DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Crosscover Insurance Services LLC	DOIID	1192910	NAIC NPN	20235664

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/11/2022		3/31/2026
Active	Non Resident	Agent	Casualty	3/11/2022		3/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/11/2022		3/31/2026
* 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	01/15/2026	03/31/2026
Surplus Lines Broker	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Trisura Insurance Company	1077019	Agent - Casualty	9/26/2022
Active	Trisura Insurance Company	1077019	Agent - Property	9/26/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hanson, Curtis Scott	1195426	Agent - Casualty	9/26/2022
Active	Hanson, Curtis Scott	1195426	Agent - Property	9/26/2022
Active	Hanson, Curtis Scott	1195426	Surplus Lines Broker - Not Applicable	9/19/2022
Inactive	Terzer, Ronald	1132746	Agent - Casualty	3/11/2022	10/31/2022
Inactive	Terzer, Ronald	1132746	Agent - Property	3/11/2022	10/31/2022
Inactive	Terzer, Ronald	1132746	Surplus Lines Broker - Not Applicable	3/11/2022	10/31/2022