DEPARTMENT OF INSURANCE

Affiliations

Name	Sandfoss, Susan Sieverman	DOIID	545534	NAIC NPN	7224409

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	8/2/2002	2/1/2013
Inactive	Resident	Agent	Casualty	8/2/2002	2/1/2013
* 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	ACUITY, A Mutual Insurance Company	300095	Agent - Casualty	8/18/2003	10/14/2011
Inactive	ACUITY, A Mutual Insurance Company	300095	Agent - Property	8/18/2003	10/14/2011
Inactive	American Fire and Casualty Company	300567	Agent - Casualty	7/16/2004	2/1/2013
Inactive	American Fire and Casualty Company	300567	Agent - Property	7/16/2004	2/1/2013
Inactive	Ansur America Insurance Company	520667	Agent - Casualty	4/5/2010	10/21/2011
Inactive	Ansur America Insurance Company	520667	Agent - Property	4/5/2010	10/21/2011
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	6/3/2004	2/1/2013
Inactive	Consolidated Insurance Company	300943	Agent - Property	6/3/2004	2/1/2013
Inactive	Employers Mutual Casualty Company	300202	Agent - Casualty	1/6/2004	9/23/2011
Inactive	Employers Mutual Casualty Company	300202	Agent - Property	1/6/2004	9/23/2011
Inactive	Frankenmuth Insurance Company	301481	Agent - Casualty	4/5/2010	10/21/2011
Inactive	Frankenmuth Insurance Company	301481	Agent - Property	4/5/2010	10/21/2011
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	7/28/2011	11/12/2011
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	7/28/2011	11/12/2011
Inactive	Grange Insurance Company	300234	Agent - Casualty	7/28/2011	11/12/2011
Inactive	Grange Insurance Company	300234	Agent - Property	7/28/2011	11/12/2011
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	7/28/2011	11/12/2011
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	7/28/2011	11/12/2011
Inactive	Great American Assurance Company	300327	Agent - Casualty	8/18/2003	3/8/2004
Inactive	Great American Assurance Company	300327	Agent - Property	8/18/2003	3/8/2004
Denied	Great American Insurance Company	301586	Agent - Casualty
Denied	Great American Insurance Company	301586	Agent - Property
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Casualty	1/6/2004	9/23/2011
Inactive	Hamilton Mutual Insurance Company	301111	Agent - Property	1/6/2004	9/23/2011
Inactive	Indiana Insurance Company	301909	Agent - Casualty	6/3/2004	2/1/2013
Inactive	Indiana Insurance Company	301909	Agent - Property	6/3/2004	2/1/2013
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	6/3/2004	2/1/2013
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	6/3/2004	2/1/2013
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	7/16/2004	2/1/2013
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	7/16/2004	2/1/2013
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	7/16/2004	2/1/2013
Inactive	Ohio Security Insurance Company	300622	Agent - Property	7/16/2004	2/1/2013
Inactive	Peerless Insurance Company	301910	Agent - Casualty	6/3/2004	2/1/2013
Inactive	Peerless Insurance Company	301910	Agent - Property	6/3/2004	2/1/2013
Inactive	Selective Insurance Company of America	500018	Agent - Casualty	11/12/2010	11/12/2011
Inactive	Selective Insurance Company of America	500018	Agent - Property	11/12/2010	11/12/2011
Inactive	Selective Insurance Company of South Carolina	500012	Agent - Casualty	11/12/2010	11/12/2011
Inactive	Selective Insurance Company of South Carolina	500012	Agent - Property	11/12/2010	11/12/2011
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Casualty	11/12/2010	1/24/2012
Inactive	Selective Insurance Company of the Southeast	300381	Agent - Property	11/12/2010	1/24/2012
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	7/28/2011	11/12/2011
Inactive	Trustgard Insurance Company	300104	Agent - Property	7/28/2011	11/12/2011
Inactive	West American Insurance Company	301112	Agent - Casualty	7/16/2004	2/1/2013
Inactive	West American Insurance Company	301112	Agent - Property	7/16/2004	2/1/2013

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Chas. H. Bilz Insurance Agency Inc.	398379	Agent - Casualty	8/22/2003	10/18/2011
Inactive	Chas. H. Bilz Insurance Agency Inc.	398379	Agent - Property	8/22/2003	10/18/2011