DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Guzman, Nelson Daniel	DOIID	754258	NAIC NPN	1114553

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	5/12/2011		9/30/2025
Active	Non Resident	Agent	Casualty	5/12/2011		9/30/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	10/28/2011		9/30/2025
* 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	Allegheny Casualty Company	545740	Agent - Casualty	4/24/2014	12/22/2020
Inactive	Capson Physicians Insurance Company	301959	Agent - Casualty	5/16/2011	9/11/2015
Active	Doctors Company, an Interinsurance Exchange (The)	301946	Agent - Casualty	5/31/2011
Active	Doctors Company, an Interinsurance Exchange (The)	301946	Agent - Property	5/31/2011
Inactive	Medicus Insurance Company	750731	Agent - Casualty	11/9/2011	1/1/2018
Inactive	NORCAL Insurance Company	301971	Agent - Casualty	1/11/2017	8/30/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	CBIZ Ins Services Inc	515291	Agent - Property	10/8/2012
Active	CBIZ Ins Services Inc	515291	Agent - Casualty	10/8/2012
Active	CBIZ Ins Services Inc	515291	Surplus Lines Broker - Not Applicable	10/8/2012
Inactive	Trinity Risk Advisors Inc	755408	Agent - Property	6/10/2011	3/31/2013
Inactive	Trinity Risk Advisors Inc	755408	Agent - Casualty	6/10/2011	3/31/2013