DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Crescent Meadow, LLC	DOIID	1143878	NAIC NPN	19950529

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	2/13/2023		3/31/2025
Active	Non Resident	Agent	Property	2/13/2023		3/31/2025
Inactive	Non Resident	Agent	Life	7/13/2021	3/21/2023
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/22/2023		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
Surplus Lines Broker	01/15/2025	03/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Bolig, Jacquelyn M	605160	Agent - Casualty	2/13/2023
Active	Bolig, Jacquelyn M	605160	Agent - Property	2/13/2023
Inactive	Jacobs, Ari Noah	1137582	Agent - Life	7/13/2021	3/21/2023
Active	Owens, Stephanie Ann	536563	Agent - Casualty	4/5/2023
Active	Owens, Stephanie Ann	536563	Agent - Property	4/5/2023
Active	Owens, Stephanie Ann	536563	Surplus Lines Broker - Not Applicable	6/22/2023