DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blanco, Michele H	DOIID	1063719	NAIC NPN	6826702

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	10/31/2019		10/31/2025
Active	Non Resident	Agent	Property	10/31/2019		10/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	5/13/2022		10/31/2025
* 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	08/15/2025	10/31/2025
Surplus Lines Broker	08/15/2025	10/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	1/17/2020
Active	Liberty Mutual Insurance Company	301159	Agent - Property	1/17/2020
Active	NGM Insurance Company	583837	Agent - Casualty	11/20/2019
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	1/17/2020
Active	Ohio Casualty Insurance Company	301492	Agent - Property	1/17/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	CRC Ins Services, LLC	502276	Agent - Casualty	1/16/2025
Active	CRC Ins Services, LLC	502276	Agent - Property	1/16/2025
Active	CRC Ins Services, LLC	502276	Surplus Lines Broker - Not Applicable	1/16/2025
Inactive	Starwind Specialty Insurance Services, LLC	513826	Agent - Casualty	11/20/2019	1/23/2025
Inactive	Starwind Specialty Insurance Services, LLC	513826	Agent - Property	1/17/2020	1/23/2025