DEPARTMENT OF INSURANCE

Affiliations

Name	Brockinton, Samuel Mark	DOIID	323890	NAIC NPN	130531

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	8/15/2000		3/31/2026
Active	Non Resident	Agent	Property	8/15/2000		3/31/2026
Inactive	Non Resident	Agent	General Lines	3/27/1991	8/15/2000
* 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	ACE American Insurance Company	300625	Agent - Casualty	5/19/2004
Active	ACE American Insurance Company	300625	Agent - Property	5/19/2004
Inactive	Chubb Indemnity Insurance Company	300438	Agent - General Lines	5/26/2000	8/15/2000
Active	Commerce and Industry Insurance Company	300881	Agent - Casualty	7/6/2006
Active	Commerce and Industry Insurance Company	300881	Agent - Property	7/6/2006
Inactive	Employers Insurance Company of Wausau	301813	Agent - Casualty	1/29/2001	4/29/2008
Inactive	Employers Insurance Company of Wausau	301813	Agent - Property	1/29/2001	4/29/2008
Inactive	Executive Risk Indemnity Inc.	301510	Agent - General Lines	5/26/2000	8/15/2000
Inactive	Federal Insurance Company	301144	Agent - Casualty	8/15/2000	6/6/2011
Inactive	Federal Insurance Company	301144	Agent - General Lines	5/26/2000	8/15/2000
Inactive	Federal Insurance Company	301144	Agent - Property	8/15/2000	6/6/2011
Inactive	Great Northern Insurance Company	301107	Agent - General Lines	5/26/2000	8/15/2000
Active	Indemnity Insurance Company of North America	301760	Agent - Casualty	5/19/2004
Active	Indemnity Insurance Company of North America	301760	Agent - Property	5/19/2004
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	1/14/2014
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	1/14/2014
Inactive	Pacific Indemnity Company	301610	Agent - General Lines	5/26/2000	8/15/2000
Inactive	Vanliner Insurance Company	301420	Agent - Casualty	8/15/2000	3/12/2002
Inactive	Vanliner Insurance Company	301420	Agent - General Lines	3/27/1991	8/15/2000
Inactive	Vanliner Insurance Company	301420	Agent - Property	8/15/2000	3/12/2002
Inactive	Vigilant Insurance Company	301143	Agent - General Lines	5/26/2000	8/15/2000
Inactive	Wausau Business Insurance Company	301476	Agent - Casualty	1/29/2001	4/29/2008
Inactive	Wausau Business Insurance Company	301476	Agent - Property	1/29/2001	4/29/2008
Inactive	Wausau Underwriters Insurance Company	301105	Agent - Casualty	1/29/2001	4/29/2008
Inactive	Wausau Underwriters Insurance Company	301105	Agent - Property	1/29/2001	4/29/2008
Inactive	Westchester Fire Insurance Company	301414	Agent - Casualty	5/19/2004	1/1/2011
Active	Westchester Fire Insurance Company	300990	Agent - Casualty	1/1/2011
Inactive	Westchester Fire Insurance Company	301414	Agent - Property	5/19/2004	1/1/2011
Active	Westchester Fire Insurance Company	300990	Agent - Property	1/1/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aon Risk Services Southwest, Inc	509878	Agent - Property	6/3/2008
Active	Aon Risk Services Southwest, Inc	509878	Agent - Casualty	6/3/2008
Inactive	Aon Risk Services, Inc. of Arkansas	539019	Agent - Property	10/4/2001	6/3/2008
Inactive	Aon Risk Services, Inc. of Arkansas	539019	Agent - Casualty	10/4/2001	6/3/2008