DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Shirley, Timothy	DOIID	886129	NAIC NPN	17231485

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Health	8/7/2015		3/31/2025
Active	Non Resident	Agent	Casualty	8/7/2015		3/31/2025
Active	Non Resident	Agent	Travel	8/7/2015		3/31/2025
Active	Non Resident	Agent	Property	8/7/2015		3/31/2025
Active	Non Resident	Agent	Life	8/7/2015		3/31/2025
* 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	American Modern Home Insurance Company	300791	Agent - Casualty	8/13/2015	3/18/2020
Inactive	American Modern Home Insurance Company	300791	Agent - Property	8/13/2015	3/18/2020
Inactive	Arch Insurance Company	300688	Agent - Casualty	8/14/2015	8/9/2019
Inactive	Arch Insurance Company	300688	Agent - Health	11/11/2015	8/9/2019
Inactive	Arch Insurance Company	300688	Agent - Property	8/14/2015	8/9/2019
Inactive	Arch Insurance Company	300688	Agent - Travel	8/14/2015	8/9/2019
Active	National Casualty Company	301483	Agent - Casualty	8/18/2015
Active	National Casualty Company	301483	Agent - Property	8/18/2015
Active	Nationwide Life Insurance Company	300495	Agent - Health	8/11/2015
Active	Nationwide Life Insurance Company	300495	Agent - Life	8/11/2015
Active	Nationwide Mutual Insurance Company	301749	Agent - Casualty	8/11/2015
Active	Nationwide Mutual Insurance Company	301749	Agent - Property	8/11/2015
Active	United States Fire Insurance Company	582240	Agent - Casualty	8/17/2015
Active	United States Fire Insurance Company	582240	Agent - Health	8/17/2015
Active	United States Fire Insurance Company	582240	Agent - Property	8/17/2015
Active	United States Fire Insurance Company	582240	Agent - Travel	8/17/2015

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 - Health	11/13/2015	1/8/2020
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Life	11/13/2015	1/8/2020
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	11/13/2015	1/8/2020
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	11/13/2015	1/8/2020
Inactive	Trip Mate, Inc	397551	Agent - Property	8/31/2015	2/28/2024
Inactive	Trip Mate, Inc	397551	Agent - Casualty	8/31/2015	2/28/2024