DEPARTMENT OF INSURANCE

Affiliations

Name	Dormanen, Stacy	DOIID	759180	NAIC NPN	10703534

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	7/25/2011	6/30/2014
Inactive	Non Resident	Agent	Casualty	7/25/2011	6/30/2014
* 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	ACE American Insurance Company	300625	Agent - Casualty	1/25/2012	6/30/2014
Inactive	ACE American Insurance Company	300625	Agent - Property	1/25/2012	6/30/2014
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	1/25/2012	6/30/2014
Inactive	ACE Fire Underwriters Insurance Company	301679	Agent - Property	1/25/2012	6/30/2014
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	1/25/2012	6/30/2014
Inactive	ACE Property and Casualty Insurance Company	300520	Agent - Property	1/25/2012	6/30/2014
Inactive	Bankers Standard Insurance Company	301620	Agent - Casualty	1/25/2012	6/30/2014
Inactive	Bankers Standard Insurance Company	301620	Agent - Property	1/25/2012	6/30/2014
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	8/29/2011	11/14/2013
Inactive	Farmington Casualty Company	301137	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Farmington Casualty Company	301137	Agent - Property	8/29/2011	11/14/2013
Inactive	Indemnity Insurance Company of North America	301760	Agent - Casualty	1/25/2012	6/30/2014
Inactive	Indemnity Insurance Company of North America	301760	Agent - Property	1/25/2012	6/30/2014
Inactive	Markel American Insurance Company	300377	Agent - Casualty	2/1/2012	6/30/2014
Inactive	Markel American Insurance Company	300377	Agent - Property	2/1/2012	6/30/2014
Inactive	Markel Insurance Company	301475	Agent - Casualty	2/1/2012	6/30/2014
Inactive	Markel Insurance Company	301475	Agent - Property	2/1/2012	6/30/2014
Inactive	Pacific Employers Insurance Company	301753	Agent - Casualty	1/25/2012	6/30/2014
Inactive	Pacific Employers Insurance Company	301753	Agent - Property	1/25/2012	6/30/2014
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Standard Fire Insurance Company (The)	301068	Agent - Property	8/29/2011	11/14/2013
Inactive	The Phoenix Insurance Company	301502	Agent - Casualty	8/29/2011	11/14/2013
Inactive	The Phoenix Insurance Company	301502	Agent - Property	8/29/2011	11/14/2013
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Travelers Casualty Insurance Company of America	300522	Agent - Property	8/29/2011	11/14/2013
Inactive	Travelers Casualty and Surety Company	301067	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Travelers Casualty and Surety Company	301067	Agent - Property	8/29/2011	11/14/2013
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Travelers Indemnity Company of America (The)	301093	Agent - Property	8/29/2011	11/14/2013
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	8/29/2011	11/14/2013
Inactive	Travelers Property Casualty Company of America	301649	Agent - Casualty	8/29/2011	11/14/2013
Inactive	Travelers Property Casualty Company of America	301649	Agent - Property	8/29/2011	11/14/2013
Inactive	Westchester Fire Insurance Company	300990	Agent - Casualty	1/25/2012	6/30/2014
Inactive	Westchester Fire Insurance Company	300990	Agent - Property	1/25/2012	6/30/2014

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Property	9/13/2011	11/15/2013
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Casualty	9/13/2011	11/15/2013