DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Jensen, David Gardner	DOIID	880271	NAIC NPN	2342936

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	6/11/2015	11/23/2020
Inactive	Non Resident	Agent	Casualty	6/11/2015	11/23/2020
* 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	Atlantic Specialty Insurance Company	518595	Agent - Casualty	2/9/2016	8/10/2020
Inactive	Atlantic Specialty Insurance Company	518595	Agent - Property	2/9/2016	8/10/2020
Inactive	Contractors Bonding and Insurance Company	300184	Agent - Casualty	4/29/2019	11/23/2020
Inactive	Contractors Bonding and Insurance Company	300184	Agent - Property	4/29/2019	11/23/2020
Inactive	Liberty Mutual Insurance Company	301159	Agent - Casualty	7/15/2015	11/23/2020
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	7/15/2015	11/23/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Of Arizona Inc	511502	Agent - Casualty	3/11/2016	3/6/2020
Inactive	Willis Of Arizona Inc	511502	Agent - Property	3/11/2016	3/6/2020
Inactive	Willis Towers Watson Insurance Services West Inc	538729	Agent - Casualty	2/1/2020	11/23/2020
Inactive	Willis Towers Watson Insurance Services West Inc	538729	Agent - Property	2/1/2020	11/23/2020