DEPARTMENT OF INSURANCE

Affiliations

Name	Van Dam, Paul	DOIID	575082	NAIC NPN	975280

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	10/9/2019	9/30/2026
Active	Non Resident	Agent	Health	10/9/2019	9/30/2026
Active	Non Resident	Agent	Property	10/9/2019	9/30/2026
* 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
Active	Charter Oak Fire Insurance Company (The)	301501	Agent - Casualty	4/7/2020
Active	Charter Oak Fire Insurance Company (The)	301501	Agent - Property	4/7/2020
Active	Farmington Casualty Company	301137	Agent - Casualty	4/7/2020
Active	Farmington Casualty Company	301137	Agent - Property	4/7/2020
Active	Standard Fire Insurance Company (The)	301068	Agent - Casualty	4/7/2020
Active	Standard Fire Insurance Company (The)	301068	Agent - Property	4/7/2020
Active	The Phoenix Insurance Company	301502	Agent - Casualty	4/7/2020
Active	The Phoenix Insurance Company	301502	Agent - Property	4/7/2020
Active	Travelers Casualty Insurance Company of America	300522	Agent - Casualty	4/7/2020
Active	Travelers Casualty Insurance Company of America	300522	Agent - Property	4/7/2020
Active	Travelers Casualty and Surety Company	301067	Agent - Casualty	4/7/2020
Active	Travelers Casualty and Surety Company	301067	Agent - Property	4/7/2020
Active	Travelers Indemnity Company (The)	301855	Agent - Casualty	4/7/2020
Active	Travelers Indemnity Company (The)	301855	Agent - Property	4/7/2020
Active	Travelers Indemnity Company of America (The)	301093	Agent - Casualty	4/7/2020
Active	Travelers Indemnity Company of America (The)	301093	Agent - Property	4/7/2020
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Casualty	4/7/2020
Active	Travelers Indemnity Company of Connecticut (The)	301591	Agent - Property	4/7/2020
Active	Travelers Property Casualty Company of America	301649	Agent - Casualty	4/7/2020
Active	Travelers Property Casualty Company of America	301649	Agent - Property	4/7/2020

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Acrisure Great Lakes Partners Insurance Services LLC	1271471	Agent - Casualty	5/16/2025
Active	Acrisure Great Lakes Partners Insurance Services LLC	1271471	Agent - Property	5/16/2025
Pending	Acrisure Great Lakes Partners Insurance Services LLC	1271471	Agent - Health
Inactive	Acrisure LLC	696181	Agent - Casualty	4/10/2020	5/16/2025
Inactive	Acrisure LLC	696181	Agent - Property	4/10/2020	5/16/2025
Denied	Campbell Agency, Inc.	573819	Agent - Casualty
Denied	Campbell Agency, Inc.	573819	Agent - Property