DEPARTMENT OF INSURANCE

Affiliations

Name	PBS Insurance Underwriting Corp	DOIID	401286	NAIC NPN	5306972

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Administrator	Not Applicable	3/25/1999	1/11/2016
Inactive	Resident	Agent	General Lines	2/4/1992	8/15/2000
Inactive	Resident	Agent	Property	8/15/2000	3/31/2016
Inactive	Resident	Agent	Casualty	8/4/2000	3/31/2016
Inactive	Resident	Surplus Lines Broker	Not Applicable	6/29/2006	2/1/2016
* 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	AIU Insurance Company	300729	Agent - Casualty	8/15/2000	7/12/2004
Inactive	AIU Insurance Company	300729	Agent - General Lines	2/1/2000	8/15/2000
Inactive	AIU Insurance Company	300729	Agent - Property	8/15/2000	7/12/2004
Inactive	Acceptance Insurance Company	300211	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Acceptance Insurance Company	300211	Agent - General Lines	12/30/1998	8/15/2000
Inactive	Acceptance Insurance Company	300211	Agent - Property	8/15/2000	3/31/2002
Inactive	Aegis Security Insurance Company	300492	Agent - General Lines	2/4/1992	3/31/1998
Inactive	American Home Assurance Company	300246	Agent - Casualty	8/15/2000	7/12/2004
Inactive	American Home Assurance Company	300246	Agent - General Lines	11/12/1996	8/15/2000
Inactive	American Home Assurance Company	300246	Agent - Property	8/15/2000	7/12/2004
Inactive	Capitol Indemnity Corporation	301030	Agent - Casualty	5/18/2010	3/31/2016
Inactive	Capitol Indemnity Corporation	301030	Agent - Property	1/31/2002	3/31/2016
Inactive	Clarendon National Insurance Company	300843	Agent - General Lines	9/30/1998	8/9/1999
Inactive	Connecticut Surety Company (The)	300802	Agent - Casualty	8/15/2000	3/31/2002
Inactive	Connecticut Surety Company (The)	300802	Agent - General Lines	4/20/1999	8/15/2000
Inactive	Deerfield Insurance Company	301197	Agent - Casualty	3/7/2002	12/31/2015
Inactive	Deerfield Insurance Company	301197	Agent - Property	3/7/2002	12/31/2015
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Casualty	2/4/2002	1/4/2010
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Property	2/4/2002	1/4/2010
Inactive	Falls Lake National Insurance Company	301796	Agent - Casualty	8/15/2000	3/25/2002
Inactive	Falls Lake National Insurance Company	301796	Agent - General Lines	4/18/1996	8/15/2000
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	3/18/2002	7/20/2005
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	3/18/2002	7/20/2005
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	5/2/2003	7/12/2004
Inactive	Illinois National Insurance Company	301367	Agent - Property	5/2/2003	7/12/2004
Inactive	Infinity Casualty Insurance Company	301280	Agent - Casualty	8/4/2000	3/25/2002
Inactive	Lincoln General Insurance Company	301580	Agent - Casualty	5/16/2003	4/12/2006
Inactive	Lincoln General Insurance Company	301580	Agent - Property	5/16/2003	4/12/2006
Inactive	Markel American Insurance Company	300377	Agent - Casualty	3/7/2002	3/31/2016
Inactive	Markel American Insurance Company	300377	Agent - Property	3/7/2002	3/31/2016
Inactive	Markel Insurance Company	301475	Agent - Casualty	12/31/2015	3/31/2016
Inactive	Markel Insurance Company	301475	Agent - Property	12/31/2015	3/31/2016
Inactive	Medical Protective Company (The)	301207	Agent - Casualty	6/9/2003	3/31/2016
Inactive	Medical Protective Company (The)	301207	Agent - Property	6/9/2003	3/31/2016
Inactive	Metropolitan General Insurance Company	300709	Agent - Casualty	8/15/2000	7/20/2005
Inactive	Metropolitan General Insurance Company	300709	Agent - General Lines	8/14/1998	8/15/2000
Inactive	Metropolitan General Insurance Company	300709	Agent - Property	8/15/2000	7/20/2005
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	8/15/2000	7/12/2004
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - General Lines	11/12/1996	8/15/2000
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	8/15/2000	7/12/2004
Inactive	Permanent General Assurance Corporation	300883	Agent - General Lines	4/22/1996	3/31/2000
Inactive	Platte River Insurance Company	301089	Agent - Casualty	5/18/2010	3/31/2016
Inactive	Platte River Insurance Company	301089	Agent - Property	1/8/2002	3/31/2016
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	3/24/2004	9/18/2007
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	3/24/2004	9/18/2007
Inactive	Progressive Max Insurance Company	301034	Agent - Casualty	2/21/2001	12/28/2005
Inactive	Progressive Max Insurance Company	301034	Agent - Property	2/21/2001	12/28/2005
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	2/21/2001	9/18/2007
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	2/21/2001	9/18/2007
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Casualty	2/21/2001	12/28/2005
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Property	2/21/2001	12/28/2005
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Casualty	3/10/2009	5/10/2011
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Property	3/10/2009	5/10/2011
Inactive	Trexis Insurance Corporation	599902	Agent - Casualty	1/10/2005	3/31/2016
Inactive	Trexis One Insurance Corporation	684197	Agent - Casualty	1/20/2009	3/31/2016
Inactive	Western Surety Company	300283	Agent - Casualty	8/15/2000	6/30/2006
Inactive	Western Surety Company	300283	Agent - General Lines	11/16/1998	8/15/2000
Inactive	Windhaven National Insurance Company	300094	Agent - Casualty	8/15/2000	3/25/2002
Inactive	Windhaven National Insurance Company	300094	Agent - General Lines	9/27/1993	8/15/2000

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Heile, Jeffrey Richard	306875	Agent - Casualty	10/2/2014	3/31/2016
Inactive	Heile, Jeffrey Richard	306875	Agent - Property	10/2/2014	3/31/2016
Inactive	Smith, Jackie Wayne	375252	Administrator - Not Applicable	3/25/1999	11/30/2015
Denied	Smith, Jackie Wayne	375252	Agent - Casualty
Inactive	Smith, Jackie Wayne	375252	Agent - General Lines	8/6/1998	8/15/2000
Denied	Smith, Jackie Wayne	375252	Agent - Property
Inactive	Smith, Jackie Wayne	375252	Surplus Lines Broker - Not Applicable	6/29/2006	11/30/2015