DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Budaj, Vicky Marie	DOIID	1114812	NAIC NPN	7959104

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	12/23/2020		6/30/2024
Active	Non Resident	Agent	Casualty	12/23/2020		6/30/2024
Active	Non Resident	Agent	Personal Lines	12/23/2020		6/30/2024
Active	Non Resident	Surplus Lines Broker	Not Applicable	6/11/2021		6/30/2024
* 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	04/15/2024	06/30/2024
Surplus Lines Broker	04/15/2024	06/30/2024

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Casualty	3/3/2022
Active	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Property	3/3/2022
Active	Zurich American Insurance Company	301121	Agent - Casualty	1/15/2021
Active	Zurich American Insurance Company	301121	Agent - Property	1/15/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Willis Towers Watson Midwest, Inc.	534348	Agent - Casualty	5/27/2021
Active	Willis Towers Watson Midwest, Inc.	534348	Agent - Property	5/27/2021
Inactive	Willis Towers Watson Northeast Inc	537673	Agent - Casualty	1/15/2021	5/27/2021
Inactive	Willis Towers Watson Northeast Inc	537673	Agent - Property	1/15/2021	5/27/2021