DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gardner Jr, Sam Parker	DOIID	904208	NAIC NPN	11130193

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	1/16/2016	12/8/2023
Inactive	Non Resident	Agent	Property	1/16/2016	12/8/2023
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	11/12/2017	12/8/2023
* 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	National Indemnity Company	301929	Agent - Casualty	12/20/2017	12/8/2023
Inactive	National Indemnity Company	301929	Agent - Property	12/20/2017	12/8/2023
Inactive	National Liability & Fire Insurance Company	300213	Agent - Casualty	12/20/2017	12/8/2023
Inactive	National Liability & Fire Insurance Company	300213	Agent - Property	12/20/2017	12/8/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CRC Ins Services, LLC	502276	Agent - Property	12/5/2022	8/10/2023
Inactive	CRC Ins Services, LLC	502276	Agent - Casualty	12/5/2022	8/10/2023
Inactive	CRC Ins Services, LLC	502276	Surplus Lines Broker - Not Applicable	12/5/2022	12/8/2023