Individual Information

JEFFREY MICHAEL HOHLBEIN

ROCKLIN, CA 95677

Active

producerlicensing@amyntagroup.com

04/01/2021

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3653332	04/01/2021	Active	04/01/2021	04/30/2024
Non-Res. Surplus Lines Broker	3654745	04/06/2021	Active	04/06/2021	04/30/2024

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	04/01/2021	Active	04/01/2021
Property	04/01/2021	Active	04/01/2021
Surplus Lines	04/06/2021	Active	04/06/2021

Company Name	Appointment Type	Status	Active Date
1163
AXIS INSURANCE COMPANY	Casualty	Active	11/01/2021
	Property	Active	11/01/2021
11126
Company Name	Appointment Type	Status	Active Date
CLEAR SPRING PROPERTY AND CASUALTY COMPANY	Casualty	Active	07/22/2021
	Property	Active	07/22/2021
1201
Company Name	Appointment Type	Status	Active Date
FIDELITY AND GUARANTY INSURANCE COMPANY	Casualty	Active	08/15/2022
	Property	Active	08/15/2022
1331
Company Name	Appointment Type	Status	Active Date
MERCHANTS BONDING COMPANY	Casualty	Active	07/06/2022
632
Company Name	Appointment Type	Status	Active Date
NORTH RIVER INSURANCE COMPANY (THE)	Casualty	Active	06/01/2022
	Property	Active	06/01/2022
1776
Company Name	Appointment Type	Status	Active Date
OHIO SECURITY INSURANCE COMPANY	Casualty	Active	06/05/2023
	Property	Active	06/05/2023
692
Company Name	Appointment Type	Status	Active Date
UNITED STATES FIRE INSURANCE COMPANY	Casualty	Active	06/01/2022
	Property	Active	06/01/2022
705
Company Name	Appointment Type	Status	Active Date
VALLEY FORGE INSURANCE COMPANY	Casualty	Active	08/31/2023
	Property	Active	08/31/2023

row(s) 1 - 15 of 15

Organization	Association Type	Type	Beg dte	End dte
AMCOM INSURANCE SERVICES, INC.	Designated Resp Lic Prdcr	Agency	04/22/2021	-
BUILDERS & TRADESMEN'S INS SERVICES INC	Designated Resp Lic Prdcr	Agency	04/12/2021	-

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