DEPARTMENT OF INSURANCE

Affiliations

Name	Green, Nicole	DOIID	1240703	NAIC NPN	18512106

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	11/4/2022	10/31/2026
Active	Non Resident	Agent	Casualty	11/4/2022	10/31/2026
* 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	08/15/2026	10/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Arch Insurance Company	300688	Agent - Casualty	11/16/2022
Active	Arch Insurance Company	300688	Agent - Property	11/16/2022
Active	Atlantic Specialty Insurance Company	518595	Agent - Casualty	11/17/2022
Active	Atlantic Specialty Insurance Company	518595	Agent - Property	11/17/2022
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	11/10/2022
Active	Liberty Mutual Insurance Company	301159	Agent - Property	11/10/2022
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	11/10/2022
Active	Ohio Casualty Insurance Company	301492	Agent - Property	11/10/2022
Active	Ohio Farmers Insurance Company	301667	Agent - Casualty	12/15/2022
Active	Ohio Farmers Insurance Company	301667	Agent - Property	12/15/2022
Active	Pennsylvania National Mutual Casualty Insurance Company	301395	Agent - Casualty	11/16/2022
Active	Pennsylvania National Mutual Casualty Insurance Company	301395	Agent - Property	11/16/2022
Active	RLI Insurance Company	301217	Agent - Casualty	12/9/2022
Active	RLI Insurance Company	301217	Agent - Property	12/9/2022
Active	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	12/2/2022
Active	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	12/2/2022
Active	The Phoenix Insurance Company	301502	Agent - Casualty	12/2/2022
Active	The Phoenix Insurance Company	301502	Agent - Property	12/2/2022
Active	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	12/2/2022
Active	Travelers Casualty and Surety Company of America	301334	Agent - Property	12/2/2022
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	12/2/2022
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	12/2/2022
Active	Travelers Property Casualty Company of America	301649	Agent - Casualty	12/2/2022
Active	Travelers Property Casualty Company of America	301649	Agent - Property	12/2/2022
Active	Valley Forge Insurance Company	301052	Agent - Casualty	3/6/2023
Active	Valley Forge Insurance Company	301052	Agent - Property	3/6/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Assuredpartners of Ohio LLC	779892	Agent - Casualty	4/17/2023
Active	Assuredpartners of Ohio LLC	779892	Agent - Property	4/17/2023