DEPARTMENT OF INSURANCE

Affiliations

Name	NCMIC Insurance Services, Inc.	DOIID	399052	NAIC NPN	2109424

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	4/5/2002		3/31/2027
Active	Non Resident	Agent	Property	8/15/2000		3/31/2027
Active	Non Resident	Agent	Casualty	8/15/2000		3/31/2027
Active	Non Resident	Agent	Health	4/5/2002		3/31/2027
Active	Non Resident	Agent	Personal Lines	6/29/2005		3/31/2027
Inactive	Non Resident	Agent	General Lines	8/6/1999	8/15/2000
* 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	01/15/2025	03/31/2025	02/19/2025	02/19/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Allied Insurance Company of America	793586	Agent - Casualty	2/2/2022
Active	Allied Insurance Company of America	793586	Agent - Property	2/2/2022
Inactive	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	3/29/2024
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	3/29/2024
Active	American Fire and Casualty Company	300567	Agent - Casualty	9/25/2024
Active	American Fire and Casualty Company	300567	Agent - Property	9/25/2024
Active	Arch Insurance Company	300688	Agent - Health	10/3/2016
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	5/6/2013	12/3/2014
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	5/6/2013	12/3/2014
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	5/6/2013	12/3/2014
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	5/6/2013	12/3/2014
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	6/28/2005	10/13/2022
Inactive	Consolidated Insurance Company	300943	Agent - Property	6/28/2005	10/13/2022
Inactive	Employers Assurance Company	300120	Agent - Casualty	3/9/2012	1/3/2024
Inactive	Employers Compensation Insurance Company	797885	Agent - Casualty	8/6/2018	1/3/2024
Inactive	Employers Preferred Insurance Company	520656	Agent - Casualty	3/9/2012	1/3/2024
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	5/8/2023
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Personal Lines	5/8/2023
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	5/8/2023
Inactive	Farmington Casualty Company	301137	Agent - Casualty	2/9/2012	11/4/2022
Inactive	Farmington Casualty Company	301137	Agent - Property	2/9/2012	11/4/2022
Inactive	Federal Insurance Company	301144	Agent - Casualty	10/31/2005	12/19/2007
Inactive	Federal Insurance Company	301144	Agent - Property	10/31/2005	12/19/2007
Active	Fidelity and Guaranty Insurance Company	301009	Agent - Casualty	8/29/2024
Active	Fidelity and Guaranty Insurance Company	301009	Agent - Property	8/29/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	2/14/2013	8/29/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	2/14/2013	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	2/14/2013	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	2/14/2013	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	2/14/2013	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	2/14/2013	8/29/2018
Inactive	Harleysville Mutual Insurance Company	301393	Agent - Casualty	11/18/2010	5/1/2012
Inactive	Harleysville Mutual Insurance Company	301393	Agent - Property	11/18/2010	5/1/2012
Active	Hartford Accident and Indemnity Company	301917	Agent - Casualty	8/24/2011
Active	Hartford Accident and Indemnity Company	301917	Agent - Property	8/24/2011
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	5/14/2004	11/7/2008
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	5/14/2004	11/7/2008
Active	Hartford Fire Insurance Company	300628	Agent - Casualty	3/9/2011
Active	Hartford Fire Insurance Company	300628	Agent - Property	3/9/2011
Inactive	Hartford Insurance Company of Illinois	1014405	Agent - Casualty	5/18/2021	7/17/2023
Inactive	Hartford Insurance Company of Illinois	1014405	Agent - Property	5/18/2021	7/17/2023
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	6/25/2009	8/22/2017
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	6/25/2009	8/22/2017
Active	Hartford Insurance Company of the Southeast	1014204	Agent - Casualty	3/15/2021
Active	Hartford Insurance Company of the Southeast	1014204	Agent - Property	3/15/2021
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	10/5/2009	6/8/2017
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	10/5/2009	6/8/2017
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	5/14/2004	11/7/2008
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	5/14/2004	11/7/2008
