DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Affiliated Ins Agencies LLC	DOIID	945179	NAIC NPN	18277910

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	2/16/2017	3/31/2027
Active	Non Resident	Agent	Life	2/16/2017	3/31/2027
Active	Non Resident	Agent	Property	5/22/2017	3/31/2027
Active	Non Resident	Agent	Casualty	5/22/2017	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	01/15/2025	03/31/2025	01/30/2025	01/30/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	1/12/2022	10/17/2024
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	1/12/2022	10/17/2024
Active	AMCO Insurance Company	300204	Agent - Casualty	2/23/2018
Active	AMCO Insurance Company	300204	Agent - Property	2/23/2018
Active	Allied Insurance Company of America	793586	Agent - Casualty	2/23/2018
Active	Allied Insurance Company of America	793586	Agent - Property	2/23/2018
Active	Allied Property and Casualty Insurance Company	300279	Agent - Casualty	2/23/2018
Active	Allied Property and Casualty Insurance Company	300279	Agent - Property	2/23/2018
Inactive	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	3/29/2024
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	3/29/2024
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	11/9/2017	12/20/2018
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	11/9/2017	12/20/2018
Active	Depositors Insurance Company	301634	Agent - Casualty	2/23/2018
Active	Depositors Insurance Company	301634	Agent - Property	2/23/2018
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	6/16/2017	8/1/2023
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Property	6/16/2017	8/1/2023
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty	2/23/2018
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Property	2/23/2018
Active	Nationwide Assurance Company	300166	Agent - Casualty	3/4/2020
Active	Nationwide General Insurance Company	300603	Agent - Casualty	8/28/2019
Active	Nationwide General Insurance Company	300603	Agent - Property	8/28/2019
Active	Nationwide Insurance Company of America	300333	Agent - Casualty	8/28/2019
Active	Nationwide Insurance Company of America	300333	Agent - Property	8/28/2019
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	2/23/2018
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	2/23/2018
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	2/2/2022
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	2/2/2022
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/6/2017	3/29/2024
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/6/2017	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/6/2017	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/6/2017	3/29/2024
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	11/9/2017	11/16/2023
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	11/9/2017	11/16/2023
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	11/9/2017	12/20/2018
Inactive	The Phoenix Insurance Company	301502	Agent - Property	11/9/2017	12/20/2018
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	11/9/2017	11/16/2023
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	11/9/2017	11/16/2023
Inactive	Travelers Personal Insurance Company	705785	Agent - Casualty	7/29/2020	11/26/2024
Inactive	Travelers Personal Insurance Company	705785	Agent - Property	7/29/2020	11/26/2024
Inactive	Trumbull Insurance Company	300242	Agent - Casualty	8/24/2017	9/27/2019
Inactive	Trumbull Insurance Company	300242	Agent - Property	8/24/2017	9/27/2019
Active	Western Surety Company	300283	Agent - Casualty	8/5/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Abdullah, Henry Shaheen	569423	Agent - Casualty	6/21/2019	7/3/2019
Inactive	Abdullah, Henry Shaheen	569423	Agent - Property	6/21/2019	7/3/2019
Active	Brown, Edward	958197	Agent - Casualty	7/5/2022
Active	Brown, Edward	958197	Agent - Property	7/5/2022
Inactive	Collins, Donald Martin	866041	Agent - Casualty	2/20/2017	3/24/2017
Inactive	Collins, Donald Martin	866041	Agent - Health	2/16/2017	3/24/2017
Inactive	Collins, Donald Martin	866041	Agent - Life	2/16/2017	3/24/2017
Inactive	Collins, Donald Martin	866041	Agent - Property	2/20/2017	3/24/2017
Inactive	Gampfer, David M	608061	Agent - Casualty	6/21/2019	7/3/2019
Inactive	Gampfer, David M	608061	Agent - Property	6/21/2019	7/3/2019
Inactive	Harris, Jennifer	819531	Agent - Casualty	9/1/2022	10/3/2022
Inactive	Harris, Jennifer	819531	Agent - Property	9/1/2022	10/3/2022
Inactive	Hayward, Sharon Rose	837774	Agent - Casualty	5/22/2017	1/17/2020
Denied	Hayward, Sharon Rose	837774	Agent - Health
Inactive	Hayward, Sharon Rose	837774	Agent - Life	5/11/2017	1/17/2020
Inactive	Hayward, Sharon Rose	837774	Agent - Property	5/22/2017	1/17/2020
Denied	Holzman, Michael	1002611	Agent - Casualty
Denied	Holzman, Michael	1002611	Agent - Property
Inactive	Keller, Sharmaine Annette	518191	Agent - Casualty	6/21/2019	7/3/2019
Inactive	Keller, Sharmaine Annette	518191	Agent - Property	6/21/2019	7/3/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Casualty	5/31/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Health	5/31/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Life	7/1/2019
Active	Kolenda, Courtney Lynne	1022910	Agent - Property	5/31/2019
Inactive	Mcbride, Shawn Patrick	945034	Agent - Casualty	4/20/2018	3/28/2023
Denied	Mcbride, Shawn Patrick	945034	Agent - Health
Denied	Mcbride, Shawn Patrick	945034	Agent - Life
Inactive	Mcbride, Shawn Patrick	945034	Agent - Property	4/20/2018	3/28/2023
Denied	Parker, William L	511526	Agent - Casualty
Inactive	Parker, William L	511526	Agent - Health	3/29/2017	1/22/2020
Inactive	Parker, William L	511526	Agent - Life	3/29/2017	1/22/2020
Denied	Parker, William L	511526	Agent - Property