DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Central Insurex Agency Inc	DOIID	833861	NAIC NPN	957636

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	2/14/2014		3/31/2026
Active	Non Resident	Agent	Casualty	2/14/2014		3/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	10/22/2019		3/31/2026
* 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	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/28/2014	9/25/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/28/2014	9/25/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	5/28/2014	5/10/2017
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	5/28/2014	5/10/2017
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	5/28/2014	5/10/2017
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	5/28/2014	5/10/2017
Inactive	Western Surety Company	300283	Agent - Casualty	3/6/2014	5/5/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bermejo, Shelby Celeste	1015422	Agent - Casualty	11/7/2018	3/9/2021
Inactive	Bermejo, Shelby Celeste	1015422	Agent - Property	11/7/2018	3/9/2021
Inactive	Brown, Jason Channing	587205	Agent - Casualty	2/14/2014	9/27/2017
Inactive	Brown, Jason Channing	587205	Agent - Property	2/14/2014	9/27/2017
Active	Etzler, Kristine M	1034577	Agent - Casualty	5/3/2019
Active	Etzler, Kristine M	1034577	Agent - Property	5/3/2019
Active	Gearhart, Mitch	1038430	Agent - Casualty	6/14/2019
Active	Gearhart, Mitch	1038430	Agent - Property	6/14/2019
Active	Gearhart, Mitch	1038430	Surplus Lines Broker - Not Applicable	10/18/2019
Inactive	Muntzinger, Kurt R	833815	Agent - Casualty	5/28/2014	6/30/2019
Inactive	Muntzinger, Kurt R	833815	Agent - Property	5/28/2014	6/30/2019
Inactive	Muntzinger, Kurt R	833815	Surplus Lines Broker - Not Applicable	2/18/2014	6/30/2019