DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burggren Jr, Richard R	DOIID	765695	NAIC NPN	16257648

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	10/4/2011	11/30/2012
Inactive	Non Resident	Agent	Casualty	10/4/2011	11/30/2012
* 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	Electric Insurance Company	301758	Agent - Casualty	10/12/2011	3/13/2012
Inactive	Electric Insurance Company	301758	Agent - Property	10/12/2011	3/13/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Electric Insurance Agency, LLC	521813	Agent - Casualty	10/19/2011	3/13/2012
Inactive	Electric Insurance Agency, LLC	521813	Agent - Property	10/19/2011	3/13/2012