DEPARTMENT OF INSURANCE

Affiliations

Name	Derby Insurance Agency	DOIID	681025	NAIC NPN	10808955

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	5/20/2008	1/24/2011
Inactive	Resident	Agent	Casualty	5/20/2008	1/24/2011
Inactive	Resident	Agent	Life	5/13/2009	1/24/2011
Inactive	Resident	Agent	Health	5/13/2009	1/24/2011
* 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	AIG Assurance Company	300897	Agent - Casualty	7/11/2008	3/10/2010
Inactive	AIG Assurance Company	300897	Agent - Property	7/11/2008	3/10/2010
Inactive	Aegis Security Insurance Company	300492	Agent - Casualty	11/14/2008	1/24/2011
Inactive	Aegis Security Insurance Company	300492	Agent - Property	11/14/2008	1/24/2011
Inactive	American Economy Insurance Company	300315	Agent - Casualty	7/18/2008	1/24/2011
Inactive	American Economy Insurance Company	300315	Agent - Property	7/18/2008	1/24/2011
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/16/2008	1/24/2011
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/16/2008	1/24/2011
Inactive	American Select Insurance Company	301229	Agent - Casualty	8/12/2008	1/24/2011
Inactive	American Select Insurance Company	301229	Agent - Property	8/12/2008	1/24/2011
Inactive	American States Insurance Company	301230	Agent - Casualty	7/18/2008	1/24/2011
Inactive	American States Insurance Company	301230	Agent - Property	7/18/2008	1/24/2011
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	10/14/2008	1/24/2011
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	10/14/2008	1/24/2011
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Casualty	8/7/2008	1/24/2011
Inactive	Automobile Insurance Company of Hartford, Connecticut	300630	Agent - Property	8/7/2008	1/24/2011
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	12/9/2009	1/24/2011
Inactive	Bristol West Insurance Company	301655	Agent - Property	12/9/2009	1/24/2011
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/16/2008	1/24/2011
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/16/2008	1/24/2011
Inactive	Countryway Insurance Company	300809	Agent - Casualty	11/1/2010	1/24/2011
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	10/21/2008	1/24/2011
Inactive	Encompass Indemnity Company	546376	Agent - Property	10/21/2008	1/24/2011
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	4/20/2009	1/24/2011
Inactive	Encompass Insurance Company of America	556578	Agent - Property	4/20/2009	1/24/2011
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	12/12/2008	1/24/2011
Inactive	Farmers Insurance Exchange	300336	Agent - Property	12/12/2008	1/24/2011
Inactive	First National Insurance Company of America	301690	Agent - Casualty	7/18/2008	1/24/2011
Inactive	First National Insurance Company of America	301690	Agent - Property	7/18/2008	1/24/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	8/4/2008	1/24/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	8/4/2008	1/24/2011
Inactive	General Insurance Company of America	300261	Agent - Casualty	7/18/2008	1/24/2011
Inactive	General Insurance Company of America	300261	Agent - Property	7/18/2008	1/24/2011
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	5/20/2009	1/24/2011
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	5/20/2009	1/24/2011
Inactive	Grange Insurance Company	300234	Agent - Casualty	5/20/2009	1/24/2011
Inactive	Grange Insurance Company	300234	Agent - Property	5/20/2009	1/24/2011
Inactive	Grange Life Insurance Company	300128	Agent - Health	5/20/2009	1/24/2011
Inactive	Grange Life Insurance Company	300128	Agent - Life	5/20/2009	1/24/2011
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	5/20/2009	1/24/2011
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	5/20/2009	1/24/2011
Inactive	Hallmark National Insurance Company	300494	Agent - Casualty	9/5/2008	1/24/2011
Inactive	Hallmark National Insurance Company	300494	Agent - Property	9/5/2008	1/24/2011
Inactive	Illinois National Insurance Company	301367	Agent - Casualty	7/11/2008	3/10/2010
Inactive	Illinois National Insurance Company	301367	Agent - Property	7/11/2008	3/10/2010
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/16/2008	1/24/2011
Inactive	Indiana Insurance Company	301909	Agent - Property	10/16/2008	1/24/2011
Inactive	Meridian Citizens Mutual Insurance Company	300935	Agent - Casualty	1/12/2010	1/24/2011
Inactive	Meridian Citizens Mutual Insurance Company	300935	Agent - Property	1/12/2010	1/24/2011
Inactive	Meridian Security Insurance Company	300423	Agent - Casualty	9/5/2008	1/24/2011
Inactive	Meridian Security Insurance Company	300423	Agent - Property	9/5/2008	1/24/2011
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/16/2008	1/24/2011
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/16/2008	1/24/2011
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/16/2008	1/24/2011
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	10/16/2008	1/24/2011
Inactive	Ohio Farmers Insurance Company	301667	Agent - Casualty	8/12/2008	1/24/2011
Inactive	Ohio Farmers Insurance Company	301667	Agent - Property	8/12/2008	1/24/2011
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	10/16/2008	1/24/2011
Inactive	Ohio Security Insurance Company	300622	Agent - Property	10/16/2008	1/24/2011
Inactive	Owners Insurance Company	300796	Agent - Casualty	10/14/2008	1/24/2011
Inactive	Owners Insurance Company	300796	Agent - Property	10/14/2008	1/24/2011
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/16/2008	1/24/2011
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/16/2008	1/24/2011
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/16/2008	1/24/2011
Inactive	Peerless Insurance Company	301910	Agent - Property	10/16/2008	1/24/2011
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Casualty	7/11/2008	3/10/2010
Inactive	Plymouth Rock Assurance Preferred Corporation	301834	Agent - Property	7/11/2008	3/10/2010
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	7/15/2008	1/24/2011
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	7/15/2008	1/24/2011
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	7/15/2008	1/24/2011
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	7/15/2008	1/24/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/18/2008	1/24/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/18/2008	1/24/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/18/2008	1/24/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/18/2008	1/24/2011
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	8/7/2008	1/24/2011
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	8/7/2008	1/24/2011
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Casualty	9/5/2008	1/24/2011
Inactive	State Auto Property & Casualty Insurance Company	301953	Agent - Property	9/5/2008	1/24/2011
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Casualty	9/5/2008	1/24/2011
Inactive	State Automobile Mutual Insurance Company	301824	Agent - Property	9/5/2008	1/24/2011
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	8/7/2008	1/24/2011
Inactive	The Phoenix Insurance Company	301502	Agent - Property	8/7/2008	1/24/2011
Inactive	Travelers Commercial Insurance Company	301506	Agent - Casualty	8/7/2008	1/24/2011
Inactive	Travelers Commercial Insurance Company	301506	Agent - Property	8/7/2008	1/24/2011
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Casualty	8/7/2008	1/24/2011
Inactive	Travelers Home and Marine Insurance Company (The)	301802	Agent - Property	8/7/2008	1/24/2011
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	8/7/2008	1/24/2011
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	8/7/2008	1/24/2011
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	8/7/2008	1/24/2011
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	8/7/2008	1/24/2011
Inactive	Trexis Insurance Corporation	599902	Agent - Casualty	9/22/2008	1/24/2011
Inactive	Trexis One Insurance Corporation	684197	Agent - Casualty	11/11/2008	1/24/2011
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	12/12/2008	1/24/2011
Inactive	Truck Insurance Exchange	300335	Agent - Property	12/12/2008	1/24/2011
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	5/20/2009	1/24/2011
Inactive	Trustgard Insurance Company	300104	Agent - Property	5/20/2009	1/24/2011
Inactive	United Financial Casualty Company	301886	Agent - Casualty	7/15/2008	1/24/2011
Inactive	United Financial Casualty Company	301886	Agent - Property	7/15/2008	1/24/2011
Inactive	West American Insurance Company	301112	Agent - Casualty	10/16/2008	1/24/2011
Inactive	West American Insurance Company	301112	Agent - Property	10/16/2008	1/24/2011
Inactive	Westfield Insurance Company	301950	Agent - Casualty	8/12/2008	1/24/2011
Inactive	Westfield Insurance Company	301950	Agent - Property	8/12/2008	1/24/2011
Inactive	Westfield National Insurance Company	301036	Agent - Casualty	8/12/2008	1/24/2011
Inactive	Westfield National Insurance Company	301036	Agent - Property	8/12/2008	1/24/2011

