DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Blake P	DOIID	847177	NAIC NPN	17335952

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	9/30/2014		9/30/2026
Active	Resident	Agent	Property	9/23/2014		9/30/2026
Active	Resident	Agent	Health	10/18/2016		9/30/2026
Active	Resident	Agent	Life	10/4/2016		9/30/2026
* 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	Shelter General Insurance Company	301109	Agent - Casualty	10/8/2014	5/2/2022
Inactive	Shelter General Insurance Company	301109	Agent - Property	10/8/2014	5/2/2022
Inactive	Shelter Life Insurance Company	300391	Agent - Health	10/27/2016	5/2/2022
Inactive	Shelter Life Insurance Company	300391	Agent - Life	10/27/2016	5/2/2022
Inactive	Shelter Mutual Insurance Company	301870	Agent - Casualty	10/8/2014	5/2/2022
Inactive	Shelter Mutual Insurance Company	301870	Agent - Property	10/8/2014	5/2/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Daniel Boone Agency, LLC.	515760	Agent - Casualty	10/8/2014	5/2/2022
Inactive	Daniel Boone Agency, LLC.	515760	Agent - Property	10/8/2014	5/2/2022