DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark, Nicole Ann	DOIID	915655	NAIC NPN	17726834

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	5/16/2016	10/31/2018
Inactive	Non Resident	Agent	Property	5/16/2016	10/31/2018
* 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	American Contractors Indemnity Company	536843	Agent - Casualty	12/6/2016	10/31/2018
Inactive	American Home Assurance Company	300246	Agent - Casualty	9/27/2016	10/31/2018
Inactive	American Home Assurance Company	300246	Agent - Property	9/27/2016	10/31/2018
Inactive	Argonaut Insurance Company	301422	Agent - Casualty	9/28/2016	8/13/2018
Inactive	Argonaut Insurance Company	301422	Agent - Property	9/28/2016	8/13/2018
Inactive	Atlantic Specialty Insurance Company	518595	Agent - Casualty	10/21/2016	9/26/2017
Inactive	Atlantic Specialty Insurance Company	518595	Agent - Property	10/21/2016	9/26/2017
Inactive	Capitol Indemnity Corporation	301030	Agent - Casualty	8/14/2017	9/8/2017
Inactive	Guarantee Company of North America USA (The)	300857	Agent - Casualty	10/5/2016	10/31/2018
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	9/27/2016	10/31/2018
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Property	9/27/2016	10/31/2018
Inactive	International Fidelity Insurance Company	301131	Agent - Casualty	11/4/2016	5/19/2017
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	9/27/2016	10/31/2018
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	9/27/2016	10/31/2018
Inactive	Platte River Insurance Company	301089	Agent - Casualty	8/14/2017	9/8/2017
Inactive	U.S. Specialty Insurance Company	300186	Agent - Casualty	12/6/2016	10/31/2018
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	8/25/2016	1/24/2018
Inactive	Zurich American Insurance Company	301121	Agent - Property	8/25/2016	1/24/2018

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 Connecticut LLC	566166	Agent - Property	8/29/2016	6/5/2017
Inactive	Willis of Connecticut LLC	566166	Agent - Casualty	8/29/2016	6/5/2017