BROOKE CORP
10SB12G/A, EX-6.01, 2001-01-16
INSURANCE AGENTS, BROKERS & SERVICE
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<PAGE>


                                                           EXHIBIT 6.01


                                     SAFECO
                         PROPERTY AND CASUALTY INSURANCE
                                AGENCY AGREEMENT

This Agreement is executed by You and Us. "You" and "Your" refers to the
individual or entity named on this contract. "We" and "Us" refers to the
Companies You are appointed with as listed on this page.

1.  This Agreement shall consist of this page and the pages identified by the
    following form numbers:

AM-1001 R3 1/98, AM-1116 R3 11198, 7-2015 KS 3/99
--------------------------------------------------------------------------------

--------------------------------------------------------------------------------

2.   This Agreement applies only to the lines checked:
                                                         P/L         C/L
     SAFECO Companies                                    /X/         /X/
     American States Companies                           /X/         /X/

3.   You represent the Enterprise Group(s) checked below:

     SAFECO Personal Lines Insurance /X/

      American States Business Insurance /X/

     SAFECO Commercial Insurance / /

4.   In order to complete references made in other parts of this Agreement,
     the following information is supplied by You:
     A.  Premium Trust (referred to in paragraph 3.3.2):
         (1) Bank in which account maintained _________________________________

         (2) Name on account _______________ Account Number ___________________


5.   You are authorized to represent the companies checked below in each state
     where 1) each company is authorized to do business and 2) where We have
     notified You that Your appointment with Us has been filed and approved by
     the appropriate state regulator, or You have provided Us with a copy of
     Your appropriate broker's license.

This supersedes all previous agreements and shall be effective

        March                 1   ,   1999 , but it
      ----------------- ----------   ------
       (Month)            (Day)      (Year)

shall not be effective earlier than the valid appointment date with the state
You have indicated in the address below.

Executed this       1    day of       March   , 1999  .
             ------------      --------------- -------
                  (Day)              (Month)   (Year)

/X/    SAFECO Insurance Company of America
/X/    General Insurance Company of America
/X/    First National Insurance Company of America
/X/    SAFECO National Insurance Company
/X/    SAFECO Insurance Company of Illinois
/ /    SAFECO Lloyds Insurance Company
/X/    American Sates Insurance Company
/X/    American Economy Insurance Company
/X/    American States Insurance Company of Texas
/ /    American States Lloyds Insurance Company
/X/    American States Preferred Insurance Company


BROOKE CORPORATION
------------------------------------------------------------------
Name of Agency

PO BOX 426
------------------------------------------------------------------

------------------------------------------------------------------

PHILLIPSBURG                  KS                      67661-0426
------------------------------------------------------------------
City                          State                          Zip


05-27-2318                       15-10182
----------------------------     ---------------------------------
SAFECO Stat No.                  American States Stat No.



BY: /s/  W. Randall Stoddard               BY /s/ Michael Hess
   -----------------------------------       ----------------------------------
        W. RANDALL STODDARD, PRESIDENT                  President


<PAGE>

                 PROPERTY & CASUALTY INSURANCE AGENCY AGREEMENT

("You" and "Your" refers to the individual or entity named on this contract.
"We," "Us" and "Our" refers to the Companies You are appointed with as listed
on the cover sheet.)

1.0      YOUR AUTHORITY

         We grant You the following authority:

         1.1     To receive, accept and bind in any jurisdiction where You are
                 properly licensed and where We have notified the state that
                 You are Our agent, proposals for contracts of insurance and
                 for fidelity bonds in such classes of risks and to such limits
                 as We may from time too time authorize by letter of
                 instruction, underwriting guide, binding guide, or other
                 written instruction.

         1.2     To countersign the kinds of insurance contract to which this
                 Agreement applies. Where countersignature by You of a new or
                 renewal policy written by You is required by law, You
                 authorize Us to countersign on behalf of You by any method
                 authorized by applicable state statutes.

         1.3     To collect, receive, and receipt for premiums on insurance
                 placed with Us by You.

2.0      YOUR LIMITATIONS

         2.1     You shall not bind Us on risks deemed unacceptable in
                 accordance with Our underwriting standards as identified in
                 Paragraph 1.1 and as supplemented from time to time.

