DEPARTMENT OF INSURANCE

Affiliations

Name	Gross, Terry Lee	DOIID	541070	NAIC NPN	1012077

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	12/13/2001	4/18/2011
Inactive	Non Resident	Agent	Casualty	12/13/2001	4/18/2011
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	10/7/2008	4/14/2011
Inactive	American Fire and Casualty Company	300567	Agent - Property	10/7/2008	4/14/2011
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/7/2008	4/14/2011
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/7/2008	4/14/2011
Inactive	First National Insurance Company of America	301690	Agent - Casualty	12/13/2001	4/14/2011
Inactive	First National Insurance Company of America	301690	Agent - Property	12/13/2001	4/14/2011
Inactive	General Insurance Company of America	300261	Agent - Casualty	12/13/2001	4/14/2011
Inactive	General Insurance Company of America	300261	Agent - Property	12/13/2001	4/14/2011
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/7/2008	4/14/2011
Inactive	Indiana Insurance Company	301909	Agent - Property	10/7/2008	4/14/2011
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/7/2008	4/14/2011
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/7/2008	4/14/2011
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/7/2008	4/14/2011
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	10/7/2008	4/14/2011
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	10/7/2008	4/14/2011
Inactive	Ohio Security Insurance Company	300622	Agent - Property	10/7/2008	4/14/2011
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/7/2008	4/14/2011
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	10/7/2008	4/14/2011
Inactive	Peerless Insurance Company	301910	Agent - Casualty	10/7/2008	4/14/2011
Inactive	Peerless Insurance Company	301910	Agent - Property	10/7/2008	4/14/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	12/13/2001	4/14/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	12/13/2001	4/14/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	12/13/2001	4/14/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	12/13/2001	4/14/2011
Inactive	West American Insurance Company	301112	Agent - Casualty	10/7/2008	4/14/2011
Inactive	West American Insurance Company	301112	Agent - Property	10/7/2008	4/14/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Emerald City Insurance Agency, Inc.	536551	Agent - Casualty	12/13/2001	4/14/2011
Inactive	Emerald City Insurance Agency, Inc.	536551	Agent - Property	12/13/2001	4/14/2011