious Institutions
    Shopping Centers
    Technology

    Lines of Business

    Auto
    Bonds
    BOP
    Builder's Risk
    Equipment Breakdown (Monoline or Package)
    Excess GL/Auto/Property/Flood
    Flood
    General Liability (Monoline or Package)
    Inland Marine (Monoline or Package)
    Liquor Liability (Monoline or Package)
    Professional Liability incl. Mgmt. Liability/Cyber/D&O/E&O/Fiduciary/Crime
    Umbrella (Monoline or Package)
    Workers' Compensation

    Halcyon Underwriters Business Development Manager can provide you with more details on the Commercial Lines Department. Please e-mail our marketing department at [email protected].

    Middle Market
    Insurance

    Target Markets (under $20k premium)

    View Carrier Listing

    Class of Business (Not all Inclusive)

    Artisan/Trade Contractors
    Banks / Financial Institutions
    Builder’s Risk — Lessors Risk — Building Owners
    Country Clubs / Golf Courses
    Distributors / Wholesalers
    Electrical Contractors
    Food Distributors
    General Contractors
    Heating & A/C Contractors
    Hospitals

    Landscape/Lawn Maintenance
    Law Firms (excluding Professional)
    Lessors Risk — Building Owners
    Manufacturers
    Offices
    Restaurants
    Retail / Stores / Chains
    Religious Institutions
    Shopping Centers
    Technology

    Lines of Business

    Auto (Monoline or as Fleet)
    Bonds
    Builders Risk
    Earthquake / DIC
    Equipment Breakdown (Monoline or Package)
    Excess GL / Auto / Property / Flood
    Flood
    General Liability (Monoline or Package)
    Inland Marine (Monoline or Package)
    Liquor Liability (Monoline or Package)
    Products Liability
    Professional Liability including Management Liability / Cyber / D&O / E&O / Fiduciary / Crime
    Property (Monoline or Package)
    Railroad Protective Liability
    Umbrella (Monoline or Package)
    Workers Compensation (Monoline or Package)

    Halcyon Underwriters Business Development Manager can provide you with more details on the Commercial Lines Department. Please e-mail our marketing department at [email protected].

     

    Success Lists

    The Halcyon Success Lists is a small sampling of our monthly new business production in each department. Please contact us if you have any questions at [email protected]

    • Middle Markets
    • Small Business
    • Personal Lines
    Middle Markets

     

    2026
    Year to Date
    2025
    Year to Date
    2024
    Year to Date
    2023
    Year to Date
    2022
    Year to Date
    2021
    Year to Date
    2020
    Year to Date
    2019
    Year to Date
    2018
    Year to Date

    Small Business

    2024
    Year to Date
    2023
    Year to Date
    2022
    Year to Date
    2021
    Year to Date
    2020
    Year to Date

    Personal Lines

    2024
    Year to Date

    Supplemental
    Forms

     Broker of Record – Letter of Assignment
     Named Insured Chart
     LRO Supplemental Application
     No Known Loss Certification
     Builder’s Risk Application

    International Partners

    Auto Trends

    • Travelers – 2022 Auto Trends
    • Chubb – 2022 Auto Trends

    Training On Demand

    Halcyon Workshop: How to Quote Cyber?

    Payment Address

    Halcyon Underwriters’ Lockbox:
    Bridge Specialty Group – SE Region
    PO Box 931978
    Atlanta, GA 31193-1978

     

    Overnight Payment Address

    Lockbox Services 931978
    Attn: Bridge Specialty Group – SE Region
    3585 Atlanta Avenue
    Hapeville GA 30354-1705

    Upcoming Events

    There are no current upcoming events, please check back soon.

    Insurance Journal

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    FAQS

    HOW DO I UPDATE MY EFT AND DIRECT DEPOSIT INFORMATION?

    Download the Bridge Specialty Group (BSG) ACH authorization form:
    https://halcyonuw.com/ach-payment-authorization-for-insurance-commission-2/ 

    Send to the BSG Accounting Team:
    Tyler Christie, Account Receivable Lead: [email protected]

    HOW DO I OBTAIN THE PRODUCER CODE FOR OUR AGENCY LOCATION?

    Send an email to [email protected].

      HOW CAN I UPDATE MY AGENCY CONTACT INFORMATION?

      Send an email to [email protected] and give us all your new contact information.

