DEPARTMENT OF INSURANCE

Affiliations

Name	Provident Ins Group LLC	DOIID	836552	NAIC NPN	17186886

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	3/21/2014	3/31/2016
Inactive	Non Resident	Agent	Casualty	3/21/2014	3/31/2016
* 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	ACE American Insurance Company	300625	Agent - Casualty	4/24/2014	12/24/2015
Inactive	ACE American Insurance Company	300625	Agent - Property	4/24/2014	12/24/2015
Inactive	Accident Insurance Company, Inc.	681435	Agent - Casualty	5/4/2015	3/31/2016
Inactive	Accident Insurance Company, Inc.	681435	Agent - Property	5/4/2015	3/31/2016
Inactive	American Alternative Insurance Corporation	301697	Agent - Casualty	5/21/2014	3/23/2016
Inactive	American Alternative Insurance Corporation	301697	Agent - Property	5/21/2014	3/23/2016
Inactive	American Family Home Insurance Company	301817	Agent - Casualty	5/21/2014	3/23/2016
Inactive	American Family Home Insurance Company	301817	Agent - Property	5/21/2014	3/23/2016
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	4/28/2014	1/4/2016
Inactive	American Fire and Casualty Company	300567	Agent - Property	4/28/2014	1/4/2016
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	5/21/2014	3/23/2016
Inactive	American Southern Home Insurance Company	626276	Agent - Property	5/21/2014	3/23/2016
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	5/13/2014	12/21/2015
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	5/13/2014	12/21/2015
Inactive	Bankers Standard Insurance Company	301620	Agent - Casualty	4/24/2014	12/24/2015
Inactive	Bankers Standard Insurance Company	301620	Agent - Property	4/24/2014	12/24/2015
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	4/28/2014	1/4/2016
Inactive	Consolidated Insurance Company	300943	Agent - Property	4/28/2014	1/4/2016
Inactive	Indemnity Insurance Company of North America	301760	Agent - Casualty	4/24/2014	12/24/2015
Inactive	Indemnity Insurance Company of North America	301760	Agent - Property	4/24/2014	12/24/2015
Inactive	Indiana Insurance Company	301909	Agent - Casualty	4/28/2014	1/4/2016
Inactive	Indiana Insurance Company	301909	Agent - Property	4/28/2014	1/4/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	4/28/2014	1/4/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	4/28/2014	1/4/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	4/28/2014	1/4/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	4/28/2014	1/4/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	4/28/2014	1/4/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Property	4/28/2014	1/4/2016
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	4/24/2014	12/24/2015
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	4/24/2014	12/24/2015
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	4/28/2014	1/4/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	4/28/2014	1/4/2016
Inactive	Peerless Insurance Company	301910	Agent - Casualty	4/28/2014	1/4/2016
Inactive	Peerless Insurance Company	301910	Agent - Property	4/28/2014	1/4/2016
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	5/13/2014	1/4/2016
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	5/13/2014	1/4/2016
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	5/13/2014	1/4/2016
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	5/13/2014	1/4/2016
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	5/13/2014	12/21/2015
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	5/13/2014	12/21/2015
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	5/13/2014	12/21/2015
Inactive	The Phoenix Insurance Company	301502	Agent - Property	5/13/2014	12/21/2015
Inactive	Travelers Commercial Insurance Company	301506	Agent - Casualty	5/13/2014	12/21/2015
Inactive	Travelers Commercial Insurance Company	301506	Agent - Property	5/13/2014	12/21/2015
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	5/13/2014	12/21/2015
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	5/13/2014	12/21/2015
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	5/13/2014	12/21/2015
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	5/13/2014	12/21/2015
Inactive	West American Insurance Company	301112	Agent - Casualty	4/28/2014	1/4/2016
Inactive	West American Insurance Company	301112	Agent - Property	4/28/2014	1/4/2016

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Schmidt, Jeffrey Timothy	836162	Agent - Casualty	3/21/2014	3/31/2016
Inactive	Schmidt, Jeffrey Timothy	836162	Agent - Property	3/21/2014	3/31/2016