         2.2     To refrain from binding or writing policies of insurance when
                 the object of the insurance is subject to unusually increased
                 risk such as covering buildings for windstorm when storm
                 warnings have been posted, or when a storm is in progress, or
                 such as writing earthquake coverage on structures located in
                 an area where a significant earthquake has occurred within the
                 previous 10 days.

         2.3     Your authority does not extent to the use of Our name or
                 logo(s) in advertising or promotional materials without Our
                 prior written consent.

         2.4     You shall not authorize any other person or entity (except
                 Your employees) to exercise any of Your authority described in
                 this Agreement without prior written consent from Us.

3.0      AGENCY OPERATIONS

         3.1     Documentation: You will forward to Us promptly, after coverage
                 is bound or amended, copies of all evidence of insurance, or
                 modifications thereof or applications therefor, effected by
                 You.

         3.2     Records - Inspection, Control and Use:

                 3.2.1    You will maintain a complete record of Your
                          transactions with Us and with policyholders which
                          shall be open to Our inspection at any time.


                                                                         Page 1

<PAGE>

                 3.2.2    You shall remain owners of the records and use and
                          control of expirations, except as provided in
                          Paragraph 8.1. If you abandon the business, ownership
                          will vest in Us. Expirations shall consist of the
                          exclusive right to own and use customer information
                          generated or developed by You, including customer
                          names, addresses, coverage terms and conditions in
                          connection with the solicitation of renewal business.

         3.3     Premium Collection and Transmittal

                 3.3.1    Premiums collected on Our behalf are held by You in a
                          fiduciary capacity. You have no interest in the
                          premiums and, except for the amount of commissions
                          authorized by Us to be deducted by You, You will make
                          no deductions from or make personal use of such funds
                          nor retain any such premiums as an offset against any
                          disputed claim You may have against Us before paying
                          the same to Us.

                 3.3.2    You will establish and maintain a premium trust
                          account in the federally insured bank or savings &
                          loan designated on form AM-1000 (the first page) of
                          this Agreement. You may not commingle premiums with
                          other funds except with Our written permission. If
                          state law permits, You may retain any interest earned
                          on premiums while they are on deposit in Your premium
                          trust account. Such retention of interest earned
                          creates no ownership interest on Your part in the
                          premiums on deposit in the trust account. You shall
                          remain liable for payment of such premiums until they
                          are received by Us. You shall remain liable for loss
                          which occurs by reason of default or failure of the
                          bank in which the trust account is maintained.

         3.4     Direct Bill Policies

                 3.4.1    Direct Billing:
                          You may request either agency billing or direct
                          billing of Commercial policies. Personal policies are
                          issued on a direct billing basis only. Each direct
                          billing payment plan We offer requires an initial
                          valid payment of amounts which will vary by plan.
                          Valid payments include: cash; checks or electronic
                          funds transfer honored by the appropriate financial
                          institution; money orders; or other negotiable
                          instruments approved in advance by Us.

                 3.4.2    When You submit an application for a policy to be
                          billed on a Direct Bill basis, You assume full
                          responsibility for collection and payment to Us of
                          the required initial payment, without deduction of
                          Your commission. If We do not receive the required
                          initial payment from You or the Insured, We will send
                          direct notice of cancellation to the insured unless
                          You furnish the evidence of cancellation We require.

                 3.4.3    If We must send notice of cancellation for
                          non-payment of the initial valid payment, We will
                          provide at least the number of days of coverage
                          required by law prior to the effective date of
                          cancellation. We will bill You for the earned premium
                          for this coverage. If You do not pay Us the earned
                          premium after We have billed You, We will deduct if
                          from Your next commission check.


                                                                         Page 2
<PAGE>

                 3.4.4    After the initial valid payment, We assume
                          responsibility for billing and collecting from the
                          insured all subsequent renewal, installment, and
                          endorsement premiums. We agree to compute and remit
                          to You promptly following the close of each month the
                          commissions We owe You, less the commissions You owe
                          Us on return premiums, in accordance with the
                          applicable schedule of commissions.

                 3.4.5    When Our direct billing plan provides for advance
                          payment of commission and subsequent installments are
                          not paid to Us by the insured, We will cancel the
                          policy for non-payment and deduct the unearned
                          commission from Your next commission check.

                 3.4.6    If Your Direct Bill Commission statement indicates
                          that You owe Us money, You agree to pay Us the full
                          amount owed within 10 days of Your receipt of Your
                          commission statement.

