Agency Information

FORTRESS INTERMEDIARIES LLC

2600 W EXECUTIVE PARKWAY

LEHI, UT 84043

801-610-2700

licensing@fortressinsurance.com

21009755

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3966034	12/07/2023	Active	12/07/2023	12/31/2026
Non-Res. Surplus Lines Broker	3969197	12/19/2023	Active	12/19/2023	12/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	12/07/2023	Active	12/07/2023
Property	12/07/2023	Active	12/07/2023
Surplus Lines	12/19/2023	Active	12/19/2023

Company Name	Appointment Type	Status	Active Date
100311
AMTRUST INSURANCE COMPANY	Casualty	Active	06/10/2024
	Property	Active	06/10/2024
1342
Company Name	Appointment Type	Status	Active Date
ARCH INSURANCE COMPANY	Casualty	Active	09/18/2024
	Property	Active	09/18/2024
100334
Company Name	Appointment Type	Status	Active Date
MILFORD CASUALTY INSURANCE COMPANY	Casualty	Active	06/10/2024
	Property	Active	06/10/2024
100333
Company Name	Appointment Type	Status	Active Date
SECURITY NATIONAL INSURANCE COMPANY	Casualty	Active	06/10/2024
	Property	Active	06/10/2024
1702
Company Name	Appointment Type	Status	Active Date
SEQUOIA INSURANCE COMPANY	Casualty	Active	06/10/2024
	Property	Active	06/10/2024
17636
Company Name	Appointment Type	Status	Active Date
TECHNOLOGY INSURANCE COMPANY INC	Casualty	Active	06/10/2024
	Property	Active	06/10/2024
1614
Company Name	Appointment Type	Status	Active Date
WESCO INSURANCE COMPANY	Casualty	Active	06/10/2024
	Property	Active	06/10/2024

row(s) 1 - 14 of 14

Name	Association Type	Agent	Begin Date	End Date
ANTHONY S EARDLEY	Designated Resp Lic Prdcr	No	12/07/2023	-
JEFFERY S HILL	Designated Resp Lic Prdcr	No	12/07/2023	-

1 - 2