DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Grass Lake Insurance Agency, Inc.	DOIID	1108548	NAIC NPN	19676228

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	11/2/2020		3/31/2026
Active	Non Resident	Agent	Property	11/2/2020		3/31/2026
Active	Non Resident	Agent	Casualty	11/2/2020		3/31/2026
Active	Non Resident	Agent	Life	11/2/2020		3/31/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Harvin, James	500085	Agent - Casualty	11/2/2020
Active	Harvin, James	500085	Agent - Health	11/2/2020
Active	Harvin, James	500085	Agent - Life	11/2/2020
Active	Harvin, James	500085	Agent - Property	11/2/2020