DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Energy Insurance Brokers Inc	DOIID	703846	NAIC NPN	1986104

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Denied	Non Resident	Agent	Personal Lines
Inactive	Non Resident	Agent	Casualty	5/29/2009	8/17/2015
Inactive	Non Resident	Agent	Property	5/29/2009	8/17/2015
* 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	American Modern Home Insurance Company	300791	Agent - Casualty	6/19/2012	8/22/2012
Inactive	American Modern Home Insurance Company	300791	Agent - Property	6/19/2012	8/22/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Reilly, Michael J	591533	Agent - Casualty	5/29/2009	8/17/2015
Inactive	Reilly, Michael J	591533	Agent - Property	5/29/2009	8/17/2015