DEPARTMENT OF INSURANCE

Affiliations

Name	Pedersen Sr, Timothy Martin	DOIID	566752	NAIC NPN	252562

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	5/24/2004	9/30/2021
Inactive	Non Resident	Agent	Casualty	5/24/2004	9/30/2021
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	4/11/2003	9/30/2021
* 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	ACE American Insurance Company	300625	Agent - Casualty	8/4/2004	11/10/2021
Inactive	ACE American Insurance Company	300625	Agent - Property	8/4/2004	11/10/2021
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	10/9/2007	5/12/2021
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	10/9/2007	5/12/2021
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	10/9/2007	5/12/2021
Inactive	American Zurich Insurance Company	300592	Agent - Property	10/9/2007	5/12/2021
Inactive	Arch Insurance Company	300688	Agent - Casualty	5/5/2008	9/30/2021
Inactive	Arch Insurance Company	300688	Agent - Property	5/5/2008	9/30/2021
Inactive	Aspen American Insurance Company	301513	Agent - Casualty	9/12/2011	11/13/2013
Inactive	Aspen American Insurance Company	301513	Agent - Property	9/12/2011	11/13/2013
Inactive	Berkley Insurance Company	301355	Agent - Casualty	1/29/2017	9/30/2021
Inactive	Capitol Indemnity Corporation	301030	Agent - Casualty	9/15/2011	10/14/2020
Inactive	Capitol Indemnity Corporation	301030	Agent - Property	9/15/2011	10/14/2020
Inactive	Indemnity Insurance Company of North America	301760	Agent - Casualty	8/4/2004	11/10/2021
Inactive	Indemnity Insurance Company of North America	301760	Agent - Property	8/4/2004	11/10/2021
Inactive	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	3/30/2016	9/30/2021
Inactive	Liberty Insurance Underwriters Inc.	301391	Agent - Property	3/30/2016	9/30/2021
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	3/30/2016	9/30/2021
Inactive	Liberty Mutual Insurance Company	301159	Agent - Property	3/30/2016	9/30/2021
Inactive	Markel Insurance Company	301475	Agent - Casualty	12/5/2006	9/30/2021
Inactive	Markel Insurance Company	301475	Agent - Property	12/5/2006	9/30/2021
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	10/29/2008	9/30/2021
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Property	10/29/2008	9/30/2021
Inactive	RLI Insurance Company	301217	Agent - Casualty	10/4/2017	2/5/2021
Inactive	RLI Insurance Company	301217	Agent - Property	10/4/2017	2/5/2021
Inactive	RSUI Indemnity Company	300513	Agent - Casualty	5/2/2006	9/30/2021
Inactive	RSUI Indemnity Company	300513	Agent - Property	5/2/2006	9/30/2021
Inactive	Starr Indemnity and Liability Company	301685	Agent - Casualty	12/30/2011	9/30/2021
Inactive	Starr Indemnity and Liability Company	301685	Agent - Property	12/30/2011	9/30/2021
Inactive	Westchester Fire Insurance Company	301414	Agent - Casualty	8/4/2004	1/1/2011
Inactive	Westchester Fire Insurance Company	300990	Agent - Casualty	1/1/2011	11/10/2021
Inactive	Westchester Fire Insurance Company	301414	Agent - Property	8/4/2004	1/1/2011
Inactive	Westchester Fire Insurance Company	300990	Agent - Property	1/1/2011	11/10/2021
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	10/9/2007	5/12/2021
Inactive	Zurich American Insurance Company	301121	Agent - Property	10/9/2007	5/12/2021
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	10/9/2007	5/12/2021
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	10/9/2007	5/12/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Brown And Riding Ins Services Inc	699380	Surplus Lines Broker - Not Applicable	3/4/2015	9/30/2021
Inactive	Brown And Riding Ins Services Inc	699380	Agent - Casualty	5/8/2013	1/25/2021
Inactive	Brown And Riding Ins Services Inc	699380	Agent - Property	5/8/2013	1/25/2021
Inactive	Travis Pedersen And Assoc Inc	509352	Surplus Lines Broker - Not Applicable	3/19/2007	3/31/2016
Inactive	Travis Pedersen And Assoc Inc	509352	Agent - Casualty	10/9/2007	3/31/2016
Inactive	Travis Pedersen And Assoc Inc	509352	Agent - Property	10/9/2007	3/31/2016