DEPARTMENT OF INSURANCE

Affiliations

Name	Safehold Special Risk, Inc	DOIID	658217	NAIC NPN	9142974

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	6/26/2009	3/31/2027
Active	Non Resident	Agent	Health	6/26/2009	3/31/2027
Active	Non Resident	Agent	Property	6/20/2007	3/31/2027
Active	Non Resident	Agent	Casualty	6/20/2007	3/31/2027
Active	Non Resident	Independent Adjuster	Property & Casualty	6/8/2011	3/31/2027
Active	Non Resident	Independent Adjuster	Workers' Compensation	6/8/2011	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/3/2008	3/31/2027
* 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
Active	ACE American Insurance Company	300625	Agent - Casualty	6/30/2014
Active	ACE American Insurance Company	300625	Agent - Health	9/20/2009
Active	ACE American Insurance Company	300625	Agent - Property	6/30/2014
Active	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	6/30/2014
Active	ACE Fire Underwriters Insurance Company	301679	Agent - Property	6/30/2014
Active	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	6/30/2014
Active	ACE Property and Casualty Insurance Company	300520	Agent - Property	6/30/2014
Inactive	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	6/28/2018	5/9/2025
Inactive	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	6/28/2018	5/9/2025
Active	AmTrust Insurance Company	300179	Agent - Casualty	9/20/2017
Active	AmTrust Insurance Company	300179	Agent - Property	9/20/2017
Inactive	American Alternative Insurance Corporation	301697	Agent - Casualty	1/22/2014	10/31/2016
Inactive	American Alternative Insurance Corporation	301697	Agent - Property	1/22/2014	10/31/2016
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Casualty	3/4/2014	10/9/2015
Inactive	American Bankers Insurance Company of Florida	300360	Agent - Property	3/4/2014	10/9/2015
Inactive	American Family Home Insurance Company	301817	Agent - Casualty	1/22/2014	6/12/2015
Inactive	American Family Home Insurance Company	301817	Agent - Property	1/22/2014	6/12/2015
Active	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	2/24/2010
Active	American Guarantee and Liability Insurance Company	301216	Agent - Property	2/24/2010
Active	American Interstate Insurance Company	301092	Agent - Casualty	11/8/2012
Active	American Interstate Insurance Company	301092	Agent - Property	11/8/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	8/19/2014	6/12/2015
Inactive	American Modern Home Insurance Company	300791	Agent - Property	8/19/2014	6/12/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	8/19/2014	6/12/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Property	8/19/2014	6/12/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	1/22/2014	6/12/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Property	1/22/2014	6/12/2015
Active	American Zurich Insurance Company	300592	Agent - Casualty	6/11/2008
Active	American Zurich Insurance Company	300592	Agent - Property	6/11/2008
Inactive	Arch Insurance Company	300688	Agent - Casualty	3/30/2010	6/23/2025
Inactive	Arch Insurance Company	300688	Agent - Property	3/30/2010	6/23/2025
Inactive	Assurance Company of America	300432	Agent - Casualty	6/11/2008	12/17/2014
Inactive	Assurance Company of America	300432	Agent - Property	6/11/2008	12/17/2014
Inactive	Bankers Standard Insurance Company	301620	Agent - Casualty	6/30/2014	6/17/2025
Inactive	Bankers Standard Insurance Company	301620	Agent - Property	6/30/2014	6/17/2025
Active	Berkley Life and Health Insurance Company	301421	Agent - Health	8/8/2018
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	10/21/2010	12/9/2013
