black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SPORTS AND SPECIAL EVENT INS AGENCY

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN215352
Status:
First Licensure:
04/11/2013
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
2047 SARANAC AVE STE 201
LAKE PLACID, NY 12946-1157
Mailing:
2047 SARANAC AVE STE 201
LAKE PLACID, NY 12946-1157
Phone:
+1 (866) 889-4763
Fax:
+1 (720) 294-9525
Email:
mark@sportsinsurance.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 05/11/2016 04/01/2027
*** NOT ACTIVE *** 07/01/2015 05/10/2016
NON-RESIDENT PRODUCER AGENCY 04/11/2013 06/30/2015

Employer

Name Issue Date License Number Expiration Date Cancel Date
ARCH INSURANCE COMPANY
02/27/2025 PCF62719
AXIS INSURANCE COMPANY
04/28/2017 PCF134278
UNITED STATES FIRE INSURANCE COMPANY
10/30/2014 PCF101256 07/01/2015
UNITED STATES FIRE INSURANCE COMPANY
08/01/2017 PCF101256

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
MARK A. DI PERNO
03/23/2017 PRN176150
DENNIS R. GONZALEZ
05/11/2016 PRN211647

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
MARK A. DI PERNO PRN176150

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
8455202

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 06/23/2025 01:37:30 AM