DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bergner, Lori Ann	DOIID	902476	NAIC NPN	17765768

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	12/23/2015	6/30/2020
Inactive	Non Resident	Agent	Casualty	12/23/2015	6/30/2020
Inactive	Non Resident	Agent	Health	12/23/2015	6/30/2020
* 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	AMEX Assurance Company	301728	Agent - Casualty	1/13/2016	8/31/2018
Inactive	AMEX Assurance Company	301728	Agent - Health	1/13/2016	8/31/2018
Inactive	AMEX Assurance Company	301728	Agent - Property	1/13/2016	8/31/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alorica Customer Care, Inc.	800938	Agent - Casualty	3/30/2016	8/31/2018
Inactive	Alorica Customer Care, Inc.	800938	Agent - Property	3/30/2016	8/31/2018
Inactive	Alorica Customer Care, Inc.	800938	Agent - Health	3/30/2016	8/31/2018