DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Andersen, Michael J	DOIID	976340	NAIC NPN	8422683

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	11/12/2017	10/26/2022
Inactive	Non Resident	Agent	Casualty	11/12/2017	10/26/2022
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	11/12/2017	10/26/2022
* 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	AIG Property Casualty Company	300621	Agent - Casualty	2/16/2018	10/26/2022
Inactive	AIG Property Casualty Company	300621	Agent - Property	2/16/2018	10/26/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Assuredpartners Jamison LLC	597159	Agent - Casualty	2/16/2018	9/14/2022
Inactive	Assuredpartners Jamison LLC	597159	Agent - Property	2/16/2018	9/14/2022
Inactive	Assuredpartners Jamison LLC	597159	Surplus Lines Broker - Not Applicable	11/28/2017	10/26/2022
Inactive	Assuredpartners Specialty Insurance Brokers LLC	592339	Agent - Casualty	7/2/2019	9/27/2022
Inactive	Assuredpartners Specialty Insurance Brokers LLC	592339	Agent - Property	7/2/2019	9/27/2022
Inactive	Assuredpartners Specialty Insurance Brokers LLC	592339	Surplus Lines Broker - Not Applicable	4/12/2018	10/4/2022
Inactive	Chamber Insurance Agency Services LLC	521229	Agent - Casualty	2/16/2018	9/28/2022
Inactive	Chamber Insurance Agency Services LLC	521229	Agent - Property	2/16/2018	9/28/2022
Inactive	Chamber Insurance Agency Services LLC	521229	Surplus Lines Broker - Not Applicable	11/28/2017	10/26/2022