DEPARTMENT OF INSURANCE

Affiliations

Name	Siebner, Wayne C	DOIID	372762	NAIC NPN	374575

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	4/23/2008	8/31/2012
Inactive	Non Resident	Agent	Casualty	4/23/2008	8/31/2012
Inactive	Non Resident	Agent	General Lines	12/5/1994	8/15/2000
Inactive	Non Resident	Agent	Personal Lines	4/23/2008	8/31/2012
* 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
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	8/15/2000	10/31/2004
Inactive	Hartford Accident and Indemnity Company	301917	Agent - General Lines	2/23/1996	8/15/2000
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	8/15/2000	10/31/2004
Inactive	Hartford Casualty Insurance Company	301332	Agent - Casualty	8/15/2000	10/31/2004
Inactive	Hartford Casualty Insurance Company	301332	Agent - General Lines	2/23/1996	8/15/2000
Inactive	Hartford Casualty Insurance Company	301332	Agent - Property	8/15/2000	10/31/2004
Inactive	Hartford Fire Insurance Company	300628	Agent - Casualty	8/15/2000	10/31/2004
Inactive	Hartford Fire Insurance Company	300628	Agent - General Lines	2/23/1996	8/15/2000
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	8/15/2000	10/31/2004
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Casualty	8/15/2000	10/31/2004
Inactive	Hartford Underwriters Insurance Company	301064	Agent - General Lines	1/10/1996	8/15/2000
Inactive	Hartford Underwriters Insurance Company	301064	Agent - Property	8/15/2000	10/31/2004
Inactive	Pie Insurance Company (The)	300514	Agent - Casualty	3/23/2001	10/31/2004
Inactive	Pie Insurance Company (The)	300514	Agent - Property	3/23/2001	10/31/2004
Inactive	Twin City Fire Insurance Company	300721	Agent - Casualty	8/15/2000	10/31/2004
Inactive	Twin City Fire Insurance Company	300721	Agent - General Lines	1/10/1996	8/15/2000
Inactive	Twin City Fire Insurance Company	300721	Agent - Property	8/15/2000	10/31/2004
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	8/15/2000	10/31/2004
Inactive	Zurich American Insurance Company	301121	Agent - General Lines	12/5/1994	8/15/2000
Inactive	Zurich American Insurance Company	301121	Agent - Property	8/15/2000	10/31/2004

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority
Denied	Arthur J. Gallagher & Co. of New York, Inc.	570065	Agent - Property
Denied	Arthur J. Gallagher & Co. of New York, Inc.	570065	Agent - Casualty
Denied	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property
Denied	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty