DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Non-Profit Insurance Services, Inc.	DOIID	1128945	NAIC NPN	9297697

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	4/12/2021	4/24/2025
Inactive	Non Resident	Agent	Property	4/12/2021	4/24/2025
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	8/31/2021	4/24/2025
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Star Insurance Company	301553	Agent - Casualty	8/25/2021	3/16/2024
Inactive	Star Insurance Company	301553	Agent - Property	8/25/2021	3/16/2024
Inactive	Williamsburg National Insurance Company	301825	Agent - Casualty	8/25/2021	3/16/2024
Inactive	Williamsburg National Insurance Company	301825	Agent - Property	8/25/2021	3/16/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wiley, Justin Allen	950235	Agent - Casualty	4/12/2021	4/24/2025
Inactive	Wiley, Justin Allen	950235	Agent - Property	4/12/2021	4/24/2025
Active	Wiley, Justin Allen	950235	Surplus Lines Broker - Not Applicable	8/31/2021