Inactive	Employers Assurance Company	300120	Agent - Casualty	3/31/2022	1/3/2024
Inactive	Employers Compensation Insurance Company	797885	Agent - Casualty	3/31/2022	1/3/2024
Inactive	Employers Preferred Insurance Company	520656	Agent - Casualty	3/31/2022	1/3/2024
Inactive	Everest Denali Insurance Company	941054	Agent - Casualty	12/25/2020	1/30/2025
Inactive	Everest Denali Insurance Company	941054	Agent - Property	12/25/2020	1/30/2025
Inactive	Everest National Insurance Company	301319	Agent - Casualty	12/25/2020	1/30/2025
Inactive	Everest National Insurance Company	301319	Agent - Property	12/25/2020	1/30/2025
Inactive	Everest Premier Insurance Company	941053	Agent - Casualty	8/3/2021	1/30/2025
Inactive	Everest Premier Insurance Company	941053	Agent - Property	8/3/2021	1/30/2025
Inactive	Executive Risk Indemnity Inc.	301510	Agent - Casualty	5/6/2024	6/17/2025
Inactive	Executive Risk Indemnity Inc.	301510	Agent - Property	5/6/2024	6/17/2025
Inactive	Farmington Casualty Company	301137	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Farmington Casualty Company	301137	Agent - Property	10/21/2010	12/9/2013
Inactive	Federal Insurance Company	301144	Agent - Casualty	5/6/2024	6/17/2025
Active	Federal Insurance Company	301144	Agent - Health	5/6/2024
Inactive	Federal Insurance Company	301144	Agent - Property	5/6/2024	6/17/2025
Inactive	Granite State Insurance Company	300818	Agent - Casualty	9/25/2014	4/3/2025
Inactive	Granite State Insurance Company	300818	Agent - Property	9/25/2014	4/3/2025
Inactive	Great American Alliance Insurance Company	301247	Agent - Casualty	6/19/2009	4/3/2025
Inactive	Great American Alliance Insurance Company	301247	Agent - Property	6/19/2009	4/3/2025
Inactive	Great American Assurance Company	300327	Agent - Casualty	6/19/2009	4/3/2025
Inactive	Great American Assurance Company	300327	Agent - Property	6/19/2009	4/3/2025
Inactive	Great American Insurance Company	301586	Agent - Casualty	6/19/2009	4/3/2025
Inactive	Great American Insurance Company	301586	Agent - Health	10/19/2017	4/3/2025
Inactive	Great American Insurance Company	301586	Agent - Property	6/19/2009	4/3/2025
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	6/19/2009	4/3/2025
Inactive	Great American Insurance Company of New York	301897	Agent - Property	6/19/2009	4/3/2025
Inactive	Great American Security Insurance Company	301228	Agent - Casualty	9/10/2010	4/3/2025
Inactive	Great American Security Insurance Company	301228	Agent - Property	9/10/2010	4/3/2025
Inactive	Hanover Insurance Company (The)	300508	Agent - Casualty	6/28/2018	5/9/2025
Inactive	Hanover Insurance Company (The)	300508	Agent - Property	6/28/2018	5/9/2025
Inactive	Harleysville Mutual Insurance Company	301393	Agent - Casualty	4/13/2009	9/29/2011
Inactive	Harleysville Mutual Insurance Company	301393	Agent - Property	4/13/2009	9/29/2011
Active	Hartford Accident and Indemnity Company	301917	Agent - Casualty	10/11/2022
Active	Hartford Accident and Indemnity Company	301917	Agent - Property	10/11/2022
Active	Hiscox Insurance Company Inc.	300894	Agent - Casualty	2/5/2014
Active	Hiscox Insurance Company Inc.	300894	Agent - Property	2/5/2014
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	9/25/2014	4/3/2025
Inactive	Illinois National Insurance Company	301367	Agent - Property	9/26/2014	4/3/2025
Active	Indemnity Insurance Company of North America	301760	Agent - Casualty	6/30/2014
Active	Indemnity Insurance Company of North America	301760	Agent - Property	6/30/2014
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	11/14/2011
Active	Manufacturers Alliance Insurance Company	519940	Agent - Casualty	11/29/2016
