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(“Customer”) hereby agrees to receive by electronic mail (e-mail) documents related to insurance policies written through or quoted by Charles J. Sellers & Co., Inc. (“Sellers & Co.”). Documents to be so delivered include but are not limited to insurance policies, policy information and declaration pages, coverage forms, endorsements, binders, certificates and evidences of insurance, automobile insurance identification cards, premium quotations, invoices, premium finance agreements, audit statements, loss control reports, claim reports, and notices of cancellation and non-renewal. This consent applies to all policies written through Sellers & Co.
The Customer agrees to provide Sellers & Co. with the current e-mail address that Customer wishes for Sellers & Co. to use and to notify Sellers & Co. of any change of e-mail address. Please note that Sellers & Co. may deliver certain documents via U.S. Mail dues to legal requirements and/or system limitations.
Customer’s signature or that of Customer’s representative signifies that Customer voluntarily agrees to use electronic records in accordance with section 309 of New York State Technology Law. Customer understands that, from the date of this agreement until such time as Customer or Customer’s representative revokes this consent in writing, Sellers & Co. will send documents to Customer in electronic form only and will not provide Customer with paper copies of documents. Customer further agrees that upon receipt of policy documents via e-mail, if requested by Sellers & Co., Customer will acknowledge such receipt via reply e-mail.
Please email documents as described above to the following email address:
