DEPARTMENT OF INSURANCE

Name	Brokamp, Mark J	DOIID	504359	NAIC NPN	1057501

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	8/15/2000		6/30/2027
Active	Non Resident	Agent	Casualty	8/15/2000		6/30/2027
Inactive	Non Resident	Agent	General Lines	4/17/2000	8/15/2000

*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	04/15/2025	06/30/2025	06/10/2025	06/10/2025	Yes

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	122 Water St Milford, OH 45150
Residence	Not Public Information