DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Ford, Rosetta S	DOIID	982034	NAIC NPN	370477

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	1/19/2018		5/31/2025
Active	Non Resident	Agent	Property	1/19/2018		5/31/2025
Active	Non Resident	Agent	Life	1/19/2018		5/31/2025
Active	Non Resident	Agent	Casualty	1/19/2018		5/31/2025
* 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	03/15/2025	05/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Church Mutual Insurance Company, S.I.	301554	Agent - Casualty	2/28/2018	12/5/2023
Active	Church Mutual Insurance Company, S.I.	301554	Agent - Health	3/7/2018
Inactive	Church Mutual Insurance Company, S.I.	301554	Agent - Property	2/28/2018	12/5/2023
Inactive	ClearPath Insurance Company	979815	Agent - Casualty	2/28/2024	1/9/2025
Active	RLI Insurance Company	301217	Agent - Casualty	8/4/2021
Active	RLI Insurance Company	301217	Agent - Property	8/4/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	C M I C Specialty Services Inc	645077	Agent - Casualty	2/28/2018	1/25/2024
Inactive	C M I C Specialty Services Inc	645077	Agent - Property	2/28/2018	1/25/2024
Inactive	C M I C Specialty Services Inc	645077	Agent - Life	11/3/2020	1/25/2024
Inactive	C M I C Specialty Services Inc	645077	Agent - Health	3/7/2018	1/25/2024