                 3.4.7    Commercial Direct Bill:
                          When You request one of the Commercial Direct Bill
                          payment plans, You are responsible for the initial
                          payment required by that plan unless We have agreed
                          in writing to some other arrangement. If Your insured
                          pays the full term premium in advance of the month in
                          which the policy becomes effective, We will pay You
                          the commission on the policy on the next commission
                          statement following the month in which the policy
                          becomes effective.

                 3.4.8    Personal Direct Bill:
                          For the first policy period premium, Your application
                          shall be accompanied by the initial valid payment
                          required for the payment plan the insured has
                          selected, without deduction of Your commission. If
                          Cash on Delivery (COD) is allowed in Your state and
                          You request COD on the application, We will bill the
                          insured for the required initial payment, but Our
                          doing so does not relieve You of Your responsibility
                          for its payment. If We do not receive the required
                          initial payment from You or from the insured by 35
                          days from the inception date of the policy, We will
                          send direct notice of cancellation to the insured
                          unless You furnish the evidence of cancellation which
                          We require. You assume responsibility for collection
                          and payment to Use for coverage provided on bound
                          applications that You submit to Us but which are not
                          eventually issued, unless You furnish the evidence of
                          cancellation We require.

         3.5     Agency Billed Policies

                 3.5.1    You agree to pay Us net premiums due on all insurance
                          placed by or through You with Us not later than 45
                          days after the end of the month in which the business
                          written becomes effective, whether such premiums are
                          collected, collectible or otherwise, and to refund
                          pro rata to Us commission on return premiums due or
                          installment premiums uncollected at the same rate as
                          that applicable to the commission originally allowed
                          on such business. Our failure to bill You for an item
                          shall not relieve You of the responsibility to pay
                          for the item. If You are delinquent in either
                          accounting or payment due Us, We may, by notice to
                          You, suspend Your authority to write any new or
                          renewal business or change any existing bonds.
                          Payment of overdue amounts shall not automatically
                          end the suspension, nor shall such suspension prevent
                          termination of this Agreement.


                                                                         Page 3
<PAGE>

                 3.5.2    You agree that on all policies of insurance You
                          produce for Us to either finance the premium or
                          collect it promptly.

                 3.5.3    If any interim or final premium developed by audit,
                          or any additional premium resulting from an
                          adjustment to a retrospective rated policy cannot be
                          collected by You, We shall undertake direct
                          collection and You shall not be responsible for such
                          collection of such premium, provided:

                          A.       You return the item to Us at the location
                                   where monthly premiums are paid by You with
                                   written notification that the item is being
                                   returned for direct collection. Your
                                   notification to Us must take place as soon
                                   as You perceive uncollectibility, but no
                                   later than 30 days after the issue date of
                                   the item; and

                          B.       We shall not pay commission to You on such
                                   premiums which We may accept for direct
                                   collection.

         3.6     Agency and Producer Licensing

                 3.6.1    Maintenance of License:
                          You will maintain a valid agency license with any
                          state in which You represent Us. You will ensure that
                          only persons who are licensed, and properly appointed
                          by Us, act as agents for business produced by You for
                          Us. You will notify Us within 3 business days of the
                          employment or termination of any person appointed to
                          represent Us. All licensed persons will comply with
                          any continuing education requirements. If, as a
                          result of Your failure to comply with these
                          requirements, We are required to pay administrative
                          penalties in any state, We shall advise You of the
                          amount of the fine, and You will reimburse Us
                          promptly.

4.0      SYSTEMS MASTER LICENSE

         4.1     LICENSE GRANT:

                 4.1.1    You accept and agree that any automated systems
                          (SYSTEMS) access We may supply to You or make
                          available for Your use from time to time will be
                          subject to and governed by the terms and conditions
                          of the master SYSTEMS license contained in this
                          Section 4.0. We grant You a license to access and use
                          such SYSTEMS for the sole purpose of processing and
                          conducting Our business on an electronic basis. You
                          are authorized to use the SYSTEMS solely for such
                          purpose.

                 4.1.2    We reserve the right to immediately terminate this
                          master license and Your SYSTEMS access if You attempt
                          to assign or transfer any rights in the SYSTEMS or
                          otherwise provide any access to the SYSTEMS to
                          another party.

