DEPARTMENT OF INSURANCE

Name	Keller, Zachary R	DOIID	720724	NAIC NPN	8866313

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	11/8/2013	6/30/2027
Active	Non Resident	Agent	Life	11/8/2013	6/30/2027
Active	Non Resident	Agent	Casualty	1/7/2010	6/30/2027
Active	Non Resident	Agent	Property	1/7/2010	6/30/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/2/2018	6/30/2027

*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	05/01/2025	05/01/2025	Yes
Surplus Lines Broker	04/15/2025	06/30/2025	05/01/2025	05/01/2025	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	Assuredpartners Of West Virginia, Llc 1002 3rd AveHuntington, WV 257011506
Residence	Not Public Information

Internet Information

Type	Address
Business Email	zach.keller@assuredpartners.com - Bad Email-Correction requested

Phone Information

Type	Phone
Business / Home Office	(973) 669-2329