DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burlingame, Martin R	DOIID	1001114	NAIC NPN	8108276

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	7/16/2018		3/31/2027
Active	Non Resident	Agent	Health	7/16/2018		3/31/2027
Active	Non Resident	Agent	Property	7/16/2018		3/31/2027
Active	Non Resident	Agent	Casualty	7/16/2018		3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/23/2021		3/31/2027
* 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	01/15/2027	03/31/2027
Surplus Lines Broker	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019
Active	American Economy Insurance Company	300315	Agent - Property	11/9/2019
Active	American National Property and Casualty Company	300392	Agent - Casualty	6/4/2020
Active	American National Property and Casualty Company	300392	Agent - Property	6/4/2020
Active	Arch Insurance Company	300688	Agent - Casualty	1/29/2019
Active	Arch Insurance Company	300688	Agent - Property	1/29/2019
Inactive	Hartford Insurance Company of the Southeast	1014204	Agent - Casualty	12/22/2021	8/2/2023
Inactive	Hartford Insurance Company of the Southeast	1014204	Agent - Property	12/22/2021	8/2/2023
Active	Jewelers Mutual Insurance Company, SI	301935	Agent - Casualty	8/25/2023
Active	Jewelers Mutual Insurance Company, SI	301935	Agent - Property	8/25/2023
Active	Markel Insurance Company	301475	Agent - Casualty	3/7/2023
Active	Markel Insurance Company	301475	Agent - Property	3/7/2023
Active	RLI Insurance Company	301217	Agent - Casualty	10/21/2024
Active	RLI Insurance Company	301217	Agent - Property	10/21/2024
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	4/4/2019
Active	SAFECO Insurance Company of America	300159	Agent - Property	4/4/2019
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	4/4/2019
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	4/4/2019
Inactive	Spinnaker Insurance Company	300099	Agent - Property	3/21/2022	12/6/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	One80 Intermediaries Inc	722533	Surplus Lines Broker - Not Applicable	8/9/2022