DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Blair, Angela Dawn	DOIID	1160267	NAIC NPN	20073578

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	10/5/2021		11/30/2025
Active	Resident	Agent	Property	10/5/2021		11/30/2025
Active	Resident	Surplus Lines Broker	Not Applicable	1/9/2023		11/30/2025
* 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	09/15/2025	11/30/2025
Surplus Lines Broker	09/15/2025	11/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Berkley Casualty Company	300731	Agent - Casualty	11/14/2022
Active	Berkley Casualty Company	300731	Agent - Property	11/14/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Risk Placement Services Inc	509419	Agent - Casualty	1/13/2023
Active	Risk Placement Services Inc	509419	Agent - Property	1/13/2023
Active	Risk Placement Services Inc	509419	Surplus Lines Broker - Not Applicable	1/13/2023