DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Rozenberg, Jeroen George	DOIID	847614	NAIC NPN	17333672

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	8/7/2014	5/31/2021
Inactive	Non Resident	Agent	Property	8/7/2014	5/31/2021
* 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	United States Fire Insurance Company	582240	Agent - Casualty	8/12/2014	3/19/2020
Inactive	United States Fire Insurance Company	582240	Agent - Property	8/12/2014	3/19/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Petpremium Inc	818198	Agent - Property	9/10/2014	3/19/2020
Inactive	Petpremium Inc	818198	Agent - Casualty	9/10/2014	3/19/2020