DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Smith, David William	DOIID	1165302	NAIC NPN	16935060

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	10/8/2021		12/31/2024
Active	Non Resident	Agent	Property	10/8/2021		12/31/2024
Active	Non Resident	Agent	Life	10/8/2021		12/31/2024
Active	Non Resident	Agent	Casualty	10/8/2021		12/31/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	11/3/2021		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
Surplus Lines Broker	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	CorePointe Insurance Company	300406	Agent - Casualty	1/20/2022
Active	CorePointe Insurance Company	300406	Agent - Property	1/20/2022
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	1/20/2022
Active	Milford Casualty Insurance Company	301460	Agent - Property	1/20/2022
Active	Southern Insurance Company	301630	Agent - Casualty	1/20/2022
Active	Southern Insurance Company	301630	Agent - Property	1/20/2022
Active	Technology Insurance Company	613278	Agent - Casualty	1/20/2022
Active	Technology Insurance Company	613278	Agent - Property	1/20/2022
Active	Wesco Insurance Company	300534	Agent - Casualty	1/20/2022
Active	Wesco Insurance Company	300534	Agent - Health	1/20/2022
Active	Wesco Insurance Company	300534	Agent - Property	1/20/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Avant Underwriters, LLC	786281	Agent - Casualty	2/11/2022	3/31/2024
Inactive	Avant Underwriters, LLC	786281	Agent - Health	2/11/2022	3/31/2024
Inactive	Avant Underwriters, LLC	786281	Agent - Property	2/11/2022	3/31/2024
Inactive	Specialty Program Group LLC	937234	Agent - Casualty	10/12/2022	12/2/2022
Denied	Specialty Program Group LLC	937234	Agent - Life
Inactive	Specialty Program Group LLC	937234	Agent - Health	10/12/2022	12/2/2022
Inactive	Specialty Program Group LLC	937234	Agent - Property	10/12/2022	12/2/2022
Active	Specialty Program Group LLC	937234	Surplus Lines Broker - Not Applicable	10/12/2022