DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Falcon Insurance Agency Great Lakes, Inc.	DOIID	633202	NAIC NPN	3243806

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	6/1/2006	3/31/2016
Inactive	Non Resident	Agent	Casualty	6/1/2006	3/31/2016
* 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	Arch Insurance Company	300688	Agent - Casualty	10/8/2007	8/13/2015
Inactive	Arch Insurance Company	300688	Agent - Property	10/8/2007	8/13/2015
Inactive	Old Republic Insurance Company	301225	Agent - Casualty	6/30/2008	7/31/2015
Inactive	Old Republic Insurance Company	301225	Agent - Property	6/30/2008	7/31/2015
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	1/24/2013	3/31/2016
Inactive	QBE Insurance Corporation	300515	Agent - Property	1/24/2013	3/31/2016
Inactive	Star Insurance Company	301553	Agent - Casualty	3/29/2011	1/21/2015
Inactive	Star Insurance Company	301553	Agent - Property	3/29/2011	1/21/2015
Inactive	State National Insurance Company, Inc.	300888	Agent - Casualty	8/1/2013	2/8/2015
Inactive	State National Insurance Company, Inc.	300888	Agent - Property	8/1/2013	2/8/2015
Inactive	U.S. Specialty Insurance Company	300186	Agent - Casualty	1/17/2008	12/1/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allen, John Russell	324744	Agent - Casualty	12/17/2010	3/31/2016
Inactive	Allen, John Russell	324744	Agent - Property	12/17/2010	3/31/2016
Inactive	Gampfer, David M	608061	Agent - Casualty	6/1/2006	8/12/2013
Inactive	Gampfer, David M	608061	Agent - Property	6/1/2006	8/12/2013
Inactive	Snead, William Murdock	512418	Agent - Casualty	6/1/2006	8/12/2013
Inactive	Snead, William Murdock	512418	Agent - Property	6/1/2006	8/12/2013