DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Chmielewski, Lisa	DOIID	741477	NAIC NPN	8217091

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	11/2/2010	7/31/2017
Inactive	Non Resident	Agent	Property	11/2/2010	7/31/2017
* 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	Travelers Indemnity Company (The)	301855	Agent - Casualty	12/14/2011	5/29/2014
Inactive	Travelers Indemnity Company (The)	301855	Agent - Property	12/14/2011	5/29/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	USI Insurance Services National, Inc	509421	Agent - Property	12/14/2011	5/7/2014
Inactive	USI Insurance Services National, Inc	509421	Agent - Casualty	12/14/2011	5/7/2014
Denied	USI Midwest LLC	517736	Agent - Property
Denied	USI Midwest LLC	517736	Agent - Casualty
Denied	Usi Insurance Services LLC	669260	Agent - Property
Denied	Usi Insurance Services LLC	669260	Agent - Casualty