DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark Jr, Samuel Wayne	DOIID	600212	NAIC NPN	1616151

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/21/2004		12/31/2026
Active	Non Resident	Agent	Property	12/21/2004		12/31/2026
* 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
Active	Berkley Regional Insurance Company	300920	Agent - Casualty	1/28/2022
Active	Berkley Regional Insurance Company	300920	Agent - Property	1/28/2022
Active	United States Fire Insurance Company	582240	Agent - Casualty	12/14/2023
Active	United States Fire Insurance Company	582240	Agent - Property	12/14/2023
Active	WCF National Insurance Company	300727	Agent - Casualty	8/10/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dale Barton Agency	765836	Agent - Casualty	10/5/2011	3/31/2025
Inactive	Dale Barton Agency	765836	Agent - Property	10/5/2011	3/31/2025
Active	Hub International Ins Services Inc	609910	Agent - Casualty	3/5/2024
Active	Hub International Ins Services Inc	609910	Agent - Property	3/5/2024