Individual Information

HARISH KAPUR

MORENO VALLEY, CA 92553

Active

accouting@acrossamericainsurance.com

09/07/2004

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	193351	09/07/2004	Active	09/07/2004	09/30/2025
Non-Res. Surplus Lines Broker	3516090	01/24/2020	Active	01/24/2020	01/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	09/07/2004	Active	09/07/2004
Health	09/07/2004	Active	09/07/2004
Life	09/07/2004	Active	09/07/2004
Property	09/07/2004	Active	09/07/2004
Surplus Lines	01/24/2020	Active	01/24/2020

Company Name	Appointment Type	Status	Active Date
106276
AETNA HEALTH INC (PA)	Health	Active	05/26/2011
770
Company Name	Appointment Type	Status	Active Date
AETNA HEALTH INSURANCE COMPANY	Health	Active	05/26/2011
7
Company Name	Appointment Type	Status	Active Date
AETNA LIFE INSURANCE COMPANY	Health	Active	05/26/2011
	Life	Active	05/26/2011
1639
Company Name	Appointment Type	Status	Active Date
COAST NATIONAL INSURANCE COMPANY	Casualty	Active	08/31/2017
261
Company Name	Appointment Type	Status	Active Date
FOREMOST INSURANCE COMPANY GRAND RAPIDS MICHIGAN	Casualty	Active	08/31/2017
	Property	Active	08/31/2017
288
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN INSURANCE COMPANY	Casualty	Active	08/30/2022
	Property	Active	08/30/2022
1776
Company Name	Appointment Type	Status	Active Date
OHIO SECURITY INSURANCE COMPANY	Casualty	Active	10/07/2008
	Property	Active	10/07/2008
1302
Company Name	Appointment Type	Status	Active Date
PROGRESSIVE NORTHERN INSURANCE COMPANY	Casualty	Active	11/01/2019
	Property	Active	11/01/2019
1261
Company Name	Appointment Type	Status	Active Date
UNITED FINANCIAL CASUALTY COMPANY	Casualty	Active	11/01/2019
	Property	Active	11/01/2019

row(s) 1 - 15 of 15

Organization	Association Type	Type	Beg dte	End dte
ALL SOLUTIONS INS AGENCY LLC	Designated Resp Lic Prdcr	Agency	09/01/2020	-
ACROSS AMERICA INSURANCE SERVICES, INC	Designated Resp Lic Prdcr	Agency	09/15/2020	-

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