PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameFusion Specialty Americas Insurance Services LlcDOIID1083560NAIC NPN19487260
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentCasualty5/11/2020 3/31/2026
ActiveNon ResidentAgentProperty5/11/2020 3/31/2026
ActiveNon ResidentSurplus Lines BrokerNot Applicable8/27/2021 3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202603/31/2026   
Surplus Lines Broker01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveImperium Insurance Company300804Agent - Casualty2/27/2023 
ActiveImperium Insurance Company300804Agent - Property2/27/2023 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveHughes, Forest Ingram 876593Agent - Casualty5/11/20202/7/2023
InactiveHughes, Forest Ingram 876593Agent - Property5/11/20202/7/2023
InactiveHughes, Forest Ingram 876593Surplus Lines Broker - Not Applicable8/27/20212/7/2023
ActiveMora, Michael Alan 1212985Agent - Casualty2/27/2023 
ActiveMora, Michael Alan 1212985Agent - Property2/27/2023 
ActiveMora, Michael Alan 1212985Surplus Lines Broker - Not Applicable10/11/2022 
DeniedStortzum, Nathan 1198744Agent - Casualty  
DeniedStortzum, Nathan 1198744Agent - Property  
InactiveStortzum, Nathan 1198744Surplus Lines Broker - Not Applicable2/7/20232/27/2023

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