DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Southwest Partners Insurance Services LLC	DOIID	1274776	NAIC NPN	20696318

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	5/16/2023	3/31/2027
Active	Non Resident	Agent	Life	5/16/2023	3/31/2027
Active	Non Resident	Agent	Health	5/16/2023	3/31/2027
Active	Non Resident	Agent	Casualty	5/16/2023	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	5/25/2023	3/31/2027
* 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	01/30/2025	01/30/2025	Yes
Surplus Lines Broker	01/15/2025	03/31/2025	01/30/2025	01/30/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	All Savers Insurance Company	301940	Agent - Health	5/16/2024
Active	All Savers Insurance Company	301940	Agent - Life	5/16/2024
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Casualty	10/28/2024
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Property	10/28/2024
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	10/28/2024
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	10/28/2024
Active	AmTrust Insurance Company	300179	Agent - Casualty	12/29/2023
Active	AmTrust Insurance Company	300179	Agent - Property	12/29/2023
Active	American Contractors Indemnity Company	536843	Agent - Casualty	6/18/2024
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	2/5/2024
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	2/5/2024
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	3/8/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	3/8/2024
Active	Anthem Life Insurance Company	301209	Agent - Health	3/8/2024
Active	Anthem Life Insurance Company	301209	Agent - Life	3/8/2024
Active	Arch Indemnity Insurance Company	301459	Agent - Casualty	2/5/2025
Active	Arch Indemnity Insurance Company	301459	Agent - Property	2/5/2025
Active	Arch Insurance Company	300688	Agent - Casualty	2/5/2025
Active	Arch Insurance Company	300688	Agent - Property	2/5/2025
Active	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	1/23/2025
Active	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	1/23/2025
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	3/8/2024
Active	Employers Assurance Company	300120	Agent - Casualty	3/22/2024
Active	Employers Compensation Insurance Company	797885	Agent - Casualty	3/22/2024
Active	Employers Preferred Insurance Company	520656	Agent - Casualty	3/22/2024
Active	Farmington Casualty Company	301137	Agent - Casualty	1/15/2025
Active	Farmington Casualty Company	301137	Agent - Property	1/15/2025
Active	Fireman's Fund Insurance Company	301423	Agent - Casualty	8/1/2024
Active	Fireman's Fund Insurance Company	301423	Agent - Property	8/1/2024
Active	Great American Insurance Company	301586	Agent - Casualty	10/24/2024
Active	Great American Insurance Company	301586	Agent - Property	10/24/2024
Active	Hanover American Insurance Company (The)	300447	Agent - Casualty	10/28/2024
Active	Hanover American Insurance Company (The)	300447	Agent - Property	10/28/2024
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	10/28/2024
Active	Hanover Insurance Company (The)	300508	Agent - Property	10/28/2024
Active	Independence American Insurance Company	524747	Agent - Casualty	9/18/2024
Active	Independence American Insurance Company	524747	Agent - Property	9/18/2024
Active	Massachusetts Bay Insurance Company	300898	Agent - Casualty	10/28/2024
Active	Massachusetts Bay Insurance Company	300898	Agent - Property	10/28/2024
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	12/29/2023
Active	Milford Casualty Insurance Company	301460	Agent - Property	12/29/2023
Active	National Specialty Insurance Company	300993	Agent - Casualty	7/29/2024
Active	National Specialty Insurance Company	300993	Agent - Property	7/29/2024
Active	Next Insurance US Company	1083825	Agent - Casualty	7/26/2024
Active	Next Insurance US Company	1083825	Agent - Property	7/26/2024
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	6/18/2024
Active	Progressive Casualty Insurance Company	300696	Agent - Property	6/18/2024
Active	Security National Insurance Company	301151	Agent - Casualty	12/29/2023
Active	Security National Insurance Company	301151	Agent - Property	12/29/2023
Active	Selective Insurance Company of the Southeast	300381	Agent - Casualty	12/4/2024
Active	Selective Insurance Company of the Southeast	300381	Agent - Property	12/4/2024
Active	Sequoia Insurance Company	628046	Agent - Casualty	12/29/2023
Active	Sequoia Insurance Company	628046	Agent - Property	12/29/2023
Active	SiriusPoint America Insurance Company	301148	Agent - Casualty	2/7/2025
Active	SiriusPoint America Insurance Company	301148	Agent - Property	2/7/2025
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	1/15/2025
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	1/15/2025
Active	Standard Insurance Company	300185	Agent - Health	12/27/2024
Active	Standard Insurance Company	300185	Agent - Life	12/27/2024
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	State National Insurance Company, Inc.	300888	Agent - Casualty	7/29/2024
Active	State National Insurance Company, Inc.	300888	Agent - Property	7/29/2024
Active	Technology Insurance Company	613278	Agent - Casualty	12/29/2023
