DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Perry, Derek J	DOIID	1033897	NAIC NPN	19071941

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/25/2019		4/30/2027
Active	Non Resident	Agent	Casualty	3/25/2019		4/30/2027
* 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	GuideOne Elite Insurance Company	300490	Agent - Casualty	4/3/2019	4/29/2025
Inactive	GuideOne Elite Insurance Company	300490	Agent - Property	4/3/2019	4/29/2025
Inactive	GuideOne Insurance Company	301794	Agent - Casualty	4/3/2019	4/29/2025
Inactive	GuideOne Insurance Company	301794	Agent - Property	4/3/2019	4/29/2025
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Casualty	4/3/2019	4/29/2025
Inactive	GuideOne Specialty Insurance Company	300278	Agent - Property	4/3/2019	4/29/2025
Active	National Specialty Insurance Company	300993	Agent - Casualty	12/14/2022
Active	National Specialty Insurance Company	300993	Agent - Property	12/14/2022
Inactive	Next Insurance US Company	1083825	Agent - Casualty	12/12/2022	4/29/2025
Inactive	Next Insurance US Company	1083825	Agent - Property	12/12/2022	4/29/2025
Active	State National Insurance Company, Inc.	300888	Agent - Casualty	12/14/2022
Active	State National Insurance Company, Inc.	300888	Agent - Property	12/14/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Suracy Insurance Agency, Inc	923753	Agent - Casualty	4/3/2019
Active	Suracy Insurance Agency, Inc	923753	Agent - Property	4/3/2019