DEPARTMENT OF INSURANCE

Affiliations

Name	Pacific Merrill Assurance Brokers LLC	DOIID	937257	NAIC NPN	9013875

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	3/5/2021		3/31/2026
Active	Non Resident	Agent	Property	3/5/2021		3/31/2026
Inactive	Non Resident	Agent	Personal Lines	11/15/2016	1/26/2021
* 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
Denied	AMCO Insurance Company	300204	Agent - Casualty
Denied	AMCO Insurance Company	300204	Agent - Property
Denied	Allied Insurance Company of America	793586	Agent - Casualty
Denied	Allied Insurance Company of America	793586	Agent - Property
Denied	Allied Property and Casualty Insurance Company	300279	Agent - Casualty
Denied	Allied Property and Casualty Insurance Company	300279	Agent - Property
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	12/22/2017	3/12/2020
Inactive	AmTrust Insurance Company	300179	Agent - Property	12/22/2017	3/12/2020
Denied	Depositors Insurance Company	301634	Agent - Casualty
Denied	Depositors Insurance Company	301634	Agent - Property
Inactive	Harleysville Insurance Company	301462	Agent - Casualty	6/29/2018	1/26/2021
Inactive	Harleysville Insurance Company	301462	Agent - Property	6/29/2018	1/26/2021
Inactive	Milford Casualty Insurance Company	301460	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Milford Casualty Insurance Company	301460	Agent - Property	12/22/2017	3/12/2020
Denied	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty
Denied	Nationwide Agribusiness Insurance Company	301008	Agent - Property
Inactive	Nationwide Assurance Company	300166	Agent - Casualty	1/12/2020	1/26/2021
Denied	Nationwide Assurance Company	300166	Agent - Property
Inactive	Nationwide General Insurance Company	300603	Agent - Casualty	8/15/2019	1/26/2021
Inactive	Nationwide General Insurance Company	300603	Agent - Property	8/15/2019	1/26/2021
Inactive	Nationwide Insurance Company of America	300333	Agent - Casualty	8/15/2019	1/26/2021
Inactive	Nationwide Insurance Company of America	300333	Agent - Property	8/15/2019	1/26/2021
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	6/29/2018	1/26/2021
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	6/29/2018	1/26/2021
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	1/12/2020	1/26/2021
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	1/12/2020	1/26/2021
Inactive	Park National Insurance Company	692514	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Park National Insurance Company	692514	Agent - Property	12/22/2017	3/12/2020
Inactive	Security National Insurance Company	301151	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Security National Insurance Company	301151	Agent - Property	12/22/2017	3/12/2020
Inactive	Technology Insurance Company	613278	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Technology Insurance Company	613278	Agent - Property	12/22/2017	3/12/2020
Inactive	Wesco Insurance Company	300534	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Wesco Insurance Company	300534	Agent - Property	12/22/2017	3/12/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Ditommaso, Kristy M	1002180	Agent - Casualty	6/22/2023
Active	Ditommaso, Kristy M	1002180	Agent - Property	6/22/2023
Denied	Martin, Robert Lawrence	354144	Agent - Casualty
Denied	Martin, Robert Lawrence	354144	Agent - Property
Inactive	Rosen, David	1085807	Agent - Casualty	3/5/2021	7/22/2022
Inactive	Rosen, David	1085807	Agent - Property	3/5/2021	7/22/2022
Inactive	Sheehy, Thomas M	633678	Agent - Casualty	11/15/2016	10/31/2020
Inactive	Sheehy, Thomas M	633678	Agent - Personal Lines	11/15/2016	10/31/2020
Inactive	Sheehy, Thomas M	633678	Agent - Property	11/15/2016	10/31/2020
Active	Sheridan, Pamala Marie	875972	Agent - Casualty	7/22/2022
Active	Sheridan, Pamala Marie	875972	Agent - Property	7/22/2022