DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Burchfield, Jevan Brady	DOIID	559857	NAIC NPN	7313761

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	4/22/2004	11/12/2004
Inactive	Non Resident	Agent	Casualty	4/22/2004	11/12/2004
* 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	Dairyland Insurance Company	301370	Agent - Casualty	5/26/2004	11/12/2004
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/15/2004	11/12/2004
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/15/2004	11/12/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Harley-Davidson Ins Services Inc	545855	Agent - Casualty	8/5/2003	9/24/2003
Inactive	Harley-Davidson Ins Services Inc	545855	Agent - Property	8/5/2003	9/24/2003