DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Anderson, Douglas S	DOIID	577799	NAIC NPN	1150663

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	10/1/2003	4/30/2005
Inactive	Non Resident	Agent	Health	10/1/2003	4/30/2005
Inactive	Non Resident	Agent	Casualty	10/1/2003	4/30/2005
Inactive	Non Resident	Agent	Life	10/1/2003	4/30/2005
* 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	Fairmont Specialty Insurance Company	300980	Agent - Casualty	6/23/2004	4/30/2005
Inactive	Fairmont Specialty Insurance Company	300980	Agent - Property	6/23/2004	4/30/2005
Inactive	Old Republic Insurance Company	301225	Agent - Casualty	2/2/2004	4/30/2005
Inactive	Old Republic Insurance Company	301225	Agent - Property	2/2/2004	4/30/2005

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Lockton Companies Inc.	398333	Agent - Casualty	1/27/2005	4/30/2005
Inactive	Lockton Companies Inc.	398333	Agent - Property	1/27/2005	4/30/2005