      Consider whether the update should include the primary agency contact with email address AND/OR an updated accounting contact name with email address.  

      PAYMENT INSTRUCTIONS:

      Epay:
      https://bridgesoutheast.epaypolicy.com/ 

      Lockbox Payments:
      Bridge Specialty Group – SE Region
      PO Box 931978
      Atlanta, GA 31193-1978

      Overnight Payments:
      Lockbox Services 931978
      ATTN: Bridge Specialty Group – SE Region
      3585 Atlanta Avenue
      Hapeville, GA 30354-1978

       

      WHEN ARE COMMISSIONS PAID?
      Commissions are deposited on the 10th business day of each month.
      If you have any accounting questions, please email us at [email protected].

      Claims

      Reporting


      If you have any problems or concerns please contact Halcyon Underwriters.

      Report A Claim

      AIG: To inquire about a U.S. claim: (877) 802-5246
      Report A Claim
      AIG Private Client Group - Personal Lines
      Report A Claim

      Fireman’s Fund Insurance Company is now integrated into Allianz Global Corporate & Specialty (AGCS). This consolidation means that current Fireman’s Fund policyholders and their brokers will benefit from the same focused insurance offerings, but with the added bonus of Allianz’s global reach and infrastructure.
      Update: Eff 4/1/17 - Fireman's Fund Personal Lines Inquiries number to call is (800) 945-7461. Email Inquiries effective 4/1/17 will be [email protected] for any former fireman's fund policy.
      Allianz Key Contact Information
      To report a New Claim: [email protected]
      Or call: 1-888-347-3428
      All other claims services: 1-800-870-8857
      Report A Claim

      Report A Claim
      Business Auto Claim: Call 1-800-897-4865

      Report A Claim

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      For claims information or to file a claim contact Braishfield
      Phone: (888) 335-6615
      Email: [email protected]
      Report A Claim
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      Report A Claim:
      Email Reporting: [email protected]
      First Notices Phone: (803) 735-0672
      First Notices Fax: (855) 285-1165
      Report A Claim

      Coterie

      Report A Claim
      Report A Claim
      Email: [email protected]
      Peninsula Insurance Bureau
      2842 Lent Road
      Apopka, Florida 32712

      Phone: (407) 880-1100
      Fax: (407) 880-1102
      Email: [email protected]
      Dual Flood & Home
      Report A Claim
      Report A Claim
      Report A Claim

      Fireman's Fund is now part of Allianz Global.

      Please select "Allianz Global Corporate & Specialty" to file a claim.

      FFVA Mutual Logo
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      Claims Hotline: (888) 639-2567
      Fax: (570) 825-0611
      Email: [email protected]
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      Phone: (800) 466-9165
      Fax: (201) 729-1010
      Email: [email protected]
      Report A Claim

      Report A Claim
      Report A Claim
      For your claim reporting needs, you can report your claim by phone by calling (800) 362-0000. You can also email the loss notice to: [email protected] or fax it to (800) 329-3297
      Once the claim is reported, please send any correspondence related to this claim, with reference to the claim number by mail, email or fax to be added to our claim file:

      Mail: PO Box 515097 Los Angeles, CA 90051
      Email: [email protected]
      Fax: (888) 268-8840
      Report A Claim
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      For your claim reporting needs, please contact Kathy Souhlaris at [email protected]
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      Phone: (914) 381-4286
      Email: [email protected]
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      Safeco Claims Contact Center - Call Directly at (800) 332-3226 to report a claim 24 hours/7 days a week.
      Report A Claim
      Fax: (770) 836-8563
      Email: [email protected]
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      Claims

      Phone: 1.855.782.7725
      Email: [email protected]
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      Phone: (888) 480-1853
      Fax: (888) 551-2982
      Email: [email protected]
      Real Estate Professional
      Report A Claim
      Cyber
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      Architects & Engineers
      Report A Claim
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      Newsletters

      • Previous Years
      2021
      First Quarter
      Second Quarter
      Third Quarter
      Fourth Quarter
      2020
      First Quarter
      Second Quarter
      Third Quarter
      Fourth Quarter

      Personal Lines

      Guidlines/Forms

      Surplus Lines Diligent Effort Form
      Supplemental Named Insured Questionnaire

      Guidelines

      AIG Guidelines Current

      Marketing - Auto

      AIG Auto Experience a Difference
      Auto Brochure
      Auto Coverage Summary
      Auto Packet
      Cash Settlement Brochure

      Marketing - Equipment Breakdown

      AIG Equipment Breakdown Coverage Summary

      Marketing - Excess

      AIG Excess
      AIG Personal Excess Coverage Summary

      Marketing - Home

      AIG Home Credits List
      AIG Homeowners Coverage Summary
      AIG Homeowners
      AIG PCGHomeowners
      Fraud Brochure
      Fraud
      Household Safeguard Brochure

      Marketing - Misc.

