DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Donnelly Jr, James R	DOIID	592457	NAIC NPN	7503147

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	8/24/2007	10/9/2013
Inactive	Non Resident	Agent	Life	8/24/2007	10/9/2013
Inactive	Non Resident	Agent	Casualty	7/15/2004	10/9/2013
Inactive	Non Resident	Agent	Property	7/15/2004	10/9/2013
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	3/30/2009	10/9/2013
* 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	Dental Concern Inc. (The)	301641	Agent - Health	3/18/2011	7/10/2013
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/18/2009	7/25/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/18/2009	7/25/2012
Inactive	Humana Health Plan, Inc.	300142	Agent - Health	3/18/2011	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Health	3/18/2011	7/10/2013
Inactive	Humana Insurance Company	301104	Agent - Life	3/18/2011	7/10/2013
Inactive	Kanawha Insurance Company	300127	Agent - Health	3/18/2011	7/10/2013
Inactive	Kanawha Insurance Company	300127	Agent - Life	3/18/2011	7/10/2013
Inactive	Rural Community Insurance Company	301891	Agent - Casualty	6/12/2009	12/1/2011
Inactive	Rural Community Insurance Company	301891	Agent - Property	6/12/2009	12/1/2011
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Health	4/24/2008	3/26/2010
Inactive	Talcott Resolution Life and Annuity Insurance Company	300932	Agent - Life	4/24/2008	3/26/2010
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	3/19/2007	6/6/2013
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	3/19/2007	6/6/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	McGriff Seibels & Williams Of Texas Inc	594025	Agent - Property	1/21/2010	6/6/2013
Inactive	McGriff Seibels & Williams Of Texas Inc	594025	Agent - Casualty	1/21/2010	6/6/2013
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	5/26/2010	7/25/2012
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	5/26/2010	7/25/2012
Denied	USI Insurance Services National, Inc	509421	Agent - Life
Denied	USI Insurance Services National, Inc	509421	Agent - Health
Inactive	USI Insurance Services National, Inc	509421	Surplus Lines Broker - Not Applicable	5/26/2010	10/30/2012
Inactive	Wells Fargo Insurance Services of Texas Inc	505616	Agent - Property	2/14/2008	4/12/2010
Inactive	Wells Fargo Insurance Services of Texas Inc	505616	Agent - Casualty	2/14/2008	4/12/2010
Inactive	Wells Fargo Insurance Services of Texas Inc	505616	Agent - Life	6/15/2009	4/12/2010
Inactive	Wells Fargo Insurance Services of Texas Inc	505616	Agent - Health	6/15/2009	4/12/2010
Inactive	Wells Fargo Insurance Services of Texas Inc	505616	Surplus Lines Broker - Not Applicable	6/15/2009	4/12/2010