DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Mga, LLC DBA : Acrisure Risk Insurance Services, KF&B Program Managers Insurance Services	DOIID	862250	NAIC NPN	17432980

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	12/23/2014	3/31/2026
Active	Non Resident	Agent	Life	1/27/2020	3/31/2026
Active	Non Resident	Agent	Health	5/16/2018	3/31/2026
Active	Non Resident	Agent	Casualty	12/23/2014	3/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	12/23/2014	3/31/2026
* 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	Manufacturers Alliance Insurance Company	519940	Agent - Casualty	10/28/2015
Active	Manufacturers Alliance Insurance Company	519940	Agent - Property	10/28/2015
Inactive	New York Marine and General Insurance Company	301932	Agent - Casualty	8/11/2015	6/6/2019
Inactive	New York Marine and General Insurance Company	301932	Agent - Property	8/11/2015	6/6/2019
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Casualty	10/28/2015
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Property	10/28/2015
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Casualty	10/28/2015
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Property	10/28/2015
Inactive	Protective Insurance Company	301117	Agent - Casualty	3/5/2018	3/9/2018
Inactive	Protective Insurance Company	301117	Agent - Property	3/5/2018	3/9/2018

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hayward, Sharon Rose	837774	Agent - Casualty	12/23/2014	3/19/2019
Denied	Hayward, Sharon Rose	837774	Agent - Health
Inactive	Hayward, Sharon Rose	837774	Agent - Life	12/23/2014	3/19/2019
Inactive	Hayward, Sharon Rose	837774	Agent - Property	12/23/2014	3/19/2019
Inactive	Hayward, Sharon Rose	837774	Surplus Lines Broker - Not Applicable	12/23/2014	1/17/2020
Active	Kalior, Lawrence John	360965	Agent - Casualty	3/19/2019
Active	Kalior, Lawrence John	360965	Agent - Property	3/19/2019
Active	Kalior, Lawrence John	360965	Surplus Lines Broker - Not Applicable	12/4/2014
Active	Kolenda, Courtney Lynne	1022910	Agent - Casualty	3/28/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Health	3/19/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Life	1/27/2020
Active	Kolenda, Courtney Lynne	1022910	Agent - Property	3/28/2019
Active	Kolenda, Courtney Lynne	1022910	Surplus Lines Broker - Not Applicable	3/19/2019
Active	Leinenbach, Michael	1065331	Agent - Casualty	2/19/2020
Active	Leinenbach, Michael	1065331	Agent - Property	2/19/2020
Inactive	Parker, William L	511526	Agent - Casualty	4/28/2018	3/19/2019
Inactive	Parker, William L	511526	Agent - Health	5/16/2018	3/19/2019
Inactive	Parker, William L	511526	Agent - Life	5/1/2018	3/19/2019
Inactive	Parker, William L	511526	Agent - Property	4/28/2018	3/19/2019
Active	Whitten, John	1197203	Agent - Health	6/21/2022
Active	Whitten, John	1197203	Agent - Life	6/21/2022