DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Mid-Atlantic XS Program Insurance Agency, LLC	DOIID	723396	NAIC NPN	7114514

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	3/5/2010		3/31/2028
Active	Non Resident	Agent	Property	3/5/2010		3/31/2028
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/19/2014		3/31/2028
* 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	Great American Insurance Company	301586	Agent - Casualty	1/8/2015
Active	Great American Insurance Company	301586	Agent - Property	1/8/2015
Active	HDI Global Insurance Company	676678	Agent - Casualty	8/9/2023
Active	HDI Global Insurance Company	676678	Agent - Property	8/9/2023
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	6/17/2016	11/30/2017
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Property	6/17/2016	11/30/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Coleman, Laurie Summers	721578	Agent - Casualty	3/5/2010
Active	Coleman, Laurie Summers	721578	Agent - Property	3/5/2010
Active	Coleman, Laurie Summers	721578	Surplus Lines Broker - Not Applicable	3/19/2014