DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Risk Theory Ins Services LLC	DOIID	901848	NAIC NPN	17746087

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/17/2015		3/31/2027
Active	Non Resident	Agent	Property	12/17/2015		3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/15/2016		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	Clear Blue Insurance Company	517511	Agent - Casualty	10/11/2019
Active	Clear Blue Insurance Company	517511	Agent - Property	10/11/2019
Inactive	New York Marine and General Insurance Company	301932	Agent - Casualty	2/21/2017	7/27/2022
Inactive	New York Marine and General Insurance Company	301932	Agent - Property	2/21/2017	7/27/2022
Active	Rock Ridge Insurance Company	1037246	Agent - Casualty	10/30/2020
Active	Rock Ridge Insurance Company	1037246	Agent - Property	10/30/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Henry, David Scott	1113391	Agent - Casualty	2/23/2021	9/22/2023
Inactive	Henry, David Scott	1113391	Agent - Property	2/23/2021	9/22/2023
Active	Henry, David Scott	1113391	Surplus Lines Broker - Not Applicable	2/23/2021
Inactive	Marshall, Gary Duane	517186	Agent - Casualty	12/15/2015	2/23/2021
Inactive	Marshall, Gary Duane	517186	Agent - Property	12/15/2015	2/23/2021
Inactive	Marshall, Gary Duane	517186	Surplus Lines Broker - Not Applicable	10/10/2019	2/23/2021
Active	Sustala, Edward John	913996	Agent - Casualty	6/2/2022
Active	Sustala, Edward John	913996	Agent - Property	6/2/2022
Active	Sustala, Edward John	913996	Surplus Lines Broker - Not Applicable	6/2/2022
Inactive	Wilburn, Bryan	649862	Surplus Lines Broker - Not Applicable	3/15/2016	7/31/2019