DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Perry, Derek J	DOIID	1033897	NAIC NPN	19071941

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/25/2019		4/30/2027
Active	Non Resident	Agent	Casualty	3/25/2019		4/30/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	02/15/2025	04/30/2025	03/13/2025	03/13/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	GuideOne Elite Insurance Company	300490	Agent - Casualty	4/3/2019
Active	GuideOne Elite Insurance Company	300490	Agent - Property	4/3/2019
Active	GuideOne Insurance Company	301794	Agent - Casualty	4/3/2019
Active	GuideOne Insurance Company	301794	Agent - Property	4/3/2019
Active	GuideOne Specialty Insurance Company	300278	Agent - Casualty	4/3/2019
Active	GuideOne Specialty Insurance Company	300278	Agent - Property	4/3/2019
Active	National Specialty Insurance Company	300993	Agent - Casualty	12/14/2022
Active	National Specialty Insurance Company	300993	Agent - Property	12/14/2022
Active	Next Insurance US Company	1083825	Agent - Casualty	12/12/2022
Active	Next Insurance US Company	1083825	Agent - Property	12/12/2022
Active	State National Insurance Company, Inc.	300888	Agent - Casualty	12/14/2022
Active	State National Insurance Company, Inc.	300888	Agent - Property	12/14/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Suracy Insurance Agency, Inc	923753	Agent - Casualty	4/3/2019
Active	Suracy Insurance Agency, Inc	923753	Agent - Property	4/3/2019