DEPARTMENT OF INSURANCE

Affiliations

Name	Burgess, Nancy A	DOIID	863889	NAIC NPN	2208047

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	12/18/2014	12/31/2019
Inactive	Non Resident	Agent	Property	12/18/2014	12/31/2019
* 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	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019	12/31/2019
Inactive	American Economy Insurance Company	300315	Agent - Property	11/9/2019	12/31/2019
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	9/7/2016	5/23/2018
Inactive	Encompass Indemnity Company	546376	Agent - Property	9/7/2016	5/23/2018
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	9/7/2016	5/23/2018
Inactive	Encompass Insurance Company of America	556578	Agent - Property	9/7/2016	5/23/2018
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	10/15/2016	1/16/2018
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	10/15/2016	1/16/2018
Inactive	Grange Insurance Company	300234	Agent - Casualty	10/15/2016	1/16/2018
Inactive	Grange Insurance Company	300234	Agent - Property	10/15/2016	1/16/2018
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	10/15/2016	1/16/2018
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	10/15/2016	1/16/2018
Inactive	Privilege Underwriters Reciprocal Exchange	769657	Agent - Casualty	12/13/2016	12/31/2019
Inactive	Privilege Underwriters Reciprocal Exchange	769657	Agent - Property	12/13/2016	12/31/2019
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	12/18/2015	1/16/2018
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	12/18/2015	1/16/2018
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	11/1/2016	12/31/2019
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	11/1/2016	12/31/2019
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	11/1/2016	12/31/2019
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	11/1/2016	12/31/2019
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	10/15/2016	1/16/2018
Inactive	Trustgard Insurance Company	300104	Agent - Property	10/15/2016	1/16/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Huntington Insurance Inc	515749	Agent - Property	12/18/2015	1/10/2018
Inactive	Huntington Insurance Inc	515749	Agent - Casualty	12/18/2015	1/10/2018