black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

ZACK SCOTT FORTMAN

PRODUCER NON-RESIDENT

License Number:
PRN386829
Status:
First Licensure:
06/25/2021
Cancel Date:
None

Mailing:
OTTAWA, OH 45875
Phone:
+1 (419) 523-4500 x630
Fax:
+1 (419) 523-0045
Email:
zfortman@fortmanins.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 06/25/2021

Agency

Name Issue Date License Number Expiration Date Cancel Date
FORTMAN INSURANCE SERVICES LLC
02/13/2023 AGN378786 06/30/2025

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLIED INSURANCE COMPANY OF AMERICA
10/08/2021 PCF216138
ALLIED PROPERTY AND CASUALTY INSURANCE COMPANY
10/08/2021 PCF223935
AMCO INSURANCE COMPANY
10/08/2021 PCF223938
DEPOSITORS INSURANCE COMPANY
10/08/2021 PCF223940
NATIONWIDE AGRIBUSINESS INSURANCE COMPANY
10/08/2021 PCF151937
NATIONWIDE ASSURANCE COMPANY
10/08/2021 PCF38952
NATIONWIDE GENERAL INSURANCE COMPANY
10/08/2021 PCF30
NATIONWIDE INSURANCE COMPANY OF AMERICA
10/08/2021 PCF422 07/09/2025
NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
10/08/2021 PCF31 01/01/2023
NATIONWIDE MUTUAL INSURANCE COMPANY
10/08/2021 PCF32
NATIONWIDE PROPERTY & CASUALTY INSURANCE COMPANY
10/08/2021 PCF151089

Authority

Description Issue Date Termination Date Status
CASUALTY 06/25/2021 Active
PROPERTY 06/25/2021 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
16161650

Other Addresses

Address Type
614 N PERRY ST
OTTAWA, OH 45875-1337
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 10/06/2025 04:01:27 AM