Agency Information

INTEGRATED SPECIALTY COVERAGES LLC

500 MAMARONECK AVENUE

HARRISON, NY 10528

760-599-7242

staceyr@sisinsure.com

19079293

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3475009	09/16/2019	Active	09/16/2019	09/30/2025
Non-Res. Surplus Lines Broker	3475016	09/16/2019	Active	09/16/2019	09/30/2025

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	09/16/2019	Active	09/16/2019
Property	09/16/2019	Active	09/16/2019
Surplus Lines	09/16/2019	Active	09/16/2019

Company Name	Appointment Type	Status	Active Date
1497
CRUM & FORSTER INDEMNITY COMPANY	Casualty	Active	10/29/2020
	Property	Active	10/29/2020
25
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN ALLIANCE INSURANCE COMPANY	Casualty	Active	02/06/2023
	Property	Active	02/06/2023
288
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN INSURANCE COMPANY	Casualty	Active	02/06/2023
	Property	Active	02/06/2023
1521
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN SPIRIT INSURANCE COMPANY	Casualty	Active	02/06/2023
	Property	Active	02/06/2023
632
Company Name	Appointment Type	Status	Active Date
NORTH RIVER INSURANCE COMPANY (THE)	Casualty	Active	10/29/2020
	Property	Active	10/29/2020
1785
Company Name	Appointment Type	Status	Active Date
SUTTON NATIONAL INSURANCE COMPANY	Casualty	Active	04/16/2024
	Property	Active	04/16/2024
692
Company Name	Appointment Type	Status	Active Date
UNITED STATES FIRE INSURANCE COMPANY	Casualty	Active	10/29/2020
	Property	Active	10/29/2020

row(s) 1 - 14 of 14

Name	Association Type	Agent	Begin Date	End Date
MATTHEW S GROSSBERG	Designated Resp Lic Prdcr	Yes	05/01/2020	-

1 - 1