DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Petzold, Walter	DOIID	793831	NAIC NPN	429854

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	10/6/2012	7/17/2019
Inactive	Non Resident	Agent	Casualty	10/6/2012	7/17/2019
* 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	Fireman's Fund Insurance Company	301423	Agent - Casualty	11/28/2012	7/17/2019
Inactive	Fireman's Fund Insurance Company	301423	Agent - Property	11/28/2012	7/17/2019
Inactive	Great Midwest Insurance Company	301418	Agent - Casualty	12/19/2016	7/17/2019
Inactive	Great Midwest Insurance Company	301418	Agent - Property	12/19/2016	7/17/2019
Inactive	Imperium Insurance Company	300804	Agent - Casualty	12/19/2016	7/17/2019
Inactive	Imperium Insurance Company	300804	Agent - Property	12/19/2016	7/17/2019
Inactive	Technology Insurance Company	613278	Agent - Casualty	8/11/2014	4/17/2019
Inactive	Technology Insurance Company	613278	Agent - Property	8/11/2014	4/17/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	11/28/2012	7/16/2018
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	11/28/2012	7/16/2018