DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bowhead Specialty Underwriters Inc.	DOIID	1102220	NAIC NPN	19853093

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	10/2/2020		3/31/2026
Active	Non Resident	Agent	Property	10/2/2020		3/31/2026
Active	Non Resident	Managing General Agent	Not Applicable	4/16/2024		3/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	10/16/2020		3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Midvale Indemnity Company	300292	Agent - Casualty	2/1/2021
Active	Midvale Indemnity Company	300292	Agent - Property	2/1/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Gisi, Gregory V	783942	Surplus Lines Broker - Not Applicable	10/16/2020	5/5/2021
Inactive	Good, Chester John	868973	Agent - Casualty	10/2/2020	5/5/2021
Inactive	Good, Chester John	868973	Agent - Property	10/2/2020	5/5/2021
Active	Mack, Benjamin Jason	800959	Agent - Casualty	4/20/2022
Active	Mack, Benjamin Jason	800959	Agent - Casualty	4/17/2024
Active	Mack, Benjamin Jason	800959	Agent - Property	4/20/2022
Active	Mack, Benjamin Jason	800959	Agent - Property	4/17/2024
Active	Mack, Benjamin Jason	800959	Surplus Lines Broker - Not Applicable	4/12/2022
Inactive	Mazzone, Susanne M	1117660	Agent - Casualty	5/5/2021	4/20/2022
Denied	Mazzone, Susanne M	1117660	Agent - Casualty
Inactive	Mazzone, Susanne M	1117660	Agent - Property	5/5/2021	4/20/2022
Denied	Mazzone, Susanne M	1117660	Agent - Property
Inactive	Mazzone, Susanne M	1117660	Surplus Lines Broker - Not Applicable	5/5/2021	4/20/2022