Active	Manufacturers Alliance Insurance Company	519940	Agent - Property	11/29/2016
Active	Markel American Insurance Company	300377	Agent - Casualty	5/28/2015
Active	Markel American Insurance Company	300377	Agent - Property	5/28/2015
Inactive	Maryland Casualty Company	301719	Agent - Casualty	6/11/2008	12/17/2014
Inactive	Maryland Casualty Company	301719	Agent - Property	6/11/2008	12/17/2014
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	9/20/2017
Active	Milford Casualty Insurance Company	301460	Agent - Property	9/20/2017
Inactive	NOVA Casualty Company	622806	Agent - Casualty	4/30/2010	5/9/2025
Inactive	NOVA Casualty Company	622806	Agent - Property	4/30/2010	5/9/2025
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	12/1/2015	4/3/2025
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	12/1/2015	4/3/2025
Inactive	New Hampshire Insurance Company	301670	Agent - Casualty	9/25/2014	4/3/2025
Inactive	New Hampshire Insurance Company	301670	Agent - Property	9/25/2014	4/3/2025
Inactive	New York Marine and General Insurance Company	301932	Agent - Casualty	10/17/2016	1/4/2023
Inactive	New York Marine and General Insurance Company	301932	Agent - Property	10/17/2016	1/4/2023
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	6/11/2008	12/17/2014
Inactive	Northern Insurance Company of New York	301317	Agent - Property	6/11/2008	12/17/2014
Active	Pacific Employers Insurance Company	301753	Agent - Casualty	6/30/2014
Active	Pacific Employers Insurance Company	301753	Agent - Property	6/30/2014
Inactive	Park National Insurance Company	692514	Agent - Casualty	9/20/2017	3/9/2025
Inactive	Park National Insurance Company	692514	Agent - Property	9/20/2017	3/9/2025
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Casualty	11/29/2016
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Property	11/29/2016
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Casualty	11/29/2016
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Property	11/29/2016
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Casualty	3/25/2019
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Property	3/25/2019
Inactive	RLI Insurance Company	301217	Agent - Casualty	8/26/2022	9/19/2023
Inactive	RLI Insurance Company	301217	Agent - Property	8/26/2022	9/19/2023
Inactive	Rural Community Insurance Company	301891	Agent - Casualty	4/20/2009	4/8/2017
Inactive	Rural Community Insurance Company	301891	Agent - Property	4/20/2009	4/8/2017
Active	Security National Insurance Company	301151	Agent - Casualty	9/20/2017
Active	Security National Insurance Company	301151	Agent - Property	9/20/2017
Active	Sequoia Insurance Company	628046	Agent - Casualty	5/5/2020
Active	Sequoia Insurance Company	628046	Agent - Property	5/5/2020
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	10/21/2010	12/9/2013
Inactive	Star Insurance Company	301553	Agent - Casualty	3/14/2013	6/2/2014
Inactive	Star Insurance Company	301553	Agent - Property	3/14/2013	6/2/2014
Active	StarNet Insurance Company	502746	Agent - Health	8/8/2018
Active	Starr Indemnity and Liability Company	301685	Agent - Casualty	7/19/2021
Active	Starr Indemnity and Liability Company	301685	Agent - Property	7/19/2021
Active	Technology Insurance Company	613278	Agent - Casualty	9/20/2017
Active	Technology Insurance Company	613278	Agent - Property	9/20/2017
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	10/21/2010	12/9/2013
Inactive	The Phoenix Insurance Company	301502	Agent - Property	10/21/2010	12/9/2013
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	10/21/2010	12/9/2013
