Individual Information

JACK GRISWOLD

Address:

BOSTON, MA 02115-3153

Status:

Active

Email:

slbilling@rein.ai

Date:

01/09/2017

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3213552	01/09/2017	Active	01/09/2017	01/31/2026
Non-Res. Surplus Lines Broker	3248056	06/12/2017	Active	06/12/2017	06/30/2026

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	01/09/2017	Active	01/09/2017
Property	01/09/2017	Active	01/09/2017
Surplus Lines	06/12/2017	Active	06/12/2017

Company Name	Appointment Type	Status	Active Date
11242
INDEPENDENCE AMERICAN INSURANCE COMPANY	Casualty	Active	08/15/2024
1566
Company Name	Appointment Type	Status	Active Date
NORTHLAND CASUALTY COMPANY	Casualty	Active	05/29/2020
	Property	Active	05/29/2020
485
Company Name	Appointment Type	Status	Active Date
NORTHLAND INSURANCE COMPANY	Casualty	Active	05/29/2020
	Property	Active	05/29/2020
1261
Company Name	Appointment Type	Status	Active Date
UNITED FINANCIAL CASUALTY COMPANY	Casualty	Active	10/09/2020
	Property	Active	10/09/2020

row(s) 1 - 7 of 7

Organization	Association Type	Type	Beg dte	End dte
REIN CONNECTED INSURANCE AGENCY, LLC	Designated Resp Lic Prdcr	Agency	09/15/2020	-

1 - 1