DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Frederick, Simone	DOIID	866762	NAIC NPN	17475005

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	1/23/2015	8/31/2017
Inactive	Non Resident	Agent	Casualty	1/23/2015	8/31/2017
* 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	Arch Insurance Company	300688	Agent - Casualty	4/14/2015	5/15/2017
Inactive	Arch Insurance Company	300688	Agent - Property	4/14/2015	5/15/2017
Inactive	Argonaut Insurance Company	301422	Agent - Casualty	5/23/2016	8/31/2017
Inactive	Argonaut Insurance Company	301422	Agent - Property	5/23/2016	8/31/2017
Inactive	Atlantic Specialty Insurance Company	518595	Agent - Casualty	5/2/2017	5/11/2017
Inactive	Atlantic Specialty Insurance Company	518595	Agent - Property	5/2/2017	5/11/2017
Inactive	Evergreen National Indemnity Company	300146	Agent - Casualty	8/3/2015	5/17/2017
Inactive	Evergreen National Indemnity Company	300146	Agent - Property	8/3/2015	5/17/2017
Inactive	Ohio Indemnity Company	301745	Agent - Casualty	8/13/2015	5/17/2017
Inactive	Ohio Indemnity Company	301745	Agent - Property	8/13/2015	5/17/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	4/14/2015	5/9/2017
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	4/14/2015	5/9/2017