DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Melissa Dawn	DOIID	623293	NAIC NPN	8685058

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Resident	Agent	Property	3/31/2008	3/31/2027
Active	Resident	Agent	Casualty	3/31/2008	3/31/2027
* 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	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019
Active	American Economy Insurance Company	300315	Agent - Property	11/9/2019
Active	American Fire and Casualty Company	300567	Agent - Casualty	12/17/2014
Active	American Fire and Casualty Company	300567	Agent - Property	12/17/2014
Active	Auto-Owners Insurance Company	301480	Agent - Casualty	6/9/2008
Active	Auto-Owners Insurance Company	301480	Agent - Property	6/9/2008
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	12/31/2008	12/7/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	12/31/2008	12/7/2017
Inactive	Celina Mutual Insurance Company (The)	301908	Agent - Casualty	12/2/2008	12/4/2025
Inactive	Celina Mutual Insurance Company (The)	301908	Agent - Property	12/2/2008	12/4/2025
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	12/17/2014	4/26/2024
Inactive	Consolidated Insurance Company	300943	Agent - Property	12/17/2014	4/26/2024
Active	Dairyland Insurance Company	301370	Agent - Casualty	11/17/2010
Active	Dairyland Insurance Company	301370	Agent - Property	11/17/2010
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	2/6/2006	4/1/2007
Inactive	Farmers Insurance Exchange	300336	Agent - Property	2/6/2006	4/1/2007
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	4/14/2025
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	4/14/2025
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	2/25/2015	2/10/2020
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	2/25/2015	2/10/2020
Inactive	Grange Insurance Company	300234	Agent - Casualty	2/25/2015	2/10/2020
Inactive	Grange Insurance Company	300234	Agent - Property	2/25/2015	2/10/2020
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	2/25/2015	2/10/2020
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	2/25/2015	2/10/2020
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	11/8/2015	3/9/2017
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	11/8/2015	3/9/2017
Inactive	Indiana Insurance Company	301909	Agent - Casualty	12/17/2014	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	12/17/2014	2/3/2023
Active	Kentucky National Insurance Company	301625	Agent - Casualty	6/30/2011
Active	Kentucky National Insurance Company	301625	Agent - Property	6/30/2011
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	12/17/2014	4/26/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	12/17/2014	4/26/2024
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	12/17/2014
Active	Ohio Casualty Insurance Company	301492	Agent - Property	12/17/2014
Active	Ohio Security Insurance Company	300622	Agent - Casualty	9/5/2014
Active	Ohio Security Insurance Company	300622	Agent - Property	9/5/2014
Active	Owners Insurance Company	300796	Agent - Casualty	6/9/2008
Active	Owners Insurance Company	300796	Agent - Property	6/9/2008
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	12/17/2014
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	12/17/2014
Inactive	Peerless Insurance Company	301910	Agent - Casualty	12/17/2014	5/8/2025
Inactive	Peerless Insurance Company	301910	Agent - Property	12/17/2014	5/8/2025
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	2/2/2006	4/1/2007
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	2/2/2006	4/1/2007
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	2/2/2006	4/1/2007
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	2/2/2006	4/1/2007
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	5/19/2015
Active	SAFECO Insurance Company of America	300159	Agent - Property	5/19/2015
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	5/19/2015
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	5/19/2015
Inactive	Trexis Insurance Corporation	599902	Agent - Casualty	1/27/2006	4/1/2007
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	3/11/2009	8/29/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	3/11/2009	8/29/2012
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	2/25/2015	2/10/2020
Inactive	Trustgard Insurance Company	300104	Agent - Property	2/25/2015	2/10/2020
Inactive	United Financial Casualty Company	301886	Agent - Casualty	2/2/2006	4/1/2007
Inactive	United Financial Casualty Company	301886	Agent - Property	2/2/2006	4/1/2007
Active	West American Insurance Company	301112	Agent - Casualty	12/17/2014
Active	West American Insurance Company	301112	Agent - Property	12/17/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hawkins & Keith Ins Agency Inc	399571	Agent - Casualty	3/31/2010
Active	Hawkins & Keith Ins Agency Inc	399571	Agent - Property	3/31/2010