Submitter Information
Broker, MGA, or direct customer details → bronze_brokers
Organization Details
Organization name is required
Format: AAA-ST-0000 (letters-state-4digits)
Valid email required
Select state
Valid US phone required
Submission Metadata
Required
Required
Step 1 of 6
Insured Information
Applicant PII → bronze_insureds (SSN stored as SHA-256 hash)
🔒 SSN is hashed client-side using SHA-256. The raw SSN never leaves the browser or gets stored in the database.
Personal Identity
Required
Required
Must be 18+ years old
Enter full SSN (###-##-####)
Valid email required
Valid US phone required
Mailing Address
Required
Required
Required
5 or 9-digit ZIP
Step 2 of 6
Property Information
Risk location details → bronze_properties
📍 If property address differs from mailing address, enter it below.
Risk Location Address
Required
Required
Required
5 or 9-digit ZIP
Physical Characteristics
Required
Required
1800–present
100–50,000 sq ft
Construction Details
Required
Required
Must be ≥ year built
Liability Indicators
Step 3 of 6
Coverage Request
Coverage type and limits → bronze_submissions
Coverage Type
HO-3
Special Form
Most common homeowners
HO-4
Renters
Contents & liability only
HO-5
Comprehensive
Open perils on all
HO-6
Condo Owner
Walls-in condo coverage
DP-1
Dwelling Basic
Named perils only
DP-3
Dwelling Special
Landlord open perils
BOP
Business Owners
Property + liability
CPP
Comm. Package
Multi-line commercial
FARM
Farm & Ranch
Dwelling + equipment
Limits & Deductibles
$50,000–$10,000,000
~$165/sq ft avg construction cost
Select deductible
Today–60 days out
Endorsements Requested
Notes
0/1000
Step 4 of 6
Supporting Documents
Upload property inspection report, deed, or photos — validated before submission → bronze_submission_attachments
Document Upload — At least one property document required
Document 1 *
Click to upload or drag & drop
PDF or JPG/PNG · Max 10MB
Document 2 (optional)
Click to upload or drag & drop
PDF or JPG/PNG · Max 10MB
✓ Validation Rules Applied:
PDF files are checked for property-related keywords (address, inspection, property, coverage, insured, roof, construction).
JPG/PNG files are verified as valid images. Generic invoices or unrelated documents are rejected.
Step 5 of 6
Review & Confirm
Verify all fields before Bronze layer commit
Generated JSON Payload
—
Submission Accepted!
Policy request committed to Bronze layer · JSON saved to disk
JSON File Path
D:\Personal\Usecase\Jsons\SUB-XXXX.json