DEPARTMENT OF INSURANCE

Affiliations

Name	Petrey, Charles William	DOIID	949971	NAIC NPN	5950845

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	4/4/2017	5/31/2027
Active	Non Resident	Agent	Casualty	4/4/2017	5/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/8/2021	5/31/2027
* 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	03/15/2025	05/31/2025	04/23/2025	04/23/2025	Yes
Surplus Lines Broker	03/15/2025	05/31/2025	04/23/2025	04/23/2025	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	6/8/2017
Active	American Guarantee and Liability Insurance Company	301216	Agent - Property	6/8/2017
Active	American Zurich Insurance Company	300592	Agent - Casualty	6/8/2017
Active	American Zurich Insurance Company	300592	Agent - Property	6/8/2017
Inactive	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	11/27/2021	11/27/2021
Active	Hartford Underwriters Insurance Company	301064	Agent - Casualty	11/26/2020
Active	Hartford Underwriters Insurance Company	301064	Agent - Property	11/26/2020
Inactive	NorthStone Insurance Company	818905	Agent - Casualty	11/27/2021	11/27/2021
Inactive	PinnaclePoint Insurance Company	819085	Agent - Casualty	11/27/2021	11/27/2021
Active	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/14/2018
Active	Sentinel Insurance Company, Limited	501696	Agent - Property	1/14/2018
Inactive	SummitPoint Insurance Company	819084	Agent - Casualty	11/27/2021	11/27/2021
Active	Trumbull Insurance Company	300242	Agent - Casualty	1/9/2018
Active	Trumbull Insurance Company	300242	Agent - Property	1/9/2018
Active	West Bend Insurance Company	672974	Agent - Casualty	8/1/2023
Active	West Bend Insurance Company	672974	Agent - Property	8/1/2023
Active	Zurich American Insurance Company	301121	Agent - Casualty	6/8/2017
Active	Zurich American Insurance Company	301121	Agent - Property	6/8/2017
Active	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	6/8/2017
Active	Zurich American Insurance Company of Illinois	301805	Agent - Property	6/8/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Willis Towers Watson Southeast Inc	399919	Agent - Property	7/7/2017
Active	Willis Towers Watson Southeast Inc	399919	Agent - Casualty	7/7/2017
Active	Willis Towers Watson Southeast Inc	399919	Surplus Lines Broker - Not Applicable	4/20/2021