DEPARTMENT OF INSURANCE

Affiliations

Name	Travis Pedersen And Assoc Inc	DOIID	509352	NAIC NPN	654366

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	3/19/2007	3/31/2016
Inactive	Non Resident	Agent	Casualty	3/19/2007	3/31/2016
Inactive	Non Resident	Agent	General Lines	4/26/2000	8/15/2000
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	3/19/2007	3/31/2016
* 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	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	10/10/2007	6/11/2013
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	10/10/2007	6/11/2013
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	10/10/2007	6/11/2013
Inactive	American Zurich Insurance Company	300592	Agent - Property	10/10/2007	6/11/2013
Inactive	Arch Insurance Company	300688	Agent - Casualty	5/13/2008	7/9/2013
Inactive	Arch Insurance Company	300688	Agent - Property	5/13/2008	7/9/2013
Inactive	Aspen American Insurance Company	301513	Agent - Casualty	9/13/2011	12/31/2013
Inactive	Aspen American Insurance Company	301513	Agent - Property	9/13/2011	12/31/2013
Inactive	Beazley Insurance Company, Inc.	300899	Agent - Casualty	12/22/2011	2/26/2013
Inactive	Beazley Insurance Company, Inc.	300899	Agent - Property	12/22/2011	2/26/2013
Inactive	Capitol Indemnity Corporation	301030	Agent - Casualty	9/15/2011	3/31/2016
Inactive	Capitol Indemnity Corporation	301030	Agent - Property	9/15/2011	3/31/2016
Inactive	Federal Insurance Company	301144	Agent - Casualty	1/16/2009	5/13/2015
Inactive	Federal Insurance Company	301144	Agent - Property	1/16/2009	5/13/2015
Inactive	Northland Insurance Company	300201	Agent - Casualty	8/15/2000	6/12/2003
Inactive	Northland Insurance Company	300201	Agent - General Lines	4/26/2000	8/15/2000
Inactive	Northland Insurance Company	300201	Agent - Property	8/15/2000	6/12/2003
Inactive	Starr Indemnity and Liability Company	301685	Agent - Casualty	12/30/2011	3/31/2016
Inactive	Starr Indemnity and Liability Company	301685	Agent - Property	12/30/2011	3/31/2016
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	10/10/2007	6/11/2013
Inactive	Zurich American Insurance Company	301121	Agent - Property	10/10/2007	6/11/2013
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	10/10/2007	6/11/2013
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	10/10/2007	6/11/2013

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Pedersen, Timothy Martin	566752	Agent - Casualty	10/9/2007	3/31/2016
Inactive	Pedersen, Timothy Martin	566752	Agent - Property	10/9/2007	3/31/2016
Inactive	Pedersen, Timothy Martin	566752	Surplus Lines Broker - Not Applicable	3/19/2007	3/31/2016
Inactive	Travis, Arthur Preston	369853	Agent - Casualty	8/15/2000	3/1/2003
Inactive	Travis, Arthur Preston	369853	Agent - General Lines	4/26/2000	8/15/2000
Inactive	Travis, Arthur Preston	369853	Agent - Property	8/15/2000	3/1/2003