DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Fallo, Charles John	DOIID	589414	NAIC NPN	3685896

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	5/14/2004	2/9/2012
Inactive	Non Resident	Agent	Property	5/14/2004	2/9/2012
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	5/14/2004	2/9/2012
* 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	American Home Assurance Company	300246	Agent - Casualty	6/28/2004	2/9/2012
Inactive	American Home Assurance Company	300246	Agent - Property	6/28/2004	2/9/2012
Inactive	Granite State Insurance Company	300818	Agent - Casualty	6/28/2004	2/9/2012
Inactive	Granite State Insurance Company	300818	Agent - Property	6/28/2004	2/9/2012
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	6/28/2004	2/9/2012
Inactive	Illinois National Insurance Company	301367	Agent - Property	6/28/2004	2/9/2012
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	8/21/2008	2/9/2012
Inactive	Insurance Company of the State of Pennsylvania	300807	Agent - Property	8/21/2008	2/9/2012
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	6/28/2004	2/9/2012
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	6/28/2004	2/9/2012
Inactive	New Hampshire Insurance Company	301670	Agent - Casualty	6/28/2004	2/9/2012
Inactive	New Hampshire Insurance Company	301670	Agent - Property	6/28/2004	2/9/2012

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	A I Risk Specialists Insurance, Inc	606902	Agent - Casualty	2/21/2006	9/30/2010
Inactive	A I Risk Specialists Insurance, Inc	606902	Agent - Property	2/21/2006	9/30/2010
Inactive	Risk Specialists Companies Ins Agency Inc	669694	Surplus Lines Broker - Not Applicable	10/27/2010	2/9/2012
Inactive	Risk Specialists Companies Ins Agency Inc	669694	Agent - Casualty	7/13/2010	2/9/2012
Inactive	Risk Specialists Companies Ins Agency Inc	669694	Agent - Property	7/13/2010	2/9/2012