DEPARTMENT OF INSURANCE

Affiliations

Name	Quiggins, Terry Douglas	DOIID	358210	NAIC NPN	7195093

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	General Lines	6/21/1989	8/15/2000
Inactive	Resident	Agent	Casualty	10/22/2002	6/30/2013
Inactive	Resident	Agent	Health	10/22/2002	6/30/2013
Inactive	Resident	Agent	Health Maintenance Organization	5/5/1999	3/1/2001
Inactive	Resident	Agent	Property	10/22/2002	6/30/2013
Inactive	Resident	Agent	Life	10/22/2002	6/30/2013
AFFIDAVIT ON FILE
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Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Health	4/15/1998	7/1/2002
Inactive	Allianz Life Insurance Company of North America	301791	Agent - Life	4/15/1998	7/1/2002
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - General Lines	5/11/1993	12/30/1999
Inactive	American Economy Insurance Company	300315	Agent - Casualty	8/15/2000	12/26/2001
Inactive	American Economy Insurance Company	300315	Agent - General Lines	11/1/1998	8/15/2000
Inactive	American Economy Insurance Company	300315	Agent - Property	8/15/2000	12/26/2001
Inactive	American States Insurance Company	301230	Agent - Casualty	8/15/2000	12/27/2001
Inactive	American States Insurance Company	301230	Agent - General Lines	11/1/1998	8/15/2000
Inactive	American States Insurance Company	301230	Agent - Property	8/15/2000	12/27/2001
Inactive	Buckeye Union Insurance Company (The)	300597	Agent - General Lines	2/5/1997	3/31/1998
Inactive	Commercial Insurance Company of Newark, New Jersey	300328	Agent - General Lines	2/4/1997	3/31/1998
Inactive	Continental Casualty Company	301019	Agent - General Lines	5/11/1993	12/30/1999
Inactive	Continental Insurance Company (The)	301242	Agent - General Lines	1/31/1997	12/30/1999
Inactive	Fidelity and Casualty Company of New York (The)	300160	Agent - General Lines	2/3/1997	12/30/1999
Inactive	First National Insurance Company of America	301690	Agent - Casualty	8/15/2000	12/26/2001
Inactive	First National Insurance Company of America	301690	Agent - General Lines	9/23/1997	8/15/2000
Inactive	First National Insurance Company of America	301690	Agent - Property	8/15/2000	12/26/2001
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/30/2004	11/4/2004
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/30/2004	11/4/2004
Inactive	General Insurance Company of America	300261	Agent - Casualty	8/15/2000	12/26/2001
Inactive	General Insurance Company of America	300261	Agent - General Lines	9/23/1997	8/15/2000
Inactive	General Insurance Company of America	300261	Agent - Property	8/15/2000	12/26/2001
Inactive	Glens Falls Insurance Company (The)	301922	Agent - General Lines	2/1/1997	12/30/1999
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Hartford Accident and Indemnity Company	301917	Agent - General Lines	12/30/1998	8/15/2000
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	8/15/2000	7/1/2002
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	12/30/1998	8/15/2000
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	8/15/2000	7/1/2002
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Hartford Fire Insurance Company	300628	Agent - General Lines	12/30/1998	8/15/2000
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	8/15/2000	7/1/2002
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - General Lines	12/30/1998	8/15/2000
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	8/15/2000	7/1/2002
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Hartford Underwriters Insurance Company	301064	Agent - General Lines	12/30/1998	8/15/2000
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	8/15/2000	7/1/2002
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/1/2001	7/1/2002
Inactive	Humana Health Plan, Inc.	300142	Agent - Health Maintenance Organization	5/5/1999	3/1/2001
Inactive	Humana Insurance Company	301104	Agent - Health	4/16/1999	7/1/2002
Inactive	Humana Insurance Company	301104	Agent - Life	4/16/1999	7/1/2002
Inactive	Infinity Casualty Insurance Company	301280	Agent - General Lines	10/3/1990	5/13/1996
Inactive	Infinity Standard Insurance Company	301643	Agent - General Lines	6/21/1989	5/30/2000
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Health	5/28/1998	7/1/2002
Inactive	Jefferson Pilot Financial Insurance Company	300756	Agent - Life	5/28/1998	7/1/2002
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Health	2/13/1998	7/1/2002
Inactive	Jefferson-Pilot Life Insurance Company	300379	Agent - Life	2/13/1998	7/1/2002
Inactive	Kansas City Fire and Marine Insurance Company	301936	Agent - General Lines	2/4/1997	12/30/1999
Inactive	Kentucky National Insurance Company	301625	Agent - General Lines	11/17/1997	12/14/1998
Inactive	LifeUSA Insurance Company	300386	Agent - Health	4/15/1998	7/1/2002
Inactive	LifeUSA Insurance Company	300386	Agent - Life	4/15/1998	7/1/2002
Inactive	Meridian Mutual Insurance Company	301303	Agent - Casualty	8/15/2000	6/1/2001
Inactive	Meridian Mutual Insurance Company	301303	Agent - General Lines	5/11/1993	8/15/2000
Inactive	Meridian Mutual Insurance Company	301303	Agent - Property	8/15/2000	6/1/2001
Inactive	National Fire Insurance Company of Hartford	301063	Agent - General Lines	5/11/1993	12/30/1999
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Ohio Casualty Insurance Company	301492	Agent - General Lines	4/29/1993	8/15/2000
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	8/15/2000	7/1/2002
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Ohio Security Insurance Company	300622	Agent - General Lines	10/1/1999	8/15/2000
Inactive	Ohio Security Insurance Company	300622	Agent - Property	8/15/2000	7/1/2002
Inactive	Paul Revere Life Insurance Company	300971	Agent - Health	4/13/1998	8/24/2000
Inactive	Paul Revere Life Insurance Company	300971	Agent - Life	4/13/1998	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Health	4/13/1998	8/24/2000
Inactive	Provident Life and Accident Insurance Company	301525	Agent - Life	4/13/1998	8/24/2000
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	8/15/2000	12/27/2001
Inactive	SAFECO Insurance Company of America	300159	Agent - General Lines	9/23/1997	8/15/2000
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	8/15/2000	12/27/2001
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	8/15/2000	12/26/2001
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - General Lines	9/23/1997	8/15/2000
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	8/15/2000	12/26/2001
Inactive	SAFECO National Insurance Company	300989	Agent - Casualty	8/15/2000	12/26/2001
Inactive	SAFECO National Insurance Company	300989	Agent - General Lines	9/23/1997	8/15/2000
Inactive	SAFECO National Insurance Company	300989	Agent - Property	8/15/2000	12/26/2001
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Health	6/1/1994	7/1/2002
Inactive	Security-Connecticut Life Insurance Company	300316	Agent - Life	6/1/1994	7/1/2002
Inactive	Shelby Casualty Insurance Company	301806	Agent - General Lines	4/27/1993	3/31/1996
Inactive	Southland Life Insurance Company	301175	Agent - Life	3/30/1998	7/1/2002
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	6/1/2001	7/1/2002
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	6/1/2001	7/1/2002
Inactive	Transcontinental Insurance Company	301731	Agent - General Lines	5/11/1993	12/30/1999
Inactive	Transportation Insurance Company	301575	Agent - General Lines	5/11/1993	12/30/1999
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Twin City Fire Insurance Company	300721	Agent - General Lines	12/30/1998	8/15/2000
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	8/15/2000	7/1/2002
Inactive	Valley Forge Insurance Company	301052	Agent - General Lines	5/11/1993	12/30/1999

