DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Buena Sombra Insurance Agency, Inc.	DOIID	509452	NAIC NPN	3225249

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Life	5/30/2000	3/5/2007
Inactive	Non Resident	Agent	Casualty	4/14/2003	3/5/2007
Inactive	Non Resident	Agent	Health	5/30/2000	3/5/2007
Inactive	Non Resident	Agent	Property	4/14/2003	3/5/2007
* 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	Peoples Benefit Life Insurance Company	301895	Agent - Health	5/30/2000	2/23/2007
Inactive	Peoples Benefit Life Insurance Company	301895	Agent - Life	5/30/2000	2/23/2007
Inactive	Stonebridge Life Insurance Company	301614	Agent - Health	3/1/2004	2/26/2007
Inactive	Stonebridge Life Insurance Company	301614	Agent - Life	3/1/2004	2/26/2007
Inactive	Transamerica Casualty Insurance Company	300311	Agent - Casualty	8/26/2004	2/21/2007
Inactive	Transamerica Casualty Insurance Company	300311	Agent - Property	8/26/2004	2/21/2007
Inactive	Work First Casualty Company	300561	Agent - Casualty	4/28/2003	7/6/2005
Inactive	Work First Casualty Company	300561	Agent - Property	4/28/2003	7/6/2005

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Short, Brian David	525608	Agent - Casualty	4/15/2003	2/21/2007
Inactive	Short, Brian David	525608	Agent - Health	7/16/2001	3/5/2007
Inactive	Short, Brian David	525608	Agent - Life	7/16/2001	3/5/2007
Inactive	Short, Brian David	525608	Agent - Property	4/15/2003	2/21/2007
Inactive	Walker, Edward H	392199	Agent - Health	5/30/2000	7/16/2001
Inactive	Walker, Edward H	392199	Agent - Life	5/30/2000	7/16/2001