DEPARTMENT OF INSURANCE

Affiliations

Name	Pacific Merrill Assurance Brokers LLC	DOIID	937257	NAIC NPN	9013875

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	3/5/2021		3/31/2026
Active	Non Resident	Agent	Property	3/5/2021		3/31/2026
Inactive	Non Resident	Agent	Personal Lines	11/15/2016	1/26/2021
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	AMCO Insurance Company	300204	Agent - Casualty
Denied	AMCO Insurance Company	300204	Agent - Property
Denied	Allied Insurance Company of America	793586	Agent - Casualty
Denied	Allied Insurance Company of America	793586	Agent - Property
Denied	Allied Property and Casualty Insurance Company	300279	Agent - Casualty
Denied	Allied Property and Casualty Insurance Company	300279	Agent - Property
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	12/22/2017	3/12/2020
Inactive	AmTrust Insurance Company	300179	Agent - Property	12/22/2017	3/12/2020
Denied	Depositors Insurance Company	301634	Agent - Casualty
Denied	Depositors Insurance Company	301634	Agent - Property
Inactive	Harleysville Insurance Company	301462	Agent - Casualty	6/29/2018	1/26/2021
Inactive	Harleysville Insurance Company	301462	Agent - Property	6/29/2018	1/26/2021
Inactive	Milford Casualty Insurance Company	301460	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Milford Casualty Insurance Company	301460	Agent - Property	12/22/2017	3/12/2020
Denied	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty
Denied	Nationwide Agribusiness Insurance Company	301008	Agent - Property
Inactive	Nationwide Assurance Company	300166	Agent - Casualty	1/12/2020	1/26/2021
Denied	Nationwide Assurance Company	300166	Agent - Property
Inactive	Nationwide General Insurance Company	300603	Agent - Casualty	8/15/2019	1/26/2021
Inactive	Nationwide General Insurance Company	300603	Agent - Property	8/15/2019	1/26/2021
Inactive	Nationwide Insurance Company of America	300333	Agent - Casualty	8/15/2019	1/26/2021
Inactive	Nationwide Insurance Company of America	300333	Agent - Property	8/15/2019	1/26/2021
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	6/29/2018	1/26/2021
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	6/29/2018	1/26/2021
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	1/12/2020	1/26/2021
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	1/12/2020	1/26/2021
Inactive	Park National Insurance Company	692514	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Park National Insurance Company	692514	Agent - Property	12/22/2017	3/12/2020
Inactive	Security National Insurance Company	301151	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Security National Insurance Company	301151	Agent - Property	12/22/2017	3/12/2020
Inactive	Technology Insurance Company	613278	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Technology Insurance Company	613278	Agent - Property	12/22/2017	3/12/2020
Inactive	Wesco Insurance Company	300534	Agent - Casualty	12/22/2017	3/12/2020
Inactive	Wesco Insurance Company	300534	Agent - Property	12/22/2017	3/12/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Ditommaso, Kristy M	1002180	Agent - Casualty	6/22/2023
Active	Ditommaso, Kristy M	1002180	Agent - Property	6/22/2023
Denied	Martin, Robert Lawrence	354144	Agent - Casualty
Denied	Martin, Robert Lawrence	354144	Agent - Property
Inactive	Rosen, David	1085807	Agent - Casualty	3/5/2021	7/22/2022
Inactive	Rosen, David	1085807	Agent - Property	3/5/2021	7/22/2022
Inactive	Sheehy, Thomas M	633678	Agent - Casualty	11/15/2016	10/31/2020
Inactive	Sheehy, Thomas M	633678	Agent - Personal Lines	11/15/2016	10/31/2020
Inactive	Sheehy, Thomas M	633678	Agent - Property	11/15/2016	10/31/2020
Active	Sheridan, Pamala Marie	875972	Agent - Casualty	7/22/2022
Active	Sheridan, Pamala Marie	875972	Agent - Property	7/22/2022