      AIG PCGPrivate Collections Brochure
      Claims Service

      Questionnaires

      Equine Questionnaire
      FL PIP Form
      PCHO – SHC FL (11-10) Sinkhole Coverage Extension Florida
      PCHO – WHC (8-00) Wind or Hail Exclusion
      PEL FL UM Select-Reject Form
      Request to Exclude Contents Coverage
      Request to Exclude Windstorm and Hail Coverage
      UM Form
      Work Comp App

      Misc.

      Understanding Our Yacht Wind Strategy

      Guidelines

      Chubb - Florida Wind Strategy
      Flood Eligibility Guidelines
      Lead With Chubb
      Why Chubb
      Chubb – Market Trends 2022: Key Facts
      Chubb – Market Trends 2022: Action Sheet

      Marketing - Auto

      Chubb – Auto Trends
      Chubb – Auto Comparison
      Chubb – Auto Testimonial
      Chubb - Auto Top 10
      Chubb - Auto
      Chubb – Young Drivers
      Chubb – Auto Testimonial 2
      Chubb – Collector Car Testimonial
      Chubb Mobile App

      Marketing - Cyber

      Chubb Cyber Solutions

      Marketing - Employment Practices

      EPLI FAQ’s
      EPLI

      Marketing - Equipment Breakdown

      Chubb – Equipment Breakdown Brochure

      Marketing - Excess Liability

      Chubb – Excess Marketing
      Chubb – Excess Sell Sheet

      Marketing - Flood

      Chubb – Benefits of Chubb Flood vs NFIP Brochures
      Chubb Excess Flood FAQ
      FL Chubb Excess Flood Application 16
      FL Chubb Primary Flood Application 16

      Marketing - Homeowners

      Chubb – Comparison
      2022 Construction Costs
      Chubb – HO Testimonial
      Chubb – HO Testimonial 2
      Chubb – HO Testimonial 3
      Chubb – HO Top Ten
      Homeowners - Marketing
      Homeowners - Heat Sensors FAQ

      Marketing - Passport 360

      Chubb – Passport 360 E Brochure
      Chubb – Passport 360 Agent FAQ
      Passport Options

      Marketing - Valuable Articles

      Chubb – VAC

      Marketing - Yacht/Watercraft

      Chubb – Boaters: Coming Out of Lay-Up Guide

      Misc.

      Account Bill – FAQ
      ADT Custom Home Services
      Family Protection
      Chubb – HO Credits
      Fire Claims - Case Studies

      Supplementals

      California Location Check Request Template
      Chubb Flood Excess App
      Chubb Flood Primary App
      Chubb UM Form
      Chubb UM Form – Excess
      Chubb VA Profile
      EPLI Questionnaire
      No Loss Letter
      Passport Enrollment Form

      Caribbean Homeowners

      Caribbean Homeowners Application Form

      Flood

      DUAL Private Primary Flood Program
      DUAL Excess Flood Application
      Flood Policy

      Yacht

      Dual High Value Yacht App
      Dual Recreational Vessel App
      Yachts Marketing Sheet

      Forms

      Blank PIP Form
      Blank UM Form

      Misc.

      Homeowners Quick Reference Guide

      Forms

      Safeco Watercraft Quick Quote Form
      UM Form w NS Form
      XS UM Rejection Form
      Safeco Classic Car Quote Form
      Safeco Motorcycle Quote Form
      Safeco RV Quote Form
      Safeco Watercraft Quote Application

      Guidelines

      Auto Guidelines
      Motorcycle Guidelines
      Umbrella Guidelines
      Watercraft Guidelines

      PMT Forms

      EFT Form
      Safeco CC Form

      Misc.