4.2      WE AGREE:

                 4.2.1    To provide You with such access to the SYSTEMS as We,
                          in Our sole discretion, deem reasonable and necessary
                          for Your use of the SYSTEMS for the purpose described
                          in paragraph 4.1.1 above.


                                                                         Page 4
<PAGE>

                 4.2.2    To provide, upon Your request, a copy of data You
                          have processed or generated through the SYSTEMS, to
                          the extent that We can retrieve it from the SYSTEMS.

         4.3     YOU AGREE:

                 4.3.1    To purchase, lease or otherwise provide terminal(s)
                          or other computer equipment We have approved as
                          reasonably suitable to access and use the SYSTEMS to
                          electronically process Our business.

                 4.3.2    To use the SYSTEMS to process Our business according
                          to Our reasonable instructions.

                 4.3.3    To be available and to make Your personnel available
                          for education and training in the use of the SYSTEMS
                          as We reasonably require.

                 4.3.4    To compile, maintain and keep all records as required
                          by law to be maintained by agents or brokers,
                          irrespective of any records the SYSTEMS produce or
                          generate, and to make such records available to Us
                          upon request.

5.0      CONFIDENTIALITY

         5.1     You agree not to disclose to third parties without Our prior
                 written permission any of Our confidential and proprietary
                 information, including but not limited to loss information
                 (such as reserve amounts and loss control reports or audits),
                 security information (such as computer passwords and
                 identification codes), or information concerning the SYSTEMS
                 (such as codes and operating instructions for the SYSTEMS).
                 Your agreement and obligation to safeguard the confidentiality
                 of such information will survive the termination of this
                 Agreement and the master license. In the event that You
                 become, or believe You may be, subject to a court order
                 requiring the disclosure of any of Our confidential and
                 proprietary information to a third party, You agree to provide
                 Us as much notice as possible so that We may intervene and
                 seek appropriate relief from the court.

         5.2     We agree not to disclose to third parties without Your prior
                 written permission any of Your confidential and proprietary
                 information, including customer lists, agency production, loss
                 history and agency payment history. Our agreement and
                 obligation to safeguard the confidentiality of such
                 information will survive the termination of this Agreement and
                 the master license.

         5.3     We both agree that neither of us will disclose to third
                 parties without Your customer's written permission any
                 confidential customer information, including but not limited
                 to customer names, addresses, telephone numbers, property
                 descriptions, policy limits and coverage types, billing and
                 payment history, driving records and other loss information,
                 except to the extent that such disclosure is, in Our sole
                 judgment, part of the business of insurance or in connection
                 with any governmental or bureau reporting either of us is
                 required to make.

         5.4     Publicly available information, including but not limited to
                 rating plans filed with government regulators and policy forms
                 filed with government regulators, is not subject to our
                 non-disclosure agreement in this section.


                                                                         Page 5
<PAGE>

         5.5     This non-disclosure agreement shall not prevent maintenance of
                 proprietary and confidential information in a single Customer
                 Information File used by the SAFECO group of companies.

6.0      COMPENSATION

         6.1     Commissions paid to You or retained by You according to the
                 schedule of commissions shall be Your sole and full
                 compensation on such business placed with Us and that such
                 commissions are payable in consideration of Your faithful
                 performance of Your duties and obligations as set forth in
                 this Agreement.

         6.2     Any undistributed commission or other funds of Yours that We
                 hold may be applied at any time to, and as an offset on, any
                 due and unpaid obligation of Yours to Us.

         6.3     You shall not assign Your right to receive commission for any
                 purpose, e.g., to provide collateral for a loan, without prior
                 written consent from Us.

         6.4     While this Agreement is in effect, You and We agree that
                 commissions shall be paid to You for the lines of business and
                 products You write, according to the commission schedule
                 attached to this Agreement. The commission schedule may be
                 changed by Us with notice to You as required by state law, or
                 by mutual written agreement between You and Us.

         6.5     No commission will be generated by any additional or return
                 premium from an adjustment to a retrospective rated policy.

         6.6     If Our Electronic Funds Transmission Program for payment of
                 Your commissions is available to You, and You choose to
                 participate in it, funds will be transmitted to Your account
                 under the terms of the Program then in effect.

7.0      AGENCY SALE OR TRANSFER

         7.1     You agree to give 30 days advance notice to Us of any sale or
                 transfer of Your business or its consolidation with another
                 firm in order that We may, at Our election, either assign this
                 Agreement to the successor organization or terminate it
                 according to Section 8.0 of this Agreement.

