DEPARTMENT OF INSURANCE

Affiliations

Name	Fawcett, Keith	DOIID	383998	NAIC NPN	441872

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Administrator	Not Applicable	6/14/2024		3/31/2026
Inactive	Non Resident	Agent	General Lines	10/29/1993	8/15/2000
Pending Replacement	Non Resident	Agent	Health	12/20/1994		3/31/2026
Pending Replacement	Non Resident	Agent	Casualty	8/15/2000		3/31/2026
Pending Replacement	Non Resident	Agent	Property	8/15/2000		3/31/2026
Pending Replacement	Non Resident	Agent	Life	12/20/1994		3/31/2026
* 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
Administrator	01/15/2026	03/31/2026
Agent	01/15/2026	03/31/2026

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	4/12/2005	9/23/2008
Inactive	ACE American Insurance Company	300625	Agent - Property	4/12/2005	9/23/2008
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	12/9/2006	9/23/2008
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Property	12/9/2006	9/23/2008
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	12/9/2006	9/23/2008
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Property	12/9/2006	9/23/2008
Pending Replacement	American General Life Insurance Company	301585	Agent - Health	12/31/2012
Pending Replacement	American General Life Insurance Company	301585	Agent - Life	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Health	12/20/1994	12/31/2012
Inactive	American General Life Insurance Company of Delaware	301057	Agent - Life	12/20/1994	12/31/2012
Pending Replacement	American Home Assurance Company	300246	Agent - Casualty	9/4/2001
Pending Replacement	American Home Assurance Company	300246	Agent - Property	9/4/2001
Pending Replacement	Arch Insurance Company	300688	Agent - Casualty	1/24/2008
Pending Replacement	Arch Insurance Company	300688	Agent - Property	1/24/2008
Inactive	Bankers Standard Insurance Company	301620	Agent - Casualty	12/9/2006	9/23/2008
Inactive	Bankers Standard Insurance Company	301620	Agent - Property	12/9/2006	9/23/2008
Pending Replacement	Commerce and Industry Insurance Company	300881	Agent - Casualty	9/4/2001
Pending Replacement	Commerce and Industry Insurance Company	300881	Agent - Property	9/4/2001
Inactive	Frontier Insurance Company	300528	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Frontier Insurance Company	300528	Agent - General Lines	1/26/1995	8/15/2000
Inactive	Frontier Insurance Company	300528	Agent - Property	8/15/2000	3/31/2002
Inactive	Indemnity Insurance Company of North America	301760	Agent - Casualty	4/12/2005	9/23/2008
Inactive	Indemnity Insurance Company of North America	301760	Agent - Property	4/12/2005	9/23/2008
Pending Replacement	MidSouth Insurance Company	739412	Agent - Casualty	11/9/2020
Pending Replacement	MidSouth Insurance Company	739412	Agent - Property	11/9/2020
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	12/9/2006	9/23/2008
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	12/9/2006	9/23/2008
Inactive	Reliance Insurance Company	300785	Agent - Casualty	8/15/2000	6/5/2001
Inactive	Reliance Insurance Company	300785	Agent - General Lines	4/23/1998	8/15/2000
Inactive	Reliance Insurance Company	300785	Agent - Property	8/15/2000	6/5/2001
Inactive	Reliance National Indemnity Company	301939	Agent - General Lines	4/23/1998	8/15/2000
Inactive	Reliance National Insurance Company	301675	Agent - General Lines	4/23/1998	8/15/2000
Pending Replacement	Safety First Insurance Company	536111	Agent - Casualty	7/23/2003
Pending Replacement	Safety National Casualty Corporation	300390	Agent - Casualty	8/15/2000
Inactive	Safety National Casualty Corporation	300390	Agent - General Lines	10/29/1993	8/15/2000
Pending Replacement	Safety National Casualty Corporation	300390	Agent - Property	8/15/2000
Inactive	United Pacific Insurance Company	300538	Agent - General Lines	4/23/1998	8/15/2000
Inactive	Westchester Fire Insurance Company	301414	Agent - Casualty	4/12/2005	9/23/2008
Inactive	Westchester Fire Insurance Company	301414	Agent - Property	4/12/2005	9/23/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending Replacement	Brentwood Reinsurance Intermediaries Inc	778833	Agent - Property	4/9/2012
Pending Replacement	Brentwood Reinsurance Intermediaries Inc	778833	Agent - Casualty	4/9/2012
Pending Replacement	Brentwood Serv Administrators Inc	397924	Administrator - Not Applicable	7/1/2024
Inactive	Brentwood Services Brokerage, Inc	640893	Agent - Property	2/9/2010	11/1/2013
Inactive	Brentwood Services Brokerage, Inc	640893	Agent - Casualty	2/9/2010	11/1/2013
Inactive	Brentwood Services, Inc.	547613	Agent - Property	4/5/2002	1/30/2007
Inactive	Brentwood Services, Inc.	547613	Agent - Casualty	4/5/2002	1/30/2007