DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Carbon Insurance Agency LLC	DOIID	1288181	NAIC NPN	20790750

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Property	7/27/2023		3/31/2025
Active	Non Resident	Agent	Casualty	7/27/2023		3/31/2025
Active	Non Resident	Surplus Lines Broker	Not Applicable	10/13/2023		3/31/2025
* 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	01/15/2025	03/31/2025
Surplus Lines Broker	01/15/2025	03/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hall, James Larry	338226	Agent - Casualty	7/27/2023
Active	Hall, James Larry	338226	Agent - Property	7/27/2023
Active	Hall, James Larry	338226	Surplus Lines Broker - Not Applicable	10/13/2023