DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Mitchell, Laura Tickerhoof	DOIID	542382	NAIC NPN	599757

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	12/6/2001	1/4/2010
Inactive	Non Resident	Agent	Property	12/6/2001	1/4/2010
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	4/5/2004	1/4/2010
* 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
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	3/4/2002	1/4/2010
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	3/4/2002	1/4/2010
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	3/4/2002	1/4/2010
Inactive	American Zurich Insurance Company	300592	Agent - Property	3/4/2002	1/4/2010
Inactive	Assurance Company of America	300432	Agent - Casualty	3/4/2002	1/4/2010
Inactive	Assurance Company of America	300432	Agent - Property	3/4/2002	1/4/2010
Inactive	Blackboard Insurance Company	301640	Agent - Casualty	3/4/2002	5/9/2006
Inactive	Blackboard Insurance Company	301640	Agent - Property	3/4/2002	5/9/2006
Inactive	Maryland Casualty Company	301719	Agent - Casualty	12/6/2001	1/4/2010
Inactive	Maryland Casualty Company	301719	Agent - Property	12/6/2001	1/4/2010
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	3/4/2002	1/4/2010
Inactive	Northern Insurance Company of New York	301317	Agent - Property	3/4/2002	1/4/2010
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	3/4/2002	1/4/2010
Inactive	Zurich American Insurance Company	301121	Agent - Property	3/4/2002	1/4/2010
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	3/4/2002	1/4/2010
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	3/4/2002	1/4/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USAssure Insurance Services, Inc.	533937	Agent - Casualty	12/26/2001	1/4/2010
Inactive	USAssure Insurance Services, Inc.	533937	Agent - Property	12/26/2001	1/4/2010