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Become A Producer

In order to do business with CRC, please complete the Brokerage Agreement, Producer Profile and W9 form below. You will need to return these documents along with

  • a current copy of the agency’s E&O dec page showing limits of at least 1 million aggregate
  • current agency/agent license for the state of residence. If the agency is located in Mississippi or Tennessee, a surplus lines license is required. For Florida agents, both the agent and agency license must be submitted
  • please also submit copies of licenses the agency may hold in any other state.
All information should be returned to, via fax to 321-757-6145 or by mail to

Agency Appointments
5 Star Specialty Programs
158 No. Harbor City Blvd.
Melbourne FL 32935
CRC Brokerage Agreement

Confidential Producer Profile

W-9 Form


Terms and ConditionsCopyright © 2014 CRC Insurance Services, Inc.
© 2015 5Star Specialty Programs is a division of and operates under the licenses of CRC Insurance Services, Inc. CA Lic No 0778135. No claim to any government works or material copyrighted by third parties. Nothing in this communication constitutes an offer, inducement, or contract of insurance. Financial strength and size ratings can change and should be reevaluated before coverage is bound. This material is intended for licensed insurance agency use only. This is not intended for business owner or insured use. If you are not a licensed agent please disregard this communication. 5Star Specialty Programs supports a diverse workforce and is an Equal Opportunity Employer who does not discriminate against individuals on the basis of race, gender, color, religion, national origin, age, sexual orientation, gender identity, disability, veteran status or other classification protected by law. Drug Free Workplace.