DEPARTMENT OF INSURANCE

Affiliations

Name	Gallagher Affinity Insurance Services, Inc.	DOIID	397758	NAIC NPN	1499729

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	12/30/1987	3/31/2027
Active	Non Resident	Agent	Casualty	5/13/2014	3/31/2027
Active	Non Resident	Agent	Life	4/19/2004	3/31/2027
Active	Non Resident	Agent	Health	4/19/2004	3/31/2027
Active	Non Resident	Agent	Property	5/13/2014	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/31/2024	3/31/2027
* 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	ACE American Insurance Company	300625	Agent - Health	3/6/2016
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Casualty	1/8/2025
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Property	1/8/2025
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	1/8/2025
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	1/8/2025
Active	American Contractors Indemnity Company	536843	Agent - Casualty	10/3/2023
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	12/4/2023	3/29/2024
Inactive	American Fire and Casualty Company	300567	Agent - Property	12/4/2023	3/29/2024
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	7/22/2010	6/15/2011
Active	American Guarantee and Liability Insurance Company	301216	Agent - Health	5/3/2024
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	7/22/2010	6/15/2011
Inactive	American States Insurance Company	301230	Agent - Casualty	12/4/2023	3/29/2024
Inactive	American States Insurance Company	301230	Agent - Property	12/4/2023	3/29/2024
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	11/18/2011	4/4/2014
Active	American Zurich Insurance Company	300592	Agent - Health	5/3/2024
Inactive	American Zurich Insurance Company	300592	Agent - Property	11/18/2011	4/4/2014
Active	Arch Indemnity Insurance Company	301459	Agent - Casualty	8/1/2023
Active	Arch Indemnity Insurance Company	301459	Agent - Property	8/1/2023
Active	Arch Insurance Company	300688	Agent - Casualty	8/1/2023
Active	Arch Insurance Company	300688	Agent - Property	8/1/2023
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Health	3/11/2009	12/10/2014
Inactive	Athene Annuity & Life Assurance Company	301798	Agent - Life	3/11/2009	12/10/2014
Active	Capitol Indemnity Corporation	301030	Agent - Casualty	3/29/2024
Active	Companion Life Insurance Company	300191	Agent - Health	10/21/2024
Active	Companion Life Insurance Company	300191	Agent - Life	10/21/2024
Active	CorePointe Insurance Company	300406	Agent - Casualty	12/20/2023
Active	CorePointe Insurance Company	300406	Agent - Property	12/20/2023
Active	Developers Surety and Indemnity Company	516432	Agent - Casualty	12/20/2023
Active	Employers Assurance Company	300120	Agent - Casualty	5/29/2024
Active	Employers Compensation Insurance Company	797885	Agent - Casualty	5/29/2024
Active	Employers Preferred Insurance Company	520656	Agent - Casualty	5/29/2024
Active	Everest Reinsurance Company	301836	Agent - Health	9/26/2024
Active	Federal Insurance Company	301144	Agent - Health	4/8/2014
Inactive	General Insurance Company of America	300261	Agent - Casualty	12/4/2023	3/29/2024
Inactive	General Insurance Company of America	300261	Agent - Property	12/4/2023	3/29/2024
Active	General Security National Insurance Company	301484	Agent - Casualty	10/30/2023
Active	General Security National Insurance Company	301484	Agent - Health	10/30/2023
