Agency Information

SAFEBUILT INSURANCE SERVICES, LLC

1811 ASTON AVE., SUITE 200

CARLSBAD, CA 92008

760-599-7242

staceyr@sisinsure.com

11590632

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	688308	02/26/2010	Active	02/26/2010	02/29/2028
Non-Res. Surplus Lines Broker	706708	07/13/2010	Active	07/13/2010	07/31/2025

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	02/26/2010	Active	02/26/2010
Property	02/26/2010	Active	02/26/2010
Surplus Lines	07/13/2010	Active	08/14/2014

Company Name	Appointment Type	Status	Active Date
1124
AGCS MARINE INSURANCE COMPANY	Casualty	Active	08/30/2018
	Property	Active	08/30/2018
757
Company Name	Appointment Type	Status	Active Date
ALLIANZ GLOBAL RISKS US INSURANCE COMPANY	Casualty	Active	08/30/2018
	Property	Active	08/30/2018
28
Company Name	Appointment Type	Status	Active Date
AMERICAN AUTOMOBILE INSURANCE COMPANY	Casualty	Active	08/30/2018
	Property	Active	08/30/2018
1342
Company Name	Appointment Type	Status	Active Date
ARCH INSURANCE COMPANY	Casualty	Active	09/13/2018
	Property	Active	09/13/2018
113385
Company Name	Appointment Type	Status	Active Date
EMPLOYERS ASSURANCE COMPANY	Casualty	Active	05/06/2020
100892
Company Name	Appointment Type	Status	Active Date
EMPLOYERS COMPENSATION INSURANCE COMPANY	Casualty	Active	05/06/2020
111020
Company Name	Appointment Type	Status	Active Date
EMPLOYERS PREFERRED INSURANCE COMPANY	Casualty	Active	05/06/2020
249
Company Name	Appointment Type	Status	Active Date
FIREMANS FUND INSURANCE COMPANY	Casualty	Active	08/30/2018
	Property	Active	08/30/2018
304
Company Name	Appointment Type	Status	Active Date
HANOVER INSURANCE COMPANY, THE	Casualty	Active	03/12/2018
	Property	Active	03/12/2018
454
Company Name	Appointment Type	Status	Active Date
NATIONAL SURETY CORPORATION	Casualty	Active	08/30/2018
	Property	Active	08/30/2018
1407
Company Name	Appointment Type	Status	Active Date
NOVA CASUALTY COMPANY	Casualty	Active	10/23/2019
	Property	Active	10/23/2019

row(s) 1 - 19 of 19

Name	Association Type	Agent	Begin Date	End Date
MATTHEW S GROSSBERG	Designated Resp Lic Prdcr	Yes	04/14/2020	-

1 - 1