DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Carlson, Ronald J	DOIID	887353	NAIC NPN	1216657

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	8/18/2015	11/30/2019
Inactive	Non Resident	Agent	Property	8/18/2015	11/30/2019
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	9/9/2015	11/30/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Velocity Risk Underwriters LLC	888496	Agent - Property	8/25/2015	11/7/2017
Inactive	Velocity Risk Underwriters LLC	888496	Agent - Casualty	8/25/2015	11/7/2017
Inactive	Velocity Risk Underwriters LLC	888496	Surplus Lines Broker - Not Applicable	9/9/2015	11/7/2017