DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Johnson, Chad William	DOIID	567015	NAIC NPN	3344493

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	3/4/2013	8/31/2015
Inactive	Non Resident	Agent	Property	4/23/2003	8/31/2015
Inactive	Non Resident	Agent	Casualty	4/23/2003	8/31/2015
* 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	Dairyland Insurance Company	301370	Agent - Casualty	11/26/2014	5/19/2015
Inactive	Dairyland Insurance Company	301370	Agent - Personal Lines	11/26/2014	5/19/2015
Inactive	Dairyland Insurance Company	301370	Agent - Property	11/26/2014	5/19/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	1/27/2012	6/22/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	1/27/2012	6/22/2015
Inactive	National General Assurance Company	301108	Agent - Casualty	4/29/2003	8/29/2005
Inactive	National General Assurance Company	301108	Agent - Personal Lines	3/5/2013	5/12/2015
Inactive	National General Insurance Company	300152	Agent - Casualty	4/29/2003	5/12/2015
Inactive	National General Insurance Company	300152	Agent - Personal Lines	3/5/2013	5/12/2015
Inactive	National General Insurance Company	300152	Agent - Property	4/29/2003	5/12/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	10/30/2011	5/20/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	10/30/2011	5/20/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	10/30/2011	5/20/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	10/30/2011	5/20/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Affinity Brokerage, LLC	544886	Agent - Casualty	10/24/2012	6/22/2015
Inactive	Affinity Brokerage, LLC	544886	Agent - Property	10/24/2012	6/22/2015
Inactive	CWI, LLC	662170	Agent - Casualty	11/7/2011	6/22/2015
Inactive	CWI, LLC	662170	Agent - Property	11/7/2011	6/22/2015
Inactive	Camping World Insurance Services of Kentucky, LLC	663187	Agent - Casualty	11/7/2011	6/22/2015
Inactive	Camping World Insurance Services of Kentucky, LLC	663187	Agent - Property	11/7/2011	6/22/2015
Inactive	National General Ins Marketing Inc	621228	Agent - Casualty	11/14/2011	5/13/2015
Inactive	National General Ins Marketing Inc	621228	Agent - Property	11/14/2011	5/13/2015