black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

GALLAGHER AFFINITY INSURANCE SERVICES, INC.

One or more of the licenses listed below were subject to license/disciplinary action. Details regarding each action can be found below under the affected license.

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN84986
Status:
First Licensure:
04/05/2002
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
2850 GOLF RD
ROLLING MEADOWS, IL 60008-4050
Mailing:
2850 GOLF RD
ROLLING MEADOWS, IL 60008-4050
Phone:
+1 (773) 867-4400
Fax:
+1 (773) 867-4423
Email:
gais.licensing@ajg.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 04/05/2002 04/01/2027

Alias, DBA or Trade Name

Name
COVERDELL

Employer

Name Issue Date License Number Expiration Date Cancel Date
ACE AMERICAN INSURANCE COMPANY
02/25/2003 PCF640 12/03/2008
ACE AMERICAN INSURANCE COMPANY
03/09/2016 PCF640
AMERICAN CONTRACTORS INDEMNITY COMPANY
10/03/2023 PCF81110
AMERICAN FIRE AND CASUALTY COMPANY
12/04/2023 PCF200822
AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY
07/26/2010 PCF366 06/15/2011
AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY
06/10/2024 PCF366
AMERICAN STATES INSURANCE COMPANY
12/04/2023 PCF377 05/08/2025
AMERICAN ZURICH INSURANCE COMPANY
07/26/2010 PCF914 06/15/2011
AMERICAN ZURICH INSURANCE COMPANY
06/10/2024 PCF914
AMERITAS LIFE INSURANCE CORP
06/11/2024 LHF944
ARCH INDEMNITY INSURANCE COMPANY
08/01/2023 PCF674
ARCH INSURANCE COMPANY
08/01/2023 PCF62719
ATHENE ANNUITY & LIFE ASSURANCE COMPANY
03/11/2009 LHF690 12/10/2014
CAPITOL INDEMNITY CORPORATION
03/29/2024 PCF162568
COREPOINTE INSURANCE COMPANY
12/20/2023 PCF398
DEVELOPERS SURETY AND INDEMNITY COMPANY
12/20/2023 PCF149532
EMPLOYERS ASSURANCE COMPANY
05/29/2024 PCF285638
EMPLOYERS COMPENSATION INSURANCE COMPANY
05/29/2024 PCF285639
EMPLOYERS PREFERRED INSURANCE COMPANY
05/29/2024 PCF285637
EVEREST REINSURANCE COMPANY
09/26/2024 PCF757
FEDERAL INSURANCE COMPANY
04/10/2014 PCF439
GENERAL INSURANCE COMPANY OF AMERICA
12/04/2023 PCF447
GENERAL SECURITY NATIONAL INSURANCE COMPANY
11/01/2023 PCF45251
GERBER LIFE INSURANCE COMPANY
02/23/2011 LHF185 03/04/2014
HARCO NATIONAL INSURANCE COMPANY
07/26/2024 PCF325
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
04/12/2024 LHF193
HDI GLOBAL INSURANCE COMPANY
11/13/2023 PCF167923
HUDSON INSURANCE COMPANY
02/09/2024 PCF165252
LEXINGTON NATIONAL INSURANCE CORPORATION
08/27/2024 PCF100664
LIBERTY MUTUAL INSURANCE COMPANY
12/04/2023 PCF331
MERCHANTS BONDING COMPANY (MUTUAL)
05/16/2024 PCF108067
MUTUAL OF OMAHA INSURANCE COMPANY
11/06/2024 LHF84
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA
12/07/2004 PCF527
NEW YORK LIFE INSURANCE COMPANY
05/07/2024 LHF230
OHIO CASUALTY INSURANCE COMPANY
12/04/2023 PCF73059
OHIO SECURITY INSURANCE COMPANY
12/04/2023 PCF200581
PEERLESS INSURANCE COMPANY
12/04/2023 PCF548
PHILADELPHIA INDEMNITY INSURANCE COMPANY
02/26/2024 PCF46041
PLATTE RIVER INSURANCE COMPANY
03/29/2024 PCF61518
STONEBRIDGE LIFE INSURANCE COMPANY
08/22/2005 LHF466 10/01/2015
SYMETRA LIFE INSURANCE COMPANY
01/06/2006 LHF777 12/06/2007
TESLA INSURANCE COMPANY
01/12/2006 PCF50 05/14/2012
TRANSAMERICA LIFE INSURANCE COMPANY
11/02/2015 LHF726
TRANSAMERICA PREMIER LIFE INSURANCE COMPANY
09/08/2004 LHF825 10/01/2020
UNITED STATES SURETY COMPANY
10/03/2023 PCF115462
US SPECIALTY INSURANCE COMPANY
10/03/2023 PCF31516
VIRGINIA SURETY COMPANY INC
12/21/2010 PCF882 06/05/2015
WASHINGTON NATIONAL INSURANCE COMPANY
03/12/2024 LHF294
WEST AMERICAN INSURANCE COMPANY
12/04/2023 PCF200576
WESTERN SURETY COMPANY
01/25/2024 PCF96
ZURICH AMERICAN INSURANCE COMPANY
07/26/2010 PCF61397
ZURICH AMERICAN INSURANCE COMPANY OF ILLINOIS
07/26/2010 PCF165251 06/15/2011
ZURICH AMERICAN INSURANCE COMPANY OF ILLINOIS
06/10/2024 PCF165251

