Vt. Stat. Ann. tit. 8, § 5033

(1) Where Vermont is the home state of the insured, each surplus lines broker shall keep in his or her office a full and true record of each surplus lines insurance contract covering a domestic risk placed by or through him or her with a surplus lines insurer, including a copy of the daily report, if any, and showing such of the following items as may be applicable: amount of the insurance and perils insured;

(2) brief description of property insured and its locations;

(3) gross premium charged;

(4) any return premium paid;

(5) rate of premium charged upon the several items of property;

(6) effective date of the contract, and its terms;

(7) name and post office address of the insured;

(8) name and post office address of the insurer;

(9) name and post office address of brokerage house, if applicable, and name of licensed individual producer with whom business was placed;

(10) amount collected from the insured; and

(11) other information as may be required by the Commissioner.