DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Catlin Insurance Services, Inc.	DOIID	662152	NAIC NPN	4767693

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	6/24/2009	9/29/2020
Inactive	Non Resident	Agent	Property	6/24/2009	9/29/2020
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	8/11/2009	9/29/2020
* 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	Catlin Insurance Company, Inc.	300979	Agent - Casualty	6/24/2009	9/29/2020
Inactive	Catlin Insurance Company, Inc.	300979	Agent - Property	6/24/2009	9/29/2020

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Belzer, Donn William	611008	Agent - Casualty	8/13/2010	9/23/2016
Inactive	Belzer, Donn William	611008	Agent - Property	8/13/2010	9/23/2016
Inactive	Belzer, Donn William	611008	Surplus Lines Broker - Not Applicable	6/23/2010	2/9/2017
Inactive	Chauvin, William Pierre	707831	Agent - Casualty	9/23/2016	9/29/2020
Inactive	Chauvin, William Pierre	707831	Agent - Property	9/23/2016	9/29/2020
Inactive	Chauvin, William Pierre	707831	Surplus Lines Broker - Not Applicable	9/23/2016	9/29/2020
Inactive	Gott, Sheila Dean	329861	Agent - Casualty	6/24/2009	9/29/2020
Inactive	Gott, Sheila Dean	329861	Agent - Property	6/24/2009	9/29/2020
Inactive	McDougall, Scott	684065	Surplus Lines Broker - Not Applicable	6/23/2010	11/18/2014