DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Lopez, Carlos F	DOIID	1166380	NAIC NPN	18103331

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Property	10/14/2021	3/31/2023
Inactive	Non Resident	Agent	Casualty	10/14/2021	3/31/2023
* 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	Inactive Date
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	10/27/2021	11/16/2021
Inactive	Bristol West Insurance Company	301655	Agent - Property	10/27/2021	11/16/2021
Inactive	CSAA Fire & Casualty Insurance Company	606666	Agent - Casualty	10/16/2021	11/19/2021
Inactive	CSAA Fire & Casualty Insurance Company	606666	Agent - Property	10/16/2021	11/19/2021
Inactive	CSAA General Insurance Company	606675	Agent - Casualty	10/16/2021	11/19/2021
Inactive	CSAA General Insurance Company	606675	Agent - Property	10/16/2021	11/19/2021
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	10/27/2021	11/16/2021
Inactive	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	10/27/2021	11/16/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Polly Insurance Agency, LLC	992125	Agent - Casualty	10/20/2021	11/16/2021
Inactive	Polly Insurance Agency, LLC	992125	Agent - Property	10/20/2021	11/16/2021