DEPARTMENT OF INSURANCE

Affiliations

Name	Simon, Kathi	DOIID	889926	NAIC NPN	11980660

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	9/4/2015	10/31/2025
Active	Non Resident	Agent	Casualty	9/4/2015	10/31/2025
* 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
Active	American Fire and Casualty Company	300567	Agent - Casualty	9/25/2015
Active	American Fire and Casualty Company	300567	Agent - Property	9/25/2015
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	9/25/2015	10/13/2022
Inactive	Consolidated Insurance Company	300943	Agent - Property	9/25/2015	10/13/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/5/2018	8/29/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/5/2018	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	6/5/2018	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	6/5/2018	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	6/5/2018	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	6/5/2018	8/29/2018
Inactive	Indiana Insurance Company	301909	Agent - Casualty	9/25/2015	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	9/25/2015	2/3/2023
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	9/25/2015	4/26/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	9/25/2015	4/26/2024
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	9/25/2015
Active	Ohio Casualty Insurance Company	301492	Agent - Property	9/25/2015
Active	Ohio Security Insurance Company	300622	Agent - Casualty	9/25/2015
Active	Ohio Security Insurance Company	300622	Agent - Property	9/25/2015
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	9/25/2015
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	9/25/2015
Active	Peerless Insurance Company	301910	Agent - Casualty	9/25/2015
Active	Peerless Insurance Company	301910	Agent - Property	9/25/2015
Active	West American Insurance Company	301112	Agent - Casualty	9/25/2015
Active	West American Insurance Company	301112	Agent - Property	9/25/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	9/29/2015	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	9/29/2015	10/9/2019
Active	Usi Insurance Services LLC	669260	Agent - Property	1/8/2019
Active	Usi Insurance Services LLC	669260	Agent - Casualty	1/8/2019