DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Chamber Services Division, Inc.	DOIID	401091	NAIC NPN	7222912

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Resident	Agent	Property
Denied	Resident	Agent	Casualty
Inactive	Resident	Agent	Life	12/31/1999	3/31/2008
Inactive	Resident	Agent	General Lines	1/21/1998	8/15/2000
Inactive	Resident	Agent	Health	12/31/1999	3/31/2008
* 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	American Fidelity Assurance Company	301004	Agent - Health	6/1/2003	2/28/2007
Inactive	American Fidelity Assurance Company	301004	Agent - Life	6/1/2003	2/28/2007
Inactive	Anthem Health Plans of Kentucky, Inc.	300999	Agent - Health	6/23/2003	6/1/2007
Inactive	Anthem Insurance Companies, Inc.	300941	Agent - Health	6/23/2003	6/1/2007
Inactive	Anthem Life Insurance Company	301209	Agent - Health	6/23/2003	6/1/2007
Inactive	Anthem Life Insurance Company	301209	Agent - Life	6/23/2003	6/1/2007
Inactive	Hanover Insurance Company (The)	300508	Agent - Casualty	8/15/2000	11/28/2005
Inactive	Hanover Insurance Company (The)	300508	Agent - General Lines	1/21/1998	8/15/2000
Inactive	Hanover Insurance Company (The)	300508	Agent - Property	8/15/2000	11/28/2005

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Chaplin, Mary Catherine	580238	Agent - Health	2/15/2004	2/28/2007
Inactive	Chaplin, Mary Catherine	580238	Agent - Life	2/15/2004	2/28/2007
Inactive	Ferguson, Bruce Wayne	338936	Agent - Casualty	8/15/2000	11/28/2005
Inactive	Ferguson, Bruce Wayne	338936	Agent - General Lines	1/21/1998	8/15/2000
Inactive	Ferguson, Bruce Wayne	338936	Agent - Property	8/15/2000	11/28/2005
Denied	McCord, Mark	360762	Agent - Casualty
Inactive	McCord, Mark	360762	Agent - Health	6/23/2003	5/28/2008
Inactive	McCord, Mark	360762	Agent - Life	6/23/2003	5/28/2008
Denied	McCord, Mark	360762	Agent - Property

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	2/8/2000	12/31/2001
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	2/8/2000	12/31/2001