DEPARTMENT OF INSURANCE

Affiliations

Name	Wilson, Dawn	DOIID	507147	NAIC NPN	2793140

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	8/15/2000		8/31/2025
Active	Non Resident	Agent	Casualty	8/15/2000		8/31/2025
Inactive	Non Resident	Agent	General Lines	4/19/2000	8/15/2000
Active	Non Resident	Surplus Lines Broker	Not Applicable	5/22/2013		8/31/2025
* 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	06/15/2025	08/31/2025
Surplus Lines Broker	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	ACE American Insurance Company	300625	Agent - Casualty	3/22/2005	9/23/2008
Inactive	ACE American Insurance Company	300625	Agent - Property	3/22/2005	9/23/2008
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	12/9/2006	9/23/2008
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Property	12/9/2006	9/23/2008
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	12/9/2006	9/23/2008
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Property	12/9/2006	9/23/2008
Active	Arch Insurance Company	300688	Agent - Casualty	1/24/2008
Active	Arch Insurance Company	300688	Agent - Property	1/24/2008
Inactive	Bankers Standard Insurance Company	301620	Agent - Casualty	12/9/2006	9/23/2008
Inactive	Bankers Standard Insurance Company	301620	Agent - Property	12/9/2006	9/23/2008
Inactive	Gray Insurance Company (The)	301532	Agent - Casualty	11/28/2023	12/19/2023
Inactive	Indemnity Insurance Company of North America	301760	Agent - Casualty	3/22/2005	9/23/2008
Inactive	Indemnity Insurance Company of North America	301760	Agent - Property	3/22/2005	9/23/2008
Active	MidSouth Insurance Company	739412	Agent - Casualty	11/9/2020
Active	MidSouth Insurance Company	739412	Agent - Property	11/9/2020
Active	Midwest Employers Casualty Company	300124	Agent - Casualty	8/15/2000
Inactive	Midwest Employers Casualty Company	300124	Agent - General Lines	4/19/2000	8/15/2000
Active	Midwest Employers Casualty Company	300124	Agent - Property	8/15/2000
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	12/9/2006	9/23/2008
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	12/9/2006	9/23/2008
Active	Safety National Casualty Corporation	300390	Agent - Casualty	4/10/2012
Active	Safety National Casualty Corporation	300390	Agent - Property	4/10/2012
Inactive	Westchester Fire Insurance Company	301414	Agent - Casualty	3/22/2005	9/23/2008
Inactive	Westchester Fire Insurance Company	301414	Agent - Property	3/22/2005	9/23/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Brentwood Reinsurance Intermediaries Inc	778833	Agent - Property	4/5/2012
Active	Brentwood Reinsurance Intermediaries Inc	778833	Agent - Casualty	4/5/2012
Active	Brentwood Reinsurance Intermediaries Inc	778833	Surplus Lines Broker - Not Applicable	4/1/2014
Inactive	Brentwood Services Brokerage, Inc	640893	Agent - Property	2/9/2010	11/1/2013
Inactive	Brentwood Services Brokerage, Inc	640893	Agent - Casualty	2/9/2010	11/1/2013
Inactive	Brentwood Services, Inc.	547613	Agent - Property	4/5/2002	10/25/2007
Inactive	Brentwood Services, Inc.	547613	Agent - Casualty	4/5/2002	10/25/2007