black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

CAPITAL INS SERVICES CORP

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN250000
Status:
First Licensure:
05/07/2015
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
4299 FIVE OAKS DR
LANSING, MI 48911-4214
Mailing:
PO BOX 27067
4299 FIVE OAKS DR
LANSING, MI 48911-4214
Phone:
+1 (517) 482-7900
Fax:
+1 (517) 482-1696
Email:
accounting@capitalinsurance.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 05/07/2015 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
CAPITOL INDEMNITY CORPORATION
10/02/2018 PCF162568
THE GUARANTEE COMPANY OF NORTH AMERICA USA
09/13/2016 PCF186703 11/16/2023
HARTFORD FIRE INSURANCE COMPANY
05/14/2019 PCF464
MERCHANTS BONDING COMPANY (MUTUAL)
06/09/2017 PCF108067 02/01/2019
MERCHANTS BONDING COMPANY (MUTUAL)
03/08/2021 PCF108067
MERCHANTS NATIONAL BONDING INC
06/09/2017 PCF205259 02/01/2019
OHIO CASUALTY INSURANCE COMPANY
05/22/2015 PCF73059
PLATTE RIVER INSURANCE COMPANY
10/02/2018 PCF61518
WESTERN SURETY COMPANY
12/11/2019 PCF96

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
ADAM T. GILROY
12/02/2016 PRN279423

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
ADAM T. GILROY PRN279423

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
961056

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: 01/15/2026 10:55:52 AM