DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Ortiz, Joal Samuel	DOIID	947752	NAIC NPN	17136412

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	7/21/2021		11/30/2024
Active	Non Resident	Agent	Casualty	7/21/2021		11/30/2024
* 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	09/15/2024	11/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dairyland Insurance Company	301370	Agent - Casualty	8/18/2021	4/30/2024
Inactive	Dairyland Insurance Company	301370	Agent - Property	8/18/2021	4/30/2024
Inactive	National Casualty Company	301483	Agent - Casualty	3/15/2017	11/30/2018
Inactive	National Casualty Company	301483	Agent - Property	3/15/2017	11/30/2018

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	DVM Insurance Agency	636779	Agent - Property	3/28/2017	11/30/2018
Inactive	DVM Insurance Agency	636779	Agent - Casualty	3/28/2017	11/30/2018