Diligent Search Report - Landy Insurance Page 2
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1
2(B) If search was performed by someone
other
than the person named on line 1, please provide full
name of that individual:
7.
(A) Was the risk described in Section 2 submitted by you or by someone under your supervision to at least (3)
insurers that are admitted in California
and
who actually write the type of insurance described on
lines 2(C) and 2(E)?
(CHECK ONE)
YES
NO
(B) If
YES,
please complete
ALL
sections of the following table; if
NO,
skip to Section 8:
Full Name of Admitted Company
First & Last Name of Company
Check if
Month, Year
Declination
Representative AND Telephone
Employee (E)
of Declination
code*
Number
or Agent (A)
1.
E ( )
(
)
-
/
A ( )
or
"Online Declination"
Website
2.
E ( )
(
)
-
/
or
"Online Declination"
A ( )
Website
3.
E ( )
(
)
-
/
or
"Online Declination"
A ( )
Website
*Declination Codes: 1 -
Company's capacity reached
2 -
underwriting reason
3 -
refused to state
4 -
other
8.
If 7(A) was answered NO, complete the following:
(A) Did you determine that fewer than 3 admitted insurers actually write the type of insurance described
on lines 2(C) and 2(E)?
(CHECK ONE)
YES
NO
(B) If
NO,
please explain in detail why the risk was submitted to
less than three
less than three
admitted insurers in
California that write this type of insurance.
(C) If
YES,
please describe how you made this determination.
The undesigned licensee hereby certifies that this report is true and correct, and that this risk is not being placed with a non-
admitted insurer for the sole purpose of securing a rate or premium lower than the lowest rate or premium available from an
admitted insurer.
(Signature of Licensee Named on Line 1)
(Date)
SL-2(Revised 06/2004)
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