DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Street, Jacob	DOIID	957035	NAIC NPN	18384480

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	6/12/2017	7/31/2018
Inactive	Non Resident	Agent	Property	6/12/2017	7/31/2018
* 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	Midvale Indemnity Company	300292	Agent - Casualty	7/18/2017	7/31/2018
Inactive	Midvale Indemnity Company	300292	Agent - Property	7/18/2017	7/31/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Geico Insurance Agency, LLC	558517	Agent - Property	7/19/2017	6/15/2018
Inactive	Geico Insurance Agency, LLC	558517	Agent - Casualty	7/19/2017	6/15/2018