Shoemaker and Besser Associates, Inc.
 
  USER ACCESS FORM
 
is American Reliable's new automated quote, issurance and policy maintenance system. This new system offers the same ease of use as our Web rater but offers enhanced fetures including:
  • Quick Quote
  • Policy issuance with a single key stroke
  • Multiple payment options
  • Credit card payments
  • Ability to initiate Endorsements and Cancellations
  • Billing and payment inquiry
  • Paper applications are no longer needed
Signing up is quick and easy. Complete the form below for each person who will be accessing this new system.
Change Profile New Profile   *Indicates a required field
     
*Agency Name:
  
*Agency Code with Shoemaker and Besser Associates:
  
DBA (if applicable):
  
*Agency Street Address:
  
*Agency City, State, Zip:
  
*Agency Phone Number:
  
Agency Email (if applicable):
  
     
*User First Name:
  
*User Last Name:
  
User Email (if applicable):
  
*User Phone Number:
   Extension:
*User Fax Number:
  
     
*New/Changed Access Requested By:
  
Requestor Phone Number:
   Extension:
Notes: