DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Zick, Mary I	DOIID	573208	NAIC NPN	7145420

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	7/21/2003	12/3/2012
Inactive	Non Resident	Agent	Property	7/21/2003	12/3/2012
* 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	Dairyland Insurance Company	301370	Agent - Casualty	4/5/2004	11/21/2011
Inactive	Dairyland Insurance Company	301370	Agent - Property	4/5/2004	11/21/2011
Inactive	Middlesex Insurance Company	590568	Agent - Casualty	12/20/2006	3/11/2011
Inactive	Middlesex Insurance Company	590568	Agent - Property	12/20/2006	3/11/2011
Inactive	Sentry Insurance Company	300222	Agent - Casualty	8/25/2003	11/21/2011
Inactive	Sentry Insurance Company	300222	Agent - Property	8/25/2003	11/21/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Parker Stevens Agency LLC	558419	Agent - Casualty	7/28/2008	11/21/2011
Inactive	Parker Stevens Agency LLC	558419	Agent - Property	7/28/2008	11/21/2011