Agency Information

EXECUTIVE INSURANCE & FINANCIAL SERVICES, INC., THE

6354 TUPELO DRIVE

CITRUS HEIGHTS, CA 95621

916-721-7272

info@executiveins.com

2747411

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	1017468	02/13/2015	Active	02/13/2015	02/28/2027
Non-Res. Surplus Lines Broker	1100421	06/18/2015	Active	06/18/2015	06/30/2027

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	02/13/2015	Active	02/13/2015
Health	06/14/2019	Active	06/14/2019
Property	02/13/2015	Active	02/13/2015
Surplus Lines	06/18/2015	Active	06/18/2015

Company Name	Appointment Type	Status	Active Date
113385
EMPLOYERS ASSURANCE COMPANY	Casualty	Active	06/09/2015
100892
Company Name	Appointment Type	Status	Active Date
EMPLOYERS COMPENSATION INSURANCE COMPANY	Casualty	Active	06/09/2015
1779
Company Name	Appointment Type	Status	Active Date
EMPLOYERS INSURANCE COMPANY OF NEVADA	Casualty	Active	06/09/2015
111020
Company Name	Appointment Type	Status	Active Date
EMPLOYERS PREFERRED INSURANCE COMPANY	Casualty	Active	06/09/2015
1536
Company Name	Appointment Type	Status	Active Date
FIRSTCOMP INSURANCE COMPANY	Casualty	Active	04/02/2025
	Property	Active	04/02/2025
1538
Company Name	Appointment Type	Status	Active Date
HMO COLORADO INC D/B/A HMO NEVADA	Health	Active	06/20/2019
1620
Company Name	Appointment Type	Status	Active Date
ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC	Health	Active	06/20/2019

row(s) 1 - 8 of 8

Name	Association Type	Agent	Begin Date	End Date
MARIE MICHELLE GROH	Designated Resp Lic Prdcr	Yes	02/11/2021	-

1 - 1