DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Koppendrayer, Nichole	DOIID	756375	NAIC NPN	7980194

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	6/16/2011	8/31/2013
Inactive	Non Resident	Agent	Property	6/16/2011	8/31/2013
* 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	Amerisure Insurance Company	300298	Agent - Casualty	12/1/2011	6/15/2012
Inactive	Amerisure Insurance Company	300298	Agent - Property	12/1/2011	6/15/2012
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Casualty	12/1/2011	6/15/2012
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Property	12/1/2011	6/15/2012
Inactive	Amerisure Partners Insurance Company	760791	Agent - Casualty	12/1/2011	6/15/2012
Inactive	Amerisure Partners Insurance Company	760791	Agent - Property	12/1/2011	6/15/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	USI Insurance Services National, Inc	509421	Agent - Property
Denied	USI Insurance Services National, Inc	509421	Agent - Casualty