DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burtch, Douglas Richard	DOIID	908382	NAIC NPN	1842064

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	3/2/2016	1/3/2023
Inactive	Non Resident	Agent	Property	3/2/2016	1/3/2023
* 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	Bristol West Insurance Company	301655	Agent - Casualty	3/9/2016	1/3/2023
Inactive	Bristol West Insurance Company	301655	Agent - Property	3/9/2016	1/3/2023
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Casualty	6/30/2021	12/5/2022
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Property	6/30/2021	12/5/2022
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	6/30/2021	12/5/2022
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	6/30/2021	12/5/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bristol West Ins Services Inc Of Florida	641653	Agent - Property	5/9/2016	12/29/2022
Inactive	Bristol West Ins Services Inc Of Florida	641653	Agent - Casualty	5/9/2016	12/29/2022
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Property	12/18/2017	12/31/2018
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Casualty	12/18/2017	12/31/2018
Inactive	Fx Insurance Agency, LLC	646184	Agent - Property	12/31/2018	1/3/2023
Inactive	Fx Insurance Agency, LLC	646184	Agent - Casualty	12/31/2018	1/3/2023