DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Perez, Mark	DOIID	1223442	NAIC NPN	20423124

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Pending Replacement	Non Resident	Agent	Property	8/16/2022		6/30/2024
Pending Replacement	Non Resident	Agent	Casualty	8/16/2022		6/30/2024
Active	Non Resident	Staff Adjuster	Property & Casualty	10/18/2023		6/30/2026
* 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	04/15/2024	06/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	5/15/2023	10/3/2023
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	5/15/2023	10/3/2023
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	8/24/2022	9/6/2023
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	8/24/2022	9/6/2023
Inactive	United Financial Casualty Company	301886	Agent - Casualty	9/28/2022	9/11/2023
Inactive	United Financial Casualty Company	301886	Agent - Property	9/28/2022	9/11/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Casualty	8/24/2022	9/8/2023
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Property	8/24/2022	9/8/2023