Individual Information

ROBERT N CLARK

KIRKLAND, WA 98033-4968

Active

licensing@choiceinsurance.net

04/27/2007

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	536593	04/27/2007	Active	04/27/2007	04/30/2028

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	04/27/2007	Active	04/27/2007
Health	04/27/2007	Active	04/27/2007
Life	04/27/2007	Active	04/27/2007
Property	04/27/2007	Active	04/27/2007

Company Name	Appointment Type	Status	Active Date
34
AMERICAN ECONOMY INSURANCE COMPANY	Casualty	Active	02/13/2023
	Property	Active	02/13/2023
11242
Company Name	Appointment Type	Status	Active Date
INDEPENDENCE AMERICAN INSURANCE COMPANY	Casualty	Active	10/28/2024
1776
Company Name	Appointment Type	Status	Active Date
OHIO SECURITY INSURANCE COMPANY	Casualty	Active	09/21/2023
	Property	Active	09/21/2023
1488
Company Name	Appointment Type	Status	Active Date
TRAVELERS PROPERTY CASUALTY INSURANCE COMPANY	Casualty	Active	05/25/2020
	Property	Active	05/25/2020
692
Company Name	Appointment Type	Status	Active Date
UNITED STATES FIRE INSURANCE COMPANY	Casualty	Active	11/08/2019
	Property	Active	11/08/2019
693
Company Name	Appointment Type	Status	Active Date
UNITED STATES LIABILITY INSURANCE COMPANY	Casualty	Active	01/12/2011
	Property	Active	01/12/2011

row(s) 1 - 11 of 11

Organization	Association Type	Type	Beg dte	End dte
CHOICE INS LLC	Designated Resp Lic Prdcr	Agency	10/16/2020	-

1 - 1