DEPARTMENT OF INSURANCE

Affiliations

Name	Capital City Insurance LLC	DOIID	716683	NAIC NPN	15148816

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Casualty	10/26/2009	3/24/2015
Inactive	Resident	Agent	Property	10/26/2009	3/24/2015
Inactive	Resident	Agent	Health	10/28/2009	3/24/2015
Inactive	Resident	Agent	Life	10/28/2009	3/24/2015
* 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 Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Health	5/31/2011	3/24/2015
Inactive	American Family Life Assurance Company of Columbus (AFLAC)	301781	Agent - Life	5/31/2011	3/24/2015
Inactive	Banner Life Insurance Company	301696	Agent - Life	6/4/2013	3/24/2015
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	9/25/2010	3/24/2015
Inactive	Bristol West Insurance Company	301655	Agent - Property	9/25/2010	3/24/2015
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	12/1/2009	10/20/2014
Inactive	Dairyland Insurance Company	301370	Agent - Property	12/1/2009	10/20/2014
Inactive	Family Life Insurance Company	300356	Agent - Health	8/19/2013	3/24/2015
Inactive	Family Life Insurance Company	300356	Agent - Life	8/19/2013	3/24/2015
Inactive	Farmers Insurance Exchange	300336	Agent - Casualty	11/30/2010	8/23/2012
Inactive	Farmers Insurance Exchange	300336	Agent - Property	11/30/2010	8/23/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/25/2010	3/24/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/25/2010	3/24/2015
Inactive	Gerber Life Insurance Company	300529	Agent - Health	10/13/2013	3/24/2015
Inactive	Gerber Life Insurance Company	300529	Agent - Life	10/13/2013	3/24/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Health	10/9/2013	3/24/2015
Inactive	Golden Rule Insurance Company	301943	Agent - Life	10/9/2013	3/24/2015
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	12/2/2009	11/7/2014
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	12/2/2009	11/7/2014
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	12/2/2009	11/7/2014
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	12/2/2009	11/7/2014
Inactive	Trexis Insurance Corporation	599902	Agent - Casualty	1/19/2010	11/4/2014
Inactive	Trexis One Insurance Corporation	684197	Agent - Casualty	10/13/2010	11/4/2014
Inactive	Truck Insurance Exchange	300335	Agent - Casualty	11/30/2010	8/23/2012
Inactive	Truck Insurance Exchange	300335	Agent - Property	11/30/2010	8/23/2012
Inactive	United Financial Casualty Company	301886	Agent - Casualty	12/2/2009	11/7/2014
Inactive	United Financial Casualty Company	301886	Agent - Property	12/2/2009	11/7/2014
Inactive	Western Surety Company	300283	Agent - Casualty	12/9/2010	3/24/2015

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Allison, Lura C	330317	Agent - Casualty	11/29/2010	2/1/2013
Inactive	Allison, Lura C	330317	Agent - Health	11/29/2010	2/1/2013
Inactive	Allison, Lura C	330317	Agent - Life	11/29/2010	2/1/2013
Inactive	Allison, Lura C	330317	Agent - Property	11/29/2010	2/1/2013
Inactive	Alvarez, Julie	770394	Agent - Health	2/8/2012	5/1/2013
Inactive	Betancourt, Nidia Caro	774915	Agent - Casualty	3/1/2012	9/8/2014
Inactive	Betancourt, Nidia Caro	774915	Agent - Health	4/25/2014	9/8/2014
Inactive	Betancourt, Nidia Caro	774915	Agent - Life	4/25/2014	9/8/2014
Inactive	Betancourt, Nidia Caro	774915	Agent - Property	3/1/2012	9/8/2014
Inactive	Dixon, Fred	844655	Agent - Casualty	8/1/2014	3/24/2015
Inactive	Dixon, Fred	844655	Agent - Property	8/1/2014	3/24/2015
Inactive	Gregory, Fred Alexander	712767	Agent - Casualty	11/17/2009	3/24/2015
Inactive	Gregory, Fred Alexander	712767	Agent - Health	11/17/2009	3/24/2015
Inactive	Gregory, Fred Alexander	712767	Agent - Life	11/17/2009	3/24/2015
Inactive	Gregory, Fred Alexander	712767	Agent - Property	11/17/2009	3/24/2015
Inactive	Harris, Jerry	634857	Agent - Casualty	2/11/2010	9/8/2014
Inactive	Harris, Jerry	634857	Agent - Property	2/11/2010	9/8/2014
Inactive	Haynes, George Peterson	782694	Agent - Casualty	4/18/2013	3/24/2015
Inactive	Haynes, George Peterson	782694	Agent - Property	4/18/2013	3/24/2015
Inactive	Hudson, Renita	844718	Agent - Casualty	7/31/2014	9/8/2014
Inactive	Mitchell, Elaine Raye	525672	Agent - Casualty	10/18/2011	4/25/2014
Inactive	Norton-Willis, Christina Lee	620001	Agent - Casualty	12/4/2013	4/25/2014
Inactive	Owens, Darnell Latrell	805157	Agent - Casualty	3/13/2013	3/24/2015
Inactive	Owens, Darnell Latrell	805157	Agent - Health	4/25/2014	3/24/2015
Inactive	Owens, Darnell Latrell	805157	Agent - Life	4/25/2014	3/24/2015
Inactive	Owens, Darnell Latrell	805157	Agent - Property	3/13/2013	3/24/2015
Inactive	Wright, Rickie L	375750	Agent - Casualty	12/9/2013	3/24/2015
Inactive	Wright, Rickie L	375750	Agent - Property	12/9/2013	11/10/2014