DEPARTMENT OF INSURANCE

Affiliations

Name	Acrisure Northwest Partners Insurance Services LLC	DOIID	1246859	NAIC NPN	20555810

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	12/14/2022	3/31/2026
Active	Non Resident	Agent	Casualty	12/14/2022	3/31/2026
Active	Non Resident	Agent	Health	12/14/2022	3/31/2026
Active	Non Resident	Agent	Life	12/14/2022	3/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/6/2023	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

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2026	03/31/2026
Surplus Lines Broker	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	ACE American Insurance Company	300625	Agent - Casualty	3/14/2025
Active	ACE American Insurance Company	300625	Agent - Property	3/14/2025
Active	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	3/14/2025
Active	ACE Fire Underwriters Insurance Company	301679	Agent - Property	3/14/2025
Active	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	3/14/2025
Active	ACE Property and Casualty Insurance Company	300520	Agent - Property	3/14/2025
Active	AIG Property Casualty Company	300621	Agent - Casualty	8/19/2024
Active	AIG Property Casualty Company	300621	Agent - Property	8/19/2024
Active	Accendo Insurance Company	300312	Agent - Life	8/12/2024
Active	Addison Insurance Company	874810	Agent - Casualty	8/23/2024
Active	Addison Insurance Company	874810	Agent - Property	8/23/2024
Active	Aetna Health and Life Insurance Company	300523	Agent - Health	8/12/2024
Active	All Savers Insurance Company	301940	Agent - Health	7/11/2024
Active	All Savers Insurance Company	301940	Agent - Life	7/11/2024
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Casualty	10/29/2024
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Property	10/29/2024
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	10/29/2024
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	10/29/2024
Active	AmTrust Insurance Company	300179	Agent - Casualty	12/29/2023
Active	AmTrust Insurance Company	300179	Agent - Property	12/29/2023
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	1/21/2024
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	1/21/2024
Active	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	1/24/2024
Active	Anthem Insurance Companies, Inc.	300941	Agent - Health	1/24/2024
Inactive	Anthem Life Insurance Company	301209	Agent - Health	1/26/2024	4/15/2025
Inactive	Anthem Life Insurance Company	301209	Agent - Life	1/26/2024	4/15/2025
Active	Arch Indemnity Insurance Company	301459	Agent - Casualty	4/24/2025
Active	Arch Indemnity Insurance Company	301459	Agent - Property	4/24/2025
Active	Arch Insurance Company	300688	Agent - Casualty	4/24/2025
Active	Arch Insurance Company	300688	Agent - Property	4/24/2025
Active	Auto-Owners Insurance Company	301480	Agent - Casualty	10/4/2024
Active	Auto-Owners Insurance Company	301480	Agent - Property	10/4/2024
Active	Bankers Standard Insurance Company	301620	Agent - Casualty	3/14/2025
Active	Bankers Standard Insurance Company	301620	Agent - Property	3/14/2025
Active	Chubb Indemnity Insurance Company	300438	Agent - Casualty	3/14/2025
Active	Chubb Indemnity Insurance Company	300438	Agent - Property	3/14/2025
Active	Chubb National Insurance Company	301392	Agent - Casualty	3/14/2025
Active	Chubb National Insurance Company	301392	Agent - Property	3/14/2025
Active	Cincinnati Casualty Company (The)	300308	Agent - Casualty	11/21/2024
Active	Cincinnati Casualty Company (The)	300308	Agent - Property	11/21/2024
Active	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	11/21/2024
Active	Cincinnati Indemnity Company (The)	301566	Agent - Property	11/21/2024
Active	Cincinnati Insurance Company	301298	Agent - Casualty	11/21/2024
Active	Cincinnati Insurance Company	301298	Agent - Property	11/21/2024
Active	Compcare Health Services Insurance Corporation	948751	Agent - Health	1/24/2024
