DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Dickson, Thomas Russell	DOIID	841697	NAIC NPN	16897238

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	5/28/2014		10/31/2026
Active	Non Resident	Agent	Casualty	5/28/2014		10/31/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	3/27/2015		10/31/2026
* 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
Active	Greenwich Insurance Company	301754	Agent - Casualty	7/28/2015
Active	Greenwich Insurance Company	301754	Agent - Property	7/28/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Complex Risk And Ins Assoc LLC	873236	Agent - Property	7/28/2015	6/3/2025
Inactive	Complex Risk And Ins Assoc LLC	873236	Agent - Casualty	7/28/2015	6/3/2025
Inactive	Complex Risk And Ins Assoc LLC	873236	Surplus Lines Broker - Not Applicable	4/8/2015	6/3/2025