Agency Information

MARY JANE LAKE INSURANCE

1544 US HIGHWAY 395 N STE 5

GARDNERVILLE, NV 89410-5231

775-782-2469

mjlakeinsurance@aol.com

7897807

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Resident Producer Firm	11012	05/01/2002	Active	08/17/2005	08/31/2023

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	05/01/2002	Active	08/17/2005
Health	05/01/2002	Active	08/17/2005
Life	05/01/2002	Active	08/17/2005
Property	05/01/2002	Active	08/17/2005

Company Name	Appointment Type	Status	Active Date
1795
AMERICAN MODERN PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	07/09/2018
	Property	Active	07/09/2018
1639
Company Name	Appointment Type	Status	Active Date
COAST NATIONAL INSURANCE COMPANY	Casualty	Active	09/15/2010
230
Company Name	Appointment Type	Status	Active Date
FARMERS INSURANCE EXCHANGE	Casualty	Active	09/10/2017
	Property	Active	09/10/2017
231
Company Name	Appointment Type	Status	Active Date
FARMERS NEW WORLD LIFE INSURANCE COMPANY	Health	Active	08/17/2005
	Life	Active	08/17/2005
247
Company Name	Appointment Type	Status	Active Date
FIRE INSURANCE EXCHANGE FIRE UNDERWRITERS ASSOCIATION	Casualty	Active	09/10/2017
	Property	Active	09/10/2017
261
Company Name	Appointment Type	Status	Active Date
FOREMOST INSURANCE COMPANY GRAND RAPIDS MICHIGAN	Casualty	Active	09/15/2010
	Property	Active	09/15/2010
1281
Company Name	Appointment Type	Status	Active Date
HOMESITE INSURANCE COMPANY	Casualty	Active	08/30/2022
	Property	Active	08/30/2022
405
Company Name	Appointment Type	Status	Active Date
MID-CENTURY INSURANCE COMPANY	Casualty	Active	09/10/2017
	Property	Active	09/10/2017
656
Company Name	Appointment Type	Status	Active Date
TRUCK INSURANCE EXCHANGE	Casualty	Active	09/10/2017
	Property	Active	09/10/2017
724
Company Name	Appointment Type	Status	Active Date
WESTERN SURETY COMPANY	Casualty	Active	10/03/2017

row(s) 1 - 18 of 18

Name	Association Type	Agent	Begin Date	End Date
MARY JANE LAKE	Designated Resp Lic Prdcr	Yes	09/16/2020	-

1 - 1