DEPARTMENT OF INSURANCE

Affiliations

Name	Mountain State Agy Alliance LLC	DOIID	739740	NAIC NPN	7705291

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	2/3/2021	3/31/2026
Active	Non Resident	Agent	Casualty	2/3/2021	3/31/2026
Denied	Non Resident	Agent	Personal Lines
* 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
Active	AMCO Insurance Company	300204	Agent - Casualty	3/14/2023
Active	AMCO Insurance Company	300204	Agent - Property	3/14/2023
Inactive	Aegis Security Insurance Company	300492	Agent - Casualty	6/23/2016	10/1/2020
Inactive	Aegis Security Insurance Company	300492	Agent - Property	6/23/2016	10/1/2020
Active	Allied Insurance Company of America	793586	Agent - Casualty	3/14/2023
Active	Allied Insurance Company of America	793586	Agent - Property	3/14/2023
Active	Allied Property and Casualty Insurance Company	300279	Agent - Casualty	3/14/2023
Active	Allied Property and Casualty Insurance Company	300279	Agent - Property	3/14/2023
Active	Allstate Indemnity Company	300778	Agent - Casualty	5/6/2021
Active	Allstate Indemnity Company	300778	Agent - Property	5/6/2021
Active	Allstate Insurance Company	300773	Agent - Casualty	5/6/2021
Active	Allstate Insurance Company	300773	Agent - Property	5/6/2021
Active	Allstate Property and Casualty Insurance Company	300593	Agent - Casualty	5/6/2021
Active	Allstate Property and Casualty Insurance Company	300593	Agent - Property	5/6/2021
Active	Allstate Vehicle & Property Insurance Company	301429	Agent - Casualty	5/6/2021
Active	Allstate Vehicle & Property Insurance Company	301429	Agent - Property	5/6/2021
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	6/19/2017	10/1/2020
Inactive	AmTrust Insurance Company	300179	Agent - Property	6/19/2017	10/1/2020
Inactive	American Economy Insurance Company	300315	Agent - Casualty	10/28/2010	10/1/2020
Inactive	American Economy Insurance Company	300315	Agent - Property	10/28/2010	10/1/2020
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/28/2010	10/1/2020
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/28/2010	10/1/2020
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	9/6/2017	10/1/2020
Inactive	American Modern Home Insurance Company	300791	Agent - Property	9/6/2017	10/1/2020
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	2/24/2025
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	2/24/2025
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	9/6/2017	10/1/2020
Inactive	American Modern Select Insurance Company	581481	Agent - Property	9/6/2017	10/1/2020
Active	American Select Insurance Company	301229	Agent - Casualty	3/18/2021
Active	American Select Insurance Company	301229	Agent - Property	3/18/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	9/6/2017	10/1/2020
Inactive	American Southern Home Insurance Company	626276	Agent - Property	9/6/2017	10/1/2020
Inactive	American States Insurance Company	301230	Agent - Casualty	10/28/2010	10/1/2020
Inactive	American States Insurance Company	301230	Agent - Property	10/28/2010	10/1/2020
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	12/26/2012	12/9/2013
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	3/29/2023	12/20/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	3/29/2023	12/20/2024
Active	CSAA Fire & Casualty Insurance Company	606666	Agent - Casualty	4/5/2023
Active	CSAA Fire & Casualty Insurance Company	606666	Agent - Property	4/5/2023
Active	CSAA General Insurance Company	606675	Agent - Casualty	4/5/2023
Active	CSAA General Insurance Company	606675	Agent - Property	4/5/2023
Active	Celina Mutual Insurance Company (The)	301908	Agent - Casualty	1/11/2022
Active	Celina Mutual Insurance Company (The)	301908	Agent - Property	1/11/2022
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	12/26/2012	12/9/2013
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/28/2010	10/1/2020
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/28/2010	10/1/2020
Active	Depositors Insurance Company	301634	Agent - Casualty	3/14/2023
Active	Depositors Insurance Company	301634	Agent - Property	3/14/2023
Inactive	Employers Assurance Company	300120	Agent - Casualty	8/1/2022	1/3/2024
Inactive	Employers Compensation Insurance Company	797885	Agent - Casualty	8/1/2022	1/3/2024
Inactive	Employers Preferred Insurance Company	520656	Agent - Casualty	8/1/2022	1/3/2024
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	6/30/2022	10/3/2024
Inactive	Encompass Indemnity Company	546376	Agent - Property	6/30/2022	10/3/2024
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	9/17/2012	12/13/2018
