DEPARTMENT OF INSURANCE

Name	Conifer Insurance Agency, Inc	DOIID	592542	NAIC NPN	5438700

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	10/4/2004	8/3/2009
Inactive	Non Resident	Agent	Property	10/4/2004	8/3/2009
Denied	Non Resident	Surplus Lines Broker	Not Applicable

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date.

Address Information

Type	Address
Business / Home Office	10 Centennial Drive Peabody, MA 01960
Mailing	10 Centennial Drive Peabody, MA 01960

Internet Information

Type	Address
Business Email	bmccarthy@conifercompanies.com
Internet	www.conifercompanies.com

Phone Information

Type	Phone
Business / Home Office	(978) 532-5445