Individual Information

FREDERICK MICHAEL SEILKOP

SUWANEE, GA 30024-7694

Active

ljoldersma@hpsi-ins.com

10/03/2017

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3278856	10/03/2017	Active	10/03/2017	10/31/2026
Non-Res. Surplus Lines Broker	3866721	01/12/2023	Active	01/12/2023	01/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	10/03/2017	Active	10/03/2017
Property	10/03/2017	Active	10/03/2017
Surplus Lines	01/12/2023	Active	01/12/2023

Company Name	Appointment Type	Status	Active Date
5
ACE FIRE UNDERWRITERS INSURANCE COMPANY	Casualty	Active	04/24/2022
	Property	Active	04/24/2022
6
Company Name	Appointment Type	Status	Active Date
ACE PROPERTY & CASUALTY INSURANCE COMPANY	Casualty	Active	01/06/2021
	Property	Active	01/06/2021
1709
Company Name	Appointment Type	Status	Active Date
CHUBB INDEMNITY INSURANCE COMPANY	Casualty	Active	11/10/2021
	Property	Active	11/10/2021
810
Company Name	Appointment Type	Status	Active Date
DOCTORS COMPANY AN INTERINSURANCE EXCHANGE,THE	Casualty	Active	11/04/2023
	Property	Active	11/04/2023
150224
Company Name	Appointment Type	Status	Active Date
HARTFORD INSURANCE COMPANY OF THE SOUTHEAST	Casualty	Active	03/29/2023
	Property	Active	03/29/2023
469
Company Name	Appointment Type	Status	Active Date
HARTFORD UNDERWRITERS INSURANCE COMPANY	Casualty	Active	07/19/2020
	Property	Active	07/19/2020
147668
Company Name	Appointment Type	Status	Active Date
MMIC INSURANCE INC	Casualty	Active	09/28/2022
1525
Company Name	Appointment Type	Status	Active Date
NORCAL INSURANCE COMPANY	Casualty	Active	03/02/2020
1811
Company Name	Appointment Type	Status	Active Date
SENTINEL INSURANCE COMPANY LTD	Casualty	Active	06/13/2023
	Property	Active	06/13/2023
1715
Company Name	Appointment Type	Status	Active Date
UMIA INSURANCE INC	Casualty	Active	09/28/2022

row(s) 1 - 17 of 17

Organization	Association Type	Type	Beg dte	End dte
HEALTHCARE PROFESSIONAL SERVICES INC	Designated Resp Lic Prdcr	Agency	05/04/2020	-

1 - 1