DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Evans, Susan R	DOIID	573269	NAIC NPN	915337

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	4/1/2013	1/31/2017
Inactive	Non Resident	Agent	Casualty	4/1/2013	1/31/2017
* 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	11/14/2014	5/19/2015
Inactive	Dairyland Insurance Company	301370	Agent - Property	11/14/2014	5/19/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/23/2012	11/20/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/23/2012	11/20/2012
Inactive	National General Assurance Company	301108	Agent - Casualty	5/15/2008	8/9/2011
Inactive	National General Insurance Company	300152	Agent - Casualty	4/2/2013	5/11/2015
Inactive	National General Insurance Company	300152	Agent - Property	4/2/2013	5/11/2015
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	5/15/2013	6/16/2015
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	5/15/2013	6/16/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	10/26/2011	11/20/2012
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	10/26/2011	11/20/2012
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	10/26/2011	11/20/2012
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	10/26/2011	11/20/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Affinity Brokerage, LLC	544886	Agent - Casualty	4/23/2013	6/16/2015
Inactive	Affinity Brokerage, LLC	544886	Agent - Property	4/23/2013	6/16/2015
Inactive	CWI, LLC	662170	Agent - Casualty	4/22/2013	6/16/2015
Inactive	CWI, LLC	662170	Agent - Property	4/22/2013	6/16/2015
Inactive	Camping World Insurance Services of Kentucky, LLC	663187	Agent - Casualty	5/10/2013	6/16/2015
Inactive	Camping World Insurance Services of Kentucky, LLC	663187	Agent - Property	5/10/2013	6/16/2015
Inactive	National General Ins Marketing Inc	621228	Agent - Casualty	4/2/2013	5/11/2015
Inactive	National General Ins Marketing Inc	621228	Agent - Property	4/2/2013	5/11/2015