DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Blaylock, Derek Alan	DOIID	515469	NAIC NPN	3648981

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	9/21/2000	11/30/2003
Inactive	Non Resident	Agent	Casualty	9/21/2000	11/30/2003
* 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	California Casualty Indemnity Exchange	301153	Agent - Casualty	9/21/2000	4/30/2003
Inactive	California Casualty Indemnity Exchange	301153	Agent - Property	9/21/2000	4/30/2003
Inactive	Progressive Max Insurance Company	301034	Agent - Casualty	2/25/2002	5/20/2003
Inactive	Progressive Max Insurance Company	301034	Agent - Property	2/25/2002	5/20/2003
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	2/25/2002	5/20/2003
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	2/25/2002	5/20/2003
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Casualty	2/25/2002	5/20/2003
Inactive	Progressive Northwestern Insurance Company	300441	Agent - Property	2/25/2002	5/20/2003

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	California Casualty Management Company	558490	Agent - Property	1/23/2003	5/20/2003
Inactive	California Casualty Management Company	558490	Agent - Casualty	1/23/2003	5/20/2003