      Loss of Use Coverage
      Mobile App with Claim Capabilities
      New Express Estimating
      Right Track FAQ’s
      Roadside Assistance
      Safeco Coverage Levels
      New Digital Enhancements Drive Results
      Safeco Specialty Products
      Safeco Specialty Essentials
      A Tale of Two Classic Cars

      Forms

      TIC EFT Enrollment
      TIC RCC Form
      Travelers UM Form
      XS UM Form

      Marketing - Auto

      2022 Auto Trends

      Marketing - Home

      2022 Home Trends

      Guidelines

      Auto Guidelines
      Umbrella Guidelines

      Misc.

      Access your Travelers account with MyTravelers®
      Discounts Quantum 2.0
      Roadside vs Premier Roadside Assistance

      Staff Directory

      Adele Brennan
        Personal Lines Director
        Personal Lines
        [email protected]
        (978) 548-3763
      Allison Shaievitz
        Operations Representative
        Personal Lines
        [email protected]
        (305) 728-7796
      Andrea Boswell
        Operations Assistant / Receptionist
        Marketing & Operations
        [email protected]
        (321) 587-4271
      Augusta Godinho - Team Leader
        Sr. Production Underwriter/VP
        Middle Market (Augusta's Team)
        [email protected]
        (407) 660-5905
      Brian Polino - Team Leader
        Managing Director/EVP
        Middle Market (Brian's Team)
        [email protected]
        (321) 527-2198
      Brittany Pearson
        Accounting & Finance Associate
        Accounting
        [email protected]
        (321) 527-2189
      Chelsea Thoms - Team Leader
        Production Underwriter
        Middle Market (Chelsea's Team)
        [email protected]
        (321) 587-4264
      Cindy Kelly
        Operations Supervisor
        Personal Lines
        [email protected]
        (978) 548-3757
      Cindy Smith - Division Leader
        Operations Leader
        Marketing & Operations
        [email protected]
        (321) 527-2180
      Cinnamon Sanjurjo
        Assistant Underwriter
        Personal Lines
        [email protected]
        (321) 587-4276
      Deidre Barnecott
        Assistant Underwriter (E-K)
        Middle Market (Brian's Team)
        [email protected]
        (321) 587-4275
      Deirdre Sanford - Division Leader
        Small Business Leader / VP
        Small Business
        [email protected]
        (407) 660-5901
      Devin Osborne - Team Leader
        Production Underwriter
        Middle Market (Devin's Team)
        [email protected]
        (321) 527-2196
      Elizabeth Woods
        Assistant Underwriter (R-Z)
        Small Business
        [email protected]
        (407) 660-5917
      Erin McKenna
        Account Manager
        Personal Lines
        [email protected]
        (978) 548-3768
      Eva Cruzada
        Sr. Assistant Underwriter
        Middle Market (Paul's Team)
        [email protected]
        (407) 660-5908
      Felisa Deutscher
        Assistant Account Manager
        Personal Lines
        [email protected]
        (978) 743-7301
      Francis Willmore
        Assistant Underwriter (L-Q)
        Middle Market (Brian's Team)
        [email protected]
        (321) 527-2182
      Greg Costas
        Operations Representative
        Personal Lines
        [email protected]
        (772) 257-7994
      Gunter Munoz
        Assistant Underwriter (Renewals F-O)
        Middle Market (Augusta's Team)
        [email protected]
        (321) 587-4281
      Heleina Correa
        Sr. Assistant Underwriter
        Middle Market (Devin's Team)
        [email protected]
        (321) 527-2185
      Jennifer Eick
        Asst. Production Underwriter
        Small Business
        [email protected]
        (321) 527-2193
      Jenny Piccard
        Assistant Underwriter
        Personal Lines
        [email protected]
        (407) 215-4796
      Jill Biega - Division Leader
        Accounting & Finance Leader
        Accounting
        [email protected]
        (407) 660-5904
      Juliana Losardo
        Sr. Assistant Underwriter (Renewals P-Z)
        Middle Market (Augusta's Team)
        [email protected]
        (407) 660-5914
      Katey Andrews
        Assistant Underwriter (D-J)
        Small Business
        [email protected]
        (321) 587-4279
      Kara Carrier
        Account Manager
        Personal Lines
        [email protected]
        (772) 226-5546
      Kyle Cogburn
        Assistant Underwriter (#'s, A-D)
        Middle Market (Brian's Team)
        [email protected]
        (321) 527-2183
      Larissa Shakespeare
        Asst. Production Underwriter
        Middle Market (Brian's Team)
        [email protected]
        (407) 660-5913
      Laura Ducharme
        Sr. Personal Lines Underwriter
        Personal Lines
        [email protected]
        (321) 527-2195
      Lauren Kovacsik
        Personal Lines Underwriter
        Personal Lines
        [email protected]
        (407) 660-5919
      Lisa Catineau
        Personal Lines Underwriter
        Personal Lines
        [email protected]
        (321) 527-2188
      Luciano Sanfilippo
        Assistant Underwiter (Trainee)
        Middle Market (Brian's Team)
        [email protected]
        (321) 587-4282
      Maday Senespleda
        Sr. Assistant Underwriter (K-Q)
        Small Business
        [email protected]
        (407) 660-9468
      Marisa Jackson
        Sr. Account Manager
        Personal Lines
        [email protected]
        (978) 548-3793
      Michael Carolan
        Business Development Leader
        Marketing & Operations
        [email protected]
        (321) 257-0250
      Noelle Srour
        Assistant Underwriter
        Personal Lines
        [email protected]
        (407) 660-5918
      Paige Shaw
        Sr. Assistant Underwriter (#'s, A-C)
        Small Business
        [email protected]
        (321) 587-4269
      Samadur Rahman
        Financial Operations Review Analyst
        Accounting
        [email protected]
        (407) 215-4790
      Samantha Cardillo
        Assistant Underwriter (#'s, A-L)
        Middle Market (Chelsea's Team)
        [email protected]
        (321) 587-4259
      Sandra Schmidt
        Assistant Underwiter (Trainee)
        Middle Market (Chelsea's Team)
        [email protected]
        (321) 587-4285
      Sarah Cadle - Division Leader
        Personal Lines Leader/VP
        Personal Lines
        [email protected]
        (321)-527-2192
      Stacey Arrendondo
        Account Manager
        Personal Lines
        [email protected]
        (772) 226-5647
      Staci Paro
        Operations Representative
        Personal Lines
        [email protected]
        (978) -548-3747
      Susie Lopez
        Sr. Assistant Underwriter
        Middle Market (Paul's Team)
        [email protected]
        (407) 660-5912
      Susie Lopez
        Sr. Assistant Underwriter (Servicing #'s, A-J)
        Middle Market (Augusta's Team)
        [email protected]
        (407) 660-5912
      Vanessa Diehl
        Assistant Underwriter (R-Z)
        Middle Market (Brian's Team)
        [email protected]
        (407) 660-5900
      Wendy McCoy
        Assistant Underwiter (Servicing K-Z)
        Middle Market (Augusta's Team)
        [email protected]
        (321) 587-4278
      Yedila Pereda
        Sr. Assistant Underwriter (Renewals #'s-E)
        Middle Market (Augusta's Team)
        [email protected]
        (321) 527-2191

