DEPARTMENT OF INSURANCE

Affiliations

Name	Triad Insurance Management & Services Agency, Inc.	DOIID	521788	NAIC NPN	3926012

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	3/12/2001	3/31/2027
Active	Non Resident	Agent	Casualty	3/12/2001	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/29/2022	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	01/15/2027	03/31/2027
Surplus Lines Broker	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Accelerant National Insurance Company	538882	Agent - Casualty	2/20/2023
Active	Accelerant National Insurance Company	538882	Agent - Property	2/20/2023
Inactive	Clarendon National Insurance Company	300843	Agent - Casualty	8/13/2001	3/31/2008
Inactive	Clarendon National Insurance Company	300843	Agent - Property	8/13/2001	3/31/2008
Inactive	Great American Assurance Company	300327	Agent - Casualty	1/14/2004	5/25/2021
Inactive	Great American Assurance Company	300327	Agent - Property	1/14/2004	5/25/2021
Inactive	Great American Insurance Company	301586	Agent - Casualty	1/14/2004	5/25/2021
Inactive	Great American Insurance Company	301586	Agent - Property	1/14/2004	5/25/2021
Active	HDI Global Insurance Company	676678	Agent - Casualty	8/9/2023
Active	HDI Global Insurance Company	676678	Agent - Property	8/9/2023
Inactive	Hallmark Insurance Company	301637	Agent - Casualty	4/27/2017	11/7/2023
Inactive	Hallmark Insurance Company	301637	Agent - Property	4/27/2017	11/7/2023
Inactive	Hudson Insurance Company	523144	Agent - Casualty	10/25/2005	7/21/2008
Inactive	Hudson Insurance Company	523144	Agent - Property	10/25/2005	7/21/2008
Active	Mitsui Sumitomo Insurance Company of America	301070	Agent - Casualty	2/28/2023
Active	Mitsui Sumitomo Insurance Company of America	301070	Agent - Property	2/28/2023
Active	Mitsui Sumitomo Insurance USA Inc.	301681	Agent - Casualty	2/28/2023
Active	Mitsui Sumitomo Insurance USA Inc.	301681	Agent - Property	2/28/2023
Inactive	Praetorian Insurance Company	301021	Agent - Casualty	11/13/2009	11/6/2020
Inactive	Praetorian Insurance Company	301021	Agent - Property	11/13/2009	11/6/2020
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	11/13/2009	11/6/2020
Inactive	QBE Insurance Corporation	300515	Agent - Property	11/13/2009	11/6/2020
Inactive	Security Insurance Company of Hartford	300973	Agent - Casualty	3/12/2001	1/15/2002
Inactive	Security Insurance Company of Hartford	300973	Agent - Property	3/12/2001	1/15/2002
Active	StarStone National Insurance Company	300812	Agent - Casualty	7/31/2012
Active	StarStone National Insurance Company	300812	Agent - Property	7/31/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dascaloff, Lisa A	661616	Agent - Casualty	10/1/2007
Active	Dascaloff, Lisa A	661616	Agent - Property	10/1/2007
Active	Dascaloff, Lisa A	661616	Surplus Lines Broker - Not Applicable	6/29/2022
Inactive	Stubbendieck, Bradley A	513143	Agent - Casualty	3/12/2001	1/28/2010
Inactive	Stubbendieck, Bradley A	513143	Agent - Property	3/12/2001	1/28/2010