Agency Information

643 INSURANCE, LLC

1794 E SCORPIO PLACE

CHANDLER, AZ 85249

480-209-5401

jonathan@643insurance.com

20084947

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res. Producer Firm	4014724	06/06/2024	Active	06/06/2024	06/30/2027

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	06/06/2024	Active	06/06/2024
Property	06/06/2024	Active	06/06/2024

Company Name	Appointment Type	Status	Active Date
1795
AMERICAN MODERN PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	06/12/2024
	Property	Active	06/12/2024
97
Company Name	Appointment Type	Status	Active Date
AUTOMOBILE INSURANCE COMPANY OF HARTFORD CONNECTICUT (THE)	Casualty	Active	06/25/2024
	Property	Active	06/25/2024
1639
Company Name	Appointment Type	Status	Active Date
COAST NATIONAL INSURANCE COMPANY	Casualty	Active	07/02/2024
261
Company Name	Appointment Type	Status	Active Date
FOREMOST INSURANCE COMPANY GRAND RAPIDS MICHIGAN	Casualty	Active	07/02/2024
	Property	Active	07/02/2024
608
Company Name	Appointment Type	Status	Active Date
STANDARD FIRE INSURANCE COMPANY (THE)	Casualty	Active	06/25/2024
	Property	Active	06/25/2024
12823
Company Name	Appointment Type	Status	Active Date
STILLWATER INSURANCE COMPANY	Casualty	Active	08/16/2024
	Property	Active	08/16/2024
16332
Company Name	Appointment Type	Status	Active Date
TRAVELERS HOME AND MARINE INSURANCE COMPANY( THE)	Casualty	Active	06/25/2024
	Property	Active	06/25/2024
651
Company Name	Appointment Type	Status	Active Date
TRAVELERS INDEMNITY COMPANY OF AMERICA (THE)	Casualty	Active	06/25/2024
	Property	Active	06/25/2024
1488
Company Name	Appointment Type	Status	Active Date
TRAVELERS PROPERTY CASUALTY INSURANCE COMPANY	Casualty	Active	06/25/2024
	Property	Active	06/25/2024

row(s) 1 - 17 of 17

Name	Association Type	Agent	Begin Date	End Date
JESSICA RAE GEPHART	Designated Resp Lic Prdcr	No	06/06/2024	-

1 - 1