Individual Information

COREY W LILE

BRENTWOOD, TN 37027-1048

Active

jjennings@occusure.com

07/15/2016

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	524235	02/02/2007	Active	07/15/2016	07/31/2025

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	02/02/2007	Active	07/15/2016
Property	02/02/2007	Active	07/15/2016
Surplus Lines	07/15/2016	Inactive	08/01/2019

Company Name	Appointment Type	Status	Active Date
100311
AMTRUST INSURANCE COMPANY	Casualty	Active	07/25/2017
	Property	Active	07/25/2017
1342
Company Name	Appointment Type	Status	Active Date
ARCH INSURANCE COMPANY	Casualty	Active	02/14/2018
	Property	Active	02/14/2018
151
Company Name	Appointment Type	Status	Active Date
COREPOINTE INSURANCE COMPANY	Casualty	Active	10/28/2021
	Property	Active	10/28/2021
100334
Company Name	Appointment Type	Status	Active Date
MILFORD CASUALTY INSURANCE COMPANY	Casualty	Active	07/25/2017
	Property	Active	07/25/2017
100333
Company Name	Appointment Type	Status	Active Date
SECURITY NATIONAL INSURANCE COMPANY	Casualty	Active	07/25/2017
	Property	Active	07/25/2017
603
Company Name	Appointment Type	Status	Active Date
SOUTHERN INSURANCE COMPANY	Casualty	Active	10/28/2021
	Property	Active	10/28/2021
17636
Company Name	Appointment Type	Status	Active Date
TECHNOLOGY INSURANCE COMPANY INC	Casualty	Active	07/25/2017
	Property	Active	07/25/2017

row(s) 1 - 14 of 14

Organization	Association Type	Type	Beg dte	End dte
OCCUSURE WORKERS' COMPENSATION SPECIALISTS, LLC	Designated Resp Lic Prdcr	Agency	12/16/2021	-

1 - 1