DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ward, Kelly Marie	DOIID	715749	NAIC NPN	8629639

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	10/28/2009	7/9/2019
* 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	21st Century North America Insurance Company	300884	Agent - Personal Lines	4/19/2016	2/10/2017
Inactive	Bristol West Insurance Company	301655	Agent - Personal Lines	7/30/2016	7/9/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Foremost Express Insurance Agency Inc.	515334	Agent - Personal Lines	6/6/2018	1/14/2019
Inactive	Fx Insurance Agency, LLC	646184	Agent - Personal Lines	1/14/2019	7/9/2019