DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Verisario, Keith M	DOIID	852116	NAIC NPN	2838656

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	9/15/2014		2/28/2025
Active	Non Resident	Agent	Health	9/15/2014		2/28/2025
Active	Non Resident	Agent	Life	9/15/2014		2/28/2025
Active	Non Resident	Agent	Property	9/15/2014		2/28/2025
* 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	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	2/23/2017	12/20/2023
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	2/23/2017	12/20/2023
Inactive	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	11/27/2021	11/27/2021
Active	Cincinnati Insurance Company	301298	Agent - Casualty	12/19/2014
Active	Cincinnati Insurance Company	301298	Agent - Property	12/19/2014
Inactive	NorthStone Insurance Company	818905	Agent - Casualty	11/27/2021	11/27/2021
Inactive	PinnaclePoint Insurance Company	819085	Agent - Casualty	11/27/2021	11/27/2021
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	8/5/2021
Active	SAFECO Insurance Company of America	300159	Agent - Property	8/5/2021
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	8/5/2021
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	8/5/2021
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	7/5/2016	8/12/2020
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	7/5/2016	8/12/2020
Inactive	SummitPoint Insurance Company	819084	Agent - Casualty	11/27/2021	11/27/2021
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	8/15/2018	8/12/2020
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	8/15/2018	8/12/2020
Active	West Bend Insurance Company	672974	Agent - Casualty	8/7/2017
Active	West Bend Insurance Company	672974	Agent - Property	8/7/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Acrisure LLC	696181	Agent - Life
Denied	Acrisure LLC	696181	Agent - Health
Active	Acrisure LLC	696181	Agent - Casualty	7/24/2020
Active	Acrisure LLC	696181	Agent - Property	7/24/2020