Individual Information

MATTHEW S GROSSBERG

Address:

SCARSDALE, NY 10583-7712

Status:

Active

Email:

staceyr@sisinsure.com

Date:

05/01/2017

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	199720	02/17/2005	Active	05/01/2017	05/31/2026
Non-Res. Surplus Lines Broker	3239346	05/02/2017	Active	05/02/2017	05/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	02/17/2005	Active	05/01/2017
Health	02/17/2005	Active	11/10/2022
Life	02/17/2005	Active	11/10/2022
Property	02/17/2005	Active	05/01/2017
Surplus Lines	05/02/2017	Active	05/02/2017

Company Name	Appointment Type	Status	Active Date
44
AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY	Casualty	Active	01/13/2022
	Property	Active	01/13/2022
1072
Company Name	Appointment Type	Status	Active Date
AMERICAN ZURICH INSURANCE COMPANY	Casualty	Active	01/13/2022
	Property	Active	01/13/2022
1497
Company Name	Appointment Type	Status	Active Date
CRUM & FORSTER INDEMNITY COMPANY	Casualty	Active	10/29/2020
	Property	Active	10/29/2020
209
Company Name	Appointment Type	Status	Active Date
EMPIRE FIRE & MARINE INSURANCE COMPANY	Casualty	Active	01/13/2022
	Property	Active	01/13/2022
237
Company Name	Appointment Type	Status	Active Date
FIDELITY AND DEPOSIT COMPANY OF MARYLAND (THE)	Casualty	Active	01/13/2022
	Property	Active	01/13/2022
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
692
Company Name	Appointment Type	Status	Active Date
UNITED STATES FIRE INSURANCE COMPANY	Casualty	Active	10/29/2020
	Property	Active	10/29/2020
737
Company Name	Appointment Type	Status	Active Date
ZURICH AMERICAN INSURANCE COMPANY	Casualty	Active	01/13/2022
	Property	Active	01/13/2022
1241
Company Name	Appointment Type	Status	Active Date
ZURICH AMERICAN INSURANCE COMPANY OF ILLINOIS	Casualty	Active	01/13/2022
	Property	Active	01/13/2022

row(s) 1 - 24 of 24

Organization	Association Type	Type	Beg dte	End dte
SAFEBUILT INSURANCE SERVICES, LLC	Designated Resp Lic Prdcr	Agency	04/14/2020	-
NORTHEAST NATIONAL BROKERAGE LLC	Designated Resp Lic Prdcr	Agency	01/17/2024	-
GASLAMP INS SERVICES	Designated Resp Lic Prdcr	Agency	04/14/2020	-
INTEGRATED SPECIALTY COVERAGES LLC	Designated Resp Lic Prdcr	Agency	05/01/2020	-
PARAMOUNT GENERAL AGENCY, LLC	Designated Resp Lic Prdcr	Agency	02/14/2023	-
J.E.P. CAPITAL, INC.	Designated Resp Lic Prdcr	Agency	05/17/2022	-
ABACUS INSURANCE BROKERS, LLC	Designated Resp Lic Prdcr	Agency	02/27/2023	-

1 - 7

MATTHEW S GROSSBERG

Address:

Status:

Email:

Date:

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License Information

Qual Information

12 Appointments

7 Organization Associations