Individual Information

MATTHEW COWAN MILLER

SAN FRANCISCO, CA 94131-2175

Active

compliance@embroker.com

09/03/2015

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3101048	09/03/2015	Active	09/03/2015	09/30/2024
Non-Res. Surplus Lines Broker	3220215	02/09/2017	Active	02/09/2017	02/28/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	09/03/2015	Active	09/03/2015
Property	09/03/2015	Active	09/03/2015
Surplus Lines	02/09/2017	Active	02/09/2017

Company Name	Appointment Type	Status	Active Date
100311
AMTRUST INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
25
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN ALLIANCE INSURANCE COMPANY	Casualty	Active	10/30/2019
	Property	Active	10/30/2019
1125
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN ASSURANCE COMPANY	Casualty	Active	10/30/2019
	Property	Active	10/30/2019
288
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN INSURANCE COMPANY	Casualty	Active	10/30/2019
	Property	Active	10/30/2019
1521
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN SPIRIT INSURANCE COMPANY	Casualty	Active	10/30/2019
	Property	Active	10/30/2019
1409
Company Name	Appointment Type	Status	Active Date
MIDVALE INDEMNITY COMPANY	Casualty	Active	12/07/2017
	Property	Active	12/07/2017
100334
Company Name	Appointment Type	Status	Active Date
MILFORD CASUALTY INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
100333
Company Name	Appointment Type	Status	Active Date
SECURITY NATIONAL INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
1702
Company Name	Appointment Type	Status	Active Date
SEQUOIA INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
17636
Company Name	Appointment Type	Status	Active Date
TECHNOLOGY INSURANCE COMPANY INC	Casualty	Active	03/23/2022
	Property	Active	03/23/2022
1614
Company Name	Appointment Type	Status	Active Date
WESCO INSURANCE COMPANY	Casualty	Active	03/23/2022
	Property	Active	03/23/2022

row(s) 1 - 22 of 22

Organization	Association Type	Type	Beg dte	End dte
EMBROKER INS SERVICES LLC	Designated Resp Lic Prdcr	Agency	12/01/2020	-

1 - 1