DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Moore, Robert Timothy	DOIID	670030	NAIC NPN	1960440

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	12/10/2007	7/31/2011
Inactive	Non Resident	Agent	Casualty	12/10/2007	7/31/2011
* 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	Amerisure Insurance Company	300298	Agent - Casualty	3/19/2008	4/14/2010
Inactive	Amerisure Insurance Company	300298	Agent - Property	3/19/2008	4/14/2010
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Casualty	3/19/2008	4/14/2010
Inactive	Amerisure Mutual Insurance Company	301576	Agent - Property	3/19/2008	4/14/2010
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	1/4/2010	4/23/2010
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	1/4/2010	4/23/2010
Inactive	Bridgefield Casualty Insurance Company	500013	Agent - Casualty	12/20/2007	7/31/2011
Inactive	Everest National Insurance Company	301319	Agent - Casualty	12/4/2008	4/27/2011
Inactive	Everest National Insurance Company	301319	Agent - Property	12/4/2008	4/27/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Roger Bouchard Ins Inc	546775	Agent - Property	3/19/2008	4/12/2010
Inactive	Roger Bouchard Ins Inc	546775	Agent - Casualty	2/22/2008	4/12/2010