DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Hayes, Ursula Denise	DOIID	570669	NAIC NPN	7010943

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	2/27/2006	8/3/2007
Inactive	Non Resident	Agent	Property	6/5/2003	4/15/2005
Inactive	Non Resident	Agent	Casualty	6/5/2003	4/15/2005
* 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	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	6/5/2003	4/15/2005
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Property	6/5/2003	4/15/2005
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	6/5/2003	4/15/2005
Inactive	Liberty Insurance Corporation	300444	Agent - Property	6/5/2003	4/15/2005
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	6/5/2003	4/15/2005
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	6/5/2003	4/15/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Helmsman Ins Agency LLC	572054	Agent - Casualty	3/1/2004	4/15/2005
Inactive	Helmsman Ins Agency LLC	572054	Agent - Property	3/1/2004	4/15/2005