DEPARTMENT OF INSURANCE

Affiliations

Name	Keystone Program Group Llc	DOIID	805208	NAIC NPN	16901975

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	3/7/2013	3/31/2025
Active	Non Resident	Agent	Casualty	3/7/2013	3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/27/2013	3/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	01/15/2025	03/31/2025
Surplus Lines Broker	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Allied Insurance Company of America	793586	Agent - Casualty	2/2/2022
Active	Allied Insurance Company of America	793586	Agent - Property	2/2/2022
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	7/13/2017	8/17/2021
Inactive	AmTrust Insurance Company	300179	Agent - Property	7/13/2017	8/17/2021
Inactive	American Economy Insurance Company	300315	Agent - Casualty	7/12/2016	3/29/2024
Inactive	American Economy Insurance Company	300315	Agent - Property	7/12/2016	3/29/2024
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	7/18/2016	3/29/2024
Inactive	American Fire and Casualty Company	300567	Agent - Property	7/18/2016	3/29/2024
Inactive	American States Insurance Company	301230	Agent - Casualty	7/12/2016	3/29/2024
Inactive	American States Insurance Company	301230	Agent - Property	7/12/2016	3/29/2024
Active	Berkley Casualty Company	300731	Agent - Casualty	10/16/2019
Active	Carolina Casualty Insurance Company	300271	Agent - Casualty	10/16/2019
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	6/10/2013	12/3/2014
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	7/18/2016	10/13/2022
Inactive	Consolidated Insurance Company	300943	Agent - Property	7/18/2016	10/13/2022
Inactive	Farmington Casualty Company	301137	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Farmington Casualty Company	301137	Agent - Property	6/10/2013	12/3/2014
Inactive	First National Insurance Company of America	301690	Agent - Casualty	7/12/2016	10/13/2022
Inactive	First National Insurance Company of America	301690	Agent - Property	7/12/2016	10/13/2022
Inactive	General Insurance Company of America	300261	Agent - Casualty	7/12/2016	3/29/2024
Inactive	General Insurance Company of America	300261	Agent - Property	7/12/2016	3/29/2024
Inactive	Great American Alliance Insurance Company	301247	Agent - Casualty	5/8/2013	10/13/2021
Inactive	Great American Alliance Insurance Company	301247	Agent - Property	5/8/2013	10/13/2021
Inactive	Great American Assurance Company	300327	Agent - Casualty	5/8/2013	3/26/2021
Inactive	Great American Assurance Company	300327	Agent - Property	5/8/2013	3/26/2021
Inactive	Great American Insurance Company	301586	Agent - Casualty	5/8/2013	3/26/2021
Inactive	Great American Insurance Company	301586	Agent - Property	5/8/2013	3/26/2021
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	5/8/2013	3/26/2021
Inactive	Great American Insurance Company of New York	301897	Agent - Property	5/8/2013	3/26/2021
Inactive	Great American Security Insurance Company	301228	Agent - Casualty	5/8/2013	3/26/2021
Inactive	Great American Security Insurance Company	301228	Agent - Property	5/8/2013	3/26/2021
Active	Great American Spirit Insurance Company	300233	Agent - Casualty	5/8/2013
Active	Great American Spirit Insurance Company	300233	Agent - Property	5/8/2013
Inactive	Indiana Insurance Company	301909	Agent - Casualty	7/18/2016	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	7/18/2016	2/3/2023
Active	Key Risk Insurance Company	630687	Agent - Casualty	10/16/2019
Active	Meridian Security Insurance Company	300423	Agent - Casualty	5/23/2017
Active	Meridian Security Insurance Company	300423	Agent - Property	5/23/2017
Active	Midwest Employers Casualty Company	300124	Agent - Casualty	10/16/2019
Inactive	Milford Casualty Insurance Company	301460	Agent - Casualty	7/13/2017	8/17/2021
Inactive	Milford Casualty Insurance Company	301460	Agent - Property	7/13/2017	8/17/2021
Active	Nationwide Assurance Company	300166	Agent - Casualty	1/12/2020
Active	Nationwide General Insurance Company	300603	Agent - Casualty	8/15/2019
Active	Nationwide General Insurance Company	300603	Agent - Property	8/15/2019
Active	Nationwide Insurance Company of America	300333	Agent - Casualty	8/15/2019
Active	Nationwide Insurance Company of America	300333	Agent - Property	8/15/2019
