DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Vouch Specialty Insurance Services, Llc	DOIID	1150919	NAIC NPN	19926463

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/12/2021		3/31/2025
Active	Non Resident	Agent	Property	8/12/2021		3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	8/12/2021		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
Surplus Lines Broker	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Employers Assurance Company	300120	Agent - Casualty	2/25/2022
Active	Employers Compensation Insurance Company	797885	Agent - Casualty	2/25/2022
Active	Employers Preferred Insurance Company	520656	Agent - Casualty	2/25/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hedge, Travis Richard	1026147	Agent - Casualty	8/12/2021
Active	Hedge, Travis Richard	1026147	Agent - Property	8/12/2021
Active	Hedge, Travis Richard	1026147	Surplus Lines Broker - Not Applicable	8/12/2021
Inactive	Nitschke, Chad	911498	Agent - Casualty	9/6/2022	1/23/2024
Inactive	Nitschke, Chad	911498	Agent - Property	9/6/2022	1/23/2024
Inactive	Nitschke, Chad	911498	Surplus Lines Broker - Not Applicable	9/26/2022	1/9/2024
Inactive	Wallace, John Henry	867220	Agent - Casualty	8/12/2021	6/28/2022
Inactive	Wallace, John Henry	867220	Agent - Property	8/12/2021	6/28/2022
Inactive	Wallace, John Henry	867220	Surplus Lines Broker - Not Applicable	8/12/2021	6/28/2022