DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jimenez, Stacy	DOIID	1119845	NAIC NPN	18065667

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	2/8/2021		2/28/2025
Active	Non Resident	Agent	Casualty	2/8/2021		2/28/2025
* 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
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	2/11/2021
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	2/11/2021
Active	American Modern Home Insurance Company	300791	Agent - Casualty	8/14/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	8/14/2023
Active	Bristol West Insurance Company	301655	Agent - Casualty	6/5/2023
Active	Bristol West Insurance Company	301655	Agent - Property	6/5/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/5/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/5/2023
Active	Homesite Insurance Company	301139	Agent - Casualty	2/6/2022
Active	Homesite Insurance Company	301139	Agent - Property	2/6/2022
Active	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	2/6/2022
Active	Homesite Insurance Company of the Midwest	874850	Agent - Property	2/6/2022
Active	Midvale Indemnity Company	300292	Agent - Casualty	2/6/2022
Active	Midvale Indemnity Company	300292	Agent - Property	2/6/2022
Active	RLI Insurance Company	301217	Agent - Casualty	5/31/2023
Active	RLI Insurance Company	301217	Agent - Property	5/31/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	5/24/2023
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	5/24/2023