DEPARTMENT OF INSURANCE

Affiliations

Name	Ford, Donald K	DOIID	630173	NAIC NPN	275174

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	4/14/2006	1/31/2025
Active	Non Resident	Agent	Casualty	4/14/2006	1/31/2025
Active	Non Resident	Agent	Health	4/14/2006	1/31/2025
Active	Non Resident	Agent	Life	4/14/2006	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
Active	ACE American Insurance Company	300625	Agent - Casualty	9/30/2010
Active	ACE American Insurance Company	300625	Agent - Property	9/30/2010
Active	Bristol West Insurance Company	301655	Agent - Casualty	6/5/2018
Active	Bristol West Insurance Company	301655	Agent - Property	6/5/2018
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/5/2018
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/5/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	5/13/2013	8/21/2017
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	5/13/2013	8/21/2017
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	5/13/2013	8/21/2017
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	5/13/2013	8/21/2017
Active	Great West Casualty Company	301015	Agent - Casualty	3/6/2018
Active	Great West Casualty Company	301015	Agent - Property	3/6/2018
Inactive	Protective Insurance Company	301117	Agent - Casualty	4/25/2018	3/31/2024
Inactive	Protective Insurance Company	301117	Agent - Property	4/25/2018	3/31/2024
Inactive	Sagamore Insurance Company	300942	Agent - Casualty	4/25/2018	3/31/2024
Inactive	Sagamore Insurance Company	300942	Agent - Property	4/25/2018	3/31/2024
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	3/29/2010	8/13/2024
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	3/29/2010	8/13/2024
Inactive	Westchester Fire Insurance Company	301414	Agent - Casualty	9/30/2010	1/1/2011
Active	Westchester Fire Insurance Company	300990	Agent - Casualty	1/1/2011
Inactive	Westchester Fire Insurance Company	301414	Agent - Property	9/30/2010	1/1/2011
Active	Westchester Fire Insurance Company	300990	Agent - Property	1/1/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	USI Insurance Services National, Inc	509421	Agent - Life
Denied	USI Insurance Services National, Inc	509421	Agent - Health
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	6/11/2010	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	6/11/2010	10/9/2019
Denied	Usi Insurance Services LLC	669260	Agent - Life
Denied	Usi Insurance Services LLC	669260	Agent - Health
Active	Usi Insurance Services LLC	669260	Agent - Casualty	1/4/2019
Active	Usi Insurance Services LLC	669260	Agent - Property	1/4/2019