DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Fedell-Willard, Nicole	DOIID	1244257	NAIC NPN	9153355

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	11/29/2022		8/31/2025
Active	Non Resident	Agent	Property	11/29/2022		8/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	12/14/2022		8/31/2025
* 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	06/15/2025	08/31/2025
Surplus Lines Broker	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AGCS Marine Insurance Company	300403	Agent - Casualty	12/21/2022
Active	AGCS Marine Insurance Company	300403	Agent - Property	12/21/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	12/28/2022
Active	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	12/28/2022
Active	Arthur J. Gallagher Risk Management Services, LLC	539806	Surplus Lines Broker - Not Applicable	12/28/2022