Request Information

To request a Broker Package, please complete the information below. The Broker Package includes a broker agreement, and detailed information on all of our products. The package will be sent to you via US Mail.

If you would like to receive a specific application via fax, please call
1-800-472-7771 and an agent will assist you.



Company/Agency
Contact Name
Address
City
State Zip 
Telephone
E-Mail Address
      


Carpenter Insurance Service
P.O. Box 874952
Kansas City, MO 64187-4952
1-800-472-7771 Fax: 913-652-7599