DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mundy, Jay Taylor	DOIID	903636	NAIC NPN	17109138

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	1/12/2016		12/31/2024
Active	Non Resident	Agent	Property	1/12/2016		12/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Independence American Insurance Company	524747	Agent - Casualty	3/25/2024
Active	Independence American Insurance Company	524747	Agent - Property	3/25/2024
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Casualty	4/8/2020
Active	Liberty Mutual Fire Insurance Company	301913	Agent - Property	4/8/2020
Active	United States Fire Insurance Company	582240	Agent - Casualty	3/4/2016
Active	United States Fire Insurance Company	582240	Agent - Property	3/4/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	PTZ Insurance Agency LTD	695420	Agent - Property	12/6/2022
Active	PTZ Insurance Agency LTD	695420	Agent - Casualty	12/6/2022