DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Coastal Insurance Underwriters, Inc.	DOIID	1062281	NAIC NPN	10095938

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	10/22/2019	3/5/2021
Inactive	Non Resident	Agent	Property	10/22/2019	3/5/2021
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	11/5/2019	3/5/2021
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Bushong, Charles Robert	577706	Agent - Casualty	10/22/2019	3/5/2021
Inactive	Bushong, Charles Robert	577706	Agent - Property	10/22/2019	3/5/2021
Inactive	Bushong, Charles Robert	577706	Surplus Lines Broker - Not Applicable	11/5/2019	3/5/2021