Active	General Security National Insurance Company	301484	Agent - Property	10/30/2023
Inactive	Gerber Life Insurance Company	300529	Agent - Health	2/23/2011	3/4/2014
Inactive	Gerber Life Insurance Company	300529	Agent - Life	2/23/2011	3/4/2014
Active	Great American Insurance Company	301586	Agent - Casualty	9/14/2023
Active	Great American Insurance Company	301586	Agent - Property	9/14/2023
Active	HDI Global Insurance Company	676678	Agent - Casualty	11/13/2023
Active	HDI Global Insurance Company	676678	Agent - Property	11/13/2023
Active	Hanover American Insurance Company (The)	300447	Agent - Casualty	1/8/2025
Active	Hanover American Insurance Company (The)	300447	Agent - Property	1/8/2025
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	1/8/2025
Active	Hanover Insurance Company (The)	300508	Agent - Property	1/8/2025
Active	Harco National Insurance Company	300706	Agent - Casualty	7/26/2024
Active	Hartford Life and Accident Insurance Company	300878	Agent - Health	4/12/2024
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	4/12/2024
Active	Hudson Insurance Company	523144	Agent - Casualty	2/9/2024
Active	Hudson Insurance Company	523144	Agent - Property	2/9/2024
Active	Lexington National Insurance Corporation	888565	Agent - Casualty	8/27/2024
Active	Liberty Mutual Insurance Company	301159	Agent - Casualty	12/4/2023
Active	Liberty Mutual Insurance Company	301159	Agent - Property	12/4/2023
Active	Massachusetts Bay Insurance Company	300898	Agent - Casualty	1/8/2025
Active	Massachusetts Bay Insurance Company	300898	Agent - Property	1/8/2025
Active	Merchants Bonding Company (Mutual)	300170	Agent - Casualty	4/25/2024
Active	Mutual of Omaha Insurance Company	301012	Agent - Health	11/6/2024
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	10/12/2004
Active	New York Life Insurance Company	300431	Agent - Health	5/7/2024
Active	New York Life Insurance Company	300431	Agent - Life	5/7/2024
Active	Occidental Life Insurance Company of North Carolina	301185	Agent - Life	11/20/2023
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	12/4/2023
Active	Ohio Casualty Insurance Company	301492	Agent - Property	12/4/2023
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	12/4/2023	3/29/2024
Inactive	Ohio Security Insurance Company	300622	Agent - Property	12/4/2023	3/29/2024
Inactive	Peerless Insurance Company	301910	Agent - Casualty	12/4/2023	5/8/2025
Inactive	Peerless Insurance Company	301910	Agent - Property	12/4/2023	5/8/2025
Active	Platte River Insurance Company	301089	Agent - Casualty	3/29/2024
Active	Principal Life Insurance Company	300129	Agent - Health	9/15/2023
Active	Principal Life Insurance Company	300129	Agent - Life	9/15/2023
Inactive	Security Life Insurance Company of America	300936	Agent - Health	11/30/2005	12/2/2010
Inactive	Security Life Insurance Company of America	300936	Agent - Life	11/30/2005	12/2/2010
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	8/22/2005	10/1/2015
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	8/22/2005	10/1/2015
Inactive	Symetra Life Insurance Company	301691	Agent - Health	1/6/2006	12/6/2007
Inactive	Symetra Life Insurance Company	301691	Agent - Life	1/6/2006	12/6/2007
Inactive	Tesla Insurance Company	300337	Agent - Casualty	7/27/2004	2/3/2009
Inactive	Tesla Insurance Company	300337	Agent - Property	7/27/2004	2/3/2009
Active	The Gray Casualty & Surety Company	661857	Agent - Casualty	4/11/2024
Inactive	Time Insurance Company	300683	Agent - Health	1/28/2005	4/12/2011
Inactive	Time Insurance Company	300683	Agent - Life	1/28/2005	4/12/2011
Active	Transamerica Life Insurance Company	300571	Agent - Health	10/1/2015
Active	Transamerica Life Insurance Company	300571	Agent - Life	10/1/2015
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Health	4/29/2004	10/1/2020
Inactive	Transamerica Premier Life Insurance Company	300558	Agent - Life	4/29/2004	10/1/2020
Active	U.S. Specialty Insurance Company	300186	Agent - Casualty	10/3/2023
Active	Verlan Fire Insurance Company	517102	Agent - Casualty	2/10/2025
Active	Verlan Fire Insurance Company	517102	Agent - Property	2/10/2025
Inactive	Virginia Surety Company, Inc.	301022	Agent - Casualty	12/21/2010	4/4/2014
Inactive	Virginia Surety Company, Inc.	301022	Agent - Property	12/21/2010	4/4/2014
Active	Washington National Insurance Company	300587	Agent - Health	3/12/2024
Active	Washington National Insurance Company	300587	Agent - Life	3/12/2024
Inactive	West American Insurance Company	301112	Agent - Casualty	12/4/2023	3/29/2024
Inactive	West American Insurance Company	301112	Agent - Property	12/4/2023	3/29/2024
Active	Western Surety Company	300283	Agent - Casualty	1/25/2024
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	7/22/2010	4/4/2014
Active	Zurich American Insurance Company	301121	Agent - Health	2/22/2024
Inactive	Zurich American Insurance Company	301121	Agent - Property	7/22/2010	4/4/2014
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	7/22/2010	6/15/2011
Active	Zurich American Insurance Company of Illinois	301805	Agent - Health	5/3/2024
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	7/22/2010	6/15/2011

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Applin, Sheree Leanne	826280	Agent - Health	10/4/2023
Inactive	Applin, Sheree Leanne	826280	Agent - Life	10/4/2023	4/15/2025
Inactive	Baran, Edward	393313	Agent - Casualty	4/9/2024	12/30/2024
Inactive	Baran, Edward	393313	Agent - Property	4/9/2024	12/30/2024
Active	Belpedio, William	1095341	Agent - Casualty	11/6/2023
Active	Belpedio, William	1095341	Agent - Property	11/6/2023
Active	Block, Joseph	1067110	Agent - Casualty	4/9/2024
Denied	Block, Joseph	1067110	Agent - Health
Denied	Block, Joseph	1067110	Agent - Life
Active	Block, Joseph	1067110	Agent - Property	4/9/2024
Active	Breckenridge, John Calvin	670892	Agent - Health	4/9/2024
Active	Breckenridge, John Calvin	670892	Agent - Life	4/9/2024
Active	Bridge, James	1334836	Agent - Health	5/10/2024
Denied	Bridge, James	1334836	Agent - Life
Active	Buckley, Daniel	876113	Agent - Casualty	11/6/2023
Active	Buckley, Daniel	876113	Agent - Health	11/6/2023
Active	Buckley, Daniel	876113	Agent - Property	11/6/2023
Active	Buckshnis, Joseph	1168191	Agent - Casualty	4/9/2024
Active	Buckshnis, Joseph	1168191	Agent - Property	4/9/2024
Active	Buseman, Christopher Ryan	909559	Agent - Casualty	4/9/2024
Active	Buseman, Christopher Ryan	909559	Agent - Property	4/9/2024
Active	Cardoso, Michael	995855	Agent - Health	9/27/2023
Active	Conley, Brett	1064395	Agent - Casualty	4/9/2024
Active	Conley, Brett	1064395	Agent - Health	4/9/2024
Denied	Conley, Brett	1064395	Agent - Life
