DEPARTMENT OF INSURANCE

Affiliations

Name	Simon, Robert	DOIID	752874	NAIC NPN	8681852

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Health	9/13/2017	11/9/2022
Inactive	Non Resident	Agent	Property	4/26/2011	11/9/2022
Inactive	Non Resident	Agent	Casualty	4/26/2011	11/9/2022
Inactive	Non Resident	Agent	Life	9/13/2017	11/9/2022
* 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	ACE American Insurance Company	300625	Agent - Casualty	7/13/2011	10/20/2022
Inactive	ACE American Insurance Company	300625	Agent - Property	7/13/2011	10/20/2022
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	2/14/2014	5/27/2022
Inactive	American Fire and Casualty Company	300567	Agent - Property	2/14/2014	5/27/2022
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	2/14/2014	11/9/2022
Inactive	Consolidated Insurance Company	300943	Agent - Property	2/14/2014	11/9/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/5/2018	8/29/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/5/2018	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	6/5/2018	8/29/2018
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	6/5/2018	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	6/5/2018	8/29/2018
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	6/5/2018	8/29/2018
Inactive	Hanover American Insurance Company (The)	300447	Agent - Casualty	10/11/2013	12/15/2014
Inactive	Hanover American Insurance Company (The)	300447	Agent - Property	10/11/2013	12/15/2014
Inactive	Hanover Insurance Company (The)	300508	Agent - Casualty	10/11/2013	12/15/2014
Inactive	Hanover Insurance Company (The)	300508	Agent - Property	10/11/2013	12/15/2014
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Health	10/16/2017	2/3/2021
Inactive	Hartford Life and Accident Insurance Company	300878	Agent - Life	10/16/2017	2/3/2021
Inactive	Indiana Insurance Company	301909	Agent - Casualty	2/14/2014	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	2/14/2014	2/3/2023
Inactive	Markel American Insurance Company	300377	Agent - Casualty	7/8/2011	11/28/2017
Inactive	Markel American Insurance Company	300377	Agent - Property	7/8/2011	11/28/2017
Inactive	Markel Insurance Company	301475	Agent - Casualty	7/8/2011	11/9/2022
Inactive	Markel Insurance Company	301475	Agent - Property	7/8/2011	11/9/2022
Inactive	Massachusetts Bay Insurance Company	300898	Agent - Casualty	10/11/2013	12/15/2014
Inactive	Massachusetts Bay Insurance Company	300898	Agent - Property	10/11/2013	12/15/2014
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	2/14/2014	11/9/2022
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	2/14/2014	11/9/2022
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	2/14/2014	5/27/2022
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	2/14/2014	5/27/2022
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	2/14/2014	5/27/2022
Inactive	Ohio Security Insurance Company	300622	Agent - Property	2/14/2014	5/27/2022
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	2/14/2014	11/9/2022
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	2/14/2014	11/9/2022
Inactive	Peerless Insurance Company	301910	Agent - Casualty	2/14/2014	11/9/2022
Inactive	Peerless Insurance Company	301910	Agent - Property	2/14/2014	11/9/2022
Inactive	Rural Community Insurance Company	301891	Agent - Property	2/12/2014	3/9/2016
Inactive	West American Insurance Company	301112	Agent - Casualty	2/14/2014	5/27/2022
Inactive	West American Insurance Company	301112	Agent - Property	2/14/2014	5/27/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	10/15/2013	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	10/15/2013	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Health	10/16/2017	10/9/2019
Inactive	USI Insurance Services National, Inc	509421	Agent - Life	10/16/2017	10/9/2019
Inactive	Usi Insurance Services LLC	669260	Agent - Property	1/3/2019	6/7/2022
Inactive	Usi Insurance Services LLC	669260	Agent - Casualty	1/3/2019	6/7/2022
Inactive	Usi Insurance Services LLC	669260	Agent - Health	1/3/2019	2/3/2021
Inactive	Usi Insurance Services LLC	669260	Agent - Life	1/3/2019	2/3/2021
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Property	7/21/2011	2/17/2014
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Casualty	7/21/2011	2/17/2014