DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Grise, John M	DOIID	1141642	NAIC NPN	3478876

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	6/24/2021		11/30/2024
Active	Non Resident	Agent	Property	6/24/2021		11/30/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/24/2021		11/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2024	11/30/2024
Surplus Lines Broker	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Berkley Casualty Company	300731	Agent - Casualty	3/5/2024
Active	Berkley Casualty Company	300731	Agent - Property	3/5/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Amwins Insurance Brokerage LLC	624422	Agent - Casualty
Denied	Amwins Insurance Brokerage LLC	624422	Agent - Property
Active	Amwins Insurance Brokerage LLC	624422	Surplus Lines Broker - Not Applicable	6/29/2021