DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Gorny, James	DOIID	920974	NAIC NPN	3616997

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Independent Adjuster	Property & Casualty	6/22/2022		9/30/2026
Active	Non Resident	Independent Adjuster	Workers' Compensation	6/22/2022		9/30/2026
* 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
Independent Adjuster	07/15/2024	09/30/2024	08/05/2024	08/05/2024	Yes

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Sedgwick Claims Management Service Inc	401194	Independent Adjuster - Property & Casualty	7/27/2016	6/12/2020