DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Becker, Keith Patrick	DOIID	702668	NAIC NPN	1080914

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	5/20/2009	3/14/2024
Inactive	Non Resident	Agent	Property	5/20/2009	3/14/2024
Denied	Non Resident	Property & Casualty Consultant	Not Applicable
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	9/16/2009	3/14/2024
* 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	9/9/2013	3/14/2024
Inactive	ACE American Insurance Company	300625	Agent - Property	9/9/2013	3/14/2024
Inactive	Federal Insurance Company	301144	Agent - Casualty	10/9/2009	2/5/2011
Inactive	Federal Insurance Company	301144	Agent - Property	10/9/2009	2/5/2011
Inactive	Great Midwest Insurance Company	301418	Agent - Casualty	1/22/2015	3/14/2024
Inactive	Great Midwest Insurance Company	301418	Agent - Property	1/22/2015	3/14/2024
Inactive	Imperium Insurance Company	300804	Agent - Casualty	1/22/2015	3/14/2024
Inactive	Imperium Insurance Company	300804	Agent - Property	1/22/2015	3/14/2024
Inactive	Medical Protective Company (The)	301207	Agent - Casualty	3/30/2016	8/3/2023
Inactive	Medical Protective Company (The)	301207	Agent - Property	3/30/2016	8/3/2023
Inactive	NORCAL Insurance Company	301971	Agent - Casualty	4/21/2021	3/14/2024
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	9/9/2013	3/14/2024
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	9/9/2013	3/14/2024
Inactive	Underwriters at Lloyd's, London	300658	Agent - Casualty	11/13/2013	7/31/2019
Inactive	Underwriters at Lloyd's, London	300658	Agent - Property	11/13/2013	7/31/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AB Risk Specialist, LLC	735620	Agent - Casualty	8/30/2010	4/5/2021
Inactive	AB Risk Specialist, LLC	735620	Agent - Property	8/30/2010	4/5/2021
Inactive	AB Risk Specialist, LLC	735620	Surplus Lines Broker - Not Applicable	7/5/2011	4/5/2021
Inactive	Willis Ins Services Of Georgia Inc	549678	Agent - Casualty	10/9/2009	2/5/2011
Inactive	Willis Ins Services Of Georgia Inc	549678	Agent - Property	10/9/2009	2/5/2011