Individual Information

JUSTIN ALLEN WILEY

Address:

ORLANDO, FL 32801-4602

Status:

Active

Email:

justin.wiley@ballator.com

Date:

04/16/2021

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3235577	04/15/2017	Active	04/16/2021	04/30/2027
Non-Res. Surplus Lines Broker	3659490	04/16/2021	Active	04/16/2021	04/30/2027

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	04/15/2017	Active	04/16/2021
Health	04/12/2022	Active	04/12/2022
Life	04/12/2022	Active	04/12/2022
Property	04/15/2017	Active	04/16/2021
Surplus Lines	04/16/2021	Active	04/16/2021

Company Name	Appointment Type	Status	Active Date
288
GREAT AMERICAN INSURANCE COMPANY	Casualty	Active	12/15/2022
	Property	Active	12/15/2022
17720
Company Name	Appointment Type	Status	Active Date
PROCENTURY INSURANCE COMPANY	Casualty	Active	08/16/2021
	Property	Active	08/16/2021
1400
Company Name	Appointment Type	Status	Active Date
STAR INSURANCE COMPANY	Casualty	Active	08/16/2021
	Property	Active	08/16/2021
1703
Company Name	Appointment Type	Status	Active Date
WILLIAMSBURG NATIONAL INSURANCE COMPANY	Casualty	Active	08/16/2021
	Property	Active	08/16/2021

row(s) 1 - 8 of 8

Organization	Association Type	Type	Beg dte	End dte
NON-PROFIT INSURANCE SERVICES, INC.	Designated Resp Lic Prdcr	Agency	04/19/2021	-
ACCRETIVE GLOBAL INSURANCE SERVICES,LLC	Designated Resp Lic Prdcr	Agency	02/07/2022	-
ACCRETIVE GLOBAL RISK ADVISORS, LLC	Designated Resp Lic Prdcr	Agency	04/04/2022	-

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