Individual Information

RICKY ALLEN BASS

WOODLAND HILLS, CA 91367

Active

sallybass@maverickinsure.com

08/07/2006

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	499229	08/07/2006	Active	08/07/2006	08/31/2024
Non-Res. Surplus Lines Broker	3298173	12/08/2017	Active	07/15/2022	07/31/2025

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	08/07/2006	Active	08/07/2006
Property	08/07/2006	Active	08/07/2006
Surplus Lines	12/08/2017	Active	07/15/2022

Company Name	Appointment Type	Status	Active Date
100311
AMTRUST INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
1373
Company Name	Appointment Type	Status	Active Date
MIDWEST EMPLOYERS CASUALTY COMPANY	Casualty	Active	07/25/2011
100334
Company Name	Appointment Type	Status	Active Date
MILFORD CASUALTY INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
983
Company Name	Appointment Type	Status	Active Date
PRAETORIAN INSURANCE COMPANY	Casualty	Active	02/28/2020
	Property	Active	02/28/2020
100333
Company Name	Appointment Type	Status	Active Date
SECURITY NATIONAL INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
1702
Company Name	Appointment Type	Status	Active Date
SEQUOIA INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
17636
Company Name	Appointment Type	Status	Active Date
TECHNOLOGY INSURANCE COMPANY INC	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
1614
Company Name	Appointment Type	Status	Active Date
WESCO INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022

row(s) 1 - 15 of 15

Organization	Association Type	Type	Beg dte	End dte
BASS & ASSOC INC	Designated Resp Lic Prdcr	Agency	04/19/2020	-

1 - 1