DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Nelson, Glendon Dale	DOIID	759552	NAIC NPN	12654039

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	2/17/2022		8/31/2025
Active	Non Resident	Agent	Property	2/17/2022		8/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/9/2023		8/31/2025
* 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	06/15/2025	08/31/2025
Surplus Lines Broker	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/27/2016	5/21/2020
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/27/2016	5/21/2020
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	1/27/2016	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	1/27/2016	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	1/27/2016	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	1/27/2016	8/29/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Icon Insurance Programs, LLC	1380499	Agent - Property	1/15/2025
Active	Icon Insurance Programs, LLC	1380499	Agent - Casualty	1/15/2025
Inactive	M & O Agencies Inc	551220	Surplus Lines Broker - Not Applicable	6/5/2015	4/8/2020