Individual Information

DAVID M SMITH

CLEVELAND, OH 44143-2329

Active

licensing@greatlakesga.com

06/21/2012

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	825104	06/21/2012	Active	06/21/2012	06/30/2027
Non-Res. Surplus Lines Broker	4081626	01/28/2025	Active	01/28/2025	01/31/2028

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	06/21/2012	Active	06/21/2012
Property	06/21/2012	Active	06/21/2012
Surplus Lines	01/28/2025	Active	01/28/2025
Managing General Agent	05/10/2016	Inactive	03/28/2025

Company Name	Appointment Type	Status	Active Date
1777
BERKLEY CASUALTY COMPANY	Casualty	Active	08/01/2019
	Property	Active	08/01/2019
130
Company Name	Appointment Type	Status	Active Date
CANAL INSURANCE COMPANY	Casualty	Active	07/17/2012
	Property	Active	07/17/2012
1710
Company Name	Appointment Type	Status	Active Date
ENDURANCE AMERICAN INSURANCE COMPANY	Casualty	Active	02/27/2018
	Property	Active	02/27/2018
288
Company Name	Appointment Type	Status	Active Date
GREAT AMERICAN INSURANCE COMPANY	Casualty	Active	06/15/2015
	Property	Active	06/15/2015
438
Company Name	Appointment Type	Status	Active Date
NATIONAL CASUALTY COMPANY	Casualty	Active	04/23/2020
	Property	Active	04/23/2020
1730
Company Name	Appointment Type	Status	Active Date
SCOTTSDALE INDEMNITY COMPANY	Casualty	Active	04/23/2020
	Property	Active	04/23/2020

row(s) 1 - 12 of 12

Organization	Association Type	Type	Beg dte	End dte
GREAT LAKES GENERAL AGENCY INC	Designated Resp Lic MGA	Agency	07/29/2024	-
GREAT LAKES GENERAL AGENCY INC	Designated Resp Lic Prdcr	Agency	03/24/2020	-
Great Lakes Transportation Risk Purchasing Group LLC	Risk Purchasing Grp-Agnt/Brkr	Company	04/01/2014	-

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