DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Van Fossen, Brian	DOIID	925850	NAIC NPN	16793183

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	8/23/2016	12/27/2018
Inactive	Non Resident	Agent	Property	8/23/2016	12/27/2018
* 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 Hallmark Insurance Company of Texas	709267	Agent - Casualty	2/27/2018	5/16/2018
Inactive	American Hallmark Insurance Company of Texas	709267	Agent - Property	2/27/2018	5/16/2018
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	9/20/2016	5/23/2018
Inactive	Bristol West Insurance Company	301655	Agent - Property	9/20/2016	5/23/2018
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	9/12/2016	1/17/2018
Inactive	Dairyland Insurance Company	301370	Agent - Property	9/12/2016	1/17/2018
Inactive	Esurance Insurance Company	301072	Agent - Casualty	9/9/2016	1/30/2017
Inactive	Esurance Insurance Company	301072	Agent - Property	9/9/2016	1/30/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	9/26/2016	10/24/2017
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	9/26/2016	10/24/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Right Answer Ins Agency LLC	780508	Agent - Property	9/12/2016	5/16/2018
Inactive	Right Answer Ins Agency LLC	780508	Agent - Casualty	9/12/2016	5/16/2018