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arison Insurance Services, Inc.	401001	Agent - Life	6/10/1998	7/1/2002
Inactive	Arison Insurance Services, Inc.	401001	Agent - Health	6/10/1998	7/1/2002
Inactive	Independent Agents, Inc	398496	Agent - General Lines	3/7/1994	8/15/2000
Inactive	Independent Agents, Inc	398496	Agent - Life	3/7/1994	7/1/2002
Inactive	Independent Agents, Inc	398496	Agent - Health	3/7/1994	7/1/2002
Inactive	Independent Agents, Inc	398496	Agent - Property	8/15/2000	7/1/2002
Inactive	Independent Agents, Inc	398496	Agent - Casualty	8/15/2000	7/1/2002
Inactive	New Independent Agents of Bardstown	398673	Agent - Life	6/24/1998	7/24/1998
Inactive	New Independent Agents of Bardstown	398673	Agent - Health	6/24/1998	7/24/1998
Inactive	New Independent Agents of Bardstown Inc.	399949	Agent - General Lines	10/20/1997	8/15/2000
Inactive	New Independent Agents of Bardstown Inc.	399949	Agent - Life	5/8/1998	7/1/2002
Inactive	New Independent Agents of Bardstown Inc.	399949	Agent - Health	5/8/1998	7/1/2002
Inactive	New Independent Agents of Bardstown Inc.	399949	Agent - Property	8/15/2000	7/1/2002
Inactive	New Independent Agents of Bardstown Inc.	399949	Agent - Casualty	8/15/2000	7/1/2002
Inactive	Sterling G. Thompson Co.	399153	Agent - Property	5/17/2002	7/1/2002
Inactive	Sterling G. Thompson Co.	399153	Agent - Casualty	5/17/2002	7/1/2002