DEPARTMENT OF INSURANCE

Name	Grigsby, Derek	DOIID	810080	NAIC NPN	16958555

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	9/28/2023		8/31/2025
Active	Non Resident	Agent	Property	9/28/2023		8/31/2025
Inactive	Non Resident	Agent	Personal Lines	6/1/2018	8/31/2019

*If a status is Pending, Pending Replacement,or the record displays Affidavit on File, click on them for more details.

No License Renewal Information

NOTE: Licensee may renew up to 6 months prior to Next Compliance Date. Licensees subject to CE must complete CE requirements before Next Compliance Date in order to successfully complete the License Renewal Process.

Address Information

Type	Address
Residence	Not Public Information
Business / Home Office	201 Lamkins St. Condo 409Pueblo, CO 81003

Phone Information

Type	Phone
Business / Home Office	(210) 498-9204