DEPARTMENT OF INSURANCE

Affiliations

Name	Tejeski, Donald John	DOIID	661192	NAIC NPN	7701703

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Casualty	7/30/2007	3/31/2027
Active	Non Resident	Agent	Property	7/30/2007	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	7/30/2007	3/31/2027
* 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	01/15/2027	03/31/2027
Surplus Lines Broker	01/15/2027	03/31/2027

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	ACE American Insurance Company	300625	Agent - Casualty	6/4/2008
Active	ACE American Insurance Company	300625	Agent - Property	6/4/2008
Active	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	6/4/2008
Active	ACE Property and Casualty Insurance Company	300520	Agent - Property	6/4/2008
Active	American Guarantee and Liability Insurance Company	301216	Agent - Casualty	2/17/2009
Active	American Guarantee and Liability Insurance Company	301216	Agent - Property	2/17/2009
Active	American Zurich Insurance Company	300592	Agent - Casualty	2/17/2009
Active	American Zurich Insurance Company	300592	Agent - Property	2/17/2009
Inactive	Harleysville Mutual Insurance Company	301393	Agent - Casualty	6/4/2010	5/1/2012
Inactive	Harleysville Mutual Insurance Company	301393	Agent - Property	6/4/2010	5/1/2012
Active	Indemnity Insurance Company of North America	301760	Agent - Casualty	6/4/2008
Active	Indemnity Insurance Company of North America	301760	Agent - Property	6/4/2008
Active	Manufacturers Alliance Insurance Company	519940	Agent - Casualty	4/18/2008
Active	Manufacturers Alliance Insurance Company	519940	Agent - Property	4/18/2008
Inactive	Nationwide Assurance Company	300166	Agent - Casualty	3/15/2020	5/7/2025
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Casualty	5/1/2012	5/7/2025
Inactive	Nationwide Mutual Insurance Company	301749	Agent - Property	5/1/2012	5/7/2025
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Casualty	3/15/2020	5/7/2025
Inactive	Nationwide Property and Casualty Insurance Company	300599	Agent - Property	3/15/2020	5/7/2025
Inactive	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Casualty	4/18/2008	9/3/2026
Inactive	Pennsylvania Manufacturers Association Insurance Company	300228	Agent - Property	4/18/2008	9/3/2026
Inactive	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Casualty	4/18/2008	9/3/2026
Inactive	Pennsylvania Manufacturers Indemnity Company	519939	Agent - Property	4/18/2008	9/3/2026
Inactive	Westchester Fire Insurance Company	301414	Agent - Casualty	6/4/2008	1/1/2011
Active	Westchester Fire Insurance Company	300990	Agent - Casualty	1/1/2011
Inactive	Westchester Fire Insurance Company	301414	Agent - Property	6/4/2008	1/1/2011
Active	Westchester Fire Insurance Company	300990	Agent - Property	1/1/2011
Active	Zurich American Insurance Company	301121	Agent - Casualty	2/17/2009
Active	Zurich American Insurance Company	301121	Agent - Property	2/17/2009
Active	Zurich American Insurance Company of Illinois	301805	Agent - Casualty	2/17/2009
Active	Zurich American Insurance Company of Illinois	301805	Agent - Property	2/17/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	AmWINS Brokerage of New York, Inc.	515357	Surplus Lines Broker - Not Applicable	3/20/2017	11/30/2022
Active	Amwins Insurance Brokerage LLC	624422	Surplus Lines Broker - Not Applicable	8/2/2022
Active	Amwins Insurance Brokerage LLC	624422	Agent - Casualty	8/2/2022
Active	Amwins Insurance Brokerage LLC	624422	Agent - Property	8/2/2022