DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Risk Theory Ins Services LLC	DOIID	901848	NAIC NPN	17746087

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/17/2015		3/31/2027
Active	Non Resident	Agent	Property	12/17/2015		3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/15/2016		3/31/2027
* 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
Active	Clear Blue Insurance Company	517511	Agent - Casualty	10/11/2019
Active	Clear Blue Insurance Company	517511	Agent - Property	10/11/2019
Inactive	New York Marine and General Insurance Company	301932	Agent - Casualty	2/21/2017	7/27/2022
Inactive	New York Marine and General Insurance Company	301932	Agent - Property	2/21/2017	7/27/2022
Active	Rock Ridge Insurance Company	1037246	Agent - Casualty	10/30/2020
Active	Rock Ridge Insurance Company	1037246	Agent - Property	10/30/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Henry, David Scott	1113391	Agent - Casualty	2/23/2021	9/22/2023
Inactive	Henry, David Scott	1113391	Agent - Property	2/23/2021	9/22/2023
Active	Henry, David Scott	1113391	Surplus Lines Broker - Not Applicable	2/23/2021
Inactive	Marshall, Gary Duane	517186	Agent - Casualty	12/15/2015	2/23/2021
Inactive	Marshall, Gary Duane	517186	Agent - Property	12/15/2015	2/23/2021
Inactive	Marshall, Gary Duane	517186	Surplus Lines Broker - Not Applicable	10/10/2019	2/23/2021
Active	Sustala, Edward John	913996	Agent - Casualty	6/2/2022
Active	Sustala, Edward John	913996	Agent - Property	6/2/2022
Active	Sustala, Edward John	913996	Surplus Lines Broker - Not Applicable	6/2/2022
Inactive	Wilburn, Bryan	649862	Surplus Lines Broker - Not Applicable	3/15/2016	7/31/2019