DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Capitol Risk Management Services, Ltd	DOIID	604655	NAIC NPN	2013820

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	12/19/2005	3/31/2021
Inactive	Non Resident	Agent	Casualty	12/19/2005	3/31/2021
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	7/15/2013	3/31/2021
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	7/15/2013	3/31/2021
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	6/27/2017	10/3/2017
Inactive	Ohio Security Insurance Company	300622	Agent - Property	6/27/2017	10/3/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kohlhausen, Richard L	342034	Agent - Casualty	12/19/2005	3/31/2021
Inactive	Kohlhausen, Richard L	342034	Agent - Property	12/19/2005	3/31/2021