DEPARTMENT OF INSURANCE

Name	Bergenfeld, David	DOIID	988613	NAIC NPN	18728304

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Independent Adjuster	Property & Casualty	3/23/2018	1/19/2021
Active	Non Resident	Staff Adjuster	Property & Casualty	1/19/2021		7/31/2026
Active	Non Resident	Staff Adjuster	Workers' Compensation	1/19/2021		7/31/2026

*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
Staff Adjuster	05/15/2024	07/31/2024	06/04/2024	06/04/2024	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
Residence	Not Public Information
Business / Home Office	Axis Insurance Company 1211 6th AveNew York, NY 100368701

Phone Information

Type	Phone
Business / Home Office	(908) 673-2996