To ensure the security of KEMI Servers, the Account Holder’s President, CEO, or Designee shall designate an administrator. By designating an administrator, the Account Holder represents and affirms that such person is trustworthy to ensure the security, confidentiality, and integrity of information accessible over KEMI Access Portals.

The Account Holder's administrator is responsible for creating and maintaining the security of all existing and new authorized user name(s) and password(s). In addition, the designated administrator shall have the rights to grant and revoke authority for the Account Holder up to, but not exceeding, the administrator's own rights.

Business or agent name *

KEMI policy number, agency number, or FEIN: *

Designated KEMI.com administrator name: *

Designated KEMI.com administrator email address: *

Designated KEMI.com administrator phone number: *

The undersigned represents that he/she has the authority to designate a KEMI.com administrator as indicated above. The Account Holder and all authorized users of the Account Holder are bound by the terms and conditions set forth in the Terms and Conditions of Use Agreement.

Your name *

Title *

Your email *

Signature of authority for designation *

Clear Signature

Date *

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KEMI.com Administrator Designation Form

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