DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Capitol Facilities Corporation	DOIID	571427	NAIC NPN	7278627

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	6/17/2003	3/29/2022
Inactive	Non Resident	Agent	Property	6/17/2003	3/29/2022
* 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	Capitol Indemnity Corporation	301030	Agent - Casualty	4/3/2013	3/29/2022
Inactive	Capitol Indemnity Corporation	301030	Agent - Property	4/3/2013	3/29/2022
Inactive	Platte River Insurance Company	301089	Agent - Casualty	4/3/2013	3/29/2022
Inactive	Platte River Insurance Company	301089	Agent - Property	4/3/2013	3/29/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bloom, Amy Jo	557744	Agent - Casualty	6/17/2003	9/16/2003
Inactive	Bloom, Amy Jo	557744	Agent - Property	6/17/2003	9/16/2003
Inactive	Hardy, Dennis M	590248	Agent - Casualty	8/4/2004	1/15/2021
Inactive	Hardy, Dennis M	590248	Agent - Property	8/4/2004	1/15/2021
Inactive	Orozco, Lisa Marie	959866	Agent - Casualty	2/11/2020	1/15/2021
Inactive	Orozco, Lisa Marie	959866	Agent - Property	2/11/2020	1/15/2021
Inactive	Schust, Mary Jane	560004	Agent - Casualty	3/11/2020	3/29/2022
Inactive	Schust, Mary Jane	560004	Agent - Property	3/11/2020	3/29/2022
Inactive	Troyer, Mardellya Margaret	576182	Agent - Casualty	9/25/2003	7/26/2004
Inactive	Troyer, Mardellya Margaret	576182	Agent - Property	9/25/2003	7/26/2004