DEPARTMENT OF INSURANCE

Affiliations

Name	Blair, Jeremy Dean	DOIID	573858	NAIC NPN	7816163

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Health	1/13/2004	1/31/2025
Active	Resident	Agent	Life	1/13/2004	1/31/2025
Active	Resident	Agent	Property	8/13/2003	1/31/2025
Active	Resident	Agent	Casualty	8/11/2003	1/31/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	7/28/2015	10/6/2016
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	7/28/2015	10/6/2016
Inactive	All America Insurance Company	300078	Agent - Casualty	8/11/2015	1/19/2017
Inactive	All America Insurance Company	300078	Agent - Property	8/11/2015	1/19/2017
Inactive	American Economy Insurance Company	300315	Agent - Casualty	11/8/2019	5/27/2022
Inactive	American Economy Insurance Company	300315	Agent - Property	11/8/2019	5/27/2022
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	3/22/2006	8/16/2016
Inactive	American Fire and Casualty Company	300567	Agent - Property	3/22/2006	8/16/2016
Active	Ansur America Insurance Company	520667	Agent - Casualty	11/22/2019
Active	Ansur America Insurance Company	520667	Agent - Property	11/22/2019
Active	Auto-Owners Insurance Company	301480	Agent - Casualty	3/3/2017
Active	Auto-Owners Insurance Company	301480	Agent - Property	3/3/2017
Active	Bristol West Insurance Company	301655	Agent - Casualty	3/29/2017
Active	Bristol West Insurance Company	301655	Agent - Property	3/29/2017
Inactive	Central Mutual Insurance Company	300965	Agent - Casualty	8/11/2015	1/19/2017
Inactive	Central Mutual Insurance Company	300965	Agent - Property	8/11/2015	1/19/2017
Active	Cincinnati Casualty Company (The)	300308	Agent - Casualty	4/18/2017
Active	Cincinnati Casualty Company (The)	300308	Agent - Property	4/18/2017
Active	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	4/18/2017
Active	Cincinnati Indemnity Company (The)	301566	Agent - Property	4/18/2017
Active	Cincinnati Insurance Company	301298	Agent - Casualty	4/18/2017
Active	Cincinnati Insurance Company	301298	Agent - Property	4/18/2017
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Health	4/18/2017	4/2/2024
Inactive	Cincinnati Life Insurance Company (The)	300601	Agent - Life	4/18/2017	4/2/2024
Active	ClearPath Insurance Company	979815	Agent - Casualty	2/28/2024
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/8/2007	8/16/2016
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/8/2007	8/16/2016
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	10/11/2011	7/21/2014
Inactive	Dairyland Insurance Company	301370	Agent - Property	10/11/2011	7/21/2014
Active	EMC Property & Casualty Company	955217	Agent - Casualty	5/12/2021
Active	EMC Property & Casualty Company	955217	Agent - Property	5/12/2021
Active	EMCASCO Insurance Company	842790	Agent - Casualty	8/22/2017
Active	EMCASCO Insurance Company	842790	Agent - Property	8/22/2017
Active	Employers Mutual Casualty Company	300202	Agent - Casualty	8/22/2017
Active	Employers Mutual Casualty Company	300202	Agent - Property	8/22/2017
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Health	4/20/2009	12/9/2010
Inactive	Equitable Financial Life Insurance Company	300808	Agent - Life	4/20/2009	12/9/2010
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/16/2016
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/16/2016
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	3/29/2017	5/10/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	3/29/2017	5/10/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	3/29/2017	5/10/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	3/29/2017	5/10/2018
Active	Frankenmuth Insurance Company	301481	Agent - Casualty	11/22/2019
Active	Frankenmuth Insurance Company	301481	Agent - Property	11/22/2019
Active	Grange Indemnity Insurance Company	300793	Agent - Casualty	10/31/2019
Active	Grange Indemnity Insurance Company	300793	Agent - Property	10/31/2019
Active	Grange Insurance Company	300234	Agent - Casualty	10/31/2019
Active	Grange Insurance Company	300234	Agent - Property	10/31/2019
Inactive	Grange Life Insurance Company	300128	Agent - Health	8/2/2005	10/3/2016
Inactive	Grange Life Insurance Company	300128	Agent - Life	8/2/2005	10/3/2016
Active	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	10/31/2019
Active	Grange Property & Casualty Insurance Company	601680	Agent - Property	10/31/2019
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Casualty	8/22/2017	1/29/2018
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Property	8/22/2017	1/29/2018
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	10/25/2017	9/26/2019
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	10/25/2017	9/26/2019
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/8/2007	8/16/2016
Inactive	Indiana Insurance Company	301909	Agent - Property	9/8/2007	8/16/2016
Inactive	Kentucky National Insurance Company	301625	Agent - Casualty	1/30/2008	1/24/2019
Inactive	Kentucky National Insurance Company	301625	Agent - Property	1/30/2008	1/24/2019
Active	Keystone National Insurance Company	745173	Agent - Casualty	11/7/2017
Active	Keystone National Insurance Company	745173	Agent - Property	11/7/2017