      Small Commercial
      Insurance

      Florist Insurance

      Target Markets (under $20k premium)

      View Carrier Listing

      Class of Business (Not all Inclusive)

      Artisan/Trade Contractors (NO GC's)
      Auto Repair/Garages
      Bakeries
      Beauty Salons/Barber Shops
      Builder's Risk - Commercial & Residential
      Delicatessens
      Distributors/Wholesalers
      Doctors/Physicians Offices
      Electrical Contractors
      Florists
      Landscape/Lawn Maintenance
      Law Firms (excluding Professional)
      Lessors Risk — Building Owners
      Manufacturers
      Offices
      Restaurants
      Retail / Stores / Chains
      Religious Institutions
      Shopping Centers
      Technology

      Lines of Business

      Auto
      Bonds
      BOP
      Builder's Risk
      Equipment Breakdown (Monoline or Package)
      Excess GL/Auto/Property/Flood
      Flood
      General Liability (Monoline or Package)
      Inland Marine (Monoline or Package)
      Liquor Liability (Monoline or Package)
      Professional Liability incl. Mgmt. Liability/Cyber/D&O/E&O/Fiduciary/Crime
      Umbrella (Monoline or Package)
      Workers' Compensation

      Halcyon Underwriters Business Development Manager can provide you with more details on the Commercial Lines Department. Please e-mail our marketing department at [email protected].