DEPARTMENT OF INSURANCE

Affiliations

Name	Carlson, Chad Nathaniel	DOIID	713258	NAIC NPN	14872037

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	9/11/2009	4/30/2011
Inactive	Non Resident	Agent	Life	9/11/2009	4/30/2011
Inactive	Non Resident	Agent	Property	9/11/2009	4/30/2011
Inactive	Non Resident	Agent	Health	9/11/2009	4/30/2011
* 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	ACE American Insurance Company	300625	Agent - Casualty	3/26/2010	4/8/2010
Inactive	ACE American Insurance Company	300625	Agent - Property	3/26/2010	4/8/2010
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	3/5/2010	10/15/2010
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	3/5/2010	10/15/2010
Inactive	Bankers Standard Insurance Company	301620	Agent - Casualty	3/26/2010	4/8/2010
Inactive	Bankers Standard Insurance Company	301620	Agent - Property	3/26/2010	4/8/2010
Inactive	Encompass Indemnity Company	546376	Agent - Casualty	3/3/2010	1/22/2011
Inactive	Encompass Indemnity Company	546376	Agent - Property	3/3/2010	1/22/2011
Inactive	Encompass Insurance Company of America	556578	Agent - Casualty	3/3/2010	1/22/2011
Inactive	Encompass Insurance Company of America	556578	Agent - Property	3/3/2010	1/22/2011
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Casualty	3/10/2010	10/21/2010
Inactive	Farmers Property and Casualty Insurance Company	301237	Agent - Property	3/10/2010	10/21/2010
Inactive	First National Insurance Company of America	301690	Agent - Casualty	4/8/2010	1/4/2011
Inactive	First National Insurance Company of America	301690	Agent - Property	4/8/2010	1/4/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/19/2009	2/18/2011
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/19/2009	2/18/2011
Inactive	General Insurance Company of America	300261	Agent - Casualty	4/8/2010	1/4/2011
Inactive	General Insurance Company of America	300261	Agent - Property	4/8/2010	1/4/2011
Inactive	Indemnity Insurance Company of North America	301760	Agent - Casualty	3/26/2010	4/8/2010
Inactive	Indemnity Insurance Company of North America	301760	Agent - Property	3/26/2010	4/8/2010
Inactive	Owners Insurance Company	300796	Agent - Casualty	3/5/2010	10/15/2010
Inactive	Owners Insurance Company	300796	Agent - Property	3/5/2010	10/15/2010
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	3/26/2010	4/8/2010
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	3/26/2010	4/8/2010
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	4/8/2010	1/4/2011
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	4/8/2010	1/4/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	4/8/2010	1/4/2011
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	4/8/2010	1/4/2011

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Casualty	11/9/2009	10/14/2010
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Property	11/9/2009	10/14/2010