DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Palotay, Michael Richard	DOIID	1174713	NAIC NPN	16306083

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	11/30/2021		11/30/2024
Active	Non Resident	Agent	Property	11/30/2021		11/30/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	1/13/2022		11/30/2024
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	09/15/2024	11/30/2024
Surplus Lines Broker	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	U.S. Specialty Insurance Company	300186	Agent - Casualty	12/1/2022
Active	U.S. Specialty Insurance Company	300186	Agent - Property	12/1/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Nas Insurance Services, LLC	710641	Agent - Casualty	12/14/2023
Active	Nas Insurance Services, LLC	710641	Agent - Property	12/14/2023
Active	Nas Insurance Services, LLC	710641	Surplus Lines Broker - Not Applicable	12/14/2023
Active	Professional Indemnity Agency Inc	636863	Agent - Casualty	12/1/2022
Active	Professional Indemnity Agency Inc	636863	Agent - Property	12/1/2022