DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Peck, Andrew Mitchell	DOIID	667303	NAIC NPN	7650578

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	10/31/2007	5/1/2015
Inactive	Non Resident	Agent	Property	10/31/2007	5/1/2015
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	6/17/2010	5/1/2015
* 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	American Modern Home Insurance Company	300791	Agent - Casualty	4/16/2015	5/1/2015
Inactive	American Modern Home Insurance Company	300791	Agent - Property	4/16/2015	5/1/2015
Inactive	Arch Insurance Company	300688	Agent - Casualty	10/16/2009	5/1/2015
Inactive	Arch Insurance Company	300688	Agent - Property	10/16/2009	5/1/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Towers Watson Midwest, Inc.	534348	Agent - Casualty	12/3/2009	12/11/2014
Inactive	Willis Towers Watson Midwest, Inc.	534348	Agent - Property	12/3/2009	12/11/2014