Individual Information

ADAM MICHAEL FAST

BEVERLY HILLS, CA 90212-3000

Active

adam@pacificway.net

08/16/2015

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3095712	08/16/2015	Active	08/16/2015	08/31/2027

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	08/16/2015	Active	08/16/2015
Health	08/16/2015	Active	08/16/2015
Life	08/16/2015	Active	08/16/2015
Property	08/16/2015	Active	08/16/2015

Company Name	Appointment Type	Status	Active Date
442
NATIONAL GUARDIAN LIFE INSURANCE COMPANY	Health	Active	07/26/2024
940
Company Name	Appointment Type	Status	Active Date
NATIONAL HEALTH INSURANCE COMPANY	Health	Active	09/29/2022
	Life	Active	09/29/2022
162
Company Name	Appointment Type	Status	Active Date
NATIONWIDE ASSURANCE COMPANY	Casualty	Active	06/07/2021
	Property	Active	06/07/2021
194
Company Name	Appointment Type	Status	Active Date
NATIONWIDE INSURANCE COMPANY OF AMERICA	Casualty	Active	06/07/2021
	Property	Active	06/07/2021
459
Company Name	Appointment Type	Status	Active Date
NATIONWIDE LIFE INSURANCE COMPANY	Health	Active	03/15/2021
	Life	Active	03/15/2021
1129
Company Name	Appointment Type	Status	Active Date
NATIONWIDE PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	06/07/2021
	Property	Active	06/07/2021
1776
Company Name	Appointment Type	Status	Active Date
OHIO SECURITY INSURANCE COMPANY	Casualty	Active	01/31/2023
	Property	Active	01/31/2023
1488
Company Name	Appointment Type	Status	Active Date
TRAVELERS PROPERTY CASUALTY INSURANCE COMPANY	Casualty	Active	12/08/2021
	Property	Active	12/08/2021

row(s) 1 - 15 of 15

Organization	Association Type	Type	Beg dte	End dte
ALPHA RISK & INS SERVICES INC	Designated Resp Lic Prdcr	Agency	09/15/2020	-

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