DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Altamont Insurance Group LLC	DOIID	1004601	NAIC NPN	17895441

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	8/10/2018	3/31/2020
Inactive	Non Resident	Agent	Casualty	8/10/2018	3/31/2020
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	10/4/2018	3/31/2020
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACE American Insurance Company	300625	Agent - Casualty	8/24/2018	3/31/2020
Inactive	ACE American Insurance Company	300625	Agent - Property	8/24/2018	3/31/2020
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	8/24/2018	3/31/2020
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Property	8/24/2018	3/31/2020
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	8/24/2018	3/31/2020
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Property	8/24/2018	3/31/2020
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	8/24/2018	3/31/2020
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	8/24/2018	3/31/2020
Inactive	Westchester Fire Insurance Company	300990	Agent - Casualty	8/24/2018	3/31/2020
Inactive	Westchester Fire Insurance Company	300990	Agent - Property	8/24/2018	3/31/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Cote, Jarrod Paul	1018049	Agent - Casualty
Denied	Cote, Jarrod Paul	1018049	Agent - Property
Denied	Gomez, Zelene	1017570	Agent - Casualty
Denied	Gomez, Zelene	1017570	Agent - Property
Inactive	Gomez, Zelene	1017570	Surplus Lines Broker - Not Applicable	4/25/2019	5/16/2019
Inactive	Mudd, Carrie B	351614	Agent - Casualty	10/10/2018	10/3/2019
Inactive	Mudd, Carrie B	351614	Agent - Property	10/10/2018	10/3/2019
Inactive	Mudd, Carrie B	351614	Surplus Lines Broker - Not Applicable	10/10/2018	3/31/2020
Inactive	Rupp, Carolyn Michelle	984022	Agent - Casualty	8/14/2018	3/31/2020
Inactive	Rupp, Carolyn Michelle	984022	Agent - Property	8/14/2018	3/31/2020
Inactive	Rupp, Carolyn Michelle	984022	Surplus Lines Broker - Not Applicable	10/4/2018	3/31/2020
Denied	Shetzer, Alan Michael	334253	Agent - Casualty
Denied	Shetzer, Alan Michael	334253	Agent - Property
Denied	Villanueva, Jocelyn Del Carmen	1030167	Agent - Casualty
Denied	Villanueva, Jocelyn Del Carmen	1030167	Agent - Property