DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Lacey, Mark	DOIID	1031256	NAIC NPN	18855361

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	3/5/2019		11/30/2025
Active	Non Resident	Agent	Casualty	3/5/2019		11/30/2025
* 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	09/15/2025	11/30/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	National Surety Corporation	300087	Agent - Casualty	3/20/2019
Active	National Surety Corporation	300087	Agent - Property	3/20/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	4/22/2019	11/30/2023
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	4/22/2019	11/30/2023