black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

DEREK WILLIAM CLARK

PRODUCER NON-RESIDENT

License Number:
PRN303374
Status:
First Licensure:
02/16/2018
Cancel Date:
None

Mailing:
FARMINGTON HILLS, MI 48331
Phone:
+1 (248) 991-1128
Fax:
+1 (248) 957-2779
Email:
derek.clark@daimler.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 02/16/2018

Agency

Name Issue Date License Number Expiration Date Cancel Date
MERCEDES-BENZ INSURANCE AGENCY LLC
02/20/2018 AGN142274 07/01/2023

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY
03/07/2018 PCF366
AMERICAN ZURICH INSURANCE COMPANY
03/07/2018 PCF914
ZURICH AMERICAN INSURANCE COMPANY
03/07/2018 PCF61397
ZURICH AMERICAN INSURANCE COMPANY OF ILLINOIS
03/07/2018 PCF165251

Authority

Description Issue Date Termination Date Status
CASUALTY 02/16/2018 Active
PROPERTY 02/16/2018 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
18622063

Other Addresses

Address Type
FARMINGTON HILLS, MI 48331
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 05/16/2025 06:09:18 PM