DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Petcoff, Andrew Daniel	DOIID	1112775	NAIC NPN	16751270

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/4/2020		5/31/2027
Active	Non Resident	Agent	Property	12/4/2020		5/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	9/23/2022		5/31/2027
* 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	03/15/2027	05/31/2027
Surplus Lines Broker	03/15/2027	05/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	8/25/2026
Active	Liberty Mutual Insurance Company	301159	Agent - Property	8/25/2026
Active	Next Insurance US Company	1083825	Agent - Casualty	7/3/2024
Active	Next Insurance US Company	1083825	Agent - Property	7/3/2024
Active	State National Insurance Company, Inc.	300888	Agent - Casualty	7/24/2024
Active	State National Insurance Company, Inc.	300888	Agent - Property	7/24/2024
Inactive	White Pine Insurance Company	868947	Agent - Casualty	10/31/2022	8/28/2026
Inactive	White Pine Insurance Company	868947	Agent - Property	10/31/2022	8/28/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mitzel Agency, Inc.	718761	Agent - Property	8/20/2026
Active	Sycamore Specialty Underwriters LLC	1245678	Agent - Casualty	12/7/2022
Active	Sycamore Specialty Underwriters LLC	1245678	Agent - Property	12/7/2022
Active	Sycamore Specialty Underwriters LLC	1245678	Surplus Lines Broker - Not Applicable	12/7/2022
Active	The Roots Insurance Agency, LLC	1303177	Agent - Casualty	10/5/2023
Active	The Roots Insurance Agency, LLC	1303177	Agent - Property	10/5/2023
Inactive	Venture Agency Holdings Inc	877277	Agent - Casualty	10/31/2022	9/22/2026
Inactive	Venture Agency Holdings Inc	877277	Agent - Property	10/31/2022	9/22/2026
Inactive	Venture Agency Holdings Inc	877277	Surplus Lines Broker - Not Applicable	10/31/2022	9/22/2026