DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Green Shield Risk Solutions LLC	DOIID	1227059	NAIC NPN	20393124

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/31/2022		3/31/2026
Active	Non Resident	Agent	Property	8/31/2022		3/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	8/31/2022		3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Blandford, Patrick M	1020561	Agent - Casualty	8/31/2022
Active	Blandford, Patrick M	1020561	Agent - Property	8/31/2022
Active	Blandford, Patrick M	1020561	Surplus Lines Broker - Not Applicable	8/31/2022