DEPARTMENT OF INSURANCE

Affiliations

Name	Simons, Larry John	DOIID	889413	NAIC NPN	3761882

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	9/1/2015	10/31/2024
Active	Non Resident	Agent	Property	9/1/2015	10/31/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/13/2017	10/31/2024
* 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	08/15/2024	10/31/2024
Surplus Lines Broker	08/15/2024	10/31/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Economy Insurance Company	300315	Agent - Casualty	11/9/2019
Active	American Economy Insurance Company	300315	Agent - Property	11/9/2019
Active	American Fire and Casualty Company	300567	Agent - Casualty	1/14/2016
Active	American Fire and Casualty Company	300567	Agent - Property	1/14/2016
Inactive	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	11/27/2021	11/27/2021
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	1/14/2016	10/13/2022
Inactive	Consolidated Insurance Company	300943	Agent - Property	1/14/2016	10/13/2022
Inactive	Indiana Insurance Company	301909	Agent - Casualty	1/14/2016	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	1/14/2016	2/3/2023
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	1/14/2016	4/26/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	1/14/2016	4/26/2024
Inactive	NorthStone Insurance Company	818905	Agent - Casualty	11/27/2021	11/27/2021
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	1/14/2016
Active	Ohio Casualty Insurance Company	301492	Agent - Property	1/14/2016
Active	Ohio Security Insurance Company	300622	Agent - Casualty	1/14/2016
Active	Ohio Security Insurance Company	300622	Agent - Property	1/14/2016
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	1/14/2016
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	1/14/2016
Active	Peerless Insurance Company	301910	Agent - Casualty	1/14/2016
Active	Peerless Insurance Company	301910	Agent - Property	1/14/2016
Inactive	PinnaclePoint Insurance Company	819085	Agent - Casualty	11/27/2021	11/27/2021
Active	RLI Insurance Company	301217	Agent - Casualty	12/18/2018
Active	RLI Insurance Company	301217	Agent - Property	12/18/2018
Active	SAFECO Insurance Company of America	300159	Agent - Casualty	1/14/2016
Active	SAFECO Insurance Company of America	300159	Agent - Property	1/14/2016
Active	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	1/14/2016
Active	SAFECO Insurance Company of Illinois	301350	Agent - Property	1/14/2016
Inactive	SummitPoint Insurance Company	819084	Agent - Casualty	11/27/2021	11/27/2021
Active	West American Insurance Company	301112	Agent - Casualty	1/14/2016
Active	West American Insurance Company	301112	Agent - Property	1/14/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Assuredpartners Of Indiana Llc	804612	Agent - Casualty	1/14/2016
Active	Assuredpartners Of Indiana Llc	804612	Agent - Property	1/14/2016
Active	Assuredpartners Of Indiana Llc	804612	Surplus Lines Broker - Not Applicable	1/17/2017