DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gisi, Gregory V	DOIID	783942	NAIC NPN	2165571

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	6/13/2012	10/17/2022
Inactive	Non Resident	Agent	Property	6/13/2012	10/17/2022
Inactive	Non Resident	Agent	Health	6/13/2012	10/17/2022
Inactive	Non Resident	Agent	Life	6/13/2012	10/17/2022
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	6/20/2018	10/17/2022
* 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	American Modern Home Insurance Company	300791	Agent - Casualty	8/12/2015	10/17/2022
Inactive	American Modern Home Insurance Company	300791	Agent - Property	8/12/2015	10/17/2022
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	3/10/2014	11/14/2021
Inactive	American Modern Select Insurance Company	581481	Agent - Property	3/10/2014	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	8/11/2014	11/14/2021
Inactive	American Southern Home Insurance Company	626276	Agent - Property	8/11/2014	11/14/2021
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	3/6/2014	10/17/2022
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	3/6/2014	10/17/2022
Inactive	Markel American Insurance Company	300377	Agent - Casualty	11/19/2014	10/17/2022
Inactive	Markel American Insurance Company	300377	Agent - Health	11/19/2014	10/17/2022
Inactive	Markel American Insurance Company	300377	Agent - Property	11/19/2014	10/17/2022
Inactive	Western Surety Company	300283	Agent - Casualty	10/26/2012	4/29/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Family Brokerage Inc	803993	Agent - Casualty	2/19/2013	10/17/2022
Inactive	American Family Brokerage Inc	803993	Agent - Property	2/19/2013	10/17/2022
Inactive	American Family Brokerage Inc	803993	Agent - Life	2/19/2013	10/17/2022
Inactive	American Family Brokerage Inc	803993	Agent - Health	2/19/2013	10/17/2022
Inactive	Bowhead Specialty Underwriters Inc.	1102220	Surplus Lines Broker - Not Applicable	10/16/2020	5/5/2021