DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lawrence, Timothy Lee	DOIID	575302	NAIC NPN	7843613

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Resident	Agent	Casualty	12/1/2003	10/31/2015
Inactive	Resident	Agent	Property	12/1/2003	10/31/2015
Inactive	Resident	Independent Adjuster	Property & Casualty	10/6/2009	10/31/2015
* 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	Nationwide Assurance Company	300166	Agent - Casualty	12/1/2003	1/18/2006
Inactive	Nationwide General Insurance Company	300603	Agent - Casualty	12/1/2003	1/18/2006
Inactive	Nationwide General Insurance Company	300603	Agent - Property	12/1/2003	1/18/2006
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Casualty	12/1/2003	1/18/2006
Inactive	Nationwide Mutual Fire Insurance Company	301722	Agent - Property	12/1/2003	1/18/2006
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	12/1/2003	1/18/2006
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	12/1/2003	1/18/2006
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	12/1/2003	1/18/2006
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	12/1/2003	1/18/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bluegrass Insurance Management, LLC	711568	Independent Adjuster - Property & Casualty	11/16/2009	10/31/2015
Inactive	Poland Insurance Agency Inc.	398996	Agent - Casualty	1/9/2004	1/18/2006
Inactive	Poland Insurance Agency Inc.	398996	Agent - Property	1/9/2004	1/18/2006