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	10/21/2010	12/14/2016
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	10/21/2010	12/14/2016
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	10/21/2010	12/9/2013
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	10/21/2010	12/9/2013
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	10/21/2010	12/9/2013
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	10/21/2010	12/9/2013
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	10/21/2010	12/9/2013
Inactive	Watford Insurance Company	556753	Agent - Casualty	2/13/2019	1/31/2025
Inactive	Watford Insurance Company	556753	Agent - Property	2/13/2019	1/31/2025
Active	Wesco Insurance Company	300534	Agent - Casualty	9/20/2017
Active	Wesco Insurance Company	300534	Agent - Property	9/20/2017
Active	Westchester Fire Insurance Company	300990	Agent - Casualty	9/16/2015
Active	Westchester Fire Insurance Company	300990	Agent - Property	9/16/2015
Active	Zurich American Insurance Company	301121	Agent - Casualty	2/24/2010
Active	Zurich American Insurance Company	301121	Agent - Property	2/24/2010
Active	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	2/24/2010
Active	Zurich American Insurance Company of Illinois	301805	Agent - Property	2/24/2010

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Agresti, Kathleen A	843687	Independent Adjuster - Property & Casualty	3/2/2017	6/7/2022
Inactive	Anderson, Curtis T	728813	Agent - Casualty	11/13/2012	4/8/2013
Inactive	Anderson, Curtis T	728813	Agent - Property	11/13/2012	4/8/2013
Denied	Anderson, Joshua Wayne	700587	Agent - Casualty
Denied	Anderson, Joshua Wayne	700587	Agent - Property
Inactive	Baughn, Kevin J	726636	Agent - Casualty	9/21/2012	3/14/2017
Inactive	Baughn, Kevin J	726636	Agent - Property	9/21/2012	3/14/2017
Inactive	Becker, Thomas	558554	Agent - Casualty	5/12/2008	4/15/2014
Inactive	Becker, Thomas	558554	Agent - Property	5/12/2008	4/15/2014
Active	Beckler, Shawn T	699184	Agent - Casualty	9/21/2012
Active	Beckler, Shawn T	699184	Agent - Property	9/21/2012
Active	Beckler, Shawn T	699184	Surplus Lines Broker - Not Applicable	9/21/2012
Inactive	Brogan, Kevin M.	618319	Agent - Casualty	2/28/2008	2/9/2009
Inactive	Brogan, Kevin M.	618319	Agent - Property	2/28/2008	2/9/2009
Inactive	Calderon, Luis A	675031	Agent - Casualty	11/12/2012	4/15/2014
Inactive	Calderon, Luis A	675031	Agent - Property	11/12/2012	4/15/2014
Active	Cash, Corey	631430	Agent - Casualty	9/21/2012
Active	Cash, Corey	631430	Agent - Health	5/29/2024
Active	Cash, Corey	631430	Agent - Life	5/29/2024
Active	Cash, Corey	631430	Agent - Property	11/12/2012
Active	Dalessio, Nicholas J	576577	Agent - Casualty	9/21/2012
Active	Dalessio, Nicholas J	576577	Agent - Property	9/21/2012
Denied	De Vries, Anne Patricia	728745	Agent - Casualty
Denied	De Vries, Anne Patricia	728745	Agent - Property
Inactive	Derouin, Brian E	614895	Agent - Casualty	9/21/2012	5/16/2014
Denied	Derouin, Brian E	614895	Agent - Health
Inactive	Derouin, Brian E	614895	Agent - Property	9/21/2012	5/16/2014
Inactive	Fauber, Carla M	681705	Agent - Casualty	9/21/2012	4/8/2013
Inactive	Fauber, Carla M	681705	Agent - Property	9/21/2012	4/8/2013
Inactive	Ferguson, Thomas A	700344	Agent - Casualty	9/21/2012	1/6/2025
Inactive	Ferguson, Thomas A	700344	Agent - Property	11/12/2012	1/6/2025
Inactive	Hatlem, David	343927	Agent - Casualty	10/30/2023	5/8/2024
Inactive	Hatlem, David	343927	Agent - Health	11/20/2023	5/8/2024
Inactive	Hatlem, David	343927	Agent - Life	11/20/2023	5/8/2024
Inactive	Hatlem, David	343927	Agent - Property	10/30/2023	5/8/2024
