DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Druen, Jacob Randall	DOIID	678437	NAIC NPN	10643564

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Casualty	9/3/2008	9/30/2012
Inactive	Resident	Agent	Property	9/3/2008	9/30/2012
* 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	6/16/2009	5/20/2011
Inactive	American Family Home Insurance Company	301817	Agent - Property	6/16/2009	5/20/2011
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	1/11/2011	5/23/2011
Inactive	American Modern Select Insurance Company	581481	Agent - Property	1/11/2011	5/23/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CMH Homes, Inc.	398100	Agent - Casualty	12/15/2010	5/2/2011
Inactive	CMH Homes, Inc.	398100	Agent - Property	12/15/2010	5/2/2011