DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Collins, Stephen Michael	DOIID	855178	NAIC NPN	3742483

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	12/14/2020		11/30/2024
Active	Non Resident	Agent	Health	12/14/2020		11/30/2024
Active	Non Resident	Agent	Property	12/14/2020		11/30/2024
Active	Non Resident	Agent	Casualty	12/14/2020		11/30/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	12/14/2020		11/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2024	11/30/2024
Surplus Lines Broker	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Employers Insurance Company of Wausau	301813	Agent - Casualty	10/9/2014	11/9/2015
Inactive	Employers Insurance Company of Wausau	301813	Agent - Property	10/9/2014	11/9/2015
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Casualty	10/9/2014	11/9/2015
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Property	10/9/2014	11/9/2015
Inactive	LM Insurance Corporation	301061	Agent - Casualty	10/9/2014	11/9/2015
Inactive	LM Insurance Corporation	301061	Agent - Property	10/9/2014	11/9/2015
Inactive	Liberty Insurance Corporation	300444	Agent - Casualty	10/9/2014	11/9/2015
Inactive	Liberty Insurance Corporation	300444	Agent - Property	10/9/2014	11/9/2015
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	10/9/2014	11/9/2015
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Property	10/9/2014	11/9/2015
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	10/9/2014	11/9/2015
Inactive	Liberty Mutual Insurance Company	301159	Agent - Property	10/9/2014	11/9/2015
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	11/11/2022
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	11/11/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	JH Berry Risk Services LLC	886816	Agent - Property	11/21/2022
Active	JH Berry Risk Services LLC	886816	Agent - Casualty	11/21/2022