Agency Bill Commission Submission This form is used for agents to submit their Agency Bill commission items for reconciling Insured(Required) Please enter the Named InsuredIs this account already entered in Hawksoft?(Required) Yes No You should not proceed if "No"Agent Selection(Required)Andrew ZockollCarmela ConiateCesar HernandezDaniel DyeDarren DyeDebbie AndersonEden MekonenElida SarmientoGary GriffithsGilberto CepedaHelen SeaJohn WhitakerJeanne RaddeJun HuangLaci BledsoeMadeline ChengMaria BiebrichPeter MonroyRandy MontgomeryRob FleischmanRosie PittmanRuth BubanSusana RuizVanna TranVickie SpreitzerWannee PiedmontWilliam OnHow would you like to proceed?(Required) I'll upload the Agency Invoice from the wholesaler I'll fill out the webform If you upload an invoice we can reconcile the commission from that. Or, you can type the info into this webform.Invoice upload(Required)Max. file size: 39 MB.Please upload the Agency Invoice from the wholesaler. It's ok if it's in the same file as the binder.Policy Number(Required) Enter exactly as you have entered the policy in Hawksoft so commission can be matchedPolicy Effective Date MM slash DD slash YYYY Wholesale Agency(Required)AbacusAG AdministratorsAmWinsAppalachian UnderwritersBASS UnderwritersBerkley AspireBTISColonial GeneralCRCGlatfeltersMedJamesPathpointProLinesProWritersRICRPSStatewideUIGUSLI Agency BillUS RiskWorldwide FacilitiesWorldWide Insurance Specialists (bonds)Other - add in Notes box before submittingBase Premium(Required) Do not include any taxes or feesTaxes & Fees(Required) Include all surplus lines taxes, filing fees, and any other fee charged by the wholesale agencyBroker Fee Only applies if you collected a broker fee. This is not the fee the wholesaler adds to the policy, sometimes called a "broker fee", "policy fee", "inspection fee", or something along those lines.Commission Rate(Required)Usually the commission rate will be 10%, 12.5%, or 15%Gross Agency Commission Amount(Required)Additional InfoPhoneThis field is for validation purposes and should be left unchanged.