DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Mid-Atlantic Partners Insurance Services LLC	DOIID	1272151	NAIC NPN	20692881

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	5/2/2023	3/31/2025
Active	Non Resident	Agent	Health	5/2/2023	3/31/2025
Active	Non Resident	Agent	Life	5/2/2023	3/31/2025
Active	Non Resident	Agent	Casualty	5/2/2023	3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	5/24/2023	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

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	AmTrust Insurance Company	300179	Agent - Casualty	12/29/2023
Active	AmTrust Insurance Company	300179	Agent - Property	12/29/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	1/22/2024
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	1/22/2024
Active	Employers Assurance Company	300120	Agent - Casualty	4/25/2024
Active	Employers Compensation Insurance Company	797885	Agent - Casualty	4/25/2024
Active	Employers Preferred Insurance Company	520656	Agent - Casualty	4/25/2024
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	12/29/2023
Active	Milford Casualty Insurance Company	301460	Agent - Property	12/29/2023
Active	Security National Insurance Company	301151	Agent - Casualty	12/29/2023
Active	Security National Insurance Company	301151	Agent - Property	12/29/2023
Active	Sequoia Insurance Company	628046	Agent - Casualty	12/29/2023
Active	Sequoia Insurance Company	628046	Agent - Property	12/29/2023
Active	Starr Indemnity and Liability Company	301685	Agent - Casualty	4/1/2024
Active	Starr Indemnity and Liability Company	301685	Agent - Health	4/1/2024
Active	Starr Indemnity and Liability Company	301685	Agent - Property	4/1/2024
Active	Technology Insurance Company	613278	Agent - Casualty	12/29/2023
Active	Technology Insurance Company	613278	Agent - Property	12/29/2023
Active	Wesco Insurance Company	300534	Agent - Casualty	12/29/2023
Active	Wesco Insurance Company	300534	Agent - Property	12/29/2023

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Kolenda, Courtney Lynne	1022910	Agent - Casualty	5/2/2023
Active	Kolenda, Courtney Lynne	1022910	Agent - Health	5/2/2023
Active	Kolenda, Courtney Lynne	1022910	Agent - Life	5/2/2023
Active	Kolenda, Courtney Lynne	1022910	Agent - Property	5/2/2023
Active	Kolenda, Courtney Lynne	1022910	Surplus Lines Broker - Not Applicable	5/24/2023