Individual Information

DUSTIN J CHALUPA

GOLDEN, CO 80401-1046

Active

dchalupa@amfam.com

07/07/2021

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3691178	07/07/2021	Active	07/07/2021	07/31/2027

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	07/07/2021	Active	07/07/2021
Life	07/07/2021	Active	07/07/2021
Property	07/07/2021	Active	07/07/2021

Company Name	Appointment Type	Status	Active Date
126590
AMERICAN FAMILY INSURANCE COMPANY	Casualty	Active	07/14/2021
	Property	Active	07/14/2021
1742
Company Name	Appointment Type	Status	Active Date
AMERICAN FAMILY LIFE INSURANCE COMPANY	Life	Active	07/14/2021
1743
Company Name	Appointment Type	Status	Active Date
AMERICAN FAMILY MUTUAL INSURANCE COMPANY, S.I.	Casualty	Active	07/14/2021
	Property	Active	07/14/2021
58
Company Name	Appointment Type	Status	Active Date
AMERICAN MODERN HOME INSURANCE COMPANY	Casualty	Active	07/15/2021
	Property	Active	07/15/2021
1795
Company Name	Appointment Type	Status	Active Date
AMERICAN MODERN PROPERTY AND CASUALTY INSURANCE COMPANY	Casualty	Active	07/15/2021
	Property	Active	07/15/2021
1744
Company Name	Appointment Type	Status	Active Date
AMERICAN STANDARD INSURANCE COMPANY OF WISCONSIN	Casualty	Active	07/14/2021
261
Company Name	Appointment Type	Status	Active Date
FOREMOST INSURANCE COMPANY GRAND RAPIDS MICHIGAN	Casualty	Active	07/15/2021
	Property	Active	07/15/2021
1409
Company Name	Appointment Type	Status	Active Date
MIDVALE INDEMNITY COMPANY	Casualty	Active	02/25/2025
	Property	Active	02/25/2025
14146
Company Name	Appointment Type	Status	Active Date
NGM INSURANCE COMPANY	Casualty	Active	02/29/2024
	Property	Active	02/29/2024
1302
Company Name	Appointment Type	Status	Active Date
PROGRESSIVE NORTHERN INSURANCE COMPANY	Casualty	Active	07/17/2024
	Property	Active	07/17/2024

row(s) 1 - 18 of 18

Organization	Association Type	Type	Beg dte	End dte
DUSTIN CHALUPA AGENCY INC	Designated Resp Lic Prdcr	Agency	07/09/2021	-

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