PUBLIC PROTECTION
CABINET
DEPARTMENT OF INSURANCE
Affiliations
NameAtkielski, Roman DavidDOIID1138666NAIC NPN15967779
License - Line of Authority Information
StatusResidencyClassLine of AuthorityActive DateInactive DateLicense Expiration Date
ActiveNon ResidentAgentProperty6/9/2021 2/28/2026
ActiveNon ResidentAgentHealth6/9/2021 2/28/2026
ActiveNon ResidentAgentCasualty6/9/2021 2/28/2026
ActiveNon ResidentSurplus Lines BrokerNot Applicable10/6/2021 2/28/2026
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.
License Renewal Information
ClassInvoice DateResponse Due / Expiration DateResponse Received DatePayment Received DateRenewal Complete
Agent12/15/202502/28/2026   
Surplus Lines Broker12/15/202502/28/2026   
Appointments with the following Insurers
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
ActiveBerkley Casualty Company300731Agent - Casualty3/13/2023 
ActiveBerkley Casualty Company300731Agent - Property3/13/2023 
ActiveUnited States Fire Insurance Company582240Agent - Casualty11/10/2021 
ActiveUnited States Fire Insurance Company582240Agent - Health10/15/2021 
ActiveUnited States Fire Insurance Company582240Agent - Property11/10/2021 
Designated to act on behalf of the following Business Entities
StatusAffiliation NameDOI NumberLine of AuthorityActive DateInactive Date
InactiveICM Insurance Service LLC937342Agent - Casualty12/1/20214/11/2022
InactiveICM Insurance Service LLC937342Agent - Health12/1/20214/11/2022
InactiveICM Insurance Service LLC937342Agent - Property12/1/20214/11/2022
InactiveICM Insurance Service LLC937342Surplus Lines Broker - Not Applicable12/9/20214/11/2022
ActiveJencap Insurance Services Inc.705614Agent - Casualty4/27/2023 
ActiveJencap Insurance Services Inc.705614Agent - Property4/27/2023 
ActiveJencap Insurance Services Inc.705614Surplus Lines Broker - Not Applicable4/27/2023 

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