DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gossett, Clinton J	DOIID	1083506	NAIC NPN	19489093

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Casualty	6/30/2020		8/31/2026
Active	Resident	Agent	Property	6/29/2020		8/31/2026
Inactive	Resident	Temporary Agent	Property	6/10/2020	6/30/2020
Inactive	Resident	Temporary Agent	Casualty	6/10/2020	6/30/2020
* 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
Active	Church Mutual Insurance Company, S.I.	301554	Agent - Casualty	6/30/2020
Active	Church Mutual Insurance Company, S.I.	301554	Agent - Property	6/29/2020
Inactive	Church Mutual Insurance Company, S.I.	301554	Temporary Agent - Casualty	6/10/2020	6/30/2020
Inactive	Church Mutual Insurance Company, S.I.	301554	Temporary Agent - Property	6/10/2020	6/30/2020
Inactive	ClearPath Insurance Company	979815	Agent - Casualty	10/17/2023	1/9/2025
Active	MGT Insurance Company	970661	Agent - Casualty	7/13/2020
Active	MGT Insurance Company	970661	Agent - Property	7/13/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	C M I C Specialty Services Inc	645077	Agent - Casualty	6/7/2022
Active	C M I C Specialty Services Inc	645077	Agent - Property	6/7/2022