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	License Expiration Date
Active	Non Resident	Agent	Property	9/23/2005	3/31/2025
Active	Non Resident	Agent	Casualty	9/23/2005	3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/14/2008	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
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