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1229 S G Ave Bldg A, Nevada, IA 50201 Mon-Fri 8-5 515-382-2389

Equipoise & Finance Professionals

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Agency Quote

Agency Quote

TAKE EQP!’S ONLINE SURVEY BELOW – Please review the questions below, and the applicable supporting reports needed, prior to starting the survey.

1) Agency Information

Contact Name

Agency Name

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Email

Phone

2) Do You Use/Are Scheduled To Convert To Applied Systems Agency MGT Software?

Converting to MGT Software, Yes or No?(Required)

Yes

No

Which One?

Please Choose An Option

Unfortunately, we do not support other management systems at this time. Thank you for visiting our website!

3) Do You Use A Third Party Document Management System (i.e. Paperwise or ETFile)?

Document Management Software, Yes or No?(Required)

Yes

No

4) What Is Your System Structure?

Are You In A Trust State?

Yes

No

Does Your Agency Utilize System Activites?

Yes

No

# Of Agencies

# Of Branches

# Of Departments

# Of Profit Centers

# Of Employees

5) General Financial Information

What Is Your Annual Commission Income By Line? (Verified By Management System Income Statement) - Please Do Not Include Contingency/bonus Income

Commercial Income (Annual)

Agency Bill (%)

Please enter a number from 1 to 100.

Direct Bill (%)

Please enter a number from 1 to 100.

Personal Income (Annual)

Agency Bill (%)

Please enter a number from 1 to 100.

Direct Bill (%)

Please enter a number from 1 to 100.

Life & Health Income (Annual)

Agency Bill (%)

Direct Bill (%)

Mpci & Hail Income (Annual)

Agency Bill (%)

Please enter a number from 1 to 100.

Direct Bill (%)

Please enter a number from 1 to 100.

Total Commission Income From Above:

Full Accounting Services Are Not Available For An Agency Of Your Size. However, We Would Be Happy To Discuss Special Project Opportunities And Our Availability.

6) General Transaction Information

Average Monthly Transaction Count For Direct Bill Reconciliations (Verified By Management System Production Report)

Direct Bill Downloads

Direct Bill Imports

Direct Bill Manual Entries

Average Monthly Deposit Count For All Cash Journals (Verified By Management System Deposit Register & Monthly Bank Statements)

Monthly Deposits (Average)

Average Monthly Disbursement Count For All Cash Journals (Verified By Management System General Ledger Register & Monthly Bank Statements)

To Vendors – Paper Checks

To Vendors – Electronic / Ach

To Producers And / Or Brokers –paper Checks

7) Which Tasks Would You Like To Outsource? - Optional Section

Only applies if your annual commission is less than $3 million as calculated above. If so, additional fields will appear.

Check All That Apply

Operations

Agency Bill

Direct Bill Record

Producer Payables

Month End *only Available When All Services Are Provided*

Special Project

8) Are You Looking For Year-round Services Or A Project Term?

Check At Least One Or Both

Year – Round

Project Term

9) What Is Your Estimated Start Date?

Date

MM slash DD slash YYYY

10) How Did You Hear About Eqp!?

Message

Consent

By clicking “Submit”, I acknowledge that I have read the EQP! General Privacy Policy and consent to providing this information.

Submitting a quote form, or ‘contact request’, does not create nor does it guarantee a contracted relationship with EQP!

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1229 S G Ave Bldg A, Nevada, IA 50201
Office Hours: Mon-Fri 8-5 CST
(515) 382-2389
info@eqpros.com