DEPARTMENT OF INSURANCE

Affiliations

Name	Small, Patrick S	DOIID	510004	NAIC NPN	765867

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	12/31/2008		5/31/2026
Active	Non Resident	Agent	Casualty	8/15/2000		5/31/2026
Active	Non Resident	Agent	Property	8/15/2000		5/31/2026
Active	Non Resident	Agent	Health	12/31/2008		5/31/2026
Inactive	Non Resident	Agent	General Lines	6/14/2000	8/15/2000
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/5/2004		5/31/2026
* 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
Agent	03/15/2024	05/31/2024	03/21/2024	03/21/2024	Yes
Surplus Lines Broker	03/15/2024	05/31/2024	03/21/2024	03/21/2024	Yes

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	9/20/2009	5/5/2014
Inactive	ACE American Insurance Company	300625	Agent - Health	9/20/2009	6/1/2015
Inactive	ACE American Insurance Company	300625	Agent - Property	9/20/2009	5/5/2014
Active	Accredited Surety and Casualty Company, Inc.	502744	Agent - Casualty	9/22/2022
Active	Accredited Surety and Casualty Company, Inc.	502744	Agent - Property	9/22/2022
Inactive	American Family Home Insurance Company	301817	Agent - Casualty	2/11/2003	9/11/2020
Inactive	American Family Home Insurance Company	301817	Agent - Property	2/11/2003	9/11/2020
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	8/15/2000	9/11/2020
Inactive	American Modern Home Insurance Company	300791	Agent - General Lines	6/14/2000	8/15/2000
Inactive	American Modern Home Insurance Company	300791	Agent - Property	8/15/2000	9/11/2020
Active	Manufacturers Alliance Insurance Company	519940	Agent - Casualty	2/20/2024
Active	Manufacturers Alliance Insurance Company	519940	Agent - Property	2/20/2024
Active	National Summit Insurance Company	300348	Agent - Casualty	1/30/2024
Active	National Summit Insurance Company	300348	Agent - Property	1/30/2024
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Casualty	2/20/2024
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Property	2/20/2024
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Casualty	2/20/2024
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Property	2/20/2024
Inactive	Rural Community Insurance Company	301891	Agent - Casualty	4/20/2009	10/28/2014
Inactive	Rural Community Insurance Company	301891	Agent - Property	4/20/2009	10/28/2014
Active	Selective Insurance Company of the Southeast	300381	Agent - Casualty	6/23/2014
Active	Selective Insurance Company of the Southeast	300381	Agent - Property	6/23/2014
Active	State National Insurance Company, Inc.	300888	Agent - Casualty	6/3/2021
Active	State National Insurance Company, Inc.	300888	Agent - Property	6/3/2021
Inactive	Underwriters at Lloyd's, London	300658	Agent - Casualty	1/25/2010	12/19/2023
Inactive	Underwriters at Lloyd's, London	300658	Agent - Property	1/25/2010	12/19/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Dual Commercial LLC	810926	Agent - Property	1/20/2021
Active	Dual Commercial LLC	810926	Agent - Casualty	1/20/2021
Active	Dual Commercial LLC	810926	Surplus Lines Broker - Not Applicable	1/20/2021
Active	Dual Commercial LLC	810926	Agent - Life	9/1/2023
Active	Dual Commercial LLC	810926	Agent - Health	9/1/2023
Inactive	Financial & Professional Risk Solutions, Inc.	396155	Agent - Property	3/8/2004	3/13/2007
Inactive	Financial & Professional Risk Solutions, Inc.	396155	Agent - Casualty	3/8/2004	3/13/2007
Inactive	Financial & Professional Risk Solutions, Inc.	396155	Surplus Lines Broker - Not Applicable	9/6/2006	1/14/2008
Inactive	Safehold Special Risk, Inc	658217	Agent - Property	6/20/2007	4/30/2014
Inactive	Safehold Special Risk, Inc	658217	Agent - Casualty	6/20/2007	4/30/2014
Inactive	Safehold Special Risk, Inc	658217	Surplus Lines Broker - Not Applicable	4/3/2008	4/30/2014
Inactive	Safehold Special Risk, Inc	658217	Agent - Life	6/26/2009	4/30/2014
Inactive	Safehold Special Risk, Inc	658217	Agent - Health	6/26/2009	4/30/2014