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DEPARTMENT OF INSURANCE
Affiliations
Name
Industria Risk & Insurance Services LLC
DOIID
987150
NAIC NPN
18512140
License - Line of Authority Information
Status
Residency
Class
Line of Authority
Active Date
Inactive Date
License Expiration Date
Inactive
Non Resident
Agent
Health
3/13/2018
7/1/2019
Inactive
Non Resident
Agent
Property
3/13/2018
3/31/2020
Inactive
Non Resident
Agent
Life
3/13/2018
7/1/2019
Inactive
Non Resident
Agent
Casualty
3/13/2018
3/31/2020
Inactive
Non Resident
Surplus Lines Broker
Not Applicable
3/13/2018
3/31/2020
* 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
Inactive
American Contractors Indemnity Company
536843
Agent - Casualty
9/18/2018
3/31/2020
Inactive
Starr Indemnity and Liability Company
301685
Agent - Casualty
12/11/2019
4/24/2020
Inactive
Starr Indemnity and Liability Company
301685
Agent - Property
12/11/2019
4/24/2020
Inactive
U.S. Specialty Insurance Company
300186
Agent - Casualty
9/18/2018
3/31/2020
Designated Individuals
Status
Affiliation Name
DOI Number
Line of Authority
Active Date
Inactive Date
Inactive
Chavious, Glenn T
561726
Agent - Casualty
3/13/2018
6/13/2019
Inactive
Chavious, Glenn T
561726
Agent - Health
3/13/2018
6/13/2019
Inactive
Chavious, Glenn T
561726
Agent - Life
3/13/2018
6/13/2019
Inactive
Chavious, Glenn T
561726
Agent - Property
3/13/2018
6/13/2019
Inactive
Chavious, Glenn T
561726
Surplus Lines Broker - Not Applicable
3/13/2018
8/15/2019
Denied
Mitilier, Jared Jay
634563
Agent - Casualty
Denied
Mitilier, Jared Jay
634563
Agent - Property
Inactive
Mitilier, Jared Jay
634563
Surplus Lines Broker - Not Applicable
3/13/2018
1/16/2020
Inactive
Sagalow, Ty Rone
1014847
Agent - Casualty
6/13/2019
3/31/2020
Inactive
Sagalow, Ty Rone
1014847
Agent - Property
6/13/2019
3/31/2020
Inactive
Sagalow, Ty Rone
1014847
Surplus Lines Broker - Not Applicable
6/13/2019
3/31/2020
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