DEPARTMENT OF INSURANCE

Affiliations

Name	Obrzut, Lisa	DOIID	796313	NAIC NPN	4683856

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Property	4/9/2015	10/1/2018
Inactive	Resident	Agent	Casualty	4/9/2015	10/1/2018
Inactive	Non Resident	Independent Adjuster	Property & Casualty	11/8/2012	9/30/2014
Withdrawn	Non Resident	Staff Adjuster	Property & Casualty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.

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	8/11/2015	10/1/2018
Inactive	American Modern Home Insurance Company	300791	Agent - Property	8/11/2015	10/1/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	8/11/2015	10/1/2018
Inactive	American Modern Select Insurance Company	581481	Agent - Property	8/11/2015	10/1/2018
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	8/11/2015	10/1/2018
Inactive	American Southern Home Insurance Company	626276	Agent - Property	8/11/2015	10/1/2018
Inactive	Auto-Owners Insurance Company	301480	Agent - Casualty	6/18/2015	11/21/2017
Inactive	Auto-Owners Insurance Company	301480	Agent - Property	6/18/2015	11/21/2017
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	5/19/2016	10/1/2018
Inactive	Bristol West Insurance Company	301655	Agent - Property	5/19/2016	10/1/2018
Inactive	Cincinnati Casualty Company (The)	300308	Agent - Casualty	4/30/2015	4/12/2017
Inactive	Cincinnati Casualty Company (The)	300308	Agent - Property	4/30/2015	4/12/2017
Inactive	Cincinnati Indemnity Company (The)	301566	Agent - Casualty	4/30/2015	4/12/2017
Inactive	Cincinnati Indemnity Company (The)	301566	Agent - Property	4/30/2015	4/12/2017
Inactive	Cincinnati Insurance Company	301298	Agent - Casualty	4/30/2015	4/12/2017
Inactive	Cincinnati Insurance Company	301298	Agent - Property	4/30/2015	4/12/2017
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	5/19/2016	10/1/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	5/19/2016	10/1/2018
Inactive	Grange Indemnity Insurance Company	300793	Agent - Casualty	5/8/2015	12/28/2017
Inactive	Grange Indemnity Insurance Company	300793	Agent - Property	5/8/2015	12/28/2017
Inactive	Grange Insurance Company	300234	Agent - Casualty	5/8/2015	12/28/2017
Inactive	Grange Insurance Company	300234	Agent - Property	5/8/2015	12/28/2017
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Casualty	5/8/2015	12/28/2017
Inactive	Grange Property & Casualty Insurance Company	601680	Agent - Property	5/8/2015	12/28/2017
Inactive	Owners Insurance Company	300796	Agent - Casualty	6/18/2015	11/21/2017
Inactive	Owners Insurance Company	300796	Agent - Property	6/18/2015	11/21/2017
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	5/29/2015	10/1/2018
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	5/29/2015	10/1/2018
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	5/29/2015	10/1/2018
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	5/29/2015	10/1/2018
Inactive	Trustgard Insurance Company	300104	Agent - Casualty	5/8/2015	12/28/2017
Inactive	Trustgard Insurance Company	300104	Agent - Property	5/8/2015	12/28/2017

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ferrell and Evans, LLC	398891	Agent - Property	4/30/2015	10/1/2018
Inactive	Ferrell and Evans, LLC	398891	Agent - Casualty	4/30/2015	10/1/2018