8.0      TERMINATION

         8.1     We agree that in the event of termination of this Agreement,
                 and provided that You have in accordance with the terms of
                 this Agreement accounted for and paid over all premiums and
                 other sums for which You may be liable to Us and are not
                 otherwise in default on this Agreement, Your records and use
                 and control of expirations shall remain Your property and be
                 left in Your undisputed possession. If You have not paid
                 amounts You owe to Us within 60 days following the termination
                 of this Agreement, the ownership of the records and the use
                 and control of the expirations shall vest exclusively in Us
                 and You shall immediately thereafter forward all such records
                 to Us.

         8.2     This Agreement shall terminate:


                                                                         Page 6
<PAGE>

                 A.       Automatically on the date any public authority
                          cancels or declines to renew Your license or
                          certificate of authority or all of Our applicable
                          companies surrender or lose Our certificate(s) of
                          authority in Your state; or

                 B.       Immediately upon either party giving written notice
                          to the other in the event of abandonment, fraud,
                          insolvency or gross and willful misconduct on the
                          part of such other party; or

                 C.       Upon either party giving the other 90 days advance
                          written notice (or longer if required by law). If You
                          have represented Us for more than 3 years and have
                          reached the minimum level of production for either
                          personal or commercial lines as specified in the
                          Profit Plus Bonus Commission Agreement in effect at
                          the date of termination, a period of rehabilitation
                          may be established if both of us agree. A separate
                          agreement between You and Us for the rehabilitation
                          period will specify what must be done to avoid
                          termination.

         8.3     Effective upon receipt of the notice of termination, Your
                 authority to solicit, bind, execute and countersign contracts
                 of insurance and fidelity bonds on Our behalf shall cease.

         8.4     You will use Your best efforts to replace all the policies You
                 have placed with Us with policies of other insurers. We will
                 provide You a listing of policies to assist You in this
                 effort.

         8.5     We will advise You of the date, as permitted by law, when We
                 will begin nonrenewing Your accounts. We reserve the right to
                 cancel or nonrenew policies in force in accordance with Our
                 underwriting standards or practices.

         8.6     With respect to policies remaining in force after termination,
                 You shall have such limited authority to act on Our behalf as
                 We set forth in written instruction provided with the notice
                 of termination or thereafter.

         8.7     Unless required by law, We will not pay You commission on
                 business written or renewed after the effective date of the
                 termination of this Agreement. If We are required by law to
                 have You continue to provide service to insureds after this
                 Agreement has been terminated, We will pay You a service fee
                 of three percent of premiums written (or such commission as
                 required by law) after the date of termination of this
                 Agreement as full compensation for such service. Such payments
                 will be made at the end of each calendar quarter and shall be
                 computed based on company records.

9.0      SUSPENSION

         Your binding authority shall be suspended:

         9.1     Automatically on the effective date of the sale or transfer of
                 Your business or its consolidation with another firm, unless
                 We were notified in writing and agreed to the sale or
                 consolidation.

         9.2     Automatically for any owner, office, manager, or other
                 employee whose license or certificate of authority has been
                 terminated or nonrenewed by a public authority.


                                                                         Page 7
<PAGE>

         9.3     Upon written notification of such suspension by the
                 appropriate regional manager, branch manager, or marketing
                 manager for Your state for non-payment of premiums or other
                 reasons.

10.0     INDEMNIFICATION

         10.1    We will defend and indemnify You against liability, including
                 costs of defense and settlements, imposed on You by law for
                 damages sustained and caused solely by Our acts or omissions,
                 provided You have not caused or contributed to such liability
                 by Your own acts or omissions. You agree as a condition of
                 such indemnification to notify Us promptly of any claim or
                 suit against You and to allow Us to make such investigation,
                 settlement or defense, of the claim or suit. We agree to
                 notify You promptly of any claim or suit against You.

         10.2    You agree to defend and indemnify Us against liability to the
                 extent You would be liable under common law, including cost of
                 defense and settlement, imposed upon Us when caused solely by
                 Your acts or omissions in violation of the terms of this
                 Agreement.

11.0     GENERAL PROVISIONS

         11.1    We are not responsible for Your expenses, license fees,
                 non-resident appointment fees or taxes.

         11.2    Any supplies, manuals or software We furnish to You shall
                 remain Our property and You will return them to Us upon Our
                 request.

