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DEPARTMENT OF INSURANCE
Affiliations
Name
Seattle Specialty Ins Services Inc
DOIID
611726
NAIC NPN
2763110
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Active
Non Resident
Agent
Casualty
9/23/2005
3/31/2027
Active
Non Resident
Agent
Property
9/23/2005
3/31/2027
Active
Non Resident
Surplus Lines Broker
Not Applicable
1/14/2008
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
01/21/2025
01/21/2025
Yes
Surplus Lines Broker
01/15/2025
03/31/2025
01/21/2025
01/21/2025
Yes
Appointments with the following Insurers
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
American Family Home Insurance Company
301817
Agent - Casualty
10/7/2005
6/16/2021
Inactive
American Family Home Insurance Company
301817
Agent - Property
10/7/2005
6/16/2021
Inactive
American Modern Home Insurance Company
300791
Agent - Casualty
10/7/2005
6/16/2021
Inactive
American Modern Home Insurance Company
300791
Agent - Property
10/7/2005
6/16/2021
Inactive
American National Property and Casualty Company
300392
Agent - Casualty
9/2/2015
7/15/2016
Inactive
American National Property and Casualty Company
300392
Agent - Property
9/2/2015
7/15/2016
Active
Arch Insurance Company
300688
Agent - Casualty
7/31/2007
Active
Arch Insurance Company
300688
Agent - Property
7/31/2007
Active
Colonial American Casualty & Surety Company
300769
Agent - Casualty
10/27/2005
Active
Colonial American Casualty & Surety Company
300769
Agent - Property
10/27/2005
Active
Fidelity and Deposit Company of Maryland
300976
Agent - Casualty
10/27/2005
Active
Fidelity and Deposit Company of Maryland
300976
Agent - Property
10/27/2005
Inactive
Great American Assurance Company
300327
Agent - Casualty
10/25/2005
11/14/2022
Inactive
Great American Assurance Company
300327
Agent - Property
10/25/2005
11/14/2022
Inactive
Great American Insurance Company
301586
Agent - Casualty
10/25/2005
11/14/2022
Inactive
Great American Insurance Company
301586
Agent - Property
10/25/2005
11/14/2022
Active
Integon National Insurance Company
301600
Agent - Casualty
10/28/2016
Active
Integon National Insurance Company
301600
Agent - Property
10/28/2016
Active
MIC General Insurance Corporation
300398
Agent - Casualty
10/28/2016
Active
MIC General Insurance Corporation
300398
Agent - Property
10/28/2016
Inactive
National Interstate Insurance Company
301301
Agent - Casualty
10/5/2005
6/28/2006
Inactive
National Interstate Insurance Company
301301
Agent - Property
10/5/2005
6/28/2006
Inactive
Spinnaker Insurance Company
300099
Agent - Casualty
10/6/2005
12/31/2008
Inactive
Spinnaker Insurance Company
300099
Agent - Property
10/6/2005
12/31/2008
Inactive
Tesla Insurance Company
300337
Agent - Casualty
1/4/2006
9/8/2014
Inactive
Tesla Insurance Company
300337
Agent - Property
1/4/2006
9/8/2014
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Dickson, John Allan
734742
Agent - Casualty
6/27/2011
3/9/2015
Inactive
Dickson, John Allan
734742
Agent - Property
6/27/2011
3/9/2015
Inactive
Dickson, John Allan
734742
Surplus Lines Broker - Not Applicable
6/27/2011
3/9/2015
Inactive
Kuhn, David Allen
595028
Agent - Casualty
6/27/2011
3/19/2012
Inactive
Kuhn, David Allen
595028
Agent - Property
6/27/2011
3/19/2012
Inactive
Kuhn, David Allen
595028
Surplus Lines Broker - Not Applicable
6/27/2011
3/19/2012
Active
Montcrieffe, Evelina Katherina
996826
Agent - Casualty
4/12/2019
Active
Montcrieffe, Evelina Katherina
996826
Agent - Property
4/12/2019
Active
Montcrieffe, Evelina Katherina
996826
Surplus Lines Broker - Not Applicable
3/25/2019
Inactive
Pedack, Richard E
352654
Agent - Casualty
9/23/2005
3/25/2019
Inactive
Pedack, Richard E
352654
Agent - Property
9/23/2005
3/25/2019
Inactive
Pedack, Richard E
352654
Surplus Lines Broker - Not Applicable
1/14/2008
3/25/2019
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