DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lacy, Robert Farrell	DOIID	872061	NAIC NPN	17529359

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	9/2/2021		8/31/2024
Active	Non Resident	Agent	Casualty	9/2/2021		8/31/2024
Inactive	Non Resident	Agent	Personal Lines	3/13/2015	8/31/2016
* 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	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Personal Lines	3/17/2015	5/11/2016
Active	Wellfleet Insurance Company	300542	Agent - Casualty	9/16/2021
Active	Wellfleet New York Insurance Company	300245	Agent - Casualty	9/16/2021
Active	Wellfleet New York Insurance Company	300245	Agent - Property	9/16/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Nationwide Sales Solutions Inc	631821	Agent - Personal Lines	3/17/2015	5/11/2016
Active	biBERK Insurance Services, Inc.	909097	Agent - Casualty	9/16/2021
Active	biBERK Insurance Services, Inc.	909097	Agent - Property	9/16/2021