DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	King-Forman Insurance Agency Inc	DOIID	1030147	NAIC NPN	2106384

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	2/25/2019	3/31/2023
Inactive	Non Resident	Agent	Casualty	2/25/2019	3/31/2023
* 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	AmGUARD Insurance Company	500010	Agent - Casualty	4/24/2019	3/31/2023
Inactive	AmGUARD Insurance Company	500010	Agent - Property	4/24/2019	3/31/2023
Inactive	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	5/18/2022
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	5/18/2022
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	9/23/2021	5/18/2022
Inactive	Ohio Security Insurance Company	300622	Agent - Property	9/23/2021	5/18/2022
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/24/2019	5/18/2022
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/24/2019	5/18/2022
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/24/2019	5/18/2022
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/24/2019	5/18/2022
Inactive	SECURA Insurance Company	301656	Agent - Casualty	3/28/2019	3/31/2023
Inactive	SECURA Insurance Company	301656	Agent - Property	3/28/2019	3/31/2023
Inactive	SECURA Supreme Insurance Company	645533	Agent - Casualty	3/28/2019	3/31/2023
Inactive	SECURA Supreme Insurance Company	645533	Agent - Property	3/28/2019	3/31/2023
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	9/23/2019	6/24/2022
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	9/23/2019	6/24/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Kamm, Adam M	557959	Agent - Casualty	8/16/2021	3/31/2023
Inactive	Kamm, Adam M	557959	Agent - Property	8/16/2021	3/31/2023
Inactive	Marino, Salvatore	1030132	Agent - Casualty	2/25/2019	8/16/2021
Inactive	Marino, Salvatore	1030132	Agent - Property	2/25/2019	8/16/2021