DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Goldman, Michelle J	DOIID	631633	NAIC NPN	1320950

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	9/16/2015		5/31/2025
Active	Non Resident	Agent	Personal Lines	9/16/2015		5/31/2025
Active	Non Resident	Agent	Casualty	9/16/2015		5/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	9/16/2015		5/31/2025
* 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	AIG Property Casualty Company	300621	Agent - Casualty	12/22/2015
Active	AIG Property Casualty Company	300621	Agent - Property	12/22/2015
Active	American Home Assurance Company	300246	Agent - Casualty	12/22/2015
Active	American Home Assurance Company	300246	Agent - Property	12/22/2015
Active	Commerce and Industry Insurance Company	300881	Agent - Casualty	12/22/2015
Active	Commerce and Industry Insurance Company	300881	Agent - Property	12/22/2015
Active	Granite State Insurance Company	300818	Agent - Casualty	12/22/2015
Active	Granite State Insurance Company	300818	Agent - Property	12/22/2015
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Casualty	12/22/2015
Active	Insurance Company of the State of Pennsylvania	300807	Agent - Property	12/22/2015
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	12/22/2015
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	12/22/2015
Active	New Hampshire Insurance Company	301670	Agent - Casualty	12/22/2015
Active	New Hampshire Insurance Company	301670	Agent - Property	12/22/2015
Inactive	RSUI Indemnity Company	300513	Agent - Casualty	8/29/2006	5/14/2015
Inactive	RSUI Indemnity Company	300513	Agent - Property	8/29/2006	5/14/2015
Inactive	Underwriters at Lloyd's, London	300658	Agent - Casualty	1/13/2016	8/7/2019
Inactive	Underwriters at Lloyd's, London	300658	Agent - Property	1/13/2016	8/7/2019

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	RSG Specialty, LLC	726176	Agent - Casualty	1/7/2016
Active	RSG Specialty, LLC	726176	Agent - Property	1/7/2016
Active	RSG Specialty, LLC	726176	Surplus Lines Broker - Not Applicable	1/7/2016