Individual Information

JERRY W CLEMENS

PARSONS, KS 67357-3123

Active

jerry@clemensinsurance.net

05/20/2020

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3545117	05/20/2020	Active	05/20/2020	05/31/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	05/20/2020	Active	05/20/2020
Property	05/20/2020	Active	05/20/2020

Company Name	Appointment Type	Status	Active Date
11671
MITSUI SUMITOMO INSURANCE COMPANY OF AMERICA	Casualty	Active	09/01/2022
	Property	Active	09/01/2022
1096
Company Name	Appointment Type	Status	Active Date
MITSUI SUMITOMO INSURANCE USA INC	Casualty	Active	09/01/2022
	Property	Active	09/01/2022
119026
Company Name	Appointment Type	Status	Active Date
NORTH POINTE INSURANCE COMPANY	Casualty	Active	01/30/2025
	Property	Active	01/30/2025
1776
Company Name	Appointment Type	Status	Active Date
OHIO SECURITY INSURANCE COMPANY	Casualty	Active	03/03/2025
	Property	Active	03/03/2025
983
Company Name	Appointment Type	Status	Active Date
PRAETORIAN INSURANCE COMPANY	Casualty	Active	01/30/2025
	Property	Active	01/30/2025
1302
Company Name	Appointment Type	Status	Active Date
PROGRESSIVE NORTHERN INSURANCE COMPANY	Casualty	Active	07/03/2021
	Property	Active	07/03/2021
1199
Company Name	Appointment Type	Status	Active Date
QBE INSURANCE CORPORATION	Casualty	Active	01/30/2025
	Property	Active	01/30/2025
608
Company Name	Appointment Type	Status	Active Date
STANDARD FIRE INSURANCE COMPANY (THE)	Casualty	Active	05/24/2021
	Property	Active	05/24/2021
1488
Company Name	Appointment Type	Status	Active Date
TRAVELERS PROPERTY CASUALTY INSURANCE COMPANY	Casualty	Active	10/12/2020
	Property	Active	10/12/2020
1399
Company Name	Appointment Type	Status	Active Date
U S SPECIALTY INSURANCE COMPANY	Casualty	Active	06/12/2023
	Property	Active	06/12/2023
1261
Company Name	Appointment Type	Status	Active Date
UNITED FINANCIAL CASUALTY COMPANY	Casualty	Active	07/03/2021
	Property	Active	07/03/2021

row(s) 1 - 22 of 22

Organization	Association Type	Type	Beg dte	End dte
CLEMENS INSURANCE AGENCY LLC -000	Designated Resp Lic Prdcr	Agency	05/22/2020	-

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