black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

ACRISURE NORTHWEST PARTNERS INSURANCE SERVICES, LLC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN439610
Status:
First Licensure:
12/15/2022
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
100 OTTAWA AVE SW
GRAND RAPIDS, MI 49503-5087
Mailing:
100 OTTAWA AVE SW
GRAND RAPIDS, MI 49503-5087
Phone:
+1 (800) 748-0351
Fax:
+1 (800) 347-3129
Email:
insurancelicensing@acrisure.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 12/15/2022 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
AIG PROPERTY CASUALTY COMPANY
08/06/2024 PCF393
ALL SAVERS INSURANCE COMPANY
07/16/2024 LHF233900
ALLMERICA FINANCIAL ALLIANCE INSURANCE COMPANY
10/29/2024 PCF75617
ALLMERICA FINANCIAL BENEFIT INSURANCE COMPANY
10/29/2024 PCF145893
AMERICAN MODERN PROPERTY & CASUALTY INSURANCE COMPANY
01/21/2024 PCF234561
AMERICAN PROGRESSIVE LIFE & HEALTH INS COMPANY OF NEW YORK
02/01/2025 LHF374
AMTRUST INSURANCE COMPANY
12/29/2023 PCF260762
ANTHEM HEALTH PLANS OF MAINE INC.
12/31/2024 LHD70566
ANTHEM INSURANCE COMPANIES INC
01/01/2025 LHF125537
ANTHEM LIFE INSURANCE COMPANY
12/31/2024 LHF70467 04/11/2025
ARCH INDEMNITY INSURANCE COMPANY
04/24/2025 PCF674
ARCH INSURANCE COMPANY
04/24/2025 PCF62719
CITIZENS INSURANCE COMPANY OF AMERICA
10/29/2024 PCF937
COMMERCE AND INDUSTRY INSURANCE COMPANY
08/06/2024 PCF413
EMPIRE HEALTHCHOICE HMO, INC.
01/01/2025 HMF285382
EMPLOYERS ASSURANCE COMPANY
04/02/2024 PCF285638
EMPLOYERS COMPENSATION INSURANCE COMPANY
04/02/2024 PCF285639
EMPLOYERS PREFERRED INSURANCE COMPANY
04/02/2024 PCF285637
EVEREST DENALI INSURANCE COMPANY
04/18/2025 PCF289213
EVEREST NATIONAL INSURANCE COMPANY
04/18/2025 PCF99574
EVEREST PREMIER INSURANCE COMPANY
04/18/2025 PCF289214
EVEREST REINSURANCE COMPANY
04/18/2025 PCF757
THE HANOVER AMERICAN INSURANCE COMPANY
10/29/2024 PCF197298
THE HANOVER INSURANCE COMPANY
10/29/2024 PCF712
MASSACHUSETTS BAY INSURANCE COMPANY
10/29/2024 PCF505
MOUNT VERNON FIRE INSURANCE COMPANY
04/01/2025 PCF83792
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA
08/06/2024 PCF527
PROGRESSIVE NORTHERN INSURANCE COMPANY
05/06/2024 PCF51006
PROGRESSIVE NORTHWESTERN INSURANCE COMPANY
05/06/2024 PCF27738
SAFECO NATIONAL INSURANCE COMPANY
03/07/2025 PCF248658
SECURITY NATIONAL INSURANCE COMPANY
12/29/2023 PCF189490
SELECTIVE INSURANCE COMPANY OF NEW YORK
12/04/2024 PCF437
SEQUOIA INSURANCE COMPANY
12/29/2023 PCF128467
TECHNOLOGY INSURANCE COMPANY INC
12/29/2023 PCF136874
UNITEDHEALTHCARE INSURANCE COMPANY
07/16/2024 LHF700
UNITEDHEALTHCARE OF NEW ENGLAND, INC.
07/16/2024 HMF393375
VERLAN FIRE INSURANCE COMPANY
10/29/2024 PCF161934
VISION SERVICE PLAN INSURANCE COMPANY
11/11/2024 LHF47545
WELLCARE OF MAINE, INC.
02/01/2025 HMD305081
WELLCARE PRESCRIPTION INSURANCE INC
02/01/2025 LHF121869
WESCO INSURANCE COMPANY
12/29/2023 PCF49735

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
DOUG BOLLMAN
02/13/2025 PRN463444
JAMES GRAYSON CASTELL
02/18/2025 PRN477216
KRISTINA CLUTE
02/18/2025 PRN343100
ANTHONY R. FULGARO
02/13/2025 PRN281042
JASON GARDNER
04/22/2025 PRN210953
DANIEL MICHAEL GRAISY
01/15/2025 PRN254546
VICKY GREEN
02/18/2025 PRN204602
BRIAN HILLIER
02/13/2025 PRN389715
ANDREW R. HOVEN
02/13/2025 PRN159966
TRAVIS HUNTER
02/18/2025 PRN319866
COURTNEY LYNNE KOLENDA
12/15/2022 PRN323398
RANDY L. OAKS
02/18/2025 PRN459288
PAIGE BARNETT RIPLEY
03/19/2025 PRN377351
NOEL SAMMS
02/18/2025 PRN339183
CLINTON TAGGART
01/14/2025 PRN496581

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
COURTNEY LYNNE KOLENDA PRN323398

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
20555810

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: 05/13/2025 08:33:35 PM