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
SHEREE LEANNE APPLIN
10/13/2023 PRN224553
WILLIAM BELPEDIO
10/11/2023 PRN359698
JOSEPH DANIEL BLOCK
07/23/2024 PRN91017
JOHN CALVIN BRECKENRIDGE
08/01/2024 PRN148725
JAMES BRIDGE
04/19/2024 PRN481667
DANIEL BUCKLEY
07/30/2024 PRN192675
MICHAEL CARDOSO
10/13/2023 PRN326523
CYNTHIA COOPER
01/24/2025 PRN505950
MARISOL DIOSES
07/30/2024 PRN246299
MICHAEL DIVITO
04/19/2023 PRN436066
KELLY LYNN EISENBIES
07/30/2024 PRN260724
THOMAS GOULD
07/30/2024 PRN299751
REES HAMNER
07/30/2024 PRN404959
RONNIE DEE HOHENBERGER
10/13/2023 PRN237928
JASON LEE JENKINS
05/02/2024 PRN106926
JEREMIAH JOSEPH
04/23/2024 PRN481173
JODI LYNN KISSNER
07/30/2024 PRN283989
THERESA ANN KLEWSAAT
07/30/2024 PRN403714
CLAY KRETSINGER
08/01/2024 PRN403908
CORY MCDONALD
08/01/2024 PRN333304
SARA MCNEILL
01/13/2025 PRN504574
AMELIA MCSHANE
08/01/2024 PRN409796
MICHAEL EUGENE MURPHY
01/02/2024 PRN93415
BRIAN NELSON
08/01/2024 PRN243161
ALYSSA NOORMAN
08/19/2024 PRN491306
JOSEPH PETERS
08/01/2024 PRN351237
LAUREN MARIE PITONYAK
08/01/2024 PRN203766
SCOTT POLANSKY
08/03/2024 PRN331050
JASON ROGERS
08/01/2024 PRN260291
JOHN EDMUND RYAN
11/21/2023 PRN93304
DEAN SANDONATO
08/03/2024 PRN361343
STEVE SHIKE
08/01/2024 PRN339870
JEFFREY B. SMITH
10/10/2024 PRN151104
SARA STEIN
08/03/2024 PRN164635
BRANDON MICHAEL TIETZ
08/03/2024 PRN244325
MARK PETER TURNER
08/03/2024 PRN236212
JORGE BERNARDO URANGA
08/03/2024 PRN393145
JASON VALLE
08/03/2024 PRN455801
STEPHEN ANDREW VANN
09/30/2024 PRN301245
JAMES WALTERICK
08/03/2024 PRN343602
JEFFREY YOUNGER
08/03/2024 PRN353265

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
MICHAEL DIVITO PRN436066

License/Disciplinary Action

Case Action Taken Date
RIRS-1360 Consent Order 05/17/2001

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
1499729

Other Phone Numbers

Phone Number Type
+1 (603) 694-5280 Office

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: 05/14/2025 12:42:08 AM