DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Bushong, Charles Robert	DOIID	577706	NAIC NPN	518177

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Casualty	9/29/2003	12/5/2023
Inactive	Non Resident	Agent	Property	9/29/2003	12/5/2023
Inactive	Non Resident	Surplus Lines Broker	Not Applicable	10/23/2019	12/5/2023
* 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	Mount Vernon Fire Insurance Company	301397	Agent - Casualty	11/4/2010	12/5/2023
Inactive	Mount Vernon Fire Insurance Company	301397	Agent - Property	11/4/2010	12/5/2023

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Ciuins LLC	1108522	Agent - Casualty	11/1/2020	2/28/2023
Inactive	Ciuins LLC	1108522	Agent - Property	11/1/2020	2/28/2023
Inactive	Ciuins LLC	1108522	Surplus Lines Broker - Not Applicable	11/9/2020	2/28/2023
Inactive	Coastal Insurance Underwriters, Inc.	1062281	Agent - Casualty	10/22/2019	3/5/2021
Inactive	Coastal Insurance Underwriters, Inc.	1062281	Agent - Property	10/22/2019	3/5/2021
Inactive	Coastal Insurance Underwriters, Inc.	1062281	Surplus Lines Broker - Not Applicable	11/5/2019	3/5/2021
Inactive	Starwind Specialty Insurance Services, LLC	513826	Agent - Casualty	12/6/2022	11/9/2023
Inactive	Starwind Specialty Insurance Services, LLC	513826	Agent - Property	12/6/2022	11/9/2023