DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kazmierczak, Amy	DOIID	368508	NAIC NPN	2856380

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Adjuster	Independent	6/5/2000	7/1/2010
Inactive	Non Resident	Apprentice Adjuster	Not Applicable	7/20/1999	6/5/2000
Active	Non Resident	Staff Adjuster	Property & Casualty	7/1/2010		7/31/2026
* 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
Staff Adjuster	05/15/2024	07/31/2024	05/30/2024	05/30/2024	Yes

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Esurance Insurance Company	301072	Adjuster - Independent	8/11/2005	7/1/2010
Active	Esurance Insurance Company	301072	Staff Adjuster - Property & Casualty	7/1/2010
Inactive	Omni Insurance Company	301545	Adjuster - Independent	6/5/2000	7/1/2010
Inactive	Omni Insurance Company	301545	Staff Adjuster - Property & Casualty	7/1/2010	1/1/2018

Sponsored By

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Unversaw, James R	330171	Apprentice Adjuster - Not Applicable	7/20/1999	6/5/2000