DEPARTMENT OF INSURANCE

Affiliations

Name	Chavez, Jose	DOIID	807819	NAIC NPN	16197934

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	4/12/2013	9/13/2018
Inactive	Non Resident	Agent	Property	4/12/2013	9/13/2018
* 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 Family Home Insurance Company	301817	Agent - Casualty	4/26/2013	9/13/2018
Inactive	American Family Home Insurance Company	301817	Agent - Property	4/26/2013	9/13/2018
Inactive	American Modern Home Insurance Company	300791	Agent - Casualty	4/26/2013	9/4/2015
Inactive	American Modern Home Insurance Company	300791	Agent - Property	4/26/2013	9/4/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Casualty	4/26/2013	9/4/2015
Inactive	American Modern Select Insurance Company	581481	Agent - Property	4/26/2013	9/4/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Casualty	4/26/2013	9/4/2015
Inactive	American Southern Home Insurance Company	626276	Agent - Property	4/26/2013	9/4/2015
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	6/28/2017	5/31/2018
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	6/28/2017	5/31/2018
Inactive	Homesite Insurance Company	301139	Agent - Casualty	7/28/2016	2/6/2018
Inactive	Homesite Insurance Company	301139	Agent - Property	7/28/2016	2/6/2018
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	7/11/2017	2/6/2018
Inactive	Homesite Insurance Company of the Midwest	874850	Agent - Property	7/11/2017	2/6/2018
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	5/31/2013	9/1/2015
Inactive	QBE Insurance Corporation	300515	Agent - Property	5/31/2013	9/1/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	4/29/2013	8/28/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	4/29/2013	8/28/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	4/29/2013	8/28/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	4/29/2013	8/28/2015
Inactive	Victoria Fire & Casualty Company	300313	Agent - Casualty	6/30/2014	9/1/2015
Inactive	Victoria Fire & Casualty Company	300313	Agent - Property	6/30/2014	9/1/2015

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 - Casualty	5/9/2013	8/28/2015
Inactive	Wells Fargo Insurance Inc.	518950	Agent - Property	5/9/2013	8/28/2015