DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gornik, Roberta Carol	DOIID	621349	NAIC NPN	8397351

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	12/7/2005	7/23/2010
Inactive	Non Resident	Agent	Casualty	12/7/2005	7/23/2010
* 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	Progressive Direct Insurance Company	301379	Agent - Casualty	12/20/2005	4/21/2009
Inactive	Progressive Direct Insurance Company	301379	Agent - Property	12/20/2005	4/21/2009
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	12/8/2006	4/21/2009
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	12/8/2006	4/21/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Casualty	7/31/2007	4/21/2009
Inactive	Progressive Advantage Agency , Inc.	518222	Agent - Property	7/31/2007	4/21/2009