DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Burgos, Justin W	DOIID	986278	NAIC NPN	8320839

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	3/2/2018		8/31/2026
Active	Non Resident	Agent	Property	3/2/2018		8/31/2026
* 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	06/15/2024	08/31/2024	07/18/2024	07/18/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	XL Reinsurance America Inc.	300723	Agent - Casualty	2/25/2019
Active	XL Reinsurance America Inc.	300723	Agent - Property	2/25/2019
Active	XL Specialty Insurance Company	301605	Agent - Casualty	2/25/2019
Active	XL Specialty Insurance Company	301605	Agent - Property	2/25/2019
Active	Zurich American Insurance Company	301121	Agent - Casualty	3/9/2018
Active	Zurich American Insurance Company	301121	Agent - Property	3/9/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Of Illinois Inc	398318	Agent - Property	3/19/2018	3/20/2018
Inactive	Willis Of Illinois Inc	398318	Agent - Casualty	3/19/2018	3/20/2018
Active	Willis Towers Watson Midwest, Inc.	534348	Agent - Property	2/22/2019
Active	Willis Towers Watson Midwest, Inc.	534348	Agent - Casualty	2/22/2019
Inactive	Willis of Minnesota, Inc.	569739	Agent - Property	3/20/2018	1/17/2019
Inactive	Willis of Minnesota, Inc.	569739	Agent - Casualty	3/20/2018	1/17/2019