DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lake, David Joseph	DOIID	1025298	NAIC NPN	19015536

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	1/16/2019	10/31/2020
Inactive	Non Resident	Agent	Casualty	1/16/2019	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	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	5/19/2020
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	5/19/2020
Inactive	NCMIC Insurance Company	301007	Agent - Casualty	4/22/2019	5/14/2020
Inactive	NCMIC Insurance Company	301007	Agent - Property	4/22/2019	5/14/2020
Inactive	Professional Solutions Insurance Company	569414	Agent - Casualty	4/22/2019	5/14/2020
Inactive	Professional Solutions Insurance Company	569414	Agent - Property	4/22/2019	5/14/2020
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/10/2019	5/19/2020
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/10/2019	5/19/2020
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/10/2019	5/19/2020
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/10/2019	5/19/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	NCMIC Insurance Services, Inc.	399052	Agent - Casualty	4/22/2019	5/19/2020
Inactive	NCMIC Insurance Services, Inc.	399052	Agent - Property	4/22/2019	5/19/2020
Inactive	Professional Solutions Insurance Services, Inc	631015	Agent - Casualty	4/23/2019	5/19/2020
Inactive	Professional Solutions Insurance Services, Inc	631015	Agent - Property	4/23/2019	5/19/2020