DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dougherty, Jeffrey Scott	DOIID	1017972	NAIC NPN	18963617

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	11/5/2018	11/13/2019
Inactive	Non Resident	Agent	Casualty	11/5/2018	11/13/2019
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	2/13/2019	11/13/2019
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	11/13/2018	11/13/2019
Inactive	Zurich American Insurance Company	301121	Agent - Property	11/13/2018	11/13/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Ins Services Of Georgia Inc	549678	Agent - Casualty	11/14/2018	10/14/2019
Inactive	Willis Ins Services Of Georgia Inc	549678	Agent - Property	11/14/2018	10/14/2019
Inactive	Willis Ins Services Of Georgia Inc	549678	Surplus Lines Broker - Not Applicable	3/7/2019	10/14/2019