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Osprey Underwriters

Agency Producer Registration

Connect your agency with Osprey’s specialty programs and wholesale markets. Verify your email, complete your agency profile, and submit it for review.

Checking your verified Osprey Underwriters account…

Fields marked (required) must be completed. You may submit before sending supporting documents.

Your registration contact

This contact manages the application using the verified email below.

First name (required)Last name (required) Title / role (required)Direct phone (required)

Agency principals

Provide at least one owner, partner or agency principal and their direct contact information.

Designated licensed representative / agency sublicensee

Optional: provide a designated licensed representative or agency sublicensee if different from your agency principals.

First name (optional) Last name (optional) Title / role (optional) Direct phone (optional) Home licensing state (optional) Individual license number (optional) Home-state representative license expiration date (optional) NPN (if available) (optional) Verified account email

Agency

Enter the legal insurance agency details. Agency approval is reviewed separately from the individual producer license.

Agency legal name (required) Agency DBA (optional) Business address (required) Suite / unit (optional) City (required) Agency address state (required) ZIP / postal code (required) Agency phone (required) Website (optional) Home licensing state (required) Agency license number (required) Home-state agency license expiration date (required)

Staff access requests

Optional: add colleagues and choose access for each person. Select both options when needed. Each person uses their own email. These requests are reviewed separately; agency approval does not automatically activate staff or Freshdesk access.

Quoting & placement: broker workspace access. Policy support: Freshdesk portal access for CSRs and servicing staff. Access does not confer binding or licensed producer authority.

States and agency focus

States where you would like to work with Osprey (required — select at least one).

Lines of business your agency focuses on

Required — select at least one.

Industries your agency focuses on

Required — select at least one. Select all that apply.

Errors & omissions

Enter the limits shown on your agency’s policy. Common combinations include $1M / $1M, $1M / $2M and $2M / $2M. The broker agreement requires at least $1M per claim and $1M aggregate with an insurer rated A- or better by A.M. Best. You may report $500K, but it does not meet that requirement. Osprey will review the evidence before approval.

E&O carrier (required) Policy number (if available) (optional) Per-claim limit (required) Annual aggregate limit (required) Expiration date (required) E&O evidence (required)

Onboarding review information

Number of licensed producers (required) Year agency established (required) Top direct carrier 1 (optional) Top direct carrier 2 (optional) Top direct carrier 3 (optional) Top wholesaler 1 (optional) Top wholesaler 2 (optional) Top wholesaler 3 (optional)

How can Osprey help your agency? (required — at least 10 characters)

Documents and acknowledgements

E&O evidence and signed broker agreement

You can submit your application before providing these documents. After submitting, email your E&O declarations page or certificate to join@ospreyuw.com with your application reference, or ask our team to email you a request. Evidence must be reviewed before approval.

Broker agreement signing contact

Download broker agreement (PDF)

Identify the person authorized to sign for your agency. This may be different from the designated licensed representative. Download the broker agreement below, complete the agency details, and have the authorized agency signer sign and date the BROKERAGE block. Osprey completes the WHOLESALER block. Submitting this form does not sign the agreement; a signed copy is required before approval.

Authorized signer’s full name (required) Authorized signer’s title (required) Authorized signer’s email (required)

Do not enter tax identifiers or banking information here. Osprey will request the W-9, signed broker agreement, home-state and other license evidence, E&O evidence, and any optional ACH authorization through an approved secure process.

Need help? Contact our registration team.