DEPARTMENT OF INSURANCE

Affiliations

Name	Cusenz, Andrea Marie	DOIID	820205	NAIC NPN	10142274

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Property	9/10/2013	9/30/2016
Inactive	Non Resident	Agent	Casualty	9/10/2013	9/30/2016
* 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 Fire and Casualty Company	300567	Agent - Casualty	11/18/2014	1/15/2016
Inactive	American Fire and Casualty Company	300567	Agent - Property	11/18/2014	1/15/2016
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	11/18/2014	1/15/2016
Inactive	Consolidated Insurance Company	300943	Agent - Property	11/18/2014	1/15/2016
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Casualty	12/31/2013	12/23/2015
Inactive	Hartford Insurance Company of the Midwest	301918	Agent - Property	12/31/2013	12/23/2015
Inactive	Indiana Insurance Company	301909	Agent - Casualty	11/18/2014	1/15/2016
Inactive	Indiana Insurance Company	301909	Agent - Property	11/18/2014	1/15/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	11/18/2014	1/15/2016
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	11/18/2014	1/15/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Casualty	11/18/2014	1/15/2016
Inactive	Ohio Casualty Insurance Company	301492	Agent - Property	11/18/2014	1/15/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Casualty	11/18/2014	1/14/2016
Inactive	Ohio Security Insurance Company	300622	Agent - Property	11/18/2014	1/14/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Casualty	11/18/2014	1/14/2016
Inactive	Peerless Indemnity Insurance Company	571682	Agent - Property	11/18/2014	1/14/2016
Inactive	Peerless Insurance Company	301910	Agent - Casualty	11/18/2014	1/14/2016
Inactive	Peerless Insurance Company	301910	Agent - Property	11/18/2014	1/14/2016
Inactive	West American Insurance Company	301112	Agent - Casualty	11/18/2014	1/15/2016
Inactive	West American Insurance Company	301112	Agent - Property	11/18/2014	1/15/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Paychex Insurance Agency Inc	509469	Agent - Casualty	12/31/2013	1/15/2016
Inactive	Paychex Insurance Agency Inc	509469	Agent - Property	12/31/2013	1/15/2016