DEPARTMENT OF INSURANCE

Affiliations

Name	Chudy, Thomas R	DOIID	726241	NAIC NPN	941230

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	4/10/2010	7/31/2015
Inactive	Non Resident	Agent	Property	4/10/2010	7/31/2015
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	4/17/2010	7/31/2015
* 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	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	3/30/2011	7/31/2015
Inactive	American Guarantee and Liability Insurance Company	301216	Agent - Property	3/30/2011	7/31/2015
Inactive	American Zurich Insurance Company	300592	Agent - Casualty	3/30/2011	7/31/2015
Inactive	American Zurich Insurance Company	300592	Agent - Property	3/30/2011	7/31/2015
Inactive	Assurance Company of America	300432	Agent - Casualty	3/30/2011	12/4/2013
Inactive	Assurance Company of America	300432	Agent - Property	3/30/2011	12/4/2013
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Casualty	3/30/2011	7/31/2015
Inactive	Colonial American Casualty & Surety Company	300769	Agent - Property	3/30/2011	7/31/2015
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	3/30/2011	7/31/2015
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	3/30/2011	7/31/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/21/2012	8/1/2014
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/21/2012	8/1/2014
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Casualty	11/21/2012	8/1/2014
Inactive	Foremost Property and Casualty Insurance Company	300871	Agent - Property	11/21/2012	8/1/2014
Inactive	Foremost Signature Insurance Company	300140	Agent - Casualty	11/21/2012	8/1/2014
Inactive	Foremost Signature Insurance Company	300140	Agent - Property	11/21/2012	8/1/2014
Inactive	Maryland Casualty Company	301719	Agent - Casualty	3/30/2011	12/4/2013
Inactive	Maryland Casualty Company	301719	Agent - Property	3/30/2011	12/4/2013
Inactive	Northern Insurance Company of New York	301317	Agent - Casualty	3/30/2011	12/4/2013
Inactive	Northern Insurance Company of New York	301317	Agent - Property	3/30/2011	12/4/2013
Inactive	Travelers Indemnity Company (The)	301855	Agent - Casualty	11/12/2012	12/9/2013
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	11/12/2012	12/9/2013
Inactive	Zurich American Insurance Company	301121	Agent - Casualty	3/30/2011	7/31/2015
Inactive	Zurich American Insurance Company	301121	Agent - Property	3/30/2011	7/31/2015
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	3/30/2011	7/31/2015
Inactive	Zurich American Insurance Company of Illinois	301805	Agent - Property	3/30/2011	7/31/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Denied	Willis Of Greater Kansas Inc -000	539585	Agent - Casualty
Denied	Willis Of Greater Kansas Inc -000	539585	Agent - Property
Inactive	Willis Of Greater Kansas Inc -000	539585	Surplus Lines Broker - Not Applicable	4/23/2010	6/1/2015