DEPARTMENT OF INSURANCE

Name	Sivy, David A	DOIID	693054	NAIC NPN	3331843

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Agent	Casualty	11/6/2008		10/31/2025
Active	Non Resident	Agent	Property	11/6/2008		10/31/2025

*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	08/15/2025	10/31/2025

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	1349 W Lane Ave Ste 900 Columbus, OH 432213503

Internet Information

Type	Address
Business Email	david.sivy@assuredpartners.com - Bad Email-Correction requested

Phone Information

Type	Phone
Business / Home Office	(614) 224-0772