DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Weis, Kelly	DOIID	786138	NAIC NPN	16500039

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	8/8/2015	11/23/2016
Inactive	Non Resident	Agent	Casualty	8/8/2015	11/23/2016
Inactive	Non Resident	Staff Adjuster	Property & Casualty	1/4/2017	12/31/2022
* 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	Nationwide Mutual Insurance Company	301749	Agent - Casualty	8/6/2012	1/6/2015
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	8/6/2012	1/6/2015
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	11/10/2015	1/2/2017
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	11/10/2015	1/2/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Property	11/10/2015	11/23/2016
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Casualty	11/10/2015	11/23/2016