DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	MCM Insurance Services , LLC	DOIID	689441	NAIC NPN	9648587

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	10/13/2008	11/19/2015
Inactive	Non Resident	Agent	Casualty	10/13/2008	11/19/2015
* 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	Aspen American Insurance Company	301513	Agent - Casualty	4/28/2014	6/29/2015
Inactive	Aspen American Insurance Company	301513	Agent - Property	4/28/2014	6/29/2015
Inactive	Great American Insurance Company	301586	Agent - Casualty	5/31/2012	11/19/2015
Inactive	Great American Insurance Company	301586	Agent - Property	5/31/2012	11/19/2015
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	3/16/2015	11/19/2015
Inactive	Liberty Mutual Insurance Company	301159	Agent - Property	3/16/2015	11/19/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bacic, Donald W	689444	Agent - Casualty	10/13/2008	11/19/2015
Inactive	Bacic, Donald W	689444	Agent - Property	10/13/2008	11/19/2015