DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gallina, Dominic Angelo	DOIID	1410966	NAIC NPN	7559059

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/16/2025		9/30/2026
Active	Non Resident	Agent	Property	7/16/2025		9/30/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/18/2025		9/30/2026
* 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	07/15/2026	09/30/2026
Surplus Lines Broker	07/15/2026	09/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	7/28/2025
Active	American Guarantee and Liability Insurance Company	301216	Agent - Property	7/28/2025
Active	American Zurich Insurance Company	300592	Agent - Casualty	7/28/2025
Active	American Zurich Insurance Company	300592	Agent - Property	7/28/2025
Active	Zurich American Insurance Company	301121	Agent - Casualty	7/28/2025
Active	Zurich American Insurance Company	301121	Agent - Property	7/28/2025
Active	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	7/28/2025
Active	Zurich American Insurance Company of Illinois	301805	Agent - Property	7/28/2025

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Willis Towers Watson Southeast Inc	399919	Agent - Casualty	8/1/2025
Active	Willis Towers Watson Southeast Inc	399919	Agent - Property	8/1/2025
Active	Willis Towers Watson Southeast Inc	399919	Surplus Lines Broker - Not Applicable	8/1/2025