DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Polsky, Elliott M	DOIID	744318	NAIC NPN	16022963

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	12/13/2010	5/31/2014
Inactive	Non Resident	Agent	Property	12/13/2010	5/31/2014
* 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	Hartford Fire Insurance Company	300628	Agent - Casualty	8/20/2012	5/31/2014
Inactive	Hartford Fire Insurance Company	300628	Agent - Property	8/20/2012	5/31/2014
Inactive	Westfield Insurance Company	301950	Agent - Casualty	10/6/2011	1/13/2014
Inactive	Westfield Insurance Company	301950	Agent - Property	10/6/2011	1/13/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assuredpartners NL, LLC	762387	Agent - Property	10/6/2011	2/25/2013
Inactive	Assuredpartners NL, LLC	762387	Agent - Casualty	10/6/2011	2/25/2013