Active	Technology Insurance Company	613278	Agent - Property	12/29/2023
Active	Travelers Casualty and Surety Company	301067	Agent - Casualty	1/15/2025
Active	Travelers Casualty and Surety Company	301067	Agent - Property	1/15/2025
Active	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	1/23/2025
Active	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	1/23/2025
Active	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	1/23/2025
Active	Travelers Indemnity Company of America (The)	301093	Agent - Property	1/23/2025
Active	Travelers Personal Insurance Company	705785	Agent - Casualty	1/15/2025
Active	Travelers Personal Insurance Company	705785	Agent - Property	1/15/2025
Active	U.S. Specialty Insurance Company	300186	Agent - Casualty	6/18/2024
Active	United Financial Casualty Company	301886	Agent - Casualty	6/18/2024
Active	United Financial Casualty Company	301886	Agent - Property	6/18/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	5/16/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	5/16/2024
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	5/16/2024
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	5/16/2024
Active	Verlan Fire Insurance Company	517102	Agent - Casualty	10/28/2024
Active	Verlan Fire Insurance Company	517102	Agent - Property	10/28/2024
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
Pending	Amorelli, Anthony	1030033	Agent - Casualty
Active	Amorelli, Anthony	1030033	Agent - Health	1/27/2025
Active	Amorelli, Anthony	1030033	Agent - Life	1/27/2025
Pending	Amorelli, Anthony	1030033	Agent - Property
Pending	Avalos, Marlon	1088226	Agent - Casualty
Pending	Avalos, Marlon	1088226	Agent - Health
Pending	Avalos, Marlon	1088226	Agent - Life
Pending	Avalos, Marlon	1088226	Agent - Property
Active	Ebert, John William	750174	Agent - Casualty	1/24/2025
Active	Ebert, John William	750174	Agent - Property	1/24/2025
Active	Ehrenfeld, Eric Jon	954862	Agent - Casualty	1/17/2025
Active	Ehrenfeld, Eric Jon	954862	Agent - Property	1/17/2025
Active	Etcheverry, Ronald Allen	868828	Agent - Casualty	1/29/2025
Pending	Etcheverry, Ronald Allen	868828	Agent - Health
Pending	Etcheverry, Ronald Allen	868828	Agent - Life
Active	Etcheverry, Ronald Allen	868828	Agent - Property	1/29/2025
Pending	Freska, Peter	1326600	Agent - Health
Pending	Freska, Peter	1326600	Agent - Life
Pending	Hampton, Wesley Gordon	653512	Agent - Casualty
Pending	Hampton, Wesley Gordon	653512	Agent - Property
Pending	Hill, Johanna	1350169	Agent - Casualty
Pending	Hill, Johanna	1350169	Agent - Property
Active	Holzman, Michael	1002611	Agent - Casualty	1/28/2025
Active	Holzman, Michael	1002611	Agent - Property	1/28/2025
Pending	Hunter, Travis	1015898	Agent - Health
Pending	Hunter, Travis	1015898	Agent - Life
Pending	Imbriano, Joseph	1113055	Agent - Casualty
Pending	Imbriano, Joseph	1113055	Agent - Health
Pending	Imbriano, Joseph	1113055	Agent - Life
Pending	Imbriano, Joseph	1113055	Agent - Property
Active	Jacobson, David Stewart	971831	Agent - Casualty	1/28/2025
Pending	Jacobson, David Stewart	971831	Agent - Health
Pending	Jacobson, David Stewart	971831	Agent - Life
Active	Jacobson, David Stewart	971831	Agent - Property	1/28/2025
Active	Kolenda, Courtney Lynne	1022910	Agent - Casualty	5/16/2023
Active	Kolenda, Courtney Lynne	1022910	Agent - Health	5/16/2023
Active	Kolenda, Courtney Lynne	1022910	Agent - Life	5/16/2023
Active	Kolenda, Courtney Lynne	1022910	Agent - Property	5/16/2023
Active	Kolenda, Courtney Lynne	1022910	Surplus Lines Broker - Not Applicable	5/25/2023
Pending	Kops, Stewart Jay	1079107	Agent - Casualty
Pending	Kops, Stewart Jay	1079107	Agent - Health
Pending	Kops, Stewart Jay	1079107	Agent - Life
Pending	Kops, Stewart Jay	1079107	Agent - Property
Active	Lawrence, Allen Matta	321297	Agent - Casualty	1/27/2025
Active	Lawrence, Allen Matta	321297	Agent - Property	1/27/2025
Pending	Mahlum, Steven Dale	631930	Agent - Casualty
Pending	Mahlum, Steven Dale	631930	Agent - Health
Pending	Mahlum, Steven Dale	631930	Agent - Life
Pending	Mahlum, Steven Dale	631930	Agent - Property
Pending	Mccall, Marnie Sharr	1372000	Agent - Health
Pending	Mccall, Marnie Sharr	1372000	Agent - Life
Denied	Penrod, Jonathon	1350291	Agent - Casualty
Denied	Penrod, Jonathon	1350291	Agent - Health
Denied	Penrod, Jonathon	1350291	Agent - Life
Denied	Penrod, Jonathon	1350291	Agent - Property
Pending	Reeves, Sylvan Robin	1330704	Agent - Casualty
Pending	Reeves, Sylvan Robin	1330704	Agent - Property
Active	Royle, Shawn	845318	Agent - Casualty	1/17/2025
Active	Royle, Shawn	845318	Agent - Property	1/17/2025
Active	Royle, Shawn	845318	Surplus Lines Broker - Not Applicable	1/17/2025
Pending	Stjernstrom, Kathryn	1307164	Agent - Casualty
Pending	Stjernstrom, Kathryn	1307164	Agent - Property
Active	Stone, Gregory Carl	523289	Agent - Casualty	10/23/2024
Active	Stone, Gregory Carl	523289	Agent - Property	10/23/2024
Active	Vucurevic, Nikola	829383	Agent - Casualty	1/29/2025
Active	Vucurevic, Nikola	829383	Agent - Health	1/29/2025
Pending	Vucurevic, Nikola	829383	Agent - Life
Active	Vucurevic, Nikola	829383	Agent - Property	1/29/2025