DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Insurer Details

NAME	MidSouth Mutual Insurance Company
DOI ID	739412
FEIN #	205072333
ALIEN #
State of Domicile	TN
Domicile Country
Merged Into
NAIC #	12839
NAIC Group #	0
Entity Type	Insurer
Admitted	10/11/2010
AM Best Rating
President	James Ronald Carbine
Process Agent	Stacy Sutcliffe Date Assigned : 3/17/2015 (See address table below for process agent address)
Authorized Insurer – these insurers are authorized to do the business of insurance by holding a Kentucky Certificate of Authority. Provides insurance coverage.

Line(s) of Authority

Property

Casualty
Vehicle Insurance
Liability Insurance
Workers' Compensation & Employer's Liability
Burglary & Theft
Personal Property Floater
Glass
Boiler & Machinery
Leakage & Fire Extinguishing Equipment
Credit
Malpractice
Elevator
Congenital Defects
Livestock
Entertainments
Failure of Certain Institutions to Record Documents
Automobile Guaranty
Miscellaneous

Type	Address
Annual Statement	213 5TH AVENUE NORTH NASHVILLE, TN 37219
Mailing	P.O. Box 1949 Brentwood, TN 370241949
Process Agent	104 Continental Place Suite 200 Brentwood, TN 37027
Statutory Home Office	214 Centerview Drive Suite 350 Brentwood, TN 37027

Type	Number
Business / Home Office	(615) 263-1300
Fax	(615) 263-1301
Annual Statement - Fax	(615) 263-1301
Annual Statement - Annual Statement	(615) 263-1300

Type	Internet Information
Annual Statement - Business Email	collette.mangold@bwood.com