DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Griswold, Jack	DOIID	941613	NAIC NPN	18256649

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	1/10/2017		11/30/2026
Active	Non Resident	Agent	Casualty	1/10/2017		11/30/2026
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/26/2017		11/30/2026
* 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
Agent	09/15/2026	11/30/2026
Surplus Lines Broker	09/15/2026	11/30/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Independence American Insurance Company	524747	Agent - Casualty	8/15/2024
Active	Independence American Insurance Company	524747	Agent - Property	8/15/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Rein Connected Insurance Agency, LLC	944833	Agent - Property	3/10/2025
Active	Rein Connected Insurance Agency, LLC	944833	Agent - Casualty	2/14/2017
Active	Rein Connected Insurance Agency, LLC	944833	Surplus Lines Broker - Not Applicable	7/19/2017