DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Petcoff, Nicholas James	DOIID	749880	NAIC NPN	16158872

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/11/2011		9/30/2027
Active	Non Resident	Agent	Casualty	3/11/2011		9/30/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/26/2011		9/30/2027
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	5/22/2019
Active	Liberty Insurance Underwriters Inc.	301391	Agent - Property	5/22/2019
Inactive	Sagamore Insurance Company	300942	Agent - Casualty	5/12/2016	2/19/2021
Inactive	Sagamore Insurance Company	300942	Agent - Property	5/12/2016	2/19/2021
Active	Starr Indemnity and Liability Company	301685	Agent - Casualty	9/18/2025
Active	Starr Indemnity and Liability Company	301685	Agent - Property	9/18/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Conifer Insurance Services, LLC	829297	Agent - Property	5/23/2016
Active	Conifer Insurance Services, LLC	829297	Agent - Casualty	5/23/2016
Active	Conifer Insurance Services, LLC	829297	Surplus Lines Broker - Not Applicable	12/10/2013
Inactive	Ethos Specialty Insurance Services LP	975725	Agent - Property	11/21/2024	11/6/2025
Inactive	Ethos Specialty Insurance Services LP	975725	Agent - Casualty	11/21/2024	11/6/2025
Inactive	Ethos Specialty Insurance Services LP	975725	Surplus Lines Broker - Not Applicable	11/21/2024	11/6/2025