Inactive	Indiana Insurance Company	301909	Agent - Casualty	6/28/2005	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	6/28/2005	2/3/2023
Inactive	Liberty Bankers Life Insurance Company	542461	Agent - Health	4/5/2002	4/11/2005
Inactive	Liberty Bankers Life Insurance Company	542461	Agent - Life	4/5/2002	4/11/2005
Active	Merchants Bonding Company (Mutual)	300170	Agent - Casualty	11/15/2012
Inactive	Merchants National Bonding Inc.	787525	Agent - Casualty	11/15/2012	2/1/2019
Inactive	Metropolitan General Insurance Company	300709	Agent - Casualty	12/26/2007	4/17/2008
Inactive	Metropolitan General Insurance Company	300709	Agent - Property	12/26/2007	4/17/2008
Active	NCMIC Insurance Company	301007	Agent - Casualty	8/15/2000
Inactive	NCMIC Insurance Company	301007	Agent - General Lines	8/6/1999	8/15/2000
Active	NCMIC Insurance Company	301007	Agent - Property	8/15/2000
Active	Nationwide Assurance Company	300166	Agent - Casualty	1/12/2020
Active	Nationwide General Insurance Company	300603	Agent - Casualty	8/15/2019
Active	Nationwide General Insurance Company	300603	Agent - Property	8/15/2019
Active	Nationwide Insurance Company of America	300333	Agent - Casualty	8/15/2019
Active	Nationwide Insurance Company of America	300333	Agent - Property	8/15/2019
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	5/1/2012
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	5/1/2012
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	1/12/2020
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	1/12/2020
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	6/28/2005	5/9/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	6/28/2005	5/9/2024
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	12/24/2007	3/29/2024
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	12/24/2007	3/29/2024
Active	Ohio Security Insurance Company	300622	Agent - Casualty	4/15/2024
Active	Ohio Security Insurance Company	300622	Agent - Property	4/15/2024
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	7/28/2014	9/26/2024
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	7/28/2014	9/26/2024
Active	Peerless Insurance Company	301910	Agent - Casualty	6/28/2005
Active	Peerless Insurance Company	301910	Agent - Property	6/28/2005
Active	Professional Solutions Insurance Company	569414	Agent - Casualty	11/29/2006
Active	Professional Solutions Insurance Company	569414	Agent - Property	11/29/2006
Active	Progressive Casualty Insurance Company	300696	Agent - Casualty	6/1/2005
Active	Progressive Casualty Insurance Company	300696	Agent - Property	6/1/2005
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	6/1/2005	12/9/2013
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	6/1/2005	12/9/2013
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Casualty	11/11/2024
Active	Property and Casualty Insurance Company of Hartford	301409	Agent - Property	11/11/2024
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	12/28/2016	3/29/2024
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	12/28/2016	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	12/28/2016	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	12/28/2016	3/29/2024
Active	Selective Insurance Company of America	500018	Agent - Casualty	3/28/2012
Active	Selective Insurance Company of America	500018	Agent - Property	3/28/2012
Active	Selective Insurance Company of South Carolina	500012	Agent - Casualty	3/28/2012
Active	Selective Insurance Company of South Carolina	500012	Agent - Property	3/28/2012
Active	Selective Insurance Company of the Southeast	300381	Agent - Casualty	3/28/2012
Active	Selective Insurance Company of the Southeast	300381	Agent - Property	3/28/2012
Active	Sentinel Insurance Company, Limited	501696	Agent - Casualty	10/5/2010
Active	Sentinel Insurance Company, Limited	501696	Agent - Property	10/5/2010
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	5/6/2013	12/3/2014
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	5/6/2013	12/3/2014
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Casualty	5/6/2013	12/3/2014
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Property	5/6/2013	12/3/2014
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	5/6/2013	12/3/2014
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	5/6/2013	12/3/2014
