black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

WITH COVERAGE INSURANCE SERVICES LLC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN462479
Status:
First Licensure:
09/08/2023
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
1440 W TAYLOR ST PMB 689
CHICAGO, IL 60607-4623
Mailing:
C/O JUSTIN D. ROSS
767 BROADWAY # 1218
NEW YORK, NY 10003
Phone:
+1 (415) 359-7052
Email:
withcoverage@3hcs.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 09/08/2023 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLMERICA FINANCIAL ALLIANCE INSURANCE COMPANY
11/02/2023 PCF75617
ALLMERICA FINANCIAL BENEFIT INSURANCE COMPANY
11/02/2023 PCF145893
CITIZENS INSURANCE COMPANY OF AMERICA
11/02/2023 PCF937
THE HANOVER AMERICAN INSURANCE COMPANY
11/02/2023 PCF197298
THE HANOVER INSURANCE COMPANY
11/02/2023 PCF712
MASSACHUSETTS BAY INSURANCE COMPANY
11/02/2023 PCF505
VERLAN FIRE INSURANCE COMPANY
11/02/2023 PCF161934

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
MAXWELL BRENNER
11/03/2023 PRN466311
JAMES CAMPBELL
01/29/2025 PRN488791
OSCAR URIEL SANTIAGO
04/25/2024 PRN414869
SANDRA MILENA TORRES PACHON
09/08/2023 PRN363005

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
MAXWELL BRENNER PRN466311

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
20817754

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: 05/17/2025 12:00:28 AM