DEPARTMENT OF INSURANCE

Name	Western Summit, LLC DBA : Western Summit Inc.	DOIID	702154	NAIC NPN	8096716

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	9/28/2015	3/31/2027
Active	Non Resident	Agent	Casualty	9/28/2015	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/31/2020	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	02/27/2025	02/27/2025	Yes
Surplus Lines Broker	01/15/2025	03/31/2025	02/27/2025	02/27/2025	Yes

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

Address Information

Type	Address
Business / Home Office	5220 S University Dr #C-202 Fort Lauderdale, FL 33328

Internet Information

Type	Address
Business Email	RUSSM@WESTERN-SUMMIT.COM

Phone Information

Type	Phone
Business / Home Office	(954) 475-0201