DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Campillo, Samuel	DOIID	1246847	NAIC NPN	17709277

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	4/12/2024		7/31/2025
Active	Non Resident	Agent	Casualty	12/14/2022		7/31/2025
Active	Non Resident	Agent	Property	12/14/2022		7/31/2025
Active	Non Resident	Agent	Health	4/12/2024		7/31/2025
* 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	05/15/2025	07/31/2025

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Arch Indemnity Insurance Company	301459	Agent - Casualty	6/11/2024
Active	Arch Indemnity Insurance Company	301459	Agent - Health	6/11/2024
Active	Arch Indemnity Insurance Company	301459	Agent - Property	6/11/2024
Active	Arch Insurance Company	300688	Agent - Casualty	6/11/2024
Active	Arch Insurance Company	300688	Agent - Health	6/11/2024
Active	Arch Insurance Company	300688	Agent - Property	6/11/2024
Active	CorePointe Insurance Company	300406	Agent - Casualty	4/9/2024
Active	CorePointe Insurance Company	300406	Agent - Property	4/9/2024
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	12/19/2022
Active	Hanover Insurance Company (The)	300508	Agent - Property	12/19/2022
Active	Milford Casualty Insurance Company	301460	Agent - Casualty	4/9/2024
Active	Milford Casualty Insurance Company	301460	Agent - Property	4/9/2024
Active	Southern Insurance Company	301630	Agent - Casualty	4/9/2024
Active	Southern Insurance Company	301630	Agent - Property	4/9/2024

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Specialty Program Group LLC	937234	Agent - Casualty	1/6/2023	1/4/2024
Inactive	Specialty Program Group LLC	937234	Agent - Property	1/6/2023	1/4/2024