DEPARTMENT OF INSURANCE

Name	Safehold Special Risk, Inc	DOIID	658217	NAIC NPN	9142974

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	6/26/2009	3/31/2027
Active	Non Resident	Agent	Health	6/26/2009	3/31/2027
Active	Non Resident	Agent	Casualty	6/20/2007	3/31/2027
Active	Non Resident	Agent	Property	6/20/2007	3/31/2027
Active	Non Resident	Independent Adjuster	Property & Casualty	6/8/2011	3/31/2027
Active	Non Resident	Independent Adjuster	Workers' Compensation	6/8/2011	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/3/2008	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	01/02/2025	01/02/2025	Yes
Independent Adjuster	01/15/2025	03/31/2025	01/02/2025	01/02/2025	Yes
Surplus Lines Broker	01/15/2025	03/31/2025	01/02/2025	01/02/2025	Yes

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	222 S Riverside Plaza Suite 900Chicago, IL 60606

Internet Information

Type	Address
Business Email	licensing@usi.com
Internet	www.usi.com

Phone Information

Type	Phone
Business / Home Office	(312) 920-9177