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
Active	Non Resident	Administrator	Not Applicable	6/14/2024		3/31/2026
Active	Non Resident	Agent	Health	12/20/1994		3/31/2026
Active	Non Resident	Agent	Life	12/20/1994		3/31/2026
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	10/29/1993	8/15/2000
* 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
Active	American General Life Insurance Company	301585	Agent - Health	12/31/2012
Active	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
Active	American Home Assurance Company	300246	Agent - Casualty	9/4/2001
Active	American Home Assurance Company	300246	Agent - Property	9/4/2001
Active	Arch Insurance Company	300688	Agent - Casualty	1/24/2008
Active	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
Active	Commerce and Industry Insurance Company	300881	Agent - Casualty	9/4/2001
Active	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
Active	MidSouth Insurance Company	739412	Agent - Casualty	11/9/2020
Active	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
Active	Safety First Insurance Company	536111	Agent - Casualty	7/23/2003
Active	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
Active	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
Active	Brentwood Reinsurance Intermediaries Inc	778833	Agent - Property	4/9/2012
Active	Brentwood Reinsurance Intermediaries Inc	778833	Agent - Casualty	4/9/2012
Active	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