DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Goss, Timothy Michael	DOIID	564771	NAIC NPN	7612726

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Adjuster	Independent	1/6/2004	1/25/2006
Inactive	Resident	Agent	Casualty	8/31/2005	3/24/2010
Inactive	Resident	Agent	Property	8/31/2005	3/24/2010
Inactive	Resident	Apprentice Adjuster	Not Applicable	2/24/2003	1/6/2004
Active	Resident	Staff Adjuster	Property & Casualty	4/20/2017		2/28/2026
* 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	MICO Insurance Company	301664	Agent - Casualty	9/1/2006	3/24/2010
Inactive	MICO Insurance Company	301664	Agent - Property	9/1/2006	3/24/2010
Inactive	Motorists Mutual Insurance Company	300963	Agent - Casualty	9/19/2005	3/24/2010
Inactive	Motorists Mutual Insurance Company	300963	Agent - Property	9/19/2005	3/24/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Chas. M. Moore Insurance Agency Inc.	400317	Agent - Casualty	10/8/2005	2/21/2010
Inactive	Chas. M. Moore Insurance Agency Inc.	400317	Agent - Property	10/8/2005	2/21/2010

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hewitt, John Carter	524998	Apprentice Adjuster - Not Applicable	2/24/2003	1/6/2004