DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bush, Jerry Clyde	DOIID	865839	NAIC NPN	17478536

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Resident	Agent	Health	1/21/2015		10/31/2025
Active	Resident	Agent	Property	2/24/2015		10/31/2025
Active	Resident	Agent	Casualty	3/17/2015		10/31/2025
Active	Resident	Agent	Life	1/21/2015		10/31/2025
* 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	Baptist Health Plan, Inc.	300157	Agent - Health	9/25/2015	3/31/2019
Inactive	Erie Family Life Insurance Company	301400	Agent - Life	5/5/2015	7/30/2021
Inactive	Erie Insurance Company	300230	Agent - Casualty	5/5/2015	7/30/2021
Inactive	Erie Insurance Company	300230	Agent - Property	5/5/2015	7/30/2021
Inactive	Erie Insurance Company of New York	789916	Agent - Casualty	9/25/2015	7/30/2021
Inactive	Erie Insurance Company of New York	789916	Agent - Property	9/25/2015	7/30/2021
Inactive	Erie Insurance Exchange	300789	Agent - Casualty	5/5/2015	7/30/2021
Inactive	Erie Insurance Exchange	300789	Agent - Property	5/5/2015	7/30/2021
Inactive	Erie Insurance Property & Casualty Company	789942	Agent - Casualty	9/25/2015	7/30/2021
Inactive	Erie Insurance Property & Casualty Company	789942	Agent - Property	9/25/2015	7/30/2021
Inactive	Flagship City Insurance Company	789965	Agent - Casualty	9/25/2015	7/30/2021
Inactive	Flagship City Insurance Company	789965	Agent - Property	9/25/2015	7/30/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Health	2/25/2016	3/31/2019
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Life	2/25/2016	3/31/2020
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Property	2/25/2016	3/31/2020
Inactive	James H Moore And Son Holdings LLC	852564	Agent - Casualty	2/25/2016	3/31/2020