Inactive	Encompass Insurance Company of America	556578	Agent - Property	9/17/2012	12/13/2018
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	3/29/2023
Active	Farmers Property and Casualty Insurance Company	301237	Agent - Property	3/29/2023
Inactive	Farmington Casualty Company	301137	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Farmington Casualty Company	301137	Agent - Property	12/26/2012	12/9/2013
Inactive	First National Insurance Company of America	301690	Agent - Casualty	10/28/2010	10/1/2020
Inactive	First National Insurance Company of America	301690	Agent - Property	10/28/2010	10/1/2020
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	3/29/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	3/29/2023
Inactive	General Insurance Company of America	300261	Agent - Casualty	10/28/2010	10/1/2020
Inactive	General Insurance Company of America	300261	Agent - Property	10/28/2010	10/1/2020
Inactive	Glatfelter Insurance Company	301640	Agent - Casualty	10/13/2016	4/30/2019
Inactive	Glatfelter Insurance Company	301640	Agent - Property	10/13/2016	4/30/2019
Inactive	Hallmark National Insurance Company	300494	Agent - Casualty	10/19/2010	11/21/2017
Inactive	Hallmark National Insurance Company	300494	Agent - Property	10/19/2010	11/21/2017
Active	Hartford Accident and Indemnity Company	301917	Agent - Casualty	12/5/2023
Active	Hartford Accident and Indemnity Company	301917	Agent - Property	12/5/2023
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/28/2010	10/1/2020
Inactive	Indiana Insurance Company	301909	Agent - Property	10/28/2010	10/1/2020
Active	MICO Insurance Company	301664	Agent - Casualty	6/10/2024
Active	MICO Insurance Company	301664	Agent - Property	6/10/2024
Inactive	Meridian Security Insurance Company	300423	Agent - Casualty	10/19/2010	10/1/2020
Inactive	Meridian Security Insurance Company	300423	Agent - Property	10/19/2010	10/1/2020
Inactive	Milbank Insurance Company	925185	Agent - Casualty	11/8/2017	10/1/2020
Inactive	Milbank Insurance Company	925185	Agent - Property	11/8/2017	10/1/2020
Inactive	Milford Casualty Insurance Company	301460	Agent - Casualty	6/19/2017	10/1/2020
Inactive	Milford Casualty Insurance Company	301460	Agent - Property	6/19/2017	10/1/2020
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty	3/14/2023
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Property	3/14/2023
Active	Nationwide Assurance Company	300166	Agent - Casualty	3/14/2023
Active	Nationwide Assurance Company	300166	Agent - Property	3/14/2023
Active	Nationwide General Insurance Company	300603	Agent - Casualty	3/14/2023
Active	Nationwide General Insurance Company	300603	Agent - Property	3/14/2023
Active	Nationwide Insurance Company of America	300333	Agent - Casualty	3/14/2023
Active	Nationwide Insurance Company of America	300333	Agent - Property	3/14/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	3/14/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	3/14/2023
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	3/14/2023
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	3/14/2023
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/28/2010	10/1/2020
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/28/2010	10/1/2020
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	5/9/2022	3/29/2024
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	5/9/2022	3/29/2024
Active	Ohio Farmers Insurance Company	301667	Agent - Casualty	3/18/2021
Active	Ohio Farmers Insurance Company	301667	Agent - Property	3/18/2021
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	5/9/2022	3/29/2024
Inactive	Ohio Security Insurance Company	300622	Agent - Property	5/9/2022	3/29/2024
Inactive	Park National Insurance Company	692514	Agent - Casualty	6/19/2017	10/1/2020
Inactive	Park National Insurance Company	692514	Agent - Property	6/19/2017	10/1/2020
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/28/2010	10/1/2020
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/28/2010	10/1/2020
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/28/2010	10/1/2020
Inactive	Peerless Insurance Company	301910	Agent - Property	10/28/2010	10/1/2020
Inactive	RLI Insurance Company	301217	Agent - Casualty	1/11/2017	10/1/2020
Inactive	RLI Insurance Company	301217	Agent - Property	1/11/2017	10/1/2020
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	5/17/2023	3/29/2024
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	5/17/2023	3/29/2024
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	10/28/2010	10/1/2020
