DEPARTMENT OF INSURANCE

Affiliations

Name	Van Dam, Paul	DOIID	575082	NAIC NPN	975280

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	10/9/2019	9/30/2024
Active	Non Resident	Agent	Casualty	10/9/2019	9/30/2024
Active	Non Resident	Agent	Property	10/9/2019	9/30/2024
* 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	07/15/2024	09/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	4/7/2020
Active	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	4/7/2020
Active	Farmington Casualty Company	301137	Agent - Casualty	4/7/2020
Active	Farmington Casualty Company	301137	Agent - Property	4/7/2020
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	4/7/2020
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	4/7/2020
Active	The Phoenix Insurance Company	301502	Agent - Casualty	4/7/2020
Active	The Phoenix Insurance Company	301502	Agent - Property	4/7/2020
Active	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	4/7/2020
Active	Travelers Casualty Insurance Company of America	300522	Agent - Property	4/7/2020
Active	Travelers Casualty and Surety Company	301067	Agent - Casualty	4/7/2020
Active	Travelers Casualty and Surety Company	301067	Agent - Property	4/7/2020
Active	Travelers Indemnity Company (The)	301855	Agent - Casualty	4/7/2020
Active	Travelers Indemnity Company (The)	301855	Agent - Property	4/7/2020
Active	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	4/7/2020
Active	Travelers Indemnity Company of America (The)	301093	Agent - Property	4/7/2020
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	4/7/2020
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	4/7/2020
Active	Travelers Property Casualty Company of America	301649	Agent - Casualty	4/7/2020
Active	Travelers Property Casualty Company of America	301649	Agent - Property	4/7/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Acrisure LLC	696181	Agent - Casualty	4/10/2020
Active	Acrisure LLC	696181	Agent - Property	4/10/2020
Denied	Campbell Agency, Inc.	573819	Agent - Casualty
Denied	Campbell Agency, Inc.	573819	Agent - Property