DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Kussow, Michelle L	DOIID	634947	NAIC NPN	652758

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	6/27/2006		3/31/2025
Active	Non Resident	Agent	Casualty	6/27/2006		3/31/2025
* 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	01/15/2025	03/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	7/11/2006
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	7/11/2006
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Casualty	8/23/2021
Active	American Modern Property and Casualty Insurance Company	301954	Agent - Property	8/23/2021
Active	Bristol West Insurance Company	301655	Agent - Casualty	11/11/2019
Active	Bristol West Insurance Company	301655	Agent - Property	11/11/2019
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/11/2019
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/11/2019
Active	Homesite Insurance Company	301139	Agent - Casualty	11/12/2019
Active	Homesite Insurance Company	301139	Agent - Property	11/12/2019
Active	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	11/12/2019
Active	Homesite Insurance Company of the Midwest	874850	Agent - Property	11/12/2019
Active	Midvale Indemnity Company	300292	Agent - Casualty	11/12/2019
Active	Midvale Indemnity Company	300292	Agent - Property	11/12/2019
Inactive	Permanent General Assurance Corporation of Ohio	709250	Agent - Casualty	12/20/2023	8/19/2024
Active	RLI Insurance Company	301217	Agent - Casualty	9/1/2020
Active	RLI Insurance Company	301217	Agent - Property	9/1/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	11/5/2019
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	11/5/2019
Inactive	General Automobile Ins Services Inc	706632	Agent - Casualty	12/27/2023	9/13/2024