DEPARTMENT OF INSURANCE

Affiliations

Name	Poljak, Diane	DOIID	1137934	NAIC NPN	8434648

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	6/4/2021	8/31/2025
Active	Non Resident	Agent	Health	6/4/2021	8/31/2025
Active	Non Resident	Agent	Life	6/4/2021	8/31/2025
Active	Non Resident	Agent	Casualty	6/4/2021	8/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/4/2021	8/31/2025
* 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	06/15/2025	08/31/2025
Surplus Lines Broker	06/15/2025	08/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	AIG Property Casualty Company	300621	Agent - Casualty	10/23/2021
Active	AIG Property Casualty Company	300621	Agent - Property	10/23/2021
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Casualty	9/26/2023	2/7/2024
Inactive	American Casualty Company of Reading, Pennsylvania	300956	Agent - Property	9/26/2023	2/7/2024
Active	Auto-Owners Insurance Company	301480	Agent - Casualty	3/30/2022
Active	Auto-Owners Insurance Company	301480	Agent - Property	3/30/2022
Active	Continental Casualty Company	301019	Agent - Casualty	12/7/2023
Active	Continental Casualty Company	301019	Agent - Property	12/7/2023
Inactive	Continental Insurance Company (The)	301242	Agent - Casualty	9/26/2023	2/7/2024
Inactive	Continental Insurance Company (The)	301242	Agent - Property	9/26/2023	2/7/2024
Active	Manufacturers Alliance Insurance Company	519940	Agent - Casualty	10/5/2022
Active	Manufacturers Alliance Insurance Company	519940	Agent - Property	10/5/2022
Active	Owners Insurance Company	300796	Agent - Casualty	3/30/2022
Active	Owners Insurance Company	300796	Agent - Property	3/30/2022
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Casualty	10/5/2022
Active	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Property	10/5/2022
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Casualty	10/5/2022
Active	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Property	10/5/2022
Active	Privilege Underwriters Reciprocal Exchange	769657	Agent - Casualty	12/9/2022
Active	Privilege Underwriters Reciprocal Exchange	769657	Agent - Property	12/9/2022
Active	Westfield Insurance Company	301950	Agent - Casualty	12/4/2023
Active	Westfield Insurance Company	301950	Agent - Property	12/4/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date
Active	Marsh & Mclennan Agency LLC	716460	Agent - Casualty	2/14/2024
Denied	Marsh & Mclennan Agency LLC	716460	Agent - Life
Denied	Marsh & Mclennan Agency LLC	716460	Agent - Health
Active	Marsh & Mclennan Agency LLC	716460	Agent - Property	2/14/2024