DEPARTMENT OF INSURANCE

Affiliations

Name	Randall, Michael Alan	DOIID	921277	NAIC NPN	14379338

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	7/15/2016	11/30/2026
Active	Non Resident	Agent	Casualty	7/15/2016	11/30/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/15/2016	11/30/2026
* 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	09/15/2024	11/30/2024	10/01/2024	10/01/2024	Yes
Surplus Lines Broker	09/15/2024	11/30/2024	10/01/2024	10/01/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AmTrust Insurance Company	300179	Agent - Casualty	2/15/2019
Active	AmTrust Insurance Company	300179	Agent - Property	2/15/2019
Active	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	7/28/2021
Active	American Guarantee and Liability Insurance Company	301216	Agent - Property	7/28/2021
Active	American Zurich Insurance Company	300592	Agent - Casualty	7/28/2021
Active	American Zurich Insurance Company	300592	Agent - Property	7/28/2021
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	2/15/2019
Active	Milford Casualty Insurance Company	301460	Agent - Property	2/15/2019
Inactive	Park National Insurance Company	692514	Agent - Casualty	2/15/2019	12/16/2023
Inactive	Park National Insurance Company	692514	Agent - Property	2/15/2019	12/16/2023
Active	Security National Insurance Company	301151	Agent - Casualty	2/15/2019
Active	Security National Insurance Company	301151	Agent - Property	2/15/2019
Active	Selective Insurance Company of America	500018	Agent - Casualty	11/9/2020
Active	Selective Insurance Company of America	500018	Agent - Property	11/9/2020
Active	Selective Insurance Company of South Carolina	500012	Agent - Casualty	11/9/2020
Active	Selective Insurance Company of South Carolina	500012	Agent - Property	11/9/2020
Active	Selective Insurance Company of the Southeast	300381	Agent - Casualty	9/20/2019
Active	Selective Insurance Company of the Southeast	300381	Agent - Property	11/9/2020
Active	Technology Insurance Company	613278	Agent - Casualty	2/15/2019
Active	Technology Insurance Company	613278	Agent - Property	2/15/2019
Active	United Financial Casualty Company	301886	Agent - Casualty	5/6/2020
Active	United Financial Casualty Company	301886	Agent - Property	5/6/2020
Active	Wesco Insurance Company	300534	Agent - Casualty	2/15/2019
Active	Wesco Insurance Company	300534	Agent - Property	2/15/2019
Active	Zurich American Insurance Company	301121	Agent - Casualty	7/28/2021
Active	Zurich American Insurance Company	301121	Agent - Property	7/28/2021
Active	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	7/28/2021
Active	Zurich American Insurance Company of Illinois	301805	Agent - Property	7/28/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assuredpartners Of Oregon LLC	905764	Agent - Property	5/10/2022	2/13/2024
Inactive	Assuredpartners Of Oregon LLC	905764	Agent - Casualty	5/10/2022	2/13/2024
Inactive	Assuredpartners Of Oregon LLC	905764	Surplus Lines Broker - Not Applicable	5/10/2022	8/18/2023