DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	At-Bay Insurance Services LLC	DOIID	978951	NAIC NPN	18403293

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/11/2017		3/31/2025
Active	Non Resident	Agent	Property	12/11/2017		3/31/2025
Active	Non Resident	Independent Adjuster	Property & Casualty	5/23/2023		3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	12/11/2017		3/31/2025
* 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
Independent Adjuster	01/15/2025	03/31/2025
Surplus Lines Broker	01/15/2025	03/31/2025

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	4/4/2022
Active	Clear Blue Insurance Company	517511	Agent - Property	4/4/2022
Active	Hartford Steam Boiler Inspection and Insurance Company	300799	Agent - Casualty	3/6/2018
Active	Hartford Steam Boiler Inspection and Insurance Company	300799	Agent - Property	3/6/2018

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hughes, Forest Ingram	876593	Agent - Casualty	12/11/2017
Active	Hughes, Forest Ingram	876593	Agent - Property	12/11/2017
Active	Hughes, Forest Ingram	876593	Surplus Lines Broker - Not Applicable	12/11/2017
Active	Sadoff, Brett Stuart	953225	Agent - Casualty	9/9/2019
Active	Sadoff, Brett Stuart	953225	Agent - Property	9/9/2019
Active	Sadoff, Brett Stuart	953225	Surplus Lines Broker - Not Applicable	9/9/2019
Active	Verdi, Julia Frances	1100889	Independent Adjuster - Property & Casualty	5/23/2023
Inactive	Ward, Cameron Bronson	833249	Agent - Casualty	12/11/2017	9/9/2019
Inactive	Ward, Cameron Bronson	833249	Agent - Property	12/11/2017	9/9/2019
Inactive	Ward, Cameron Bronson	833249	Surplus Lines Broker - Not Applicable	12/11/2017	9/9/2019