DEPARTMENT OF INSURANCE

Affiliations

Name	Assurety Nw Inc	DOIID	805274	NAIC NPN	8165446

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	3/7/2013	3/31/2015
Inactive	Non Resident	Agent	Casualty	3/7/2013	3/31/2015
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mansfield, Michael Scott	805155	Agent - Casualty	3/7/2013	3/31/2015
Inactive	Mansfield, Michael Scott	805155	Agent - Property	3/7/2013	3/31/2015