DEPARTMENT OF INSURANCE

Affiliations

Name	Program Ins Management Of Sarasota Inc Dba Chemplan DBA : ChemPlan	DOIID	698457	NAIC NPN	7178393

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	11/23/2009	3/31/2021
Inactive	Non Resident	Agent	Casualty	11/23/2009	3/31/2021
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	6/21/2011	3/31/2021
* 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	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	12/31/2012	3/31/2021
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	12/31/2012	3/31/2021
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	12/31/2012	3/31/2021
Inactive	American Zurich Insurance Company	300592	Agent - Property	12/31/2012	3/31/2021
Inactive	Aspen American Insurance Company	301513	Agent - Casualty	8/14/2013	12/30/2014
Inactive	Aspen American Insurance Company	301513	Agent - Property	8/14/2013	12/30/2014
Inactive	Berkley Insurance Company	301355	Agent - Casualty	3/23/2017	10/25/2017
Inactive	Berkley National Insurance Company	515028	Agent - Casualty	3/23/2017	10/25/2017
Inactive	Berkley National Insurance Company	515028	Agent - Property	3/23/2017	10/25/2017
Inactive	Berkley Regional Insurance Company	300920	Agent - Casualty	3/23/2017	10/25/2017
Inactive	Berkley Regional Insurance Company	300920	Agent - Property	3/23/2017	10/25/2017
Inactive	Great Divide Insurance Company	301636	Agent - Casualty	8/10/2010	3/31/2021
Inactive	Great Divide Insurance Company	301636	Agent - Property	8/10/2010	3/31/2021
Inactive	National Specialty Insurance Company	300993	Agent - Casualty	1/15/2014	1/15/2021
Inactive	National Specialty Insurance Company	300993	Agent - Property	1/15/2014	1/15/2021
Inactive	Riverport Insurance Company	301714	Agent - Casualty	3/23/2017	10/25/2017
Inactive	Riverport Insurance Company	301714	Agent - Property	3/23/2017	10/25/2017
Inactive	Star Insurance Company	301553	Agent - Casualty	12/2/2009	1/14/2021
Inactive	Star Insurance Company	301553	Agent - Property	12/2/2009	1/14/2021
Inactive	StarNet Insurance Company	502746	Agent - Casualty	3/23/2017	10/25/2017
Inactive	StarNet Insurance Company	502746	Agent - Property	3/23/2017	10/25/2017
Inactive	Starr Indemnity and Liability Company	301685	Agent - Casualty	6/15/2012	3/31/2021
Inactive	Starr Indemnity and Liability Company	301685	Agent - Property	6/15/2012	3/31/2021
Inactive	State National Insurance Company, Inc.	300888	Agent - Casualty	8/16/2013	1/15/2021
Inactive	State National Insurance Company, Inc.	300888	Agent - Property	8/16/2013	1/15/2021
Inactive	Tri-State Insurance Company of Minnesota	663528	Agent - Casualty	3/23/2017	10/25/2017
Inactive	Tri-State Insurance Company of Minnesota	663528	Agent - Property	3/23/2017	10/25/2017
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	12/31/2012	3/31/2021
Inactive	Zurich American Insurance Company	301121	Agent - Property	12/31/2012	3/31/2021
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	12/31/2012	3/31/2021
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	12/31/2012	3/31/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kerr, Christopher Bruce	358357	Agent - Casualty	11/23/2009	3/31/2021
Inactive	Kerr, Christopher Bruce	358357	Agent - Property	11/23/2009	3/31/2021
Inactive	Shaw, Emily Marie	985746	Agent - Casualty	3/27/2018	4/3/2020
Inactive	Shaw, Emily Marie	985746	Agent - Property	3/27/2018	4/3/2020
Inactive	Shaw, Emily Marie	985746	Surplus Lines Broker - Not Applicable	2/20/2019	3/31/2021
Inactive	Yorston, Michael A	754677	Surplus Lines Broker - Not Applicable	6/21/2011	11/16/2018