DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Grandison, Thomas Adam	DOIID	1146867	NAIC NPN	19969896

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/26/2021		12/31/2025
Active	Non Resident	Agent	Property	7/26/2021		12/31/2025
* 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	10/15/2025	12/31/2025

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	9/10/2023
Active	Independence American Insurance Company	524747	Agent - Property	9/10/2023
Active	United States Fire Insurance Company	582240	Agent - Casualty	7/29/2021
Active	United States Fire Insurance Company	582240	Agent - Property	7/29/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	PTZ Insurance Agency LTD	695420	Agent - Casualty	12/6/2022
Active	PTZ Insurance Agency LTD	695420	Agent - Property	12/6/2022