DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Grandison, Thomas Adam	DOIID	1146867	NAIC NPN	19969896

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/26/2021		12/31/2025
Active	Non Resident	Agent	Property	7/26/2021		12/31/2025
* 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
Active	Independence American Insurance Company	524747	Agent - Casualty	9/10/2023
Active	Independence American Insurance Company	524747	Agent - Property	9/10/2023
Active	United States Fire Insurance Company	582240	Agent - Casualty	7/29/2021
Active	United States Fire Insurance Company	582240	Agent - Property	7/29/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	PTZ Insurance Agency LTD	695420	Agent - Casualty	12/6/2022
Active	PTZ Insurance Agency LTD	695420	Agent - Property	12/6/2022