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	4/11/2013
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	4/11/2013
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	1/12/2020
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	1/12/2020
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	7/18/2016	5/9/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	7/18/2016	5/9/2024
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	7/18/2016	3/29/2024
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	7/18/2016	3/29/2024
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	7/18/2016	3/29/2024
Inactive	Ohio Security Insurance Company	300622	Agent - Property	7/18/2016	3/29/2024
Inactive	Park National Insurance Company	692514	Agent - Casualty	7/13/2017	8/17/2021
Inactive	Park National Insurance Company	692514	Agent - Property	7/13/2017	8/17/2021
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	7/18/2016
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	7/18/2016
Active	Peerless Insurance Company	301910	Agent - Casualty	7/18/2016
Active	Peerless Insurance Company	301910	Agent - Property	7/18/2016
Inactive	Protective Insurance Company	301117	Agent - Casualty	12/5/2016	9/29/2017
Inactive	Protective Insurance Company	301117	Agent - Property	12/5/2016	9/29/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/12/2016	3/29/2024
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/12/2016	3/29/2024
Inactive	Security National Insurance Company	301151	Agent - Casualty	7/13/2017	8/17/2021
Inactive	Security National Insurance Company	301151	Agent - Property	7/13/2017	8/17/2021
Inactive	Sequoia Insurance Company	628046	Agent - Casualty	5/5/2020	8/17/2021
Inactive	Sequoia Insurance Company	628046	Agent - Property	5/5/2020	8/17/2021
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	6/10/2013	12/3/2014
Active	StarNet Insurance Company	502746	Agent - Casualty	10/16/2019
Active	Starr Indemnity and Liability Company	301685	Agent - Casualty	5/30/2024
Active	Starr Indemnity and Liability Company	301685	Agent - Property	5/30/2024
Active	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	5/23/2017
Active	State Auto Property & Casualty Insurance Company	301953	Agent - Property	5/23/2017
Active	State Automobile Mutual Insurance Company	301824	Agent - Casualty	5/23/2017
Active	State Automobile Mutual Insurance Company	301824	Agent - Property	5/23/2017
Inactive	Technology Insurance Company	613278	Agent - Casualty	7/13/2017	8/17/2021
Inactive	Technology Insurance Company	613278	Agent - Property	7/13/2017	8/17/2021
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	6/10/2013	12/3/2014
Inactive	The Phoenix Insurance Company	301502	Agent - Property	6/10/2013	12/3/2014
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	6/10/2013	12/3/2014
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	6/10/2013	12/3/2014
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	6/10/2013	12/3/2014
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	6/10/2013	12/3/2014
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	6/10/2013	12/3/2014
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	6/10/2013	12/3/2014
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	6/10/2013	12/3/2014
Inactive	Wesco Insurance Company	300534	Agent - Casualty	7/13/2017	8/17/2021
Inactive	Wesco Insurance Company	300534	Agent - Property	7/13/2017	8/17/2021
Inactive	West American Insurance Company	301112	Agent - Casualty	7/18/2016	3/29/2024
Inactive	West American Insurance Company	301112	Agent - Property	7/18/2016	3/29/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hilbert, Amber-Lee	824678	Surplus Lines Broker - Not Applicable	10/19/2021
Active	Irwin, David James	752148	Agent - Casualty	10/19/2021
Active	Irwin, David James	752148	Agent - Property	10/19/2021
Active	Joyce, Joseph P	695192	Agent - Casualty	3/7/2013
Active	Joyce, Joseph P	695192	Agent - Property	3/7/2013
Inactive	Moran, Jeffrey Eugene	804965	Agent - Casualty	7/30/2013	6/30/2022
Inactive	Moran, Jeffrey Eugene	804965	Agent - Property	7/30/2013	6/30/2022
Inactive	Moran, Jeffrey Eugene	804965	Surplus Lines Broker - Not Applicable	3/27/2013	5/25/2022