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	3/8/2016
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	3/8/2016
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	5/6/2013	12/3/2014
Inactive	The Phoenix Insurance Company	301502	Agent - Property	5/6/2013	12/3/2014
Active	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	1/23/2012
Active	Travelers Casualty Insurance Company of America	300522	Agent - Property	1/23/2012
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	5/6/2013	12/3/2014
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	5/6/2013	12/3/2014
Active	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	5/2/2018
Active	Travelers Casualty and Surety Company of America	301334	Agent - Property	5/2/2018
Inactive	Travelers Commercial Insurance Company	301506	Agent - Casualty	5/6/2013	12/3/2014
Inactive	Travelers Commercial Insurance Company	301506	Agent - Property	5/6/2013	12/3/2014
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	8/3/2018	12/15/2020
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	8/3/2018	12/15/2020
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	5/6/2013	12/3/2014
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	5/6/2013	12/3/2014
Active	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	6/17/2015
Active	Travelers Indemnity Company of America (The)	301093	Agent - Property	6/17/2015
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	5/6/2013
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	5/6/2013
Inactive	Travelers Personal Insurance Company	705785	Agent - Casualty	10/17/2019	12/15/2020
Inactive	Travelers Personal Insurance Company	705785	Agent - Property	10/17/2019	12/15/2020
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	11/15/2011	12/15/2020
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	11/15/2011	12/15/2020
Active	Trumbull Insurance Company	300242	Agent - Casualty	5/16/2018
Active	Trumbull Insurance Company	300242	Agent - Property	5/16/2018
Active	Twin City Fire Insurance Company	300721	Agent - Casualty	4/30/2014
Active	Twin City Fire Insurance Company	300721	Agent - Property	4/30/2014
Active	West American Insurance Company	301112	Agent - Casualty	6/27/2024
Active	West American Insurance Company	301112	Agent - Property	6/27/2024
Inactive	Westfield Insurance Company	301950	Agent - Casualty	4/18/2012	9/17/2014
Inactive	Westfield Insurance Company	301950	Agent - Property	4/18/2012	9/17/2014
Inactive	Westfield National Insurance Company	301036	Agent - Casualty	4/18/2012	9/17/2014
Inactive	Westfield National Insurance Company	301036	Agent - Property	4/18/2012	9/17/2014

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Angerstein, Heather M	664176	Agent - Casualty	2/10/2016
Active	Angerstein, Heather M	664176	Agent - Personal Lines	2/10/2016
Active	Angerstein, Heather M	664176	Agent - Property	2/10/2016
Active	Blessing, Danita J	936865	Agent - Casualty	2/2/2017
Active	Blessing, Danita J	936865	Agent - Personal Lines	2/2/2017
Active	Blessing, Danita J	936865	Agent - Property	2/2/2017
Inactive	Cannon, Karen M	662074	Agent - Casualty	4/18/2011	3/1/2017
Denied	Cannon, Karen M	662074	Agent - Personal Lines
Inactive	Cannon, Karen M	662074	Agent - Property	4/18/2011	3/1/2017
Inactive	Clark, Barbara J	631939	Agent - Casualty	2/2/2007	3/30/2016
Denied	Clark, Barbara J	631939	Agent - Health
Denied	Clark, Barbara J	631939	Agent - Life
Inactive	Clark, Barbara J	631939	Agent - Property	2/2/2007	3/30/2016
Inactive	Clark, Linda J	632560	Agent - Casualty	2/6/2007	7/10/2007
Inactive	Clark, Linda J	632560	Agent - Property	2/6/2007	7/10/2007
Inactive	Darnell, Douglas W	543601	Agent - Casualty	1/5/2004	7/9/2007
Inactive	Darnell, Douglas W	543601	Agent - Health	9/5/2006	4/18/2011
Inactive	Darnell, Douglas W	543601	Agent - Life	9/5/2006	4/18/2011
Denied	Darnell, Douglas W	543601	Agent - Personal Lines
Inactive	Darnell, Douglas W	543601	Agent - Property	1/5/2004	7/9/2007
Inactive	Dominguez, Ida	703615	Agent - Casualty	2/2/2017	1/31/2019
Inactive	Dominguez, Ida	703615	Agent - Property	2/2/2017	12/15/2023
Inactive	Genck, Steven	808824	Agent - Casualty	6/6/2013	2/12/2015
Denied	Genck, Steven	808824	Agent - Personal Lines
Inactive	Genck, Steven	808824	Agent - Property	6/6/2013	2/12/2015
Active	Gordon, Lorenzo	1316580	Agent - Casualty	1/23/2024
