DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gysbers, Simon	DOIID	1019983	NAIC NPN	18958805

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	8/21/2019		5/31/2025
Active	Non Resident	Agent	Personal Lines	11/21/2018		5/31/2025
Active	Non Resident	Agent	Casualty	8/21/2019		5/31/2025
* 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	Essentia Insurance Company	300342	Agent - Casualty	9/10/2019	11/28/2023
Inactive	Essentia Insurance Company	300342	Agent - Personal Lines	12/6/2018	11/28/2023
Inactive	Essentia Insurance Company	300342	Agent - Property	9/10/2019	11/28/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hagerty Ins Agency LLC	541031	Agent - Personal Lines	12/6/2018	11/28/2023