DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Derigiotis, David A	DOIID	1248564	NAIC NPN	17503743

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/25/2022		10/31/2025
Active	Non Resident	Agent	Property	12/25/2022		10/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/17/2023		10/31/2025
* 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
Active	Arch Insurance Company	300688	Agent - Casualty	5/22/2024
Active	Arch Insurance Company	300688	Agent - Property	5/22/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Embroker Ins Services LLC	901870	Agent - Casualty
Denied	Embroker Ins Services LLC	901870	Agent - Property