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Health	8/12/2024
Active	Continental Life Insurance Company of Brentwood Tennessee	301526	Agent - Life	8/12/2024
Active	Employers Assurance Company	300120	Agent - Casualty	4/2/2024
Active	Employers Compensation Insurance Company	797885	Agent - Casualty	4/2/2024
Active	Employers Preferred Insurance Company	520656	Agent - Casualty	4/2/2024
Active	Executive Risk Indemnity Inc.	301510	Agent - Casualty	3/14/2025
Active	Executive Risk Indemnity Inc.	301510	Agent - Property	3/14/2025
Active	Federal Insurance Company	301144	Agent - Casualty	3/14/2025
Active	Federal Insurance Company	301144	Agent - Property	3/14/2025
Active	Great Northern Insurance Company	301107	Agent - Casualty	3/14/2025
Active	Great Northern Insurance Company	301107	Agent - Property	3/14/2025
Active	Hanover American Insurance Company (The)	300447	Agent - Casualty	10/29/2024
Active	Hanover American Insurance Company (The)	300447	Agent - Property	10/29/2024
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	10/29/2024
Active	Hanover Insurance Company (The)	300508	Agent - Property	10/29/2024
Active	Indemnity Insurance Company of North America	301760	Agent - Casualty	3/14/2025
Active	Indemnity Insurance Company of North America	301760	Agent - Property	3/14/2025
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	8/6/2024
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Property	8/6/2024
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	3/29/2024
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Property	3/29/2024
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	3/29/2024
Active	Liberty Mutual Insurance Company	301159	Agent - Property	3/29/2024
Active	Massachusetts Bay Insurance Company	300898	Agent - Casualty	10/29/2024
Active	Massachusetts Bay Insurance Company	300898	Agent - Property	10/29/2024
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	12/29/2023
Active	Milford Casualty Insurance Company	301460	Agent - Property	12/29/2023
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	8/6/2024
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	8/6/2024
Active	Pacific Employers Insurance Company	301753	Agent - Casualty	3/14/2025
Active	Pacific Employers Insurance Company	301753	Agent - Property	3/14/2025
Active	Pacific Indemnity Company	301610	Agent - Casualty	3/14/2025
Active	Pacific Indemnity Company	301610	Agent - Property	3/14/2025
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	5/6/2024
Active	Progressive Casualty Insurance Company	300696	Agent - Property	5/6/2024
Active	Security National Insurance Company	301151	Agent - Casualty	12/29/2023
Active	Security National Insurance Company	301151	Agent - Property	12/29/2023
Active	Selective Insurance Company of the Southeast	300381	Agent - Casualty	12/4/2024
Active	Selective Insurance Company of the Southeast	300381	Agent - Property	12/4/2024
Active	Sequoia Insurance Company	628046	Agent - Casualty	12/29/2023
Active	Sequoia Insurance Company	628046	Agent - Property	12/29/2023
Active	Starr Indemnity and Liability Company	301685	Agent - Casualty	4/1/2024
Active	Starr Indemnity and Liability Company	301685	Agent - Health	4/1/2024
Active	Starr Indemnity and Liability Company	301685	Agent - Property	4/1/2024
Active	Technology Insurance Company	613278	Agent - Casualty	12/29/2023
Active	Technology Insurance Company	613278	Agent - Property	12/29/2023
Active	United Financial Casualty Company	301886	Agent - Casualty	5/6/2024
Active	United Financial Casualty Company	301886	Agent - Property	5/6/2024
Active	United Fire & Casualty Company	301374	Agent - Casualty	8/23/2024
Active	United Fire & Casualty Company	301374	Agent - Property	8/23/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Health	7/11/2024
Active	UnitedHealthcare Insurance Company	300946	Agent - Life	7/11/2024
Active	UnitedHealthcare of Kentucky, Ltd.	301337	Agent - Health	7/11/2024
