DEPARTMENT OF INSURANCE

Affiliations

Name	Fornof, Troy Dean	DOIID	374133	NAIC NPN	371844

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/28/2022		5/31/2026
Active	Non Resident	Agent	Casualty	3/28/2022		5/31/2026
Active	Non Resident	Agent	Life	9/13/2022		5/31/2026
Inactive	Non Resident	Agent	Health	8/12/2004	5/31/2008
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/28/2022		5/31/2026
* 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
Active	American General Life Insurance Company	301585	Agent - Life	11/8/2023
Inactive	American Strategic Insurance Corp	883540	Agent - Casualty	5/24/2023	9/24/2024
Inactive	American Strategic Insurance Corp	883540	Agent - Property	5/24/2023	9/24/2024
Inactive	Arch Insurance Company	300688	Agent - Casualty	8/23/2004	5/31/2008
Inactive	Arch Insurance Company	300688	Agent - Health	8/23/2004	5/31/2008
Inactive	Arch Insurance Company	300688	Agent - Property	8/23/2004	5/31/2008
Active	Berkley Casualty Company	300731	Agent - Casualty	8/9/2023
Active	Berkley Casualty Company	300731	Agent - Property	8/9/2023
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	5/4/2023	1/17/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	5/4/2023	1/17/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/4/2023	1/17/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/4/2023	1/17/2024
Inactive	Jewelers Mutual Insurance Company, SI	301935	Agent - Casualty	4/24/2023	2/15/2024
Inactive	Jewelers Mutual Insurance Company, SI	301935	Agent - Property	4/24/2023	2/15/2024
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	9/27/2006	9/19/2007
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Property	9/27/2006	9/19/2007
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	3/28/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	3/28/2023
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	9/22/1995	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	8/12/2004	11/21/2006
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	8/1/2023
Active	SAFECO Insurance Company of America	300159	Agent - Property	8/1/2023
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	6/13/2023
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	6/13/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	1st Street Agency LLC	947689	Agent - Property	4/17/2023
Active	1st Street Agency LLC	947689	Agent - Casualty	4/17/2023
Inactive	Focus Ins Services Llc	891877	Agent - Property	4/17/2023	3/11/2024
Inactive	Focus Ins Services Llc	891877	Agent - Casualty	4/17/2023	3/11/2024
Inactive	Focus Ins Services Llc	891877	Surplus Lines Broker - Not Applicable	7/13/2022	3/11/2024
Inactive	Macneill Group, Inc.	1205011	Agent - Property	5/16/2022	3/27/2024
Inactive	Macneill Group, Inc.	1205011	Agent - Casualty	5/16/2022	3/27/2024
Active	Macneill Group, Inc.	1205011	Surplus Lines Broker - Not Applicable	5/16/2022
Inactive	Risk Placement Services Inc	509419	Agent - Property	3/8/2024	8/29/2024
Inactive	Risk Placement Services Inc	509419	Agent - Casualty	3/8/2024	8/29/2024
Active	Risk Placement Services Inc	509419	Surplus Lines Broker - Not Applicable	3/8/2024
Inactive	We Insure Life & Health LLC	1309405	Agent - Life	11/7/2023	8/12/2024
Inactive	We Insure, LLC	1071581	Agent - Property	3/28/2023	2/13/2024
Inactive	We Insure, LLC	1071581	Agent - Casualty	3/28/2023	2/13/2024