DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Nicholas Ross	DOIID	366025	NAIC NPN	7198490

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Property	4/30/2024		4/30/2025
Inactive	Resident	Agent	General Lines	11/30/1998	8/15/2000
Pending	Resident	Agent	Casualty
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aegis Security Insurance Company	300492	Agent - Casualty	12/26/2013	11/8/2022
Inactive	Aegis Security Insurance Company	300492	Agent - Property	12/26/2013	11/8/2022
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	8/15/2000	6/30/2001
Inactive	AmTrust Insurance Company	300179	Agent - General Lines	7/29/1999	8/15/2000
Inactive	AmTrust Insurance Company	300179	Agent - Property	8/15/2000	6/30/2001
Inactive	American Economy Insurance Company	300315	Agent - Casualty	7/11/2022	4/30/2023
Inactive	American Economy Insurance Company	300315	Agent - Property	7/11/2022	4/30/2023
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	6/16/2004	4/30/2023
Inactive	American Fire and Casualty Company	300567	Agent - Property	6/16/2004	4/30/2023
Inactive	American Select Insurance Company	301229	Agent - Casualty	7/29/2003	8/26/2009
Inactive	American Select Insurance Company	301229	Agent - Property	7/29/2003	8/26/2009
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	7/29/2003	12/7/2006
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	7/29/2003	12/7/2006
Inactive	Bridgefield Casualty Insurance Company	500013	Agent - Casualty	6/14/2005	4/30/2023
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	1/22/2012	4/30/2023
Inactive	Consolidated Insurance Company	300943	Agent - Property	1/22/2012	4/30/2023
Inactive	EMC Property & Casualty Company	955217	Agent - Casualty	6/10/2021	4/30/2023
Inactive	EMC Property & Casualty Company	955217	Agent - Property	6/10/2021	4/30/2023
Inactive	EMCASCO Insurance Company	842790	Agent - Casualty	2/12/2015	4/30/2023
Inactive	EMCASCO Insurance Company	842790	Agent - Property	2/12/2015	4/30/2023
Inactive	Employers Mutual Casualty Company	300202	Agent - Casualty	7/29/2003	4/30/2023
Inactive	Employers Mutual Casualty Company	300202	Agent - Property	7/29/2003	4/30/2023
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	11/28/2012	4/30/2023
Inactive	Encompass Indemnity Company	546376	Agent - Property	11/28/2012	4/30/2023
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	11/28/2012	12/13/2018
Inactive	Encompass Insurance Company of America	556578	Agent - Property	11/28/2012	12/13/2018
Inactive	Farmington Casualty Company	301137	Agent - Casualty	6/18/2001	12/27/2002
Inactive	Farmington Casualty Company	301137	Agent - Property	6/18/2001	12/27/2002
Inactive	Grange Indemnity Insurance Company	300793	Agent - General Lines	12/31/1998	8/15/2000
Inactive	Grange Insurance Company	300234	Agent - General Lines	11/30/1998	8/15/2000
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Casualty	7/29/2003	12/15/2017
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Property	7/29/2003	12/15/2017
Inactive	Indiana Insurance Company	301909	Agent - Casualty	1/22/2012	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	1/22/2012	2/3/2023
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	7/29/2003	4/30/2023
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	8/4/1999	8/15/2000
Inactive	Kentucky National Insurance Company	301625	Agent - Property	7/29/2003	4/30/2023
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	1/22/2012	4/30/2023
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	1/22/2012	4/30/2023
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	7/29/2003	4/30/2023
Inactive	Ohio Casualty Insurance Company	301492	Agent - General Lines	2/23/1999	8/15/2000
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	7/29/2003	4/30/2023
Inactive	Ohio Farmers Insurance Company	301667	Agent - Casualty	7/29/2003	8/26/2009
Inactive	Ohio Farmers Insurance Company	301667	Agent - Property	7/29/2003	8/26/2009
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	6/16/2004	4/30/2023
Inactive	Ohio Security Insurance Company	300622	Agent - Property	6/16/2004	4/30/2023
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/2/2021	6/10/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/2/2021	6/10/2021
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	1/22/2012	4/30/2023
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	1/22/2012	4/30/2023
Inactive	Peerless Insurance Company	301910	Agent - Casualty	1/22/2012	4/30/2023
Inactive	Peerless Insurance Company	301910	Agent - Property	1/22/2012	4/30/2023
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	1/22/2012	4/30/2023
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	1/22/2012	4/30/2023
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/11/2022	4/30/2023
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/11/2022	4/30/2023
Inactive	Security National Insurance Company	301151	Agent - Casualty	8/15/2000	6/30/2001
Inactive	Security National Insurance Company	301151	Agent - General Lines	6/11/1999	8/15/2000
Inactive	Security National Insurance Company	301151	Agent - Property	8/15/2000	6/30/2001
Inactive	Selective Insurance Company of America	500018	Agent - Casualty	6/23/2014	4/30/2023
Inactive	Selective Insurance Company of America	500018	Agent - Property	6/23/2014	4/30/2023
Inactive	Selective Insurance Company of South Carolina	500012	Agent - Casualty	6/23/2014	4/30/2023
Inactive	Selective Insurance Company of South Carolina	500012	Agent - Property	6/23/2014	4/30/2023
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Casualty	6/23/2014	4/30/2023
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Property	6/23/2014	4/30/2023
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	7/29/2003	12/7/2006
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	7/29/2003	12/7/2006
Inactive	State Automobile Mutual Insurance Company	301824	Agent - General Lines	3/3/1999	8/15/2000
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	7/29/2003	12/7/2006
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	7/29/2003	12/7/2006
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	7/29/2003	12/7/2006
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	7/29/2003	12/7/2006
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	7/29/2003	12/7/2006
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	7/29/2003	12/7/2006
Inactive	Trinity Universal Insurance Company	300911	Agent - Casualty	8/15/2000	6/30/2001
Inactive	Trinity Universal Insurance Company	300911	Agent - General Lines	7/29/1999	8/15/2000
Inactive	Trinity Universal Insurance Company	300911	Agent - Property	8/15/2000	6/30/2001
Inactive	Union Insurance Company of Providence	842791	Agent - Casualty	2/12/2015	4/30/2023
Inactive	Union Insurance Company of Providence	842791	Agent - Property	2/12/2015	4/30/2023
Inactive	West American Insurance Company	301112	Agent - Casualty	6/16/2004	4/30/2023
Inactive	West American Insurance Company	301112	Agent - Property	6/16/2004	4/30/2023
Inactive	West Bend Insurance Company	672974	Agent - Casualty	10/10/2012	4/30/2023
Inactive	West Bend Insurance Company	672974	Agent - Property	10/10/2012	4/30/2023
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/2/2021	6/10/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/2/2021	6/10/2021
Inactive	Westfield Insurance Company	301950	Agent - Casualty	7/29/2003	4/30/2023
Inactive	Westfield Insurance Company	301950	Agent - Property	7/29/2003	4/30/2023
Inactive	Westfield National Insurance Company	301036	Agent - Casualty	7/29/2003	8/26/2009
Inactive	Westfield National Insurance Company	301036	Agent - Property	7/29/2003	8/26/2009
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/2/2021	6/10/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/2/2021	6/10/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/2/2021	6/10/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/2/2021	6/10/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/2/2021	6/10/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/2/2021	6/10/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nelson Ins Agency Inc	400059	Agent - Property	7/29/2003	4/30/2023
Inactive	Nelson Ins Agency Inc	400059	Agent - Casualty	7/29/2003	4/30/2023