Inactive	Hollander, Susan	920514	Agent - Casualty	8/5/2016	10/9/2018
Denied	Hollander, Susan	920514	Agent - Health
Inactive	Hollander, Susan	920514	Agent - Property	8/5/2016	10/9/2018
Inactive	Lucas, Hubert	822694	Agent - Casualty	1/8/2014	10/31/2016
Inactive	Lucas, Hubert	822694	Agent - Property	1/8/2014	10/31/2016
Inactive	Mejia, Annette	635434	Agent - Casualty	4/7/2014	11/18/2015
Inactive	Mejia, Annette	635434	Agent - Property	4/7/2014	11/18/2015
Active	Morgan, Eric	1399787	Independent Adjuster - Property & Casualty	5/21/2025
Active	Morgan, Eric	1399787	Independent Adjuster - Workers' Compensation	5/21/2025
Denied	Olsson, Elizabeth Leigh	701559	Agent - Casualty
Denied	Olsson, Elizabeth Leigh	701559	Agent - Property
Inactive	Patrick, Ryan H	726574	Agent - Casualty	9/21/2012	6/10/2024
Inactive	Patrick, Ryan H	726574	Agent - Property	11/16/2012	6/10/2024
Active	Paulk, John	813350	Agent - Casualty	3/18/2014
Active	Paulk, John	813350	Agent - Property	3/18/2014
Inactive	Paulk, John Irvine	392044	Agent - Casualty	3/18/2014	1/5/2016
Inactive	Paulk, John Irvine	392044	Agent - Property	3/18/2014	1/5/2016
Inactive	Paulk, John Irvine	392044	Surplus Lines Broker - Not Applicable	3/18/2014	1/5/2016
Active	Potter, Lori J	768460	Agent - Casualty	11/12/2012
Active	Potter, Lori J	768460	Agent - Property	11/12/2012
Inactive	Pozmantier, Jeffrey Louis	505617	Agent - Casualty	2/17/2009	10/30/2023
Inactive	Pozmantier, Jeffrey Louis	505617	Agent - Health	4/30/2014	10/30/2023
Inactive	Pozmantier, Jeffrey Louis	505617	Agent - Life	4/30/2014	10/30/2023
Inactive	Pozmantier, Jeffrey Louis	505617	Agent - Property	2/17/2009	10/30/2023
Inactive	Pozmantier, Jeffrey Louis	505617	Surplus Lines Broker - Not Applicable	2/17/2009	11/10/2023
Denied	Richards, Helen A	728024	Agent - Casualty
Denied	Richards, Helen A	728024	Agent - Property
Active	Riley, Mary Ellen	752636	Independent Adjuster - Property & Casualty	6/8/2011
Active	Riley, Mary Ellen	752636	Independent Adjuster - Workers' Compensation	6/8/2011
Inactive	Schreiber, Cheryn R	743001	Agent - Casualty	9/21/2012	4/25/2019
Inactive	Schreiber, Cheryn R	743001	Agent - Property	9/21/2012	4/25/2019
Inactive	Schulze, Mary Beth	511579	Independent Adjuster - Property & Casualty	9/21/2012	5/12/2025
Inactive	Shopoff, Holly Lynn	318319	Agent - Casualty	2/17/2009	5/5/2009
Inactive	Shopoff, Holly Lynn	318319	Agent - Property	2/17/2009	5/5/2009
Inactive	Small, Patrick S	510004	Agent - Casualty	6/20/2007	4/30/2014
Inactive	Small, Patrick S	510004	Agent - Health	6/26/2009	4/30/2014
Inactive	Small, Patrick S	510004	Agent - Life	6/26/2009	4/30/2014
Inactive	Small, Patrick S	510004	Agent - Property	6/20/2007	4/30/2014
Inactive	Small, Patrick S	510004	Surplus Lines Broker - Not Applicable	4/3/2008	4/30/2014
Inactive	Snyder, Donald	541492	Agent - Casualty	7/17/2015	11/30/2020
Inactive	Snyder, Donald	541492	Agent - Property	7/17/2015	11/30/2020
Active	Thim, Cheryl A	717720	Agent - Casualty	11/12/2012
Active	Thim, Cheryl A	717720	Agent - Property	11/12/2012
Inactive	Trull, Joseph	881187	Agent - Casualty	11/10/2015	4/5/2023
Denied	Trull, Joseph	881187	Agent - Health
Inactive	Trull, Joseph	881187	Agent - Property	11/10/2015	4/5/2023
Denied	Wachenschwanz, Doreen A	507110	Agent - Casualty
Denied	Wachenschwanz, Doreen A	507110	Agent - Health
Denied	Wachenschwanz, Doreen A	507110	Agent - Property
Active	Walker, Mistica	1399791	Independent Adjuster - Property & Casualty	5/21/2025
Active	Walker, Mistica	1399791	Independent Adjuster - Workers' Compensation	5/21/2025
Inactive	Walters, Trendolyn	925355	Independent Adjuster - Property & Casualty	8/23/2016	10/18/2024