DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Roberts, David	DOIID	651521	NAIC NPN	1295225

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Health	3/31/2009	11/30/2012
Inactive	Non Resident	Agent	Casualty	3/26/2007	11/30/2012
Inactive	Non Resident	Agent	Life	3/31/2009	11/30/2012
Inactive	Non Resident	Agent	Property	3/26/2007	11/30/2012
* 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	Fireman's Fund Insurance Company	301423	Agent - Casualty	6/12/2009	10/5/2011
Inactive	Fireman's Fund Insurance Company	301423	Agent - Property	6/12/2009	10/5/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	9/4/2007	11/30/2012
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	9/4/2007	11/30/2012

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	9/11/2007	4/6/2011
Inactive	Arthur J. Gallagher Risk Management Services, LLC	539806	Agent - Property	9/11/2007	4/6/2011