DEPARTMENT OF INSURANCE
Affiliations
NameFields, Breonna DOIID1107800NAIC NPN19692484
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentProperty11/6/2025 12/31/2026
ActiveNon ResidentAgentCasualty11/6/2025 12/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent10/15/202612/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveBristol West Insurance Company301655Agent - Casualty5/13/20213/22/2023
InactiveBristol West Insurance Company301655Agent - Property5/13/20213/22/2023
InactiveDairyland Insurance Company301370Agent - Casualty6/10/20213/20/2023
InactiveDairyland Insurance Company301370Agent - Property6/10/20213/20/2023
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Casualty11/24/2025 
ActiveForemost Insurance Company Grand Rapids, Michigan301027Agent - Property11/24/2025 
InactiveProgressive Casualty Insurance Company300696Agent - Casualty2/1/20215/1/2023
InactiveProgressive Casualty Insurance Company300696Agent - Property2/1/20215/1/2023
ActiveRoot Insurance Company964834Agent - Casualty11/21/2025 
ActiveRoot Insurance Company964834Agent - Property11/21/2025 
InactiveUnited Financial Casualty Company301886Agent - Casualty2/1/20215/1/2023
InactiveUnited Financial Casualty Company301886Agent - Property2/1/20215/1/2023
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveElite Insurance Group, Inc1068895Agent - Casualty11/21/2025 
ActiveElite Insurance Group, Inc1068895Agent - Property11/21/2025 
InactiveInsuranceZebra, Inc.794167Agent - Casualty2/1/20213/17/2023
InactiveInsuranceZebra, Inc.794167Agent - Property2/1/20213/17/2023

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