DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Dultz, Thomas Sheldon	DOIID	638183	NAIC NPN	2577636

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	8/22/2006	5/2/2013
Inactive	Non Resident	Agent	Property	8/22/2006	5/2/2013
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	7/23/2007	8/5/2011
* 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	Everest National Insurance Company	301319	Agent - Casualty	12/1/2006	11/29/2010
Inactive	Everest National Insurance Company	301319	Agent - Property	12/1/2006	11/29/2010
Inactive	Starr Indemnity and Liability Company	301685	Agent - Casualty	4/27/2009	4/5/2010
Inactive	Starr Indemnity and Liability Company	301685	Agent - Property	4/27/2009	4/5/2010

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	C V Starr & Co	636526	Agent - Casualty	8/23/2007	6/25/2010
Inactive	C V Starr & Co	636526	Agent - Property	8/23/2007	6/25/2010
Inactive	C V Starr & Co	636526	Surplus Lines Broker - Not Applicable	7/25/2008	6/25/2010