DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Provenance Specialty Ins Agency LLC	DOIID	714228	NAIC NPN	14980038

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	9/23/2009		3/31/2025
Active	Resident	Agent	Property	9/23/2009		3/31/2025
Denied	Resident	Agent	Personal Lines
Denied	Resident	Agent	Life
Active	Resident	Surplus Lines Broker	Not Applicable	9/18/2014		3/31/2025
* 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	01/15/2025	03/31/2025
Surplus Lines Broker	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Great American Assurance Company	300327	Agent - Casualty	1/30/2014	4/27/2021
Inactive	Great American Assurance Company	300327	Agent - Property	1/30/2014	4/27/2021
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	10/26/2009	10/5/2010
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	10/26/2009	10/5/2010
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	10/26/2009	10/5/2010
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	10/26/2009	10/5/2010
Inactive	United Financial Casualty Company	301886	Agent - Casualty	10/26/2009	10/5/2010
Inactive	United Financial Casualty Company	301886	Agent - Property	10/26/2009	10/5/2010

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Fries, John Patrick	546817	Agent - Casualty	10/8/2009	8/31/2013
Inactive	Fries, John Patrick	546817	Agent - Property	10/8/2009	8/31/2013
Active	Jones, Kathy Lundy	320752	Agent - Casualty	11/5/2020
Active	Jones, Kathy Lundy	320752	Agent - Property	11/5/2020
Active	Jones, Kathy Lundy	320752	Surplus Lines Broker - Not Applicable	9/18/2014
Active	Jones, William Lynn	378928	Agent - Casualty	9/23/2009
Active	Jones, William Lynn	378928	Agent - Property	9/23/2009
Denied	Kearns, Michael Douglas	714881	Agent - Life