DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Campbell, Kelly	DOIID	926794	NAIC NPN	17121279

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	4/10/2023		1/31/2025
Active	Non Resident	Agent	Property	4/10/2023		1/31/2025
Active	Non Resident	Staff Adjuster	Property & Casualty	8/29/2016		1/31/2025
* 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	11/15/2024	01/31/2025
Staff Adjuster	11/15/2024	01/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Midvale Indemnity Company	300292	Agent - Casualty	4/10/2023
Active	Midvale Indemnity Company	300292	Agent - Property	4/10/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Fx Insurance Agency, LLC	646184	Agent - Casualty	4/19/2023
Active	Fx Insurance Agency, LLC	646184	Agent - Property	4/19/2023
Active	Kraft Lake Insurance Agency, Inc.	658511	Agent - Casualty	4/19/2023
Active	Kraft Lake Insurance Agency, Inc.	658511	Agent - Property	4/19/2023