Active	Milbank Insurance Company	925185	Agent - Casualty	7/12/2020
Active	Milbank Insurance Company	925185	Agent - Property	7/12/2020
Inactive	Motorists Mutual Insurance Company	300963	Agent - Casualty	12/23/2015	2/27/2019
Inactive	Motorists Mutual Insurance Company	300963	Agent - Property	12/23/2015	2/27/2019
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/8/2007	8/16/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/8/2007	8/16/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	3/22/2006	8/16/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	3/22/2006	8/16/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	3/22/2006	8/16/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Property	3/22/2006	8/16/2016
Inactive	Old Guard Insurance Company	533854	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Old Guard Insurance Company	533854	Agent - Property	6/1/2021	6/9/2021
Active	Owners Insurance Company	300796	Agent - Casualty	3/3/2017
Active	Owners Insurance Company	300796	Agent - Property	3/3/2017
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/8/2007	8/16/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	9/8/2007	8/16/2016
Inactive	Peerless Insurance Company	301910	Agent - Casualty	9/8/2007	8/16/2016
Inactive	Peerless Insurance Company	301910	Agent - Property	9/8/2007	8/16/2016
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Casualty	3/20/2017
Active	Philadelphia Indemnity Insurance Company	301221	Agent - Property	3/20/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	9/15/2016	10/27/2022
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	9/15/2016	10/27/2022
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	9/15/2016	5/27/2022
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	9/15/2016	5/27/2022
Active	Selective Insurance Company of America	500018	Agent - Casualty	9/14/2016
Active	Selective Insurance Company of America	500018	Agent - Property	9/14/2016
Active	Selective Insurance Company of South Carolina	500012	Agent - Casualty	9/14/2016
Active	Selective Insurance Company of South Carolina	500012	Agent - Property	9/14/2016
Active	Selective Insurance Company of the Southeast	300381	Agent - Casualty	9/14/2016
Active	Selective Insurance Company of the Southeast	300381	Agent - Property	9/14/2016
Active	State Automobile Mutual Insurance Company	301824	Agent - Casualty	3/22/2017
Active	State Automobile Mutual Insurance Company	301824	Agent - Property	3/22/2017
Inactive	Trumbull Insurance Company	300242	Agent - Casualty	10/26/2017	9/26/2019
Inactive	Trumbull Insurance Company	300242	Agent - Property	10/26/2017	9/26/2019
Active	Trustgard Insurance Company	300104	Agent - Casualty	10/31/2019
Active	Trustgard Insurance Company	300104	Agent - Property	10/31/2019
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	3/1/2017	12/5/2018
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	3/1/2017	12/5/2018
Active	Union Insurance Company of Providence	842791	Agent - Casualty	8/22/2017
Active	Union Insurance Company of Providence	842791	Agent - Property	8/22/2017
Inactive	West American Insurance Company	301112	Agent - Casualty	3/22/2006	8/16/2016
Inactive	West American Insurance Company	301112	Agent - Property	3/22/2006	8/16/2016
Active	West Bend Insurance Company	672974	Agent - Casualty	12/7/2017
Active	West Bend Insurance Company	672974	Agent - Property	12/7/2017
Inactive	Westfield Champion Insurance Company	1054839	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Champion Insurance Company	1054839	Agent - Property	6/1/2021	6/9/2021
Active	Westfield Insurance Company	301950	Agent - Casualty	6/7/2017
Active	Westfield Insurance Company	301950	Agent - Property	6/7/2017
Inactive	Westfield Premier Insurance Company	1055055	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Premier Insurance Company	1055055	Agent - Property	6/1/2021	6/9/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Superior Insurance Company	1054978	Agent - Property	6/1/2021	6/9/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Casualty	6/1/2021	6/9/2021
Inactive	Westfield Touchstone Insurance Company	1055057	Agent - Property	6/1/2021	6/9/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assuredpartners Nl, Llc	762387	Agent - Casualty	7/10/2014	8/12/2016
Inactive	Assuredpartners Nl, Llc	762387	Agent - Property	7/10/2014	8/12/2016
Inactive	Assuredpartners Nl, Llc	762387	Agent - Health	7/10/2014	8/12/2016
Inactive	Assuredpartners Nl, Llc	762387	Agent - Life	7/10/2014	8/12/2016
Inactive	Creech And Stafford Insurance Agency Inc.	400968	Agent - Casualty	11/22/2005	3/28/2018
Inactive	Creech And Stafford Insurance Agency Inc.	400968	Agent - Property	11/22/2005	3/28/2018
Inactive	Creech And Stafford Insurance Agency Inc.	400968	Agent - Health	2/10/2009	10/3/2016
Inactive	Creech And Stafford Insurance Agency Inc.	400968	Agent - Life	11/22/2005	10/3/2016
Active	Ferrell and Evans, LLC	398891	Agent - Casualty	1/13/2017
Active	Ferrell and Evans, LLC	398891	Agent - Property	1/13/2017
Inactive	Ferrell and Evans, LLC	398891	Agent - Health	4/18/2017	4/2/2024
Inactive	Ferrell and Evans, LLC	398891	Agent - Life	4/18/2017	4/2/2024