Agency Information

CANNON COCHRAN MANAGEMENT SERVICES, INC.

Address:

3510 NORTH CAUSEWAY BLVD STE 400

METAIRIE, LA 70002

Phone

217-446-1089

URL:

Email:

compliancelicensing@ccmsi.com

National Producer Number:

1040560

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Independent Adjuster	18795	12/28/2004	Active	12/28/2004	12/31/2025
Non-Res. Managing Gen Agency	3414156	02/08/2019	Active	02/08/2019	02/28/2025
Non-Res. Producer Firm	9692	10/01/2001	Active	04/15/2004	04/30/2025
Non-Res. Third Party Admin.	17700	10/01/2009	Active	10/01/2009	03/31/2025

Qualification Type	Original Issue Date	Status	Effective Date
Adj - Property and Casualty	07/01/2018	Active	07/01/2018
Adj - Workers Compensation	05/25/2022	Active	05/25/2022
Casualty	10/01/2001	Active	04/15/2004
Health	10/01/2001	Active	04/15/2004
Life	10/01/2001	Active	04/15/2004
Managing General Agent	02/08/2019	Active	02/08/2019
Property	10/01/2001	Active	04/15/2004
TPA3-SF Employer Program/WC	10/01/2009	Active	10/01/2009
TPA4 - Workers Compensation	10/01/2009	Active	10/01/2009

Company Name	Appointment Type	Status	Active Date
936
SAFETY NATIONAL CASUALTY CORPORATION	Casualty	Active	04/21/2004
	Property	Active	04/21/2004

row(s) 1 - 2 of 2

Name	Association Type	Agent	Begin Date	End Date
GEORGE BRYAN THOMAS	Designated Resp Lic Prdcr	Yes	09/15/2020	02/28/2025
GEORGE BRYAN THOMAS	Designated Resp Lic Prdcr	No	07/21/2021	04/30/2025
JANET LEE SHERLOCK	Designated Resp Lic Adjuster	No	11/07/2022	12/31/2025
KEVIN DOUGLAS SOVEREIGN	Designated Resp Lic Prdcr	No	07/20/2021	12/31/2025
KEVIN DOUGLAS SOVEREIGN	Designated Resp Lic Adjuster	No	07/21/2021	12/31/2025
KEVIN DOUGLAS SOVEREIGN	Designated Resp Lic Adjuster	No	09/15/2020	12/31/2025
NICOLE LYNN SARTAIN	Designated Resp Lic Adjuster	No	05/25/2022	12/31/2025

1 - 7