DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	The Willis Agency	DOIID	878064	NAIC NPN	17589989

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Casualty	5/14/2015	3/31/2021
Inactive	Resident	Agent	Property	5/14/2015	3/31/2021
Inactive	Resident	Agent	Health	5/14/2015	3/31/2021
Inactive	Resident	Agent	Life	5/14/2015	3/31/2021
* 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	Bristol West Insurance Company	301655	Agent - Casualty	7/21/2015	4/18/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	7/21/2015	4/18/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	7/21/2015	4/18/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	7/21/2015	4/18/2017
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	7/9/2015	3/31/2021
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	7/9/2015	3/31/2021
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	6/1/2015	4/23/2018
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	6/1/2015	4/23/2018
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	6/1/2015	4/23/2018
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	6/1/2015	4/23/2018
Inactive	Titan Indemnity Company	300556	Agent - Casualty	5/27/2015	9/20/2017
Inactive	Titan Indemnity Company	300556	Agent - Property	5/27/2015	9/20/2017
Inactive	United Financial Casualty Company	301886	Agent - Casualty	7/9/2015	3/31/2021
Inactive	United Financial Casualty Company	301886	Agent - Property	7/9/2015	3/31/2021
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	5/27/2015	9/20/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	5/27/2015	9/20/2017

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis, Jeremy Dwan	389349	Agent - Casualty	5/14/2015	3/31/2021
Inactive	Willis, Jeremy Dwan	389349	Agent - Health	5/14/2015	3/31/2021
Inactive	Willis, Jeremy Dwan	389349	Agent - Life	5/14/2015	3/31/2021
Inactive	Willis, Jeremy Dwan	389349	Agent - Property	5/14/2015	3/31/2021