Active	Conley, Brett	1064395	Agent - Property	4/9/2024
Active	Cooper, Cynthia	1380878	Agent - Casualty	2/20/2025
Active	Cooper, Cynthia	1380878	Agent - Property	2/20/2025
Inactive	Coverdell, Paul Douglas	378112	Administrator - Not Applicable	12/30/1987	8/17/2000
Active	Cronen, Bryan C	389734	Agent - Health	4/9/2024
Active	Cronen, Bryan C	389734	Agent - Life	4/9/2024
Inactive	Di Benedetto, Vincent E	682989	Administrator - Not Applicable	6/18/2008	8/8/2022
Inactive	Di Benedetto, Vincent E	682989	Agent - Casualty	5/13/2014	1/8/2025
Inactive	Di Benedetto, Vincent E	682989	Agent - Health	3/21/2014	1/8/2025
Inactive	Di Benedetto, Vincent E	682989	Agent - Life	3/21/2014	1/8/2025
Inactive	Di Benedetto, Vincent E	682989	Agent - Property	5/13/2014	1/8/2025
Active	Dioses, Marisol	868863	Agent - Health	4/9/2024
Active	Dioses, Marisol	868863	Agent - Life	4/9/2024
Active	Divito, Michael	1240081	Agent - Casualty	4/9/2024
Active	Divito, Michael	1240081	Agent - Health	4/9/2024
Denied	Divito, Michael	1240081	Agent - Life
Active	Divito, Michael	1240081	Agent - Property	4/9/2024
Denied	Doering, Thomas Michael	1098785	Agent - Health
Denied	Doering, Thomas Michael	1098785	Agent - Life
Active	Eisenbies, Charles	865192	Agent - Health	11/12/2024
Active	Garvin, Kevin Patrick	1221187	Administrator - Not Applicable	8/8/2022
Denied	Gould, Thomas	979140	Agent - Health
Denied	Gould, Thomas	979140	Agent - Life
Active	Hamner, Rees	1174946	Agent - Health	3/6/2025
Active	Hamner, Rees	1174946	Agent - Life	3/6/2025
Active	Hawksworth, Alita	1046921	Agent - Casualty	4/15/2024
Active	Hawksworth, Alita	1046921	Agent - Property	4/15/2024
Active	Hohenberger, Ronnie Dee	727963	Agent - Health	9/27/2023
Active	Hohenberger, Ronnie Dee	727963	Agent - Life	9/27/2023
Active	Jenkins, Jason Lee	581960	Agent - Casualty	5/2/2024
Active	Jenkins, Jason Lee	581960	Agent - Property	5/2/2024
Inactive	Jensen, Samantha Joy	1054027	Agent - Casualty	4/15/2024	1/22/2025
Inactive	Jensen, Samantha Joy	1054027	Agent - Property	4/15/2024	1/22/2025
Inactive	Jensen, Thomas	1055895	Agent - Casualty	4/16/2024	1/23/2025
Inactive	Jensen, Thomas	1055895	Agent - Property	4/16/2024	1/23/2025
Inactive	Joseph, Jeremiah	1333822	Agent - Casualty	4/18/2024	4/26/2024
Inactive	Joseph, Jeremiah	1333822	Agent - Property	4/18/2024	4/26/2024
Active	King, Angela	791012	Agent - Health	4/16/2024
Active	Kissner, Jodi Lynn	1072363	Agent - Health	4/16/2024
Active	Kissner, Jodi Lynn	1072363	Agent - Life	4/16/2024
Active	Klewsaat, Theresa Ann	1172584	Agent - Health	11/6/2023
Active	Klewsaat, Theresa Ann	1172584	Agent - Life	11/6/2023
Inactive	Kolker, Steven Charles	681954	Administrator - Not Applicable	7/1/2009	11/30/2015
Inactive	Kolker, Steven Charles	681954	Agent - Casualty	5/8/2009	4/4/2014
Inactive	Kolker, Steven Charles	681954	Agent - Health	9/3/2008	4/4/2014
Inactive	Kolker, Steven Charles	681954	Agent - Life	9/3/2008	4/4/2014
Inactive	Kolker, Steven Charles	681954	Agent - Property	5/8/2009	4/4/2014
Active	Kretsinger, Clay	1173103	Agent - Health	4/15/2024
Active	Kretsinger, Clay	1173103	Agent - Life	4/15/2024
Denied	Locke, Rebecca Jeanne	1197711	Agent - Health
Denied	Locke, Rebecca Jeanne	1197711	Agent - Life
Denied	Matthews, John A	911154	Agent - Health
Denied	Matthews, John A	911154	Agent - Life
Active	Mcdonald, Cory	1044924	Agent - Casualty	4/15/2024
