Agency Information

CLARK INSURANCE

1945 CONGRESS ST BLDG A

PORTLAND, ME 4102-1903

207-774-6257

strottier@clarkinsurance.com

686188

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	865172	02/06/2013	Active	11/26/2018	11/30/2024
Non-Res. Surplus Lines Broker	3645679	03/19/2021	Active	03/19/2021	03/31/2024

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	02/06/2013	Active	11/26/2018
Property	02/06/2013	Active	11/26/2018
Surplus Lines	03/19/2021	Active	03/19/2021

Company Name	Appointment Type	Status	Active Date
288
GREAT AMERICAN INSURANCE COMPANY	Casualty	Active	11/03/2021
	Property	Active	11/03/2021
18015
Company Name	Appointment Type	Status	Active Date
MEMIC INDEMNITY COMPANY	Casualty	Active	01/02/2019
608
Company Name	Appointment Type	Status	Active Date
STANDARD FIRE INSURANCE COMPANY (THE)	Casualty	Active	01/30/2019
	Property	Active	01/30/2019
4
Company Name	Appointment Type	Status	Active Date
TRAVELERS CASUALTY AND SURETY COMPANY	Casualty	Active	01/30/2019
	Property	Active	01/30/2019
1054
Company Name	Appointment Type	Status	Active Date
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA	Casualty	Active	11/11/2020
	Property	Active	11/11/2020
650
Company Name	Appointment Type	Status	Active Date
TRAVELERS INDEMNITY COMPANY (THE)	Casualty	Active	01/30/2019
	Property	Active	01/30/2019

row(s) 1 - 11 of 11

Name	Association Type	Agent	Begin Date	End Date
JEFFREY ADAM LIND	Designated Resp Lic Prdcr	Yes	06/12/2020	-

1 - 1