DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Crum & Forster Insurance Brokers, Inc.	DOIID	570764	NAIC NPN	1332882

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	6/30/2003		3/31/2025
Active	Non Resident	Agent	Casualty	6/30/2003		3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/8/2020		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	Inactive Date
Active	Crum & Forster Indemnity Company	582241	Agent - Casualty	5/21/2008
Active	Crum & Forster Indemnity Company	582241	Agent - Property	5/21/2008
Inactive	Fairmont Insurance Company	301924	Agent - Casualty	7/9/2003	3/31/2010
Inactive	Fairmont Insurance Company	301924	Agent - Property	7/9/2003	3/31/2010
Active	North River Insurance Company (The)	301739	Agent - Casualty	1/4/2019
Active	North River Insurance Company (The)	301739	Agent - Property	1/4/2019
Inactive	StarStone National Insurance Company	300812	Agent - Casualty	7/9/2003	3/29/2004
Inactive	StarStone National Insurance Company	300812	Agent - Property	7/9/2003	3/29/2004
Inactive	TIG Insurance Company	301750	Agent - Casualty	6/30/2003	11/4/2003
Inactive	TIG Insurance Company	301750	Agent - Property	6/30/2003	11/4/2003
Active	United States Fire Insurance Company	582240	Agent - Casualty	9/14/2006
Active	United States Fire Insurance Company	582240	Agent - Property	9/14/2006

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Adee, Marc James	825840	Agent - Casualty	3/27/2014	5/2/2017
Inactive	Adee, Marc James	825840	Agent - Property	3/27/2014	5/2/2017
Inactive	Brown, Duane Walter	524609	Agent - Casualty	6/25/2004	4/23/2012
Inactive	Brown, Duane Walter	524609	Agent - Property	6/25/2004	4/23/2012
Inactive	Lala, Teresa Dawn	878640	Agent - Casualty	8/11/2015	6/21/2023
Inactive	Lala, Teresa Dawn	878640	Agent - Property	8/11/2015	6/21/2023
Active	Paddock, Amie Berry	1117398	Agent - Casualty	7/5/2023
Active	Paddock, Amie Berry	1117398	Agent - Property	7/5/2023
Active	Paddock, Amie Berry	1117398	Surplus Lines Broker - Not Applicable	3/9/2021
Inactive	Simons, Kathy Ann	558438	Agent - Casualty	6/30/2003	6/25/2004
Inactive	Simons, Kathy Ann	558438	Agent - Property	6/30/2003	6/25/2004
Inactive	Strange, Stephen Luther	668711	Agent - Casualty	4/23/2012	3/27/2014
Inactive	Strange, Stephen Luther	668711	Agent - Property	4/23/2012	3/27/2014
Inactive	Tortorici, Maureen	969016	Surplus Lines Broker - Not Applicable	7/8/2020	7/5/2023