DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Keller, Mark Lowry	DOIID	501947	NAIC NPN	1678601

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	8/15/2000		3/31/2026
Active	Non Resident	Agent	Casualty	8/15/2000		3/31/2026
Inactive	Non Resident	Agent	General Lines	2/7/2000	8/15/2000
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	12/18/2008	9/4/2015
* 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
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	8/16/2011	8/16/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	8/16/2011	8/16/2017
Inactive	Capital City Insurance Company, Inc.	300472	Agent - Casualty	8/15/2000	12/13/2010
Inactive	Capital City Insurance Company, Inc.	300472	Agent - General Lines	2/7/2000	8/15/2000
Inactive	Capital City Insurance Company, Inc.	300472	Agent - Property	8/15/2000	12/13/2010
Active	Employers Insurance Company of Wausau	301813	Agent - Casualty	6/7/2022
Active	Employers Insurance Company of Wausau	301813	Agent - Property	6/7/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/4/2010	8/31/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/4/2010	8/31/2017
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	6/7/2022
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Property	6/7/2022
Inactive	North Pointe Insurance Company	301029	Agent - Casualty	12/12/2012	1/4/2023
Inactive	North Pointe Insurance Company	301029	Agent - Property	12/12/2012	1/4/2023
Inactive	Praetorian Insurance Company	301021	Agent - Casualty	2/9/2010	1/4/2023
Inactive	Praetorian Insurance Company	301021	Agent - Property	2/9/2010	1/4/2023
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	12/11/2012	1/4/2023
Inactive	QBE Insurance Corporation	300515	Agent - Property	12/11/2012	1/4/2023
Active	Travelers Casualty and Surety Company	301067	Agent - Casualty	7/16/2018
Active	Travelers Casualty and Surety Company	301067	Agent - Property	7/16/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Davis-Garvin Agency Inc	397738	Agent - Property	12/23/2008	3/31/2018
Inactive	Davis-Garvin Agency Inc	397738	Agent - Casualty	12/23/2008	3/31/2018
Inactive	Davis-Garvin Agency Inc	397738	Surplus Lines Broker - Not Applicable	12/23/2008	9/4/2015