Active	Mcdonald, Cory	1044924	Agent - Property	4/15/2024
Active	Mcneill, Sara	1378332	Agent - Casualty	2/20/2025
Active	Mcneill, Sara	1378332	Agent - Property	3/5/2025
Active	Mcshane, Amelia	1186115	Agent - Casualty	4/16/2024
Active	Mcshane, Amelia	1186115	Agent - Property	4/16/2024
Active	Moore, Michael	560206	Agent - Casualty	6/27/2024
Active	Moore, Michael	560206	Agent - Property	6/27/2024
Active	Murphy, Michael Eugene	564982	Agent - Health	11/6/2023
Active	Murphy, Michael Eugene	564982	Agent - Life	11/6/2023
Active	Nelson, Brian	862551	Agent - Casualty	4/16/2024
Active	Nelson, Brian	862551	Agent - Property	4/16/2024
Active	Noorman, Alyssa	1354486	Agent - Health	9/13/2024
Denied	Noorman, Alyssa	1354486	Agent - Life
Inactive	Owens, Michael Lewis	359320	Administrator - Not Applicable	4/29/1999	11/10/2008
Inactive	Owens, Michael Lewis	359320	Agent - Casualty	7/27/2004	11/10/2008
Inactive	Owens, Michael Lewis	359320	Agent - Health	4/19/2004	11/10/2008
Inactive	Owens, Michael Lewis	359320	Agent - Life	4/19/2004	11/10/2008
Inactive	Owens, Michael Lewis	359320	Agent - Property	7/27/2004	11/10/2008
Denied	Owens, Ronald Lee	1114545	Agent - Health
Denied	Owens, Ronald Lee	1114545	Agent - Life
Inactive	Pescosolido, Carrie	1017498	Agent - Casualty	4/16/2024	1/29/2025
Inactive	Pescosolido, Carrie	1017498	Agent - Property	4/16/2024	1/29/2025
Active	Peters, Joseph	1078376	Agent - Casualty	4/16/2024
Active	Peters, Joseph	1078376	Agent - Property	4/16/2024
Active	Pitonyak, Lauren Marie	783177	Agent - Casualty	4/11/2024
Active	Pitonyak, Lauren Marie	783177	Agent - Property	4/11/2024
Denied	Polansky, Scott	1070725	Agent - Health
Active	Rogers, Jason	898952	Agent - Casualty	8/2/2024
Active	Rogers, Jason	898952	Agent - Property	8/2/2024
Active	Rogers, Jason	898952	Surplus Lines Broker - Not Applicable	7/31/2024
Active	Ryan, John E	367068	Agent - Health	11/6/2023
Active	Ryan, John E	367068	Agent - Life	11/6/2023
Active	Sandonato, Dean	1119999	Agent - Health	11/6/2023
Active	Shike, Steve	1058259	Agent - Casualty	4/11/2024
Active	Shike, Steve	1058259	Agent - Property	4/11/2024
Active	Smith, Jeffrey B	675810	Agent - Health	10/24/2024
Active	Smith, Jeffrey B	675810	Agent - Life	10/24/2024
Active	Stein, Sara	701969	Agent - Casualty	4/11/2024
Denied	Stein, Sara	701969	Agent - Health
Denied	Stein, Sara	701969	Agent - Life
Active	Stein, Sara	701969	Agent - Property	4/11/2024
Active	Tietz, Brandon Michael	763616	Agent - Casualty	4/11/2024
Active	Tietz, Brandon Michael	763616	Agent - Property	4/11/2024
Active	Turner, Mark Peter	815867	Agent - Casualty	4/11/2024
Active	Turner, Mark Peter	815867	Agent - Property	4/11/2024
Active	Valle, Jason	1282983	Agent - Casualty	4/11/2024
Active	Valle, Jason	1282983	Agent - Property	4/11/2024
Active	Vann, Stephen	757386	Agent - Casualty	9/26/2024
Active	Vann, Stephen	757386	Agent - Property	9/26/2024
Active	Vincent, Jolie	811676	Agent - Casualty	4/11/2024
Active	Vincent, Jolie	811676	Agent - Health	4/11/2024
Denied	Vincent, Jolie	811676	Agent - Life
Active	Vincent, Jolie	811676	Agent - Property	4/11/2024
Active	Walterick, James	1064253	Agent - Health	11/6/2023
Inactive	Walterick, James	1064253	Agent - Life	11/6/2023	3/26/2025
Active	West, Kenneth D	745395	Agent - Health	4/11/2024
Active	West, Kenneth D	745395	Agent - Life	4/11/2024