Individual Information

TRACEY ANN BORRA

Address:

PORTLAND, OR 97219-3963

Status:

Active

Email:

tracey@caerusinsurance.com

Date:

07/24/2019

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3457965	07/24/2019	Active	07/24/2019	07/31/2025

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	07/24/2019	Active	07/24/2019
Health	07/24/2019	Active	07/24/2019
Life	07/24/2019	Active	07/24/2019
Property	07/24/2019	Active	07/24/2019

Company Name	Appointment Type	Status	Active Date
1409
MIDVALE INDEMNITY COMPANY	Casualty	Active	08/09/2023
	Property	Active	08/09/2023
14146
Company Name	Appointment Type	Status	Active Date
NGM INSURANCE COMPANY	Casualty	Active	09/02/2020
	Property	Active	09/02/2020

row(s) 1 - 4 of 4

Organization	Association Type	Type	Beg dte	End dte
CAERUS INSURANCE LLC	Designated Resp Lic Prdcr	Agency	02/20/2021	-

1 - 1