DEPARTMENT OF INSURANCE

Name	Bergman, Kelly	DOIID	1276270	NAIC NPN	20723572

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date	Designated Home State
Active	Non Resident	Independent Adjuster	Property & Casualty	5/25/2023		10/31/2024	Florida

*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
Independent Adjuster	08/15/2024	10/31/2024

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Business / Home Office	7717 Creek Bend Rockford, IL 61114
Residence	Not Public Information

Phone Information

Type	Phone
Business / Home Office	(800) 428-9336