DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Derigiotis, David A	DOIID	1248564	NAIC NPN	17503743

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Property	12/25/2022		10/31/2025
Pending Replacement	Non Resident	Agent	Casualty	12/25/2022		10/31/2025
Pending Replacement	Non Resident	Surplus Lines Broker	Not Applicable	3/17/2023		10/31/2025
* 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	08/15/2025	10/31/2025
Surplus Lines Broker	08/15/2025	10/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Pending Replacement	Arch Insurance Company	300688	Agent - Casualty	5/22/2024
Pending Replacement	Arch Insurance Company	300688	Agent - Property	5/22/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Embroker Ins Services LLC	901870	Agent - Casualty
Denied	Embroker Ins Services LLC	901870	Agent - Property
Pending	Flow Specialty Insurance Services LLC	1392494	Agent - Casualty
Pending	Flow Specialty Insurance Services LLC	1392494	Agent - Property
Pending	Flow Specialty Insurance Services LLC	1392494	Surplus Lines Broker - Not Applicable