DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, India	DOIID	1258173	NAIC NPN	19724304

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	2/24/2023		11/30/2024
Active	Non Resident	Agent	Casualty	2/24/2023		11/30/2024
* 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	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Caterpillar Insurance Company	300759	Agent - Casualty	2/27/2023
Active	Caterpillar Insurance Company	300759	Agent - Property	2/27/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Caterpillar Insurance Services Corporation	557115	Agent - Casualty	3/14/2023
Active	Caterpillar Insurance Services Corporation	557115	Agent - Property	3/14/2023