black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

INTER INS AGENCY SERVICES LTD

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN301175
Status:
First Licensure:
01/13/2018
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
380 N BROADWAY STE 400
JERICHO, NY 11753-2109
Mailing:
380 N BROADWAY STE 400
JERICHO, NY 11753-2109
Phone:
+1 (516) 352-7500 x1000
Fax:
+1 (516) 437-0435
Email:
accounting.support@interinsurance.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 01/13/2018 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN FAMILY HOME INSURANCE
10/28/2020 PCF201383
MANUFACTURERS ALLIANCE INSURANCE COMPANY
04/08/2021 PCF82408
MITSUI SUMITOMO INSURANCE COMPANY OF AMERICA
07/30/2019 PCF82584
MITSUI SUMITOMO INSURANCE USA INC
07/30/2019 PCF1019
PENNSYLVANIA MANUFACTURERS INDEMNITY COMPANY
04/08/2021 PCF82412
PENNSYLVANIA MANUFACTURERS' ASSOCIATION INSURANCE COMPANY
04/08/2021 PCF82421

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
JOSE A. BLAY JR
03/30/2023 PRN136301
DONALD A. DERHAM
01/13/2018 PRN300898

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
JOSE A. BLAY JR PRN136301

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
2013793

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: 05/23/2025 05:35:06 PM