Submission of this referral form does not waive or amend the terms of my existing producer
agreement with Crump, including but not limited to, any licensing and contracting requirements.
I acknowledge that Crump may accept or reject the submitted referral in its sole and absolute
discretion. Crump shall timely communicate its acceptance or rejection of the referral with me.
I acknowledge that if my referral results in a placed and effective insurance policy through Crump,
then I will receive total compensation in the amount of fifty percent (50%) of the placed case
commissions, payable in accordance with my existing compensation level reflected in Crump’s systems
on a single-case basis when I am licensed in the state of sale.
In consideration of the payable compensation described above, I waive and relinquish any ownership
rights concerning the referral, any policy resulting from the referral and/or entitlement to any
other compensation concerning the referral to Crump.
Successful Submission
Thank you for using Sales Assist – we will take it from here. Next we will:
Your Sales Assist team will keep you informed with periodic status updates. Once the policy is placed in force, you will receive a percent of the placed case commissions, payable in accordance with your existing compensation level reflected in Crump's systems on a single-case basis when you are licensed in the state of sale.
Call your Sales Assist team at 866.417.8376 with any questions.
