DEPARTMENT OF INSURANCE

Affiliations

Name	Sampson, Jon-Breck	DOIID	891952	NAIC NPN	16874231

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	9/18/2015	6/30/2017
Inactive	Non Resident	Agent	Casualty	9/18/2015	6/30/2017
* 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	ACE American Insurance Company	300625	Agent - Casualty	4/8/2016	12/9/2016
Inactive	ACE American Insurance Company	300625	Agent - Property	4/8/2016	12/9/2016
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	4/8/2016	12/9/2016
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Property	4/8/2016	12/9/2016
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	4/8/2016	12/9/2016
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Property	4/8/2016	12/9/2016
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	4/13/2016	11/7/2016
Inactive	American Fire and Casualty Company	300567	Agent - Property	4/13/2016	11/7/2016
Inactive	Bankers Standard Insurance Company	301620	Agent - Casualty	4/8/2016	12/9/2016
Inactive	Bankers Standard Insurance Company	301620	Agent - Property	4/8/2016	12/9/2016
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	1/27/2016	11/21/2016
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	4/13/2016	11/7/2016
Inactive	Consolidated Insurance Company	300943	Agent - Property	4/13/2016	11/7/2016
Inactive	Farmington Casualty Company	301137	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Farmington Casualty Company	301137	Agent - Property	1/27/2016	11/21/2016
Inactive	Indemnity Insurance Company of North America	301760	Agent - Casualty	4/8/2016	12/9/2016
Inactive	Indemnity Insurance Company of North America	301760	Agent - Property	4/8/2016	12/9/2016
Inactive	Indiana Insurance Company	301909	Agent - Casualty	4/13/2016	11/7/2016
Inactive	Indiana Insurance Company	301909	Agent - Property	4/13/2016	11/7/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	4/13/2016	11/7/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	4/13/2016	11/7/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	4/13/2016	11/7/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	4/13/2016	11/7/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	4/13/2016	11/7/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Property	4/13/2016	11/7/2016
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	4/8/2016	12/9/2016
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	4/8/2016	12/9/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	4/13/2016	11/7/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	4/13/2016	11/7/2016
Inactive	Peerless Insurance Company	301910	Agent - Casualty	4/13/2016	11/7/2016
Inactive	Peerless Insurance Company	301910	Agent - Property	4/13/2016	11/7/2016
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	5/23/2016	11/7/2016
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	5/23/2016	11/7/2016
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	1/27/2016	11/21/2016
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	1/27/2016	11/21/2016
Inactive	The Phoenix Insurance Company	301502	Agent - Property	1/27/2016	11/21/2016
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	1/27/2016	11/21/2016
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	1/27/2016	11/21/2016
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	1/27/2016	11/21/2016
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	1/27/2016	11/21/2016
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	1/27/2016	11/21/2016
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	1/27/2016	11/21/2016
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	1/27/2016	11/21/2016
Inactive	West American Insurance Company	301112	Agent - Casualty	4/13/2016	11/7/2016
Inactive	West American Insurance Company	301112	Agent - Property	4/13/2016	11/7/2016
Inactive	Westfield Insurance Company	301950	Agent - Casualty	4/28/2016	11/5/2016
Inactive	Westfield Insurance Company	301950	Agent - Property	4/28/2016	11/5/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Mcgriff Insurance Services, LLC	400877	Agent - Casualty	3/3/2016	11/2/2016
Inactive	Mcgriff Insurance Services, LLC	400877	Agent - Property	3/3/2016	11/2/2016