[Your Name]
[Your Address]
[City, State, Zip Code]
[Email Address]
[Phone Number]
[Date]

[First Party's Name]
[First Party's Address]
[City, State, Zip Code]

[Second Party's Name]
[Second Party's Address]
[City, State, Zip Code]

Re: Insurance Broker Agreement

Dear [First Party's Name] and [Second Party's Name],

This Insurance Broker Agreement (the "Agreement") is entered into as of [Date] (the "Effective Date") by and between [First Party's Name], with a registered address at [First Party's Address], referred to as the "Company" (hereinafter referred to as the "First Party"), and [Second Party's Name], with a registered address at [Second Party's Address], referred to as the "Insurance Broker" (hereinafter referred to as the "Second Party"). The First Party and the Second Party shall collectively be referred to as the "Parties."

WHEREAS, the First Party is engaged in [describe the nature of the business or individual requiring insurance];

WHEREAS, the Second Party is duly licensed and qualified to act as an insurance broker in [Jurisdiction];

WHEREAS, the First Party desires to appoint the Second Party to act as its exclusive insurance broker; and

WHEREAS, the Second Party is willing to provide insurance brokerage services to the First Party.

NOW, THEREFORE, in consideration of the mutual covenants contained herein, and for other good and valuable consideration, the receipt and sufficiency of which are hereby acknowledged, the Parties agree as follows:

1. Scope of Engagement
   1.1 The First Party hereby appoints the Second Party as its exclusive insurance broker for a period of [insert duration] (the "Engagement Period").
   1.2 The Second Party agrees to provide brokerage services specifically related to identifying, recommending, and procuring insurance policies that adequately meet the First Party's insurance needs.
   1.3 The Second Party shall use the First Party's insurance application forms when submitting insurance proposals to the appropriate insurance providers.

2. Duties and Responsibilities
   2.1 The Second Party shall exercise the utmost professional skill and care in providing brokerage services and shall act in the best interests of the First Party.
   2.2 The Second Party shall maintain all necessary licenses, permits, and qualifications as required by law to act as an insurance broker within [Jurisdiction].
   2.3 The Second Party shall not be responsible for managing or adjusting insurance claims on behalf of the First Party, unless otherwise agreed upon in writing.

3. Compensation
   3.1 The First Party shall compensate the Second Party for brokerage services rendered as follows: [describe the compensation structure, such as commission, hourly rate, etc.].
   3.2 The Parties shall agree upon the specific compensation rates and terms in a separate agreement, which shall be attached to this Agreement as Appendix A.

4. Confidentiality
   4.1 The Second Party agrees to keep any proprietary or confidential information obtained from the First Party strictly confidential. This obligation shall survive the termination of this Agreement.

5. Termination
   5.1 Either Party may terminate this Agreement upon [provide termination notice period, e.g., 30 days] written notice to the other Party.
   5.2 Upon termination or expiration of this Agreement, any obligations or liabilities that have accrued prior to such termination shall survive.

6. Governing Law and Jurisdiction
   6.1 This Agreement shall be governed and construed in accordance with the laws of [Jurisdiction].
   6.2 Any disputes arising under or in connection with this Agreement shall be subject to the exclusive jurisdiction of the courts of [Jurisdiction].

7. Entire Agreement
   7.1 This Agreement contains the entire understanding between the Parties with respect to the subject matter hereof and supersedes all prior agreements, understandings, negotiations, and discussions, whether oral or written.
   7.2 No modification, amendment, or waiver of any provision of this Agreement shall be effective unless in writing and signed by both Parties.

IN WITNESS WHEREOF, the Parties hereto have executed this Insurance Broker Agreement as of the Effective Date.

[First Party's Name]
By: _______________________________
Printed Name: _______________________
Title: _______________________________

[Second Party's Name]
By: _______________________________
Printed Name: _______________________
Title: _______________________________

Date: ________________________________

Please note that this is a draft version of the Insurance Broker Agreement and may require further review and customization to fit specific needs.