DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Klevens, Shereen Nicole	DOIID	642115	NAIC NPN	8570672

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	10/13/2006	8/31/2008
Active	Non Resident	Agent	Property	1/7/2022		8/31/2024
Active	Non Resident	Agent	Casualty	1/7/2022		8/31/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/15/2022		8/31/2024
* 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	06/15/2024	08/31/2024
Surplus Lines Broker	06/15/2024	08/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Zurich American Insurance Company	301121	Agent - Casualty	1/18/2022
Active	Zurich American Insurance Company	301121	Agent - Property	1/18/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Willis Towers Watson Southeast Inc	399919	Agent - Casualty	2/1/2022
Active	Willis Towers Watson Southeast Inc	399919	Agent - Property	2/1/2022
Active	Willis Towers Watson Southeast Inc	399919	Surplus Lines Broker - Not Applicable	2/1/2022