black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

AMERICAN INTERSTATE INSURANCE COMPANY

INSURANCE COMPANY

License Number:
PCF45974
Status:
First Licensure:
05/13/1996
Cancel Date:
None
Renewal Date:
08/10/2025
NAIC Code:
31895

Mailing:
ANGELA PEARSON
2301 HIGHWAY 190 W
DERIDDER, LA 70634-6004
Phone:
+1 (337) 460-3205
Fax:
+1 (337) 462-5519
Email:
apearson@amerisafe.com

History

License Type Start Date End Date
INSURANCE COMPANY 05/13/1996 08/10/2025

Employee

Name Issue Date License Number Expiration Date Cancel Date
AMERISAFE GENERAL AGENCY INC
09/24/2004 AGN66064
LAURIE A. BRANCH
03/15/2018 PRN36822
EDWARD VINCENT ENNIS III
08/01/2002 PRN76126
VINCENT JOHN GAGLIANO
11/25/2014 PRN242132
IRONPEAK MID-ATLANTIC, INC
04/05/2018 AGN228711
IRONPEAK MIDWEST, INC.
04/05/2018 AGN237981
IRONPEAK SOUTH, INC.
04/05/2018 AGN238226

Supervised Entity

None.

Authority

Description Issue Date Termination Date Status
WORKERS COMPENSATION 05/13/1996 Active
OTHER LIABILITY 05/13/1996 Active
PRODUCTS LIABILITY 10/25/2000 Active
PROPERTY AND CASUALTY 05/13/1996 05/13/1996 Terminated

Contacts

Type Contact
PRODUCER LICENSING CONTACT TALISHA BOWDEN
TALISHA BOWDEN
2301 HIGHWAY 190 W
DERIDDER, LA 70634-6004
Phone: +1 (337) 460-3287
Email: licensing@amerisafe.com
WORKERS COMPENSATION CLAIMS AMANDA LOFTIN
AMERICAN INTERSTATE INSURANCE COMPANY
2301 HIGHWAY 190 W
DERIDDER, LA 70634-6004
Phone: +1 (337) 460-3606
Fax: +1 (337) 460-3606
Email: aloftin@amerisafe.com
SERVICE OF PROCESS CORPORATION SERVICE COMPANY
45 MEMORIAL CIR
AUGUSTA, ME 04330-6400
Phone: +1 (800) 927-9800
Fax: +1 (302) 636-5454
Email: sop@cscglobal.com

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN)

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 08:40:40 PM