Agency Information

ACRISURE MGA LLC

Address:

100 OTTAWA AVENUE SW

GRAND RAPIDS, MI 49503

Phone

800-748-0351

URL:

Email:

insurancelicensing@acrisure.com

National Producer Number:

17432980

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	1002950	12/02/2014	Active	12/02/2014	12/31/2026
Non-Res. Surplus Lines Broker	1006084	12/16/2014	Active	12/16/2014	12/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	12/02/2014	Active	12/02/2014
Health	12/02/2014	Active	12/02/2014
Life	12/02/2014	Active	12/02/2014
Property	12/02/2014	Active	12/02/2014
Surplus Lines	12/16/2014	Active	12/16/2014

Company Name	Appointment Type	Status	Active Date
11243
MANUFACTURERS ALLIANCE INSURANCE COMPANY	Casualty	Active	10/28/2015
	Property	Active	10/28/2015
807
Company Name	Appointment Type	Status	Active Date
PENNSYLVANIA MANUFACTURERS ASSOCIATION INSURANCE	Casualty	Active	10/28/2015
	Property	Active	10/28/2015
11244
Company Name	Appointment Type	Status	Active Date
PENNSYLVANIA MANUFACTURERS INDEMNITY COMPANY	Casualty	Active	10/28/2015
	Property	Active	10/28/2015
156872
Company Name	Appointment Type	Status	Active Date
TRISURA INSURANCE COMPANY	Casualty	Active	05/14/2021
	Property	Active	05/14/2021

row(s) 1 - 8 of 8

Name	Association Type	Agent	Begin Date	End Date
COURTNEY LYNNE KOLENDA	Designated Resp Lic Prdcr	Yes	04/27/2020	-
LAWRENCE JOHN KALIOR	Designated Resp Lic Prdcr	Yes	04/27/2020	-

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