DEPARTMENT OF INSURANCE

Affiliations

Name	Roman, Kimberley Dawn	DOIID	759667	NAIC NPN	2722781

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	8/17/2011	6/30/2022
Inactive	Non Resident	Agent	Property	8/17/2011	6/30/2022
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	7/30/2011	5/24/2022
* 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	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	6/19/2014	12/21/2015
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	6/19/2014	12/21/2015
Inactive	Farmington Casualty Company	301137	Agent - Casualty	6/19/2014	12/21/2015
Inactive	Farmington Casualty Company	301137	Agent - Property	6/19/2014	12/21/2015
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Casualty	6/19/2014	12/3/2014
Inactive	St. Paul Fire and Marine Insurance Company	300782	Agent - Property	6/19/2014	12/3/2014
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Casualty	6/19/2014	12/3/2014
Inactive	St. Paul Guardian Insurance Company	301372	Agent - Property	6/19/2014	12/3/2014
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Casualty	6/19/2014	12/3/2014
Inactive	St. Paul Mercury Insurance Company	300783	Agent - Property	6/19/2014	12/3/2014
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	6/19/2014	6/30/2022
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	6/19/2014	6/30/2022
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	6/19/2014	12/21/2015
Inactive	The Phoenix Insurance Company	301502	Agent - Property	6/19/2014	12/21/2015
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	6/19/2014	12/21/2015
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	6/19/2014	12/21/2015
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	6/19/2014	6/30/2022
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	6/19/2014	6/30/2022
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Casualty	6/19/2014	6/30/2022
Inactive	Travelers Casualty and Surety Company of America	301334	Agent - Property	6/19/2014	6/30/2022
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	6/19/2014	11/30/2017
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	6/19/2014	11/30/2017
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	6/19/2014	12/21/2015
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	6/19/2014	12/21/2015
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	6/19/2014	12/21/2015
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	6/19/2014	12/21/2015
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	6/19/2014	6/30/2022
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	6/19/2014	6/30/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Heffernan Ins Brokers	597449	Surplus Lines Broker - Not Applicable	3/26/2012	5/24/2022