PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NamePrivate Client Select Insurance Services LLCDOIID1242047NAIC NPN20516454
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentProperty11/13/2022 3/31/2026
ActiveNon ResidentAgentCasualty11/13/2022 3/31/2026
ActiveNon ResidentIndependent AdjusterProperty & Casualty11/21/2022 3/31/2026
ActiveNon ResidentManaging General AgentNot Applicable1/31/2024 3/31/2026
ActiveNon ResidentSurplus Lines BrokerNot Applicable11/13/2022 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
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent01/15/202603/31/2026   
Independent Adjuster01/15/202603/31/2026   
Managing General Agent01/15/202603/31/2026   
Surplus Lines Broker01/15/202603/31/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveAIG Property Casualty Company300621Agent - Casualty1/26/2023 
ActiveAIG Property Casualty Company300621Agent - Property1/26/2023 
ActiveAmerican Home Assurance Company300246Agent - Casualty1/26/2023 
ActiveAmerican Home Assurance Company300246Agent - Property1/26/2023 
ActiveCommerce and Industry Insurance Company300881Agent - Casualty1/26/2023 
ActiveCommerce and Industry Insurance Company300881Agent - Property1/26/2023 
ActiveGranite State Insurance Company300818Agent - Casualty1/26/2023 
ActiveGranite State Insurance Company300818Agent - Property1/26/2023 
ActiveIllinois National Insurance Company301367Agent - Casualty1/26/2023 
ActiveIllinois National Insurance Company301367Agent - Property1/26/2023 
ActiveInsurance Company of the State of Pennsylvania300807Agent - Casualty1/26/2023 
ActiveInsurance Company of the State of Pennsylvania300807Agent - Property1/26/2023 
ActiveNew Hampshire Insurance Company301670Agent - Casualty10/3/2024 
ActiveNew Hampshire Insurance Company301670Agent - Property10/3/2024 
Designated Individuals
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveBayram, Marc Anthony 896756Agent - Casualty11/13/2022 
ActiveBayram, Marc Anthony 896756Agent - Property11/13/2022 
InactiveBazan, Brian C 1207681Agent - Casualty2/21/20245/23/2024
InactiveBazan, Brian C 1207681Agent - Property2/21/20245/23/2024
InactiveBazan, Brian C 1207681Surplus Lines Broker - Not Applicable2/21/202412/23/2024
ActiveBlohm, Frederick George 732753Independent Adjuster - Property & Casualty11/21/2022 
InactiveBradley, Vanessa 654543Agent - Casualty2/21/20245/14/2024
InactiveBradley, Vanessa 654543Agent - Property2/21/20245/14/2024
InactiveCarlisle, Janine V 860419Agent - Casualty2/21/202412/3/2024
InactiveCarlisle, Janine V 860419Agent - Property2/21/202412/3/2024
ActiveColon, Gail Allen 831419Agent - Casualty11/13/2022 
ActiveColon, Gail Allen 831419Agent - Casualty1/31/2024 
ActiveColon, Gail Allen 831419Agent - Property11/13/2022 
ActiveColon, Gail Allen 831419Agent - Property1/31/2024 
ActiveColon, Gail Allen 831419Surplus Lines Broker - Not Applicable11/13/2022 
ActiveDelffs, Patricia Anne 877894Agent - Casualty2/21/2024 
ActiveDelffs, Patricia Anne 877894Agent - Property2/21/2024 
InactiveEiring, Carla Bisgaard 1180896Agent - Casualty2/21/202411/1/2024
InactiveEiring, Carla Bisgaard 1180896Agent - Property2/21/202411/1/2024
InactiveEiring, Carla Bisgaard 1180896Surplus Lines Broker - Not Applicable2/21/202411/1/2024
ActiveGouwens, Patrick Robert 374260Independent Adjuster - Property & Casualty12/13/2023 
DeniedHuntley, Guy M 1303047Agent - Casualty  
DeniedHuntley, Guy M 1303047Agent - Property  
ActiveHuntley, Guy M 1303047Surplus Lines Broker - Not Applicable2/21/2024 
ActiveKean, Lana Doucet 873289Agent - Casualty2/21/2024 
ActiveKean, Lana Doucet 873289Agent - Property2/21/2024 
ActiveMoore, Kelly J 878057Agent - Casualty2/21/2024 
ActiveMoore, Kelly J 878057Agent - Property2/21/2024 
ActiveSaxon, Mary Kay 506862Agent - Casualty12/23/2024 
ActiveSaxon, Mary Kay 506862Agent - Property12/23/2024 
ActiveWeinberger, Sandra Jean 877908Agent - Casualty2/21/2024 
ActiveWeinberger, Sandra Jean 877908Agent - Property2/21/2024 

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