DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Roman, Gale A	DOIID	846131	NAIC NPN	398541

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	7/23/2014		12/31/2024
Active	Non Resident	Agent	Casualty	7/23/2014		12/31/2024
Active	Non Resident	Agent	Personal Lines	7/23/2014		12/31/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	10/15/2024	12/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Harleysville Insurance Company	301462	Agent - Casualty	9/27/2018
Inactive	Harleysville Insurance Company	301462	Agent - Property	9/27/2018	8/25/2023
Inactive	Hartford Insurance Company of Illinois	1014405	Agent - Casualty	11/27/2019	7/19/2023
Inactive	Hartford Insurance Company of Illinois	1014405	Agent - Property	11/27/2019	7/19/2023
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	9/27/2018
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	9/27/2018
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	8/12/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Acrisure LLC	696181	Agent - Property	9/17/2020
Active	Acrisure LLC	696181	Agent - Casualty	9/17/2020
Denied	Acrisure LLC	696181	Agent - Personal Lines
Inactive	ECR Innovators LLC	846427	Agent - Property	9/27/2018	3/31/2022
Inactive	ECR Innovators LLC	846427	Agent - Casualty	9/12/2018	3/31/2022
Denied	ECR Innovators LLC	846427	Agent - Personal Lines