DEPARTMENT OF INSURANCE

Affiliations

Name	Clark Insurance	DOIID	823735	NAIC NPN	686188

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	10/9/2013	12/27/2022
Inactive	Non Resident	Agent	Property	10/9/2013	12/27/2022
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	3/17/2021	12/27/2022
* 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	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	10/15/2019	8/12/2022
Inactive	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	10/15/2019	8/12/2022
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	8/14/2014	11/18/2022
Inactive	American Fire and Casualty Company	300567	Agent - Property	8/14/2014	11/18/2022
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	9/23/2019	12/15/2020
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	9/23/2019	12/15/2020
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	8/14/2014	10/13/2022
Inactive	Consolidated Insurance Company	300943	Agent - Property	8/14/2014	10/13/2022
Inactive	Farmington Casualty Company	301137	Agent - Casualty	9/23/2019	12/27/2022
Inactive	Farmington Casualty Company	301137	Agent - Property	9/23/2019	12/27/2022
Inactive	Indiana Insurance Company	301909	Agent - Casualty	8/14/2014	11/18/2022
Inactive	Indiana Insurance Company	301909	Agent - Property	8/14/2014	11/18/2022
Inactive	Liberty Insurance Underwriters Inc.	301391	Agent - Casualty	12/29/2015	12/27/2022
Inactive	Liberty Insurance Underwriters Inc.	301391	Agent - Property	12/29/2015	12/27/2022
Inactive	Massachusetts Bay Insurance Company	300898	Agent - Casualty	10/15/2019	8/12/2022
Inactive	Massachusetts Bay Insurance Company	300898	Agent - Property	10/15/2019	8/12/2022
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	8/14/2014	11/18/2022
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	8/14/2014	11/18/2022
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	8/14/2014	11/18/2022
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	8/14/2014	11/18/2022
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	8/14/2014	11/18/2022
Inactive	Ohio Security Insurance Company	300622	Agent - Property	8/14/2014	11/18/2022
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	8/14/2014	11/18/2022
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	8/14/2014	11/18/2022
Inactive	Peerless Insurance Company	301910	Agent - Casualty	8/14/2014	11/18/2022
Inactive	Peerless Insurance Company	301910	Agent - Property	8/14/2014	11/18/2022
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	9/23/2019	12/27/2022
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	9/23/2019	12/27/2022
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	9/23/2019	12/15/2020
Inactive	The Phoenix Insurance Company	301502	Agent - Property	9/23/2019	12/15/2020
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	9/23/2019	12/15/2020
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	9/23/2019	12/15/2020
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	9/23/2019	12/27/2022
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	9/23/2019	12/27/2022
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	9/23/2019	12/27/2022
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	9/23/2019	12/27/2022
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	9/23/2019	12/27/2022
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	9/23/2019	12/27/2022
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	9/23/2019	12/15/2020
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	9/23/2019	12/15/2020
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	9/23/2019	12/27/2022
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	9/23/2019	12/27/2022
Inactive	West American Insurance Company	301112	Agent - Casualty	8/14/2014	11/18/2022
Inactive	West American Insurance Company	301112	Agent - Property	8/14/2014	11/18/2022

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Lind, Jeffrey Adam	1050874	Agent - Casualty	1/28/2020	12/27/2022
Inactive	Lind, Jeffrey Adam	1050874	Agent - Property	1/28/2020	12/27/2022
Inactive	Lind, Jeffrey Adam	1050874	Surplus Lines Broker - Not Applicable	3/17/2021	12/27/2022
Inactive	Ramsdell, George Lee	820782	Agent - Casualty	10/9/2013	1/8/2020
Inactive	Ramsdell, George Lee	820782	Agent - Property	10/9/2013	1/8/2020
Inactive	Twitchell, Scott Bradley	691781	Agent - Casualty	1/27/2020	12/31/2021
Inactive	Twitchell, Scott Bradley	691781	Agent - Property	1/27/2020	12/31/2021