DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Koellner, Polly	DOIID	746686	NAIC NPN	16053637

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Independent Adjuster	Workers' Compensation	9/10/2020		6/30/2026
Active	Non Resident	Independent Adjuster	Property & Casualty	9/10/2020		6/30/2026
Denied	Resident	Staff Adjuster	Property & Casualty
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Aig Claims Inc	401148	Independent Adjuster - Property & Casualty	6/8/2017	10/23/2019