DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bloom, Amy Jo	DOIID	557744	NAIC NPN	347915

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	9/30/2002	2/29/2004
Inactive	Non Resident	Agent	Casualty	9/30/2002	2/29/2004
* 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	Platte River Insurance Company	301089	Agent - Casualty	3/1/2003	2/29/2004
Inactive	Platte River Insurance Company	301089	Agent - Property	11/25/2002	11/20/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Capitol Facilities Corporation	571427	Agent - Casualty	6/17/2003	9/16/2003
Inactive	Capitol Facilities Corporation	571427	Agent - Property	6/17/2003	9/16/2003