DEPARTMENT OF INSURANCE

Affiliations

Name	Staples, Brian K	DOIID	1162631	NAIC NPN	6587108

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	9/28/2021	5/31/2027
Active	Non Resident	Agent	Casualty	9/28/2021	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

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AmTrust Insurance Company	300179	Agent - Casualty	2/6/2026
Active	AmTrust Insurance Company	300179	Agent - Property	2/6/2026
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	8/17/2023	5/19/2025
Inactive	American Modern Property and Casualty Insurance Company	301954	Agent - Property	8/17/2023	5/19/2025
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	4/17/2023	1/11/2025
Inactive	Dairyland Insurance Company	301370	Agent - Property	4/17/2023	1/11/2025
Inactive	Integon Indemnity Corporation	300674	Agent - Casualty	2/14/2024	1/16/2025
Inactive	Integon Indemnity Corporation	300674	Agent - Property	2/14/2024	1/16/2025
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	5/21/2024	1/10/2025
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	5/21/2024	1/10/2025
Inactive	Liberty Mutual Personal Insurance Company	959584	Agent - Casualty	2/17/2022	9/26/2024
Inactive	Liberty Mutual Personal Insurance Company	959584	Agent - Property	2/17/2022	9/26/2024
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	5/12/2023	1/10/2025
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	5/12/2023	1/10/2025
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	1/6/2022	1/27/2025
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	1/6/2022	1/27/2025
Active	Security National Insurance Company	301151	Agent - Casualty	2/6/2026
Active	Security National Insurance Company	301151	Agent - Property	2/6/2026
Active	Sequoia Insurance Company	628046	Agent - Casualty	2/6/2026
Active	Sequoia Insurance Company	628046	Agent - Property	2/6/2026
Active	Technology Insurance Company	613278	Agent - Casualty	2/6/2026
Active	Technology Insurance Company	613278	Agent - Property	2/6/2026
Active	Wesco Insurance Company	300534	Agent - Casualty	2/6/2026
Active	Wesco Insurance Company	300534	Agent - Property	2/6/2026

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Helmsman Insurance Agency Llc	572054	Agent - Casualty	8/22/2024	5/19/2025
Inactive	Helmsman Insurance Agency Llc	572054	Agent - Property	8/22/2024	5/19/2025