         11.3    You are not Our employee, nor shall anything contained in this
                 Agreement be construed to create an employee-employer
                 relationship between You and Us or between Your sub-agents and
                 Us.

         11.4    This Agreement supersedes all prior agreements between us.

         11.5    Changes to this Agreement shall be by mutual written agreement.

         11.6    This Agreement shall be subject to and construed under the
                 laws of the State of Washington. If any provision of this
                 Agreement is found to violate the laws of the United States or
                 the state in which enforcement is sought, it is agreed that
                 such provision shall not invalidate the entire Agreement, but
                 the Agreement shall be construed as if it does not contain the
                 invalid provision.

         11.7    All notices to You shall be sent to Your address shown on the
                 cover page of this Agreement (AM-1000). All notices to Us
                 shall be sent to Our local office to the attention of Our
                 Marketing Manager. Either of us may change their address under
                 this paragraph by giving the other written notice of the new
                 address.






                                                                         Page 8
<PAGE>

                                                COMMISSION SCHEDULE

                                                  PERSONAL LINES

<TABLE>
<CAPTION>

------------------------------------------------------------- ------------- -------------- ------------- -----------
                                                               SAFECO OF                      FIRST       SAFECO OF
                                                               ILLINOIS*       GENERAL       NATIONAL      AMERICA
                                                              ------------- -------------- ------------- -----------
<S>                                                           <C>           <C>            <C>           <C>

AUTOMOBILE
   Any automobile rated for a driver under age 21........          5%*          --              5%            5%
   Recreational Vehicle Policy...........................         --            --             --            20%
   All other.............................................         10%*          --             10%           10%
PROPERTY
   Boatowners............................................         --            --             --            20%
   Dwelling Fire.........................................         --            --             --            20%
   Tenant Homeowners.....................................         20%*          20%*           --            20%
   Homeowners/Condominiums...............................         15%*          15%*           --            15%
UMBRELLA.................................................         --            --             --            15%

------------------------------------------------------------- ------------- -------------- ------------- -------------

                                                 COMMERCIAL LINES

--------------------------------------------------------------------------- -------------- ------------- -------------
                                       (may be negotiated -- not to exceed)

SAFEPLAN SYSTEMS
   Package..............................................................        --             --            15%
   Automobile...........................................................        --             --            15%
   Workers' Compensation................................................        --              7%           --
   Specialty Contractors'...............................................        --             --            15%
PROTECTION PLAN
   PACKAGE
     General Liability..................................................        20%            10%           15%
     Property...........................................................        20%            20%           20%
     Inland Marine......................................................        20%            20%           20%
   EXCEPTIONS:
     Earthquake.........................................................        15%            15%           15%
     Commercial First Plan..............................................        15%            15%           15%
   GENERAL LIABILITY....................................................        15%            10%           15%
   PROPERTY.............................................................        20%            20%           20%
   INLAND MARINE........................................................        20%            20%           20%
   PROFESSIONAL LIABILITY...............................................        20%            --            20%
   UMBRELLA.............................................................        15%            --            15%
   CRIME, FIDELITY......................................................        20%            20%           20%
   AUTOMOBILE...........................................................        15%            10%           15%
   WORKERS' COMPENSATION................................................   To be negotiated -- not to exceed 10%

--------------------------------------------------------------------------- ------------------------------------------
</TABLE>

ALL MULTIPLE LOCATION FORM POLICIES, ALL POLICIES WRITTEN UNDER ANY EXCESS RATE
PLAN AND ALL POLICIES COVERING OUTSIDE OF AGENT'S RESIDENT STATE SHALL BE
REFERRED TO THE COMPANY FOR COMMISSION ARRANGEMENTS.





Effective the ____________________ day of ___________________, _______.

Executed this ____________________ day of ___________________, _______.

*SAFECO INSURANCE COMPANY OF ILLINOIS
 SAFECO INSURANCE COMPANY OF AMERICA
 GENERAL INSURANCE COMPANY OF AMERICA
 FIRST NATIONAL INSURANCE COMPANY OF AMERICA


                                            -----------------------------------
                                            (Agency Name)           (Stat. No.)

By: /s/ W. Randall Stoddard                 By:
   --------------------------------------      --------------------------------
       W. RANDALL STODDARD, PRESIDENT
                                        *Change Made



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