DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Kuzma, Adam David	DOIID	947910	NAIC NPN	18352769

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Self-Service Storage Space	3/8/2017	9/30/2021
* 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	New Hampshire Insurance Company	301670	Agent - Self-Service Storage Space	4/10/2017	2/2/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	CAS Holdings LLC	947908	Agent - Self-Service Storage Space	3/8/2017	3/31/2021