DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Justin	DOIID	1062907	NAIC NPN	15692363

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	10/28/2019		12/31/2024
Active	Non Resident	Agent	Casualty	10/28/2019		12/31/2024
* 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	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Bristol West Insurance Company	301655	Agent - Casualty	9/11/2020
Active	Bristol West Insurance Company	301655	Agent - Property	9/11/2020
Active	CSAA Fire & Casualty Insurance Company	606666	Agent - Casualty	10/30/2019
Active	CSAA Fire & Casualty Insurance Company	606666	Agent - Property	10/30/2019
Active	CSAA General Insurance Company	606675	Agent - Casualty	10/30/2019
Active	CSAA General Insurance Company	606675	Agent - Property	10/30/2019
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	5/5/2020	10/3/2024
Inactive	Encompass Indemnity Company	546376	Agent - Property	5/5/2020	10/3/2024
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Casualty	4/27/2020	12/29/2021
Inactive	Farmers Direct Property and Casualty Insurance Company	300957	Agent - Property	4/27/2020	12/29/2021
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	4/27/2020
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	4/27/2020
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/11/2020
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/11/2020
Active	Unitrin Auto and Home Insurance Company	301538	Agent - Casualty	3/17/2021
Active	Unitrin Auto and Home Insurance Company	301538	Agent - Property	3/17/2021
Active	Unitrin Safeguard Insurance Company	301371	Agent - Casualty	3/17/2021
Active	Unitrin Safeguard Insurance Company	301371	Agent - Property	3/17/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Casualty	1/22/2020
Active	Aca Club Insurance Agency, Inc.	1033550	Agent - Property	1/22/2020