DEPARTMENT OF INSURANCE

Affiliations

Name	Forman, Christopher Michael	DOIID	769754	NAIC NPN	2813662

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Casualty	11/29/2011	10/31/2025
Pending Replacement	Non Resident	Agent	Property	11/29/2011	10/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	3/29/2024
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	3/29/2024
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	1/4/2012	12/7/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	1/4/2012	12/7/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/4/2012	6/3/2025
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/4/2012	6/3/2025
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	3/19/2015	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	3/19/2015	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	3/19/2015	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	3/19/2015	8/29/2018
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	11/1/2018	12/11/2020
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	11/1/2018	12/11/2020
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	12/22/2020	7/19/2023
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	12/22/2020	7/19/2023
Pending Replacement	Markel American Insurance Company	300377	Agent - Casualty	7/28/2025
Pending Replacement	Markel American Insurance Company	300377	Agent - Property	7/28/2025
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	3/13/2019	10/15/2021
Inactive	Ohio Security Insurance Company	300622	Agent - Property	3/13/2019	10/15/2021
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	12/5/2011	3/29/2024
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	12/5/2011	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	12/5/2011	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	12/5/2011	3/29/2024
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	8/5/2016	12/13/2017
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	8/5/2016	12/13/2017
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	5/23/2017	12/2/2018
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	5/23/2017	12/2/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	TWFG Insurance Services, LLC	675713	Agent - Property	12/18/2012	6/3/2025
Inactive	TWFG Insurance Services, LLC	675713	Agent - Casualty	12/18/2012	6/3/2025