DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark Insurance Agency LLC	DOIID	1387472	NAIC NPN	21496653

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Property	3/3/2025		3/31/2027
Active	Resident	Agent	Life	3/3/2025		3/31/2027
Active	Resident	Agent	Casualty	3/3/2025		3/31/2027
Active	Resident	Agent	Health	3/3/2025		3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	3/19/2025
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	3/19/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Clark, William C	676888	Agent - Casualty	3/3/2025
Active	Clark, William C	676888	Agent - Health	3/3/2025
Active	Clark, William C	676888	Agent - Life	3/3/2025
Active	Clark, William C	676888	Agent - Property	3/3/2025