DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Ursus Insurance Services Inc.	DOIID	1133618	NAIC NPN	19882283

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	5/7/2021		3/31/2027
Active	Non Resident	Agent	Property	5/7/2021		3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	5/18/2021		3/31/2027
* 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	State National Insurance Company, Inc.	300888	Agent - Casualty	11/8/2023
Active	State National Insurance Company, Inc.	300888	Agent - Property	11/8/2023

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Taylor, Zachary	1119921	Agent - Casualty	11/8/2023
Active	Taylor, Zachary	1119921	Agent - Property	11/8/2023
Active	Taylor, Zachary	1119921	Surplus Lines Broker - Not Applicable	10/16/2023
Inactive	Trimble, Nathan	1131040	Agent - Casualty	5/7/2021	10/16/2023
Inactive	Trimble, Nathan	1131040	Agent - Property	5/7/2021	10/16/2023
Inactive	Trimble, Nathan	1131040	Surplus Lines Broker - Not Applicable	5/18/2021	10/16/2023