DEPARTMENT OF INSURANCE

Affiliations

Name	Amtrust North America Inc	DOIID	581977	NAIC NPN	7075035

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Denied	Non Resident	Adjuster	Independent
Active	Non Resident	Agent	Property	11/12/2004	3/31/2026
Active	Non Resident	Agent	Casualty	11/12/2004	3/31/2026
Active	Non Resident	Independent Adjuster	Workers' Compensation	1/21/2009	3/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	2/25/2016	3/31/2026
* 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
Active	AIG Assurance Company	300897	Agent - Casualty	10/22/2014
Active	AIG Assurance Company	300897	Agent - Property	10/22/2014
Active	AmTrust Insurance Company	300179	Agent - Casualty	1/20/2010
Active	AmTrust Insurance Company	300179	Agent - Property	1/20/2010
Active	CorePointe Insurance Company	300406	Agent - Casualty	12/4/2015
Active	CorePointe Insurance Company	300406	Agent - Property	12/4/2015
Inactive	Developers Surety and Indemnity Company	516432	Agent - Casualty	6/18/2014	3/21/2016
Active	Heritage Indemnity Company	301155	Agent - Casualty	5/8/2018
Active	Heritage Indemnity Company	301155	Agent - Property	5/8/2018
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	10/22/2014
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Property	10/22/2014
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	3/12/2020
Active	Liberty Mutual Insurance Company	301159	Agent - Property	3/12/2020
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	1/20/2010
Active	Milford Casualty Insurance Company	301460	Agent - Property	1/20/2010
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	10/22/2014
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	10/22/2014
Active	New Hampshire Insurance Company	301670	Agent - Casualty	10/22/2014
Active	New Hampshire Insurance Company	301670	Agent - Property	10/22/2014
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	3/12/2020
Active	Ohio Casualty Insurance Company	301492	Agent - Property	3/12/2020
Active	Park National Insurance Company	692514	Agent - Casualty	10/10/2013
Active	Park National Insurance Company	692514	Agent - Property	10/10/2013
Active	Security National Insurance Company	301151	Agent - Casualty	1/20/2010
Active	Security National Insurance Company	301151	Agent - Property	1/20/2010
Active	Sequoia Insurance Company	628046	Agent - Casualty	10/10/2013
Active	Sequoia Insurance Company	628046	Agent - Property	10/10/2013
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	11/18/2014	12/21/2015
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	11/18/2014	12/21/2015
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Casualty	11/18/2014	12/21/2015
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Property	11/18/2014	12/21/2015
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	11/18/2014	12/21/2015
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	11/18/2014	12/21/2015
Inactive	State National Insurance Company, Inc.	300888	Agent - Casualty	1/26/2005	7/17/2017
Inactive	State National Insurance Company, Inc.	300888	Agent - Property	1/26/2005	7/17/2017
Active	Technology Insurance Company	613278	Agent - Casualty	3/1/2007
Active	Technology Insurance Company	613278	Agent - Property	3/1/2007
Active	Wesco Insurance Company	300534	Agent - Casualty	3/1/2007
Active	Wesco Insurance Company	300534	Agent - Property	3/1/2007

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Butler, Sirahn A	848391	Agent - Casualty	7/31/2023	8/11/2023
Inactive	Butler, Sirahn A	848391	Agent - Property	7/31/2023	8/11/2023
Active	Childs, Cherina A	818202	Agent - Casualty	4/10/2025
Active	Childs, Cherina A	818202	Agent - Property	4/10/2025
Inactive	Corrao, Carmen Jonathon	1353001	Agent - Casualty	8/20/2024	3/5/2025
Inactive	Corrao, Carmen Jonathon	1353001	Agent - Property	8/20/2024	3/5/2025
Inactive	Ganguzza, Angelo T	660163	Agent - Casualty	8/17/2017	5/31/2019
Inactive	Ganguzza, Angelo T	660163	Agent - Property	8/17/2017	5/31/2019
Inactive	Ganguzza, Angelo T	660163	Surplus Lines Broker - Not Applicable	8/17/2017	5/31/2019
Active	Gedney, Michelle R	647222	Agent - Casualty	4/22/2019
Active	Gedney, Michelle R	647222	Agent - Property	4/22/2019
Active	Gedney, Michelle R	647222	Surplus Lines Broker - Not Applicable	5/31/2019
Inactive	Hollander, Stuart Dov	579477	Agent - Casualty	11/12/2004	4/26/2018
Inactive	Hollander, Stuart Dov	579477	Agent - Property	11/12/2004	4/26/2018
Inactive	Hollander, Stuart Dov	579477	Surplus Lines Broker - Not Applicable	2/25/2016	4/26/2018
Inactive	Jessie, Emily Elizabeth	731837	Staff Adjuster - Property & Casualty	9/19/2024	10/1/2024
Inactive	Jessie, Emily Elizabeth	731837	Staff Adjuster - Workers' Compensation	9/19/2024	10/1/2024
Active	Layden, Daniel	968259	Agent - Casualty	6/18/2024
Active	Layden, Daniel	968259	Agent - Property	6/18/2024
Inactive	Leo, Jeffrey P	580001	Agent - Casualty	3/21/2018	1/15/2019
Inactive	Leo, Jeffrey P	580001	Agent - Property	3/21/2018	1/15/2019
Inactive	Martin, Lisa	611283	Independent Adjuster - Property & Casualty	4/8/2021	9/19/2024
Active	Mcclure, Rachel	962996	Agent - Casualty	8/20/2024
Active	Mcclure, Rachel	962996	Agent - Property	8/20/2024
Active	Melnik, Scott T	756933	Independent Adjuster - Property & Casualty	10/1/2024
Active	Melnik, Scott T	756933	Independent Adjuster - Workers' Compensation	10/1/2024
Active	Odear, Dylan Paul	1367457	Agent - Casualty	11/19/2024
Active	Odear, Dylan Paul	1367457	Agent - Property	11/18/2024
Inactive	Price, Darrell Lynn	692861	Independent Adjuster - Workers' Compensation	1/21/2009	3/5/2019
Inactive	Sawyer, Erick Edison	641947	Staff Adjuster - Property & Casualty	3/5/2019	4/8/2021
Inactive	Sharp, Zelma Faye	1032867	Agent - Casualty	3/28/2019	12/16/2024
Inactive	Sharp, Zelma Faye	1032867	Agent - Property	3/28/2019	12/16/2024
Inactive	Shear, Stephanie Hope	720664	Agent - Casualty	8/21/2024	4/5/2025
Inactive	Shear, Stephanie Hope	720664	Agent - Property	8/21/2024	4/5/2025
Inactive	Trivison, Delynn Dotherow	622432	Agent - Casualty	1/12/2018	4/22/2019
Inactive	Trivison, Delynn Dotherow	622432	Agent - Property	1/12/2018	4/22/2019
Active	Webb, Erin Marie	981495	Agent - Casualty	8/20/2024
Active	Webb, Erin Marie	981495	Agent - Property	8/20/2024
Active	Zoltowski, Joseph Christopher	1301519	Agent - Casualty	10/6/2023
Active	Zoltowski, Joseph Christopher	1301519	Agent - Property	10/6/2023