Individual Information

SARAH ELIZABETH MAE STORMS

Address:

PHOENIX, AZ 85016-8202

Status:

Active

Email:

sstorms@mica-insurance.com

Date:

08/05/2016

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3175357	08/05/2016	Active	08/05/2016	08/31/2025
Non-Res. Surplus Lines Broker	3439488	05/14/2019	Active	05/14/2019	05/31/2028

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	08/05/2016	Active	08/05/2016
Health	04/08/2020	Active	04/08/2020
Life	04/08/2020	Active	04/08/2020
Property	05/14/2019	Active	05/14/2019
Surplus Lines	05/14/2019	Active	05/14/2019

Company Name	Appointment Type	Status	Active Date
117484
MUTUAL INSURANCE COMPANY OF ARIZONA	Casualty	Active	02/05/2018

row(s) 1 - 1 of 1

Organization	Association Type	Type	Beg dte	End dte
M I C A INS SERVICES INC	Designated Resp Lic Prdcr	Agency	05/21/2020	-

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