DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mosaic Americas Insurance Services LLC	DOIID	1115454	NAIC NPN	19737952

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	1/5/2021		3/31/2025
Active	Non Resident	Agent	Casualty	1/5/2021		3/31/2025
Active	Non Resident	Independent Adjuster	Property & Casualty	3/21/2024		3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/5/2021		3/31/2025
* 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	01/15/2025	03/31/2025
Independent Adjuster	01/15/2025	03/31/2025
Surplus Lines Broker	01/15/2025	03/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Delong, Yosha R	1119354	Agent - Casualty
Denied	Delong, Yosha R	1119354	Agent - Property
Active	Delong, Yosha R	1119354	Surplus Lines Broker - Not Applicable	4/8/2021
Active	Doroff, Elissa	668504	Independent Adjuster - Property & Casualty	3/21/2024
Active	Hughes, Forest Ingram	876593	Agent - Casualty	1/5/2021
Active	Hughes, Forest Ingram	876593	Agent - Property	1/5/2021
Active	Hughes, Forest Ingram	876593	Surplus Lines Broker - Not Applicable	1/5/2021