DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Complex Risk And Ins Assoc LLC	DOIID	873236	NAIC NPN	17431437

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/26/2015		3/31/2027
Active	Non Resident	Agent	Casualty	3/26/2015		3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/8/2015		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	01/15/2027	03/31/2027
Surplus Lines Broker	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Greenwich Insurance Company	301754	Agent - Casualty	7/28/2015
Active	Greenwich Insurance Company	301754	Agent - Property	7/28/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Cozens, Jonathan Brian	841817	Agent - Casualty	3/26/2015	5/14/2019
Inactive	Cozens, Jonathan Brian	841817	Agent - Property	3/26/2015	5/14/2019
Inactive	Dickson, Thomas Russell	841697	Agent - Casualty	7/28/2015	6/3/2025
Inactive	Dickson, Thomas Russell	841697	Agent - Property	7/28/2015	6/3/2025
Inactive	Dickson, Thomas Russell	841697	Surplus Lines Broker - Not Applicable	4/8/2015	6/3/2025
Active	Mairano, Ronald C	639134	Agent - Casualty	6/3/2025
Active	Mairano, Ronald C	639134	Agent - Property	6/3/2025
Active	Mairano, Ronald C	639134	Surplus Lines Broker - Not Applicable	6/3/2025