DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Gosiewski, David M	DOIID	630157	NAIC NPN	3240144

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	4/14/2006	11/30/2008
Inactive	Non Resident	Agent	Casualty	4/14/2006	11/30/2008
* 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	SAFECO Insurance Company of America	300159	Agent - Casualty	6/7/2006	11/21/2006
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	6/7/2006	11/21/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Casualty	7/3/2006	11/21/2006
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	7/3/2006	11/21/2006