DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Cermak, Matthew John	DOIID	845464	NAIC NPN	3583521

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/14/2014		6/30/2026
Active	Non Resident	Agent	Life	7/14/2014		6/30/2026
Active	Non Resident	Agent	Health	7/14/2014		6/30/2026
Active	Non Resident	Agent	Property	7/14/2014		6/30/2026
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	9/25/2015	6/30/2016
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

License Renewal Information

Class	Invoice Date	Response Due / Expiration Date	Response Received Date	Payment Received Date	Renewal Complete
Agent	04/15/2024	06/30/2024	04/10/2024	04/10/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Arch Insurance Company	300688	Agent - Casualty	8/26/2015	6/22/2020
Inactive	Arch Insurance Company	300688	Agent - Health	8/26/2015	6/22/2020
Inactive	Arch Insurance Company	300688	Agent - Property	8/26/2015	6/22/2020
Active	Continental Casualty Company	301019	Agent - Casualty	2/10/2022
Active	Continental Casualty Company	301019	Agent - Property	2/10/2022
Inactive	CorePointe Insurance Company	300406	Agent - Casualty	8/14/2014	10/4/2017
Inactive	CorePointe Insurance Company	300406	Agent - Property	8/14/2014	10/4/2017
Active	Granite State Insurance Company	300818	Agent - Casualty	8/12/2015
Active	Granite State Insurance Company	300818	Agent - Property	8/12/2015
Active	Illinois National Insurance Company	301367	Agent - Casualty	8/12/2015
Active	Illinois National Insurance Company	301367	Agent - Property	8/12/2015
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	8/12/2015
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	8/12/2015
Active	New Hampshire Insurance Company	301670	Agent - Casualty	8/12/2015
Active	New Hampshire Insurance Company	301670	Agent - Property	8/12/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AmWins Program Underwriters, Inc	521669	Agent - Casualty	11/22/2017
Active	AmWins Program Underwriters, Inc	521669	Agent - Property	11/22/2017
Inactive	Willis Of Michigan Inc	561744	Agent - Casualty	8/14/2014	11/7/2017
Inactive	Willis Of Michigan Inc	561744	Agent - Property	8/14/2014	11/7/2017