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.

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