DEPARTMENT OF INSURANCE

Affiliations

Name	Insurtech Groups LLC	DOIID	1209103	NAIC NPN	20350022

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Life	6/6/2022	3/31/2026
Active	Non Resident	Agent	Property	6/6/2022	3/31/2026
Active	Non Resident	Agent	Health	6/6/2022	3/31/2026
Active	Non Resident	Agent	Casualty	6/6/2022	3/31/2026
* 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	01/15/2026	03/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AMCO Insurance Company	300204	Agent - Casualty	3/8/2023
Active	AMCO Insurance Company	300204	Agent - Property	3/8/2023
Active	Allied Insurance Company of America	793586	Agent - Casualty	3/8/2023
Active	Allied Insurance Company of America	793586	Agent - Property	3/8/2023
Active	Allied Property and Casualty Insurance Company	300279	Agent - Casualty	3/8/2023
Active	Allied Property and Casualty Insurance Company	300279	Agent - Property	3/8/2023
Inactive	American Strategic Insurance Corp	883540	Agent - Casualty	9/7/2022	8/15/2024
Inactive	American Strategic Insurance Corp	883540	Agent - Property	9/7/2022	8/15/2024
Active	Amica Life Insurance Company	301676	Agent - Life	10/18/2023
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	9/9/2022	7/16/2024
Inactive	Bristol West Insurance Company	301655	Agent - Property	9/9/2022	7/16/2024
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	7/7/2023	7/22/2024
Inactive	Continental Insurance Company (The)	301242	Agent - Property	7/7/2023	7/22/2024
Active	Depositors Insurance Company	301634	Agent - Casualty	3/8/2023
Active	Depositors Insurance Company	301634	Agent - Property	3/8/2023
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	8/12/2022	7/16/2024
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	8/12/2022	7/16/2024
Inactive	Fidelity Security Life Insurance Company	300466	Agent - Life	12/22/2022	12/13/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	8/12/2022	7/16/2024
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	8/12/2022	7/16/2024
Active	Great American Alliance Insurance Company	301247	Agent - Casualty	11/8/2022
Active	Great American Alliance Insurance Company	301247	Agent - Property	11/8/2022
Active	Great American Insurance Company	301586	Agent - Casualty	11/8/2022
Active	Great American Insurance Company	301586	Agent - Property	11/8/2022
Active	Great American Spirit Insurance Company	300233	Agent - Casualty	11/8/2022
Active	Great American Spirit Insurance Company	300233	Agent - Property	11/8/2022
Inactive	Integon Indemnity Corporation	300674	Agent - Casualty	8/30/2022	6/11/2024
Inactive	Integon Indemnity Corporation	300674	Agent - Property	8/30/2022	6/11/2024
Inactive	National Specialty Insurance Company	300993	Agent - Casualty	7/20/2023	6/25/2024
Inactive	National Specialty Insurance Company	300993	Agent - Property	7/20/2023	6/25/2024
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Casualty	3/8/2023
Active	Nationwide Agribusiness Insurance Company	301008	Agent - Property	3/8/2023
Active	Nationwide Assurance Company	300166	Agent - Casualty	3/8/2023
Active	Nationwide Assurance Company	300166	Agent - Property	3/8/2023
Active	Nationwide General Insurance Company	300603	Agent - Casualty	3/8/2023
Active	Nationwide General Insurance Company	300603	Agent - Property	3/8/2023
Active	Nationwide Insurance Company of America	300333	Agent - Casualty	3/8/2023
Active	Nationwide Insurance Company of America	300333	Agent - Property	3/8/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	3/8/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	3/8/2023
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	3/8/2023
Active	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	3/8/2023
Inactive	Next Insurance US Company	1083825	Agent - Casualty	7/13/2023	6/25/2024
Inactive	Next Insurance US Company	1083825	Agent - Property	7/13/2023	6/25/2024
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	9/7/2022	7/22/2024
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	9/7/2022	7/22/2024
Inactive	State National Insurance Company, Inc.	300888	Agent - Casualty	7/20/2023	6/25/2024
Inactive	State National Insurance Company, Inc.	300888	Agent - Property	7/20/2023	6/25/2024
Inactive	United Financial Casualty Company	301886	Agent - Casualty	3/16/2023	7/22/2024
Inactive	United Financial Casualty Company	301886	Agent - Property	3/16/2023	7/22/2024
Inactive	Valley Forge Insurance Company	301052	Agent - Casualty	7/7/2023	7/22/2024
Inactive	Valley Forge Insurance Company	301052	Agent - Property	7/7/2023	7/22/2024

