DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Card Protection Program Insurance Agency LLC	DOIID	1314615	NAIC NPN	21011258

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	12/13/2023		3/31/2025
Active	Non Resident	Agent	Casualty	12/13/2023		3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	12/28/2023		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

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Kolenda, Courtney Lynne	1022910	Agent - Casualty	12/13/2023
Active	Kolenda, Courtney Lynne	1022910	Agent - Property	12/13/2023
Active	Kolenda, Courtney Lynne	1022910	Surplus Lines Broker - Not Applicable	12/28/2023