Agency Information

PROVENCE FINANCIAL & INSURANCE SERVICES

9355 E STOCKTON BLVD

ELK GROVE, CA 95624

866-777-1035

insurancelicensing@acrisure.com

18274464

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	3214902	01/17/2017	Active	01/17/2017	01/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	01/17/2017	Active	01/17/2017
Health	07/26/2018	Active	07/26/2018
Life	07/26/2018	Active	07/26/2018
Property	01/17/2017	Active	01/17/2017

Company Name	Appointment Type	Status	Active Date
1717
AMERICAN CONTRACTORS INDEMNITY COMPANY	Casualty	Active	07/13/2018
1795
Company Name	Appointment Type	Status	Active Date
AMERICAN MODERN PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	03/11/2019
	Property	Active	03/11/2019
1779
Company Name	Appointment Type	Status	Active Date
EMPLOYERS INSURANCE COMPANY OF NEVADA	Casualty	Active	11/24/2020
310
Company Name	Appointment Type	Status	Active Date
HARTFORD LIFE AND ACCIDENT INSURANCE COMPANY	Health	Active	06/24/2021
	Life	Active	06/24/2021
1379
Company Name	Appointment Type	Status	Active Date
HOMETOWN HEALTH PLAN INCORPORATED	Health	Active	10/15/2018
995
Company Name	Appointment Type	Status	Active Date
HOMETOWN HEALTH PROVIDERS INSURANCE COMPANY	Health	Active	10/15/2018
1295
Company Name	Appointment Type	Status	Active Date
PHILADELPHIA INDEMNITY INSURANCE COMPANY	Casualty	Active	08/08/2019
	Property	Active	08/08/2019
1550
Company Name	Appointment Type	Status	Active Date
PROMINENCE HEALTHFIRST	Health	Active	10/16/2022
1792
Company Name	Appointment Type	Status	Active Date
PROMINENCE PREFERRED HEALTH INSURANCE COMPANY INC	Health	Active	10/16/2022
1399
Company Name	Appointment Type	Status	Active Date
U S SPECIALTY INSURANCE COMPANY	Casualty	Active	07/13/2018
1667
Company Name	Appointment Type	Status	Active Date
UNITED CONCORDIA INSURANCE COMPANY	Health	Active	08/01/2018

row(s) 1 - 14 of 14

Name	Association Type	Agent	Begin Date	End Date
JULIE ANN BAKER	Designated Resp Lic Prdcr	Yes	06/01/2020	-
MARIE DEBRA SCHRYER	Designated Resp Lic Prdcr	Yes	01/14/2021	-

1 - 2