DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lay, Kevin A	DOIID	721693	NAIC NPN	3165928

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	1/25/2010	9/30/2021
Inactive	Non Resident	Agent	Casualty	1/25/2010	9/30/2021
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	1/29/2010	6/18/2014
* 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	Fireman's Fund Insurance Company	301423	Agent - Casualty	5/5/2016	9/30/2021
Inactive	Fireman's Fund Insurance Company	301423	Agent - Property	5/5/2016	9/30/2021
Inactive	NOVA Casualty Company	622806	Agent - Casualty	1/7/2019	9/30/2021
Inactive	NOVA Casualty Company	622806	Agent - Property	1/7/2019	9/30/2021
Inactive	State National Insurance Company, Inc.	300888	Agent - Casualty	12/26/2012	2/29/2016
Inactive	State National Insurance Company, Inc.	300888	Agent - Property	12/26/2012	2/29/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	DGU Ins Assoc LLC	730478	Agent - Property	6/17/2010	4/9/2014
Inactive	DGU Ins Assoc LLC	730478	Agent - Casualty	6/17/2010	4/9/2014
Inactive	DGU Ins Assoc LLC	730478	Surplus Lines Broker - Not Applicable	9/22/2010	4/9/2014
Inactive	Risk Placement Services Inc	509419	Agent - Property	5/5/2016	3/9/2021
Inactive	Risk Placement Services Inc	509419	Agent - Casualty	5/5/2016	3/9/2021