Active	Gordon, Lorenzo	1316580	Agent - Property	1/23/2024
Inactive	Hegland, Linda S	727056	Agent - Casualty	4/18/2011	10/25/2016
Denied	Hegland, Linda S	727056	Agent - Personal Lines
Inactive	Hegland, Linda S	727056	Agent - Property	4/18/2011	10/25/2016
Inactive	Jackson, Elisabeth M	954205	Agent - Casualty	6/12/2017	1/31/2019
Inactive	Jackson, Elisabeth M	954205	Agent - Personal Lines	6/12/2017	1/31/2019
Inactive	Jackson, Elisabeth M	954205	Agent - Property	6/12/2017	1/31/2019
Active	Johnson, Richard J	632580	Agent - Casualty	2/6/2007
Denied	Johnson, Richard J	632580	Agent - Health
Denied	Johnson, Richard J	632580	Agent - Life
Active	Johnson, Richard J	632580	Agent - Property	2/6/2007
Inactive	Lake, David Joseph	1025298	Agent - Casualty	4/22/2019	5/19/2020
Inactive	Lake, David Joseph	1025298	Agent - Property	4/22/2019	5/19/2020
Inactive	Magie, Frances J	632551	Agent - Casualty	2/6/2007	2/4/2008
Denied	Magie, Frances J	632551	Agent - Personal Lines
Inactive	Magie, Frances J	632551	Agent - Property	2/6/2007	2/4/2008
Inactive	Mccaulley, Kimberly K	610664	Agent - Casualty	2/6/2007	7/1/2008
Inactive	Mccaulley, Kimberly K	610664	Agent - Property	2/6/2007	7/1/2008
Active	Morgan, Samuel	1214754	Agent - Casualty	12/4/2024
Active	Morgan, Samuel	1214754	Agent - Property	12/4/2024
Inactive	Nelson, Peter A	685698	Agent - Casualty	3/14/2014	3/1/2017
Inactive	Nelson, Peter A	685698	Agent - Property	3/14/2014	3/1/2017
Inactive	Patton, Karen	913695	Agent - Casualty	4/22/2019	2/7/2020
Inactive	Patton, Karen	913695	Agent - Personal Lines	4/22/2019	2/5/2020
Inactive	Patton, Karen	913695	Agent - Property	4/22/2019	2/7/2020
Active	Pesta, Irene M	944877	Agent - Casualty	2/20/2017
Active	Pesta, Irene M	944877	Agent - Personal Lines	2/20/2017
Active	Pesta, Irene M	944877	Agent - Property	2/20/2017
Inactive	Pratt, Andrew L	597050	Agent - Casualty	2/6/2007	4/18/2011
Inactive	Pratt, Andrew L	597050	Agent - Property	2/6/2007	4/18/2011
Active	Simpson, Arthur J	640334	Agent - Casualty	9/22/2020
Active	Simpson, Arthur J	640334	Agent - Health	9/22/2020
Denied	Simpson, Arthur J	640334	Agent - Life
Active	Simpson, Arthur J	640334	Agent - Property	9/22/2020
Active	Soda, Joseph S	362725	Agent - Casualty	8/15/2000
Inactive	Soda, Joseph S	362725	Agent - General Lines	8/6/1999	8/15/2000
Active	Soda, Joseph S	362725	Agent - Health	9/5/2006
Active	Soda, Joseph S	362725	Agent - Life	9/5/2006
Inactive	Soda, Joseph S	362725	Agent - Personal Lines	6/29/2005	3/14/2024
Active	Soda, Joseph S	362725	Agent - Property	8/15/2000
Inactive	Soda, Krista Lynn	306731	Agent - Casualty	8/15/2000	1/5/2004
Inactive	Soda, Krista Lynn	306731	Agent - General Lines	8/6/1999	8/15/2000
Inactive	Soda, Krista Lynn	306731	Agent - Property	8/15/2000	1/5/2004
Active	Staley, Crystal Marie	772823	Agent - Casualty	3/20/2013
Active	Staley, Crystal Marie	772823	Agent - Property	3/20/2013
Inactive	Stevens, Dora B	917278	Agent - Casualty	6/20/2016	8/13/2019
Inactive	Stevens, Dora B	917278	Agent - Property	6/20/2016	8/13/2019
Inactive	Swanson, Amy Marie	386482	Agent - Casualty	8/15/2000	9/9/2002
Inactive	Swanson, Amy Marie	386482	Agent - General Lines	8/6/1999	8/15/2000
Inactive	Swanson, Amy Marie	386482	Agent - Property	8/15/2000	9/9/2002
Inactive	Thomas, Seth C	938616	Agent - Casualty	12/14/2016	7/8/2019
Inactive	Thomas, Seth C	938616	Agent - Personal Lines	12/14/2016	5/15/2019
Inactive	Thomas, Seth C	938616	Agent - Property	12/14/2016	7/8/2019
Active	Trevino, Michael	855024	Agent - Casualty	8/18/2022
Active	Trevino, Michael	855024	Agent - Health	8/18/2022
Active	Trevino, Michael	855024	Agent - Life	8/18/2022
Active	Trevino, Michael	855024	Agent - Property	8/18/2022
Inactive	Tyler, Oscar Donald	352616	Agent - Casualty	8/15/2000	6/30/2003
Inactive	Tyler, Oscar Donald	352616	Agent - General Lines	8/6/1999	8/15/2000
Inactive	Tyler, Oscar Donald	352616	Agent - Property	8/15/2000	6/30/2003
Active	Westerhold, Amanda L	951612	Agent - Casualty	6/12/2017
Active	Westerhold, Amanda L	951612	Agent - Property	6/12/2017
Inactive	Wickman, Elizabeth A	791816	Agent - Casualty	3/20/2013	2/17/2015
Inactive	Wickman, Elizabeth A	791816	Agent - Property	3/20/2013	2/17/2015
Inactive	Wilsbacher, Pat	708398	Agent - Casualty	4/18/2011	10/5/2016
Denied	Wilsbacher, Pat	708398	Agent - Personal Lines
Inactive	Wilsbacher, Pat	708398	Agent - Property	4/18/2011	10/5/2016