CakePHP: the rapid development php framework

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Thank you for your business!

Merchant
BB Insurance Marketing, Inc.

10167 W Sunrise Blvd 3rd Floor
Plantation, FL, 33322


Payer
Name Verified Name is REQUIRED
Address
Address2
City State Zip
Email Verified Email is REQUIRED
Phone
Check Info
BBIMI Client Name This Field is REQUIRED
Payee
Routing Number Verified Unverified
Account Number Verified Unverified
Check Number Verified Unverified
Date
Amount
$
Verified Unverified

IMPORTANT INSTRUCTIONS:

**Please do not put $ or comma in the AMOUNT field!*** For example, a payment of $12,345.67 should be entered as 12345.67

**Please include your BBIMI CLIENT NAME in the Payer Name field.***

Please note - Your submission is an authorization for an ACH transaction. Submission of ACH authorization does not guarantee coverage until confirmed by the agency. Acceptance of payment does not guarantee coverage in the event the policy has lapsed or entered a cancellation status by the insurance company.

CakePHP: the rapid development php framework