Agency Information

EVERGREEN UNI LLC

6140 PARKLAND BLVD STE 321

MAYFIELD HTS, OH 44124-6106

440-229-3407

regulatory@evergreen-national.com

17211821

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	951846	05/08/2014	Active	05/08/2014	05/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	05/08/2014	Active	05/08/2014
Property	05/08/2014	Active	05/08/2014

Company Name	Appointment Type	Status	Active Date
1342
ARCH INSURANCE COMPANY	Casualty	Active	09/01/2022
	Property	Active	09/01/2022
14117
Company Name	Appointment Type	Status	Active Date
BOND SAFEGUARD INSURANCE COMPANY	Casualty	Active	12/09/2019
1710
Company Name	Appointment Type	Status	Active Date
ENDURANCE AMERICAN INSURANCE COMPANY	Casualty	Active	12/09/2019
14192
Company Name	Appointment Type	Status	Active Date
ENDURANCE ASSURANCE CORPORATION	Casualty	Active	12/09/2019
1711
Company Name	Appointment Type	Status	Active Date
EVERGREEN NATIONAL INDEMNITY COMPANY	Casualty	Active	11/08/2022
	Property	Active	11/08/2022
1791
Company Name	Appointment Type	Status	Active Date
LEXON INSURANCE COMPANY	Casualty	Active	12/09/2019
1390
Company Name	Appointment Type	Status	Active Date
OHIO INDEMNITY COMPANY	Casualty	Active	12/20/2022
1399
Company Name	Appointment Type	Status	Active Date
U S SPECIALTY INSURANCE COMPANY	Casualty	Active	06/13/2016
	Property	Active	06/13/2016

row(s) 1 - 11 of 11

Name	Association Type	Agent	Begin Date	End Date
MATTHEW TRACY TUCKER	Designated Resp Lic Prdcr	Yes	03/07/2023	-

1 - 1