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bayard, Shaundre T	1003479	Agent - Casualty	1/4/2023	5/24/2023
Inactive	Bayard, Shaundre T	1003479	Agent - Property	1/4/2023	5/24/2023
Inactive	Brookshire, James Adam	1210861	Agent - Casualty	8/18/2022	12/10/2022
Denied	Brookshire, James Adam	1210861	Agent - Health
Denied	Brookshire, James Adam	1210861	Agent - Life
Inactive	Brookshire, James Adam	1210861	Agent - Property	8/18/2022	12/10/2022
Inactive	Burns, Bridget J	1246310	Agent - Casualty	12/15/2022	5/24/2023
Inactive	Burns, Bridget J	1246310	Agent - Property	12/15/2022	5/24/2023
Inactive	Cano, Brenda	940249	Agent - Casualty	10/4/2022	11/8/2022
Inactive	Cano, Brenda	940249	Agent - Property	10/4/2022	11/8/2022
Denied	Gaymes, Devanand D	1222256	Agent - Life
Inactive	Hackett, Tonia Darice	555415	Agent - Casualty	9/7/2022	7/26/2023
Inactive	Hackett, Tonia Darice	555415	Agent - Property	9/7/2022	7/26/2023
Inactive	Jordan, Jerenetta Nicole	1246575	Agent - Casualty	1/4/2023	5/1/2023
Inactive	Jordan, Jerenetta Nicole	1246575	Agent - Property	1/4/2023	5/1/2023
Inactive	Kanwal, Leeza	1255734	Agent - Casualty	5/15/2023	12/5/2024
Inactive	Kanwal, Leeza	1255734	Agent - Property	5/15/2023	12/5/2024
Inactive	Krupp, Derek William	1210776	Agent - Casualty	11/18/2022	11/29/2022
Inactive	Krupp, Derek William	1210776	Agent - Property	11/18/2022	11/29/2022
Inactive	Lybbert, Brant	777113	Agent - Casualty	3/13/2023	3/31/2023
Inactive	Lybbert, Brant	777113	Agent - Property	3/13/2023	3/31/2023
Inactive	Mahnke, Petra Marie	711127	Agent - Casualty	9/14/2022	11/8/2022
Inactive	Mahnke, Petra Marie	711127	Agent - Property	9/14/2022	11/8/2022
Inactive	Mcclure, Jeremy William	1159308	Agent - Casualty	2/10/2023	7/26/2023
Inactive	Mcclure, Jeremy William	1159308	Agent - Property	2/10/2023	7/26/2023
Inactive	Ortiz, Jose Fernando	1208484	Agent - Casualty	7/6/2023	9/16/2024
Denied	Ortiz, Jose Fernando	1208484	Agent - Health
Denied	Ortiz, Jose Fernando	1208484	Agent - Life
Inactive	Ortiz, Jose Fernando	1208484	Agent - Property	7/6/2023	9/16/2024
Inactive	Padilla, Erik	1214147	Agent - Casualty	9/14/2022	11/8/2022
Inactive	Padilla, Erik	1214147	Agent - Property	9/14/2022	11/8/2022
Inactive	Poynter, Gregory Allen	1025198	Agent - Casualty	8/18/2022	9/29/2022
Denied	Poynter, Gregory Allen	1025198	Agent - Health
Denied	Poynter, Gregory Allen	1025198	Agent - Life
Inactive	Poynter, Gregory Allen	1025198	Agent - Property	8/18/2022	9/29/2022
Inactive	Rigdon, Melissa Rose	676117	Agent - Casualty	4/7/2023	12/5/2024
Inactive	Rigdon, Melissa Rose	676117	Agent - Property	4/7/2023	12/5/2024
Inactive	Sarathy, Adithya	1150728	Agent - Casualty	8/18/2022	11/11/2024
Inactive	Sarathy, Adithya	1150728	Agent - Property	8/18/2022	11/11/2024
Inactive	Scott, Kesheira Shavon	764479	Agent - Casualty	8/18/2022	12/5/2024
Inactive	Scott, Kesheira Shavon	764479	Agent - Property	8/18/2022	12/5/2024
Active	Shi, Yolanda Elizabeth	1203739	Agent - Casualty	6/6/2022
Active	Shi, Yolanda Elizabeth	1203739	Agent - Health	6/6/2022
Active	Shi, Yolanda Elizabeth	1203739	Agent - Life	6/6/2022
Active	Shi, Yolanda Elizabeth	1203739	Agent - Property	6/6/2022
Inactive	Smiley, Joann L	1238853	Agent - Casualty	11/3/2022	4/19/2023
Inactive	Smiley, Joann L	1238853	Agent - Property	11/3/2022	4/19/2023
Inactive	Smith, Julia Delores	1184972	Agent - Casualty	5/22/2023	12/5/2024
Inactive	Smith, Julia Delores	1184972	Agent - Property	5/22/2023	12/5/2024