DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bozarth, Adam W	DOIID	867714	NAIC NPN	13584990

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	2/3/2015	10/31/2018
Inactive	Non Resident	Agent	Property	2/3/2015	10/31/2018
* 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	1/20/2017	10/31/2018
Inactive	ACE American Insurance Company	300625	Agent - Property	1/20/2017	10/31/2018
Inactive	AXIS Insurance Company	301290	Agent - Casualty	8/16/2017	10/31/2018
Inactive	AXIS Insurance Company	301290	Agent - Property	8/16/2017	10/31/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Affinity Insurance Services, Inc.	396178	Agent - Property	1/20/2017	10/31/2018
Inactive	Affinity Insurance Services, Inc.	396178	Agent - Casualty	1/20/2017	10/31/2018