DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Nordby-Gaulin, Dawn M	DOIID	610060	NAIC NPN	5782724

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	6/9/2005		3/31/2028
Active	Non Resident	Agent	Casualty	6/9/2005		3/31/2028
* 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
Active	Amica Mutual Insurance Company	301405	Agent - Casualty	6/16/2005
Active	Amica Mutual Insurance Company	301405	Agent - Property	6/16/2005
Active	Amica Property and Casualty Insurance Company	962874	Agent - Casualty	4/20/2018
Active	Amica Property and Casualty Insurance Company	962874	Agent - Property	4/20/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/4/2012	7/14/2021
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/4/2012	7/14/2021
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	11/18/2008	10/5/2009
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	11/18/2008	10/5/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Amica General Agency, LLC	509383	Agent - Property	6/29/2007
Active	Amica General Agency, LLC	509383	Agent - Casualty	6/29/2007