DEPARTMENT OF INSURANCE

Affiliations

Name	Fornof, Troy Dean	DOIID	374133	NAIC NPN	371844

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/28/2022		5/31/2026
Active	Non Resident	Agent	Casualty	3/28/2022		5/31/2026
Active	Non Resident	Agent	Life	9/13/2022		5/31/2026
Inactive	Non Resident	Agent	Health	8/12/2004	5/31/2008
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/28/2022		5/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	03/15/2026	05/31/2026
Surplus Lines Broker	03/15/2026	05/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American General Life Insurance Company	301585	Agent - Life	11/8/2023
Inactive	American Strategic Insurance Corp	883540	Agent - Casualty	5/24/2023	9/24/2024
Inactive	American Strategic Insurance Corp	883540	Agent - Property	5/24/2023	9/24/2024
Inactive	Arch Insurance Company	300688	Agent - Casualty	8/23/2004	5/31/2008
Inactive	Arch Insurance Company	300688	Agent - Health	8/23/2004	5/31/2008
Inactive	Arch Insurance Company	300688	Agent - Property	8/23/2004	5/31/2008
Inactive	Berkley Casualty Company	300731	Agent - Casualty	8/9/2023	10/31/2025
Inactive	Berkley Casualty Company	300731	Agent - Property	8/9/2023	10/31/2025
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	5/4/2023	1/17/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	5/4/2023	1/17/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/4/2023	1/17/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/4/2023	1/17/2024
Inactive	Jewelers Mutual Insurance Company, SI	301935	Agent - Casualty	4/24/2023	2/15/2024
Inactive	Jewelers Mutual Insurance Company, SI	301935	Agent - Property	4/24/2023	2/15/2024
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	9/27/2006	9/19/2007
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Property	9/27/2006	9/19/2007
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	3/28/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	3/28/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/22/1995	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/12/2004	11/21/2006
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	8/1/2023	9/23/2025
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	8/1/2023	9/23/2025
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	6/13/2023	9/23/2025
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	6/13/2023	9/23/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	1st Street Agency LLC	947689	Agent - Property	4/17/2023
Active	1st Street Agency LLC	947689	Agent - Casualty	4/17/2023
Inactive	Focus Ins Services Llc	891877	Agent - Property	4/17/2023	3/11/2024
Inactive	Focus Ins Services Llc	891877	Agent - Casualty	4/17/2023	3/11/2024
Inactive	Focus Ins Services Llc	891877	Surplus Lines Broker - Not Applicable	7/13/2022	3/11/2024
Inactive	Macneill Group, Inc.	1205011	Agent - Property	5/16/2022	3/27/2024
Inactive	Macneill Group, Inc.	1205011	Agent - Casualty	5/16/2022	3/27/2024
Active	Macneill Group, Inc.	1205011	Surplus Lines Broker - Not Applicable	5/16/2022
Inactive	Risk Placement Services Inc	509419	Agent - Property	3/8/2024	8/29/2024
Inactive	Risk Placement Services Inc	509419	Agent - Casualty	3/8/2024	8/29/2024
Active	Risk Placement Services Inc	509419	Surplus Lines Broker - Not Applicable	3/8/2024
Inactive	We Insure Life & Health LLC	1309405	Agent - Life	11/7/2023	8/12/2024
Inactive	We Insure, LLC	1071581	Agent - Property	3/28/2023	2/13/2024
Inactive	We Insure, LLC	1071581	Agent - Casualty	3/28/2023	2/13/2024