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	10/28/2010	10/1/2020
Inactive	Security National Insurance Company	301151	Agent - Casualty	6/19/2017	10/1/2020
Inactive	Security National Insurance Company	301151	Agent - Property	6/19/2017	10/1/2020
Inactive	Sequoia Insurance Company	628046	Agent - Casualty	5/5/2020	10/1/2020
Inactive	Sequoia Insurance Company	628046	Agent - Property	5/5/2020	10/1/2020
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	7/3/2024
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	7/3/2024
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	10/19/2010	10/1/2020
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Property	10/19/2010	10/1/2020
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	10/19/2010	10/1/2020
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	10/19/2010	10/1/2020
Inactive	Technology Insurance Company	613278	Agent - Casualty	6/19/2017	10/1/2020
Inactive	Technology Insurance Company	613278	Agent - Property	6/19/2017	10/1/2020
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	6/26/2018	10/1/2020
Inactive	The Phoenix Insurance Company	301502	Agent - Property	6/26/2018	10/1/2020
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	12/26/2012	12/21/2015
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	12/26/2012	12/21/2015
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	12/26/2012	12/9/2013
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Property	12/26/2012	12/9/2013
Inactive	Travelers Commercial Insurance Company	301506	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Travelers Commercial Insurance Company	301506	Agent - Property	12/26/2012	12/9/2013
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	6/18/2018	10/1/2020
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	6/18/2018	10/1/2020
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	12/26/2012	12/9/2013
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	12/26/2012	12/9/2013
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	12/26/2012	12/9/2013
Active	Travelers Personal Insurance Company	705785	Agent - Casualty	4/4/2022
Active	Travelers Personal Insurance Company	705785	Agent - Property	4/4/2022
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	12/26/2012	12/9/2013
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	12/26/2012	12/9/2013
Inactive	Wesco Insurance Company	300534	Agent - Casualty	6/19/2017	10/1/2020
Inactive	Wesco Insurance Company	300534	Agent - Property	6/19/2017	10/1/2020
Inactive	West American Insurance Company	301112	Agent - Casualty	10/28/2010	10/1/2020
Inactive	West American Insurance Company	301112	Agent - Property	10/28/2010	10/1/2020
Active	Westfield Insurance Company	301950	Agent - Casualty	3/18/2021
Active	Westfield Insurance Company	301950	Agent - Property	3/18/2021
Active	Westfield National Insurance Company	301036	Agent - Casualty	3/18/2021
Active	Westfield National Insurance Company	301036	Agent - Property	3/18/2021

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Blankenship, Colten J	1083671	Agent - Casualty	7/17/2023
Active	Blankenship, Colten J	1083671	Agent - Property	7/17/2023
Denied	Facemyer, Amiee Maria	1285896	Agent - Casualty
Denied	Facemyer, Amiee Maria	1285896	Agent - Property
Inactive	Flowers, Kristin L	1103419	Agent - Casualty	2/3/2021	9/5/2024
Inactive	Flowers, Kristin L	1103419	Agent - Property	2/3/2021	9/5/2024
Active	Garrison, Donyia Anita	1365244	Agent - Casualty	10/20/2024
Active	Garrison, Donyia Anita	1365244	Agent - Property	10/20/2024
Active	Hage, Hannah E	864005	Agent - Casualty	7/17/2023
Active	Hage, Hannah E	864005	Agent - Property	7/17/2023
Active	Jude, David	1138761	Agent - Casualty	7/17/2023
Active	Jude, David	1138761	Agent - Property	7/17/2023
Inactive	Kerns, Mary P	325257	Agent - Casualty	10/14/2010	7/31/2020
Inactive	Kerns, Mary P	325257	Agent - Property	10/14/2010	7/31/2020
Active	Osborne, Debra Laura	940135	Agent - Casualty	7/17/2023
Active	Osborne, Debra Laura	940135	Agent - Property	7/17/2023
Inactive	Scarberry, Kelly Shay	846157	Agent - Casualty	7/17/2023	11/27/2024
Inactive	Scarberry, Kelly Shay	846157	Agent - Property	7/17/2023	11/27/2024
Active	Vallet, Calister Jeremy	1173761	Agent - Casualty	7/17/2023
Active	Vallet, Calister Jeremy	1173761	Agent - Property	7/17/2023
Active	Wardrip, Heather M	513620	Agent - Casualty	9/5/2024
Active	Wardrip, Heather M	513620	Agent - Property	9/5/2024
Active	White, Tina Lynn	989947	Agent - Casualty	7/17/2023
Active	White, Tina Lynn	989947	Agent - Property	7/17/2023