DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Douglass, Cameron	DOIID	1328085	NAIC NPN	18130851

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/6/2024		1/31/2026
Active	Non Resident	Agent	Casualty	3/6/2024		1/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/11/2024		1/31/2026
* 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
Agent	11/15/2025	01/31/2026
Surplus Lines Broker	11/15/2025	01/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AGCS Marine Insurance Company	300403	Agent - Casualty	4/10/2024
Active	AGCS Marine Insurance Company	300403	Agent - Property	4/10/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	4/10/2024
Active	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	4/10/2024
Active	Arthur J. Gallagher Risk Management Services, LLC	539806	Surplus Lines Broker - Not Applicable	3/21/2024