DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dietz, Anthony John	DOIID	1125297	NAIC NPN	19772460

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/18/2021		8/31/2026
Active	Non Resident	Agent	Casualty	3/18/2021		8/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	5/12/2023		8/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	06/15/2024	08/31/2024	07/02/2024	07/02/2024	Yes
Surplus Lines Broker	06/15/2024	08/31/2024	07/02/2024	07/02/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AGCS Marine Insurance Company	300403	Agent - Casualty	2/28/2024
Active	AGCS Marine Insurance Company	300403	Agent - Property	2/28/2024
Active	Arch Indemnity Insurance Company	301459	Agent - Casualty	5/31/2023
Active	Arch Indemnity Insurance Company	301459	Agent - Property	5/31/2023
Active	Arch Insurance Company	300688	Agent - Casualty	5/31/2023
Active	Arch Insurance Company	300688	Agent - Property	5/31/2023
Active	Contractors Bonding and Insurance Company	300184	Agent - Casualty	8/25/2023
Active	Contractors Bonding and Insurance Company	300184	Agent - Property	8/25/2023
Active	RLI Insurance Company	301217	Agent - Casualty	8/25/2023
Active	RLI Insurance Company	301217	Agent - Property	8/25/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Procore Insurance Services, Inc.	1218993	Agent - Casualty	10/26/2023
Active	Procore Insurance Services, Inc.	1218993	Agent - Property	10/26/2023
Active	Procore Insurance Services, Inc.	1218993	Surplus Lines Broker - Not Applicable	10/26/2023