DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Corpuz, Terri Golding	DOIID	1010075	NAIC NPN	3076389

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	9/15/2018		7/31/2025
Active	Non Resident	Agent	Property	9/15/2018		7/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/8/2019		7/31/2025
* 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	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	11/27/2021	11/27/2021
Inactive	NorthStone Insurance Company	818905	Agent - Casualty	11/27/2021	11/27/2021
Inactive	PinnaclePoint Insurance Company	819085	Agent - Casualty	11/27/2021	11/27/2021
Inactive	SummitPoint Insurance Company	819084	Agent - Casualty	11/27/2021	11/27/2021
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	9/24/2018	6/23/2022
Inactive	Zurich American Insurance Company	301121	Agent - Property	9/24/2018	6/23/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Willis Towers Watson Southeast Inc	399919	Agent - Property	2/1/2020	6/7/2021
Inactive	Willis Towers Watson Southeast Inc	399919	Agent - Casualty	2/1/2020	6/7/2021
Active	Willis Towers Watson Southeast Inc	399919	Surplus Lines Broker - Not Applicable	2/1/2020
Inactive	Willis of Virginia, LLC	533452	Agent - Property	4/10/2019	1/8/2020
Inactive	Willis of Virginia, LLC	533452	Agent - Casualty	4/10/2019	1/8/2020