DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Wiersma, Richard Charles	DOIID	612362	NAIC NPN	6725272

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	7/21/2005	6/30/2018
Inactive	Non Resident	Agent	Property	7/21/2005	6/30/2018
* 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	American Family Home Insurance Company	301817	Agent - Casualty	11/17/2005	11/28/2012
Inactive	American Family Home Insurance Company	301817	Agent - Property	11/17/2005	11/28/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	11/17/2005	11/28/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Property	11/17/2005	11/28/2012
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	1/23/2007	11/28/2012
Inactive	American Modern Select Insurance Company	581481	Agent - Property	1/23/2007	11/28/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/20/2005	9/16/2013
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/20/2005	9/16/2013
Inactive	National General Insurance Company	300152	Agent - Casualty	8/24/2011	6/30/2018
Inactive	National General Insurance Company	300152	Agent - Property	8/24/2011	6/30/2018
Inactive	National Interstate Insurance Company	301301	Agent - Casualty	9/27/2006	4/21/2009
Inactive	National Interstate Insurance Company	301301	Agent - Property	9/27/2006	4/21/2009
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	3/24/2016	5/7/2018
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	3/24/2016	5/7/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Mobility Ins Coverage Inc	628694	Agent - Property
Denied	Mobility Ins Coverage Inc	628694	Agent - Casualty
Inactive	Recreation Ins Specialists Llc	806124	Agent - Property	7/29/2013	6/30/2018
Inactive	Recreation Ins Specialists Llc	806124	Agent - Casualty	7/29/2013	6/30/2018