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Alonzo, Deborah Ann	350743	Agent - Casualty	6/12/2008	1/24/2011
Inactive	Alonzo, Deborah Ann	350743	Agent - Property	6/12/2008	1/24/2011
Inactive	Benge, Rayna A	582669	Agent - Casualty	6/12/2008	1/24/2011
Inactive	Benge, Rayna A	582669	Agent - Property	6/12/2008	1/24/2011
Inactive	Girdler, Brandon Richard	669615	Agent - Casualty	9/11/2010	1/24/2011
Inactive	Girdler, Brandon Richard	669615	Agent - Health	9/11/2010	1/24/2011
Inactive	Girdler, Brandon Richard	669615	Agent - Life	9/11/2010	1/24/2011
Inactive	Girdler, Brandon Richard	669615	Agent - Property	9/11/2010	1/24/2011
Inactive	Hansford, Jonathan Niles	686805	Agent - Casualty	9/11/2010	1/1/2011
Inactive	Hansford, Jonathan Niles	686805	Agent - Property	9/11/2010	1/1/2011
Inactive	Hobdy, Marcella	561908	Agent - Casualty	6/12/2008	12/23/2009
Inactive	Hobdy, Marcella	561908	Agent - Property	6/12/2008	12/23/2009
Inactive	Morgan, Mary Anne	333056	Agent - Casualty	9/11/2010	1/24/2011
Inactive	Morgan, Mary Anne	333056	Agent - Health	9/11/2010	1/24/2011
Inactive	Morgan, Mary Anne	333056	Agent - Life	9/11/2010	1/24/2011
Inactive	Morgan, Mary Anne	333056	Agent - Property	9/11/2010	1/24/2011
Inactive	Patterson, Barbara Ann	333470	Agent - Casualty	6/12/2008	1/24/2011
Inactive	Patterson, Barbara Ann	333470	Agent - Property	6/12/2008	1/24/2011
Inactive	Patterson, Danny A	356025	Agent - Casualty	5/20/2008	1/24/2011
Inactive	Patterson, Danny A	356025	Agent - Health	5/13/2009	1/24/2011
Inactive	Patterson, Danny A	356025	Agent - Life	5/13/2009	1/24/2011
Inactive	Patterson, Danny A	356025	Agent - Property	5/20/2008	1/24/2011
Inactive	Patterson, Matthew Danny	362118	Agent - Casualty	6/12/2008	1/24/2011
Inactive	Patterson, Matthew Danny	362118	Agent - Property	6/12/2008	1/24/2011
Inactive	Pearson, Autumn Renee	586733	Agent - Casualty	6/12/2008	1/24/2011
Inactive	Pearson, Autumn Renee	586733	Agent - Property	6/12/2008	1/24/2011
Inactive	Phillips, Kristi M	546180	Agent - Casualty	6/12/2008	1/24/2011
Inactive	Phillips, Kristi M	546180	Agent - Property	6/12/2008	1/24/2011
Inactive	Rogers, Joseph Gordon	393435	Agent - Casualty	6/12/2008	1/13/2011
Inactive	Rogers, Joseph Gordon	393435	Agent - Property	6/12/2008	1/13/2011