DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bailey, Justin Daniel	DOIID	1245067	NAIC NPN	15827692

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	12/2/2022		1/31/2025
Active	Non Resident	Agent	Casualty	12/2/2022		1/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	12/2/2022		1/31/2025
* 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	11/15/2024	01/31/2025
Surplus Lines Broker	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	12/22/2022
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	12/22/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Risk Specialists Companies Ins Agency Inc	669694	Agent - Casualty	2/21/2023
Active	Risk Specialists Companies Ins Agency Inc	669694	Agent - Property	2/21/2023
Active	Risk Specialists Companies Ins Agency Inc	669694	Surplus Lines Broker - Not Applicable	2/21/2023