DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Surmon, Aisha Michelle	DOIID	887176	NAIC NPN	17669696

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	11/16/2015	10/31/2020
Inactive	Non Resident	Agent	Property	11/16/2015	10/31/2020
* 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	Bristol West Insurance Company	301655	Agent - Casualty	12/14/2016	12/6/2019
Inactive	Bristol West Insurance Company	301655	Agent - Property	12/14/2016	12/6/2019
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	6/13/2017	1/13/2020
Inactive	Dairyland Insurance Company	301370	Agent - Property	6/13/2017	1/13/2020
Inactive	Safe Auto Insurance Company	300419	Agent - Casualty	11/17/2015	10/31/2020
Inactive	Safe Auto Insurance Company	300419	Agent - Property	11/17/2015	10/31/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Safe Auto Group Agency Inc	557065	Agent - Casualty	11/17/2015	10/31/2020
Inactive	Safe Auto Group Agency Inc	557065	Agent - Property	11/17/2015	10/31/2020