DEPARTMENT OF INSURANCE

Affiliations

Name	Petrey, Charles William	DOIID	949971	NAIC NPN	5950845

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	4/4/2017	5/31/2025
Active	Non Resident	Agent	Casualty	4/4/2017	5/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/8/2021	5/31/2025
* 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
Active	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	6/8/2017
Active	American Guarantee and Liability Insurance Company	301216	Agent - Property	6/8/2017
Active	American Zurich Insurance Company	300592	Agent - Casualty	6/8/2017
Active	American Zurich Insurance Company	300592	Agent - Property	6/8/2017
Inactive	BrickStreet Mutual Insurance Company	709251	Agent - Casualty	11/27/2021	11/27/2021
Active	Hartford Underwriters Insurance Company	301064	Agent - Casualty	11/26/2020
Active	Hartford Underwriters Insurance Company	301064	Agent - Property	11/26/2020
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
Active	Sentinel Insurance Company, Limited	501696	Agent - Casualty	1/14/2018
Active	Sentinel Insurance Company, Limited	501696	Agent - Property	1/14/2018
Inactive	SummitPoint Insurance Company	819084	Agent - Casualty	11/27/2021	11/27/2021
Active	Trumbull Insurance Company	300242	Agent - Casualty	1/9/2018
Active	Trumbull Insurance Company	300242	Agent - Property	1/9/2018
Active	West Bend Insurance Company	672974	Agent - Casualty	8/1/2023
Active	West Bend Insurance Company	672974	Agent - Property	8/1/2023
Active	Zurich American Insurance Company	301121	Agent - Casualty	6/8/2017
Active	Zurich American Insurance Company	301121	Agent - Property	6/8/2017
Active	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	6/8/2017
Active	Zurich American Insurance Company of Illinois	301805	Agent - Property	6/8/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Willis Towers Watson Southeast Inc	399919	Agent - Property	7/7/2017
Active	Willis Towers Watson Southeast Inc	399919	Agent - Casualty	7/7/2017
Active	Willis Towers Watson Southeast Inc	399919	Surplus Lines Broker - Not Applicable	4/20/2021