Active	UnitedHealthcare of Ohio, Inc.	300493	Agent - Health	7/11/2024
Active	Verlan Fire Insurance Company	517102	Agent - Casualty	10/29/2024
Active	Verlan Fire Insurance Company	517102	Agent - Property	10/29/2024
Active	Vigilant Insurance Company	301143	Agent - Casualty	3/14/2025
Active	Vigilant Insurance Company	301143	Agent - Property	3/14/2025
Active	WellCare Health Insurance Company of Kentucky, Inc.	301478	Agent - Health	2/1/2025
Active	WellCare Prescription Insurance Inc.	654329	Agent - Health	2/1/2025
Active	Wesco Insurance Company	300534	Agent - Casualty	12/29/2023
Active	Wesco Insurance Company	300534	Agent - Property	12/29/2023
Active	Westchester Fire Insurance Company	300990	Agent - Casualty	3/14/2025
Active	Westchester Fire Insurance Company	300990	Agent - Property	3/14/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Baker, Lloyd Richard	1252185	Agent - Casualty	6/17/2025
Active	Baker, Lloyd Richard	1252185	Agent - Property	6/17/2025
Active	Buckalew, Patricia	929949	Agent - Casualty	5/28/2025
Active	Buckalew, Patricia	929949	Agent - Property	5/28/2025
Denied	Clute, Kristina	1063462	Agent - Casualty
Denied	Clute, Kristina	1063462	Agent - Property
Active	Fulgaro, Anthony	737828	Agent - Casualty	1/27/2025
Active	Fulgaro, Anthony	737828	Agent - Property	1/27/2025
Active	Gardner, Jason	880727	Agent - Casualty	4/22/2025
Active	Gardner, Jason	880727	Agent - Property	4/22/2025
Active	Gardner, Jason	880727	Surplus Lines Broker - Not Applicable	4/22/2025
Denied	Harrington, Mark	1337320	Agent - Casualty
Denied	Harrington, Mark	1337320	Agent - Health
Denied	Harrington, Mark	1337320	Agent - Life
Denied	Harrington, Mark	1337320	Agent - Property
Active	Hentschell, Brad G	905783	Agent - Casualty	6/17/2025
Active	Hentschell, Brad G	905783	Agent - Property	6/17/2025
Active	Hoven, Andrew R	682525	Agent - Casualty	1/27/2025
Active	Hoven, Andrew R	682525	Agent - Health	1/27/2025
Denied	Hoven, Andrew R	682525	Agent - Life
Active	Hoven, Andrew R	682525	Agent - Property	1/27/2025
Denied	Hunter, Travis	1015898	Agent - Health
Denied	Hunter, Travis	1015898	Agent - Life
Active	Jarrett, Amy Michelle	973328	Agent - Casualty	4/25/2025
Active	Jarrett, Amy Michelle	973328	Agent - Property	4/25/2025
Active	Kamizeles-Williams, Amanda	1242220	Agent - Casualty	5/28/2025
Active	Kamizeles-Williams, Amanda	1242220	Agent - Property	5/28/2025
Active	Kolenda, Courtney Lynne	1022910	Agent - Casualty	12/14/2022
Active	Kolenda, Courtney Lynne	1022910	Agent - Health	12/14/2022
Active	Kolenda, Courtney Lynne	1022910	Agent - Life	12/14/2022
Active	Kolenda, Courtney Lynne	1022910	Agent - Property	12/14/2022
Active	Kolenda, Courtney Lynne	1022910	Surplus Lines Broker - Not Applicable	1/6/2023
Active	Oaks, Randy L	1290282	Agent - Casualty	1/29/2025
Active	Oaks, Randy L	1290282	Agent - Property	1/29/2025
Active	Oaks, Randy L	1290282	Surplus Lines Broker - Not Applicable	1/29/2025
Active	Rucker, Daniel R	815636	Agent - Casualty	5/14/2025
Active	Rucker, Daniel R	815636	Agent - Property	5/14/2025
Active	Samms, Noel Winston	1057104	Agent - Casualty	1/29/2025
Active	Samms, Noel Winston	1057104	Agent - Property	1/29/2025
Pending	Stalnaker, Cole Lloyd	1148113	Agent - Health
Pending	Stalnaker, Cole Lloyd	1148113	Agent - Life
Pending	Sumpter, Jasah Leigh	1346321	Agent - Casualty
Pending	Sumpter, Jasah Leigh	1346321	Agent - Property
Denied	Taggart, Clinton	1363730	Agent - Casualty
Denied	Taggart, Clinton	1363730	Agent - Health
Denied	Taggart, Clinton	1363730	Agent - Life
Denied	Taggart, Clinton	1363730	Agent - Property
Active	Thompson, Charles Armond	357347	Agent - Casualty	5/29/2025
Active	Thompson, Charles Armond	357347	Agent - Property	5/29/2025
Active	Thompson, Charles Armond	357347	Surplus Lines Broker - Not Applicable	5/29/2025
Active	Varnadoe, Joni	564386	Agent - Casualty	3/28/2025
Active	Varnadoe, Joni	564386	Agent - Property	3/28/2025