DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Montcrieffe, Evelina Katherina	DOIID	996826	NAIC NPN	18727642

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	6/6/2018		8/31/2024
Active	Non Resident	Agent	Casualty	6/6/2018		8/31/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/16/2018		8/31/2024
* 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	06/15/2024	08/31/2024
Surplus Lines Broker	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Integon National Insurance Company	301600	Agent - Casualty	4/12/2019
Active	Integon National Insurance Company	301600	Agent - Property	4/12/2019
Active	MIC General Insurance Corporation	300398	Agent - Casualty	4/12/2019
Active	MIC General Insurance Corporation	300398	Agent - Property	4/12/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	NGLS Insurance Services , Inc	399928	Agent - Property	4/12/2019
Active	NGLS Insurance Services , Inc	399928	Agent - Casualty	4/12/2019
Active	NGLS Insurance Services , Inc	399928	Surplus Lines Broker - Not Applicable	3/25/2019
Active	Seattle Specialty Ins Services Inc	611726	Agent - Property	4/12/2019
Active	Seattle Specialty Ins Services Inc	611726	Agent - Casualty	4/12/2019
Active	Seattle Specialty Ins Services Inc	611726	Surplus Lines Broker - Not Applicable	3/25/2019