DEPARTMENT OF INSURANCE

Affiliations

Name	Urbanciz, Jason	DOIID	931291	NAIC NPN	5786518

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	9/29/2016	7/31/2018
Inactive	Non Resident	Agent	Property	9/29/2016	7/31/2018
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Engs Ins Agency LLC	930587	Agent - Property	10/4/2016	4/3/2017
Inactive	Engs Ins Agency LLC	930587	Agent - Casualty	10/4/2016	4/3/2017