DEPARTMENT OF INSURANCE

Affiliations

Name	Insential, Inc. DBA : MIC Insurance Group	DOIID	655553	NAIC NPN	9128311

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Health	6/19/2013	3/31/2027
Active	Non Resident	Agent	Casualty	12/27/2007	3/31/2027
Active	Non Resident	Agent	Life	6/19/2013	3/31/2027
Active	Non Resident	Agent	Property	12/27/2007	3/31/2027
Active	Non Resident	Surplus Lines Broker	Not Applicable	4/19/2012	3/31/2027
* 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	ACE American Insurance Company	300625	Agent - Casualty	8/21/2014
Active	ACE American Insurance Company	300625	Agent - Property	8/21/2014
Inactive	AmTrust Insurance Company	300179	Agent - Casualty	12/28/2015	8/12/2021
Inactive	AmTrust Insurance Company	300179	Agent - Property	12/28/2015	8/12/2021
Inactive	Arch Insurance Company	300688	Agent - Casualty	4/27/2015	4/27/2017
Inactive	Arch Insurance Company	300688	Agent - Property	4/27/2015	4/27/2017
Inactive	CastlePoint National Insurance Company	300082	Agent - Casualty	1/31/2008	6/8/2016
Inactive	CastlePoint National Insurance Company	300082	Agent - Property	1/31/2008	6/8/2016
Inactive	Federal Insurance Company	301144	Agent - Casualty	11/14/2011	2/12/2014
Inactive	Federal Insurance Company	301144	Agent - Property	11/14/2011	2/12/2014
Inactive	Great American Insurance Company	301586	Agent - Casualty	7/22/2014	10/13/2016
Inactive	Great American Insurance Company	301586	Agent - Property	7/22/2014	10/13/2016
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Health	11/18/2013
Active	Lincoln National Life Insurance Company (The)	301382	Agent - Life	11/18/2013
Inactive	Milford Casualty Insurance Company	301460	Agent - Casualty	12/28/2015	8/12/2021
Inactive	Milford Casualty Insurance Company	301460	Agent - Property	12/28/2015	8/12/2021
Inactive	Park National Insurance Company	692514	Agent - Casualty	12/28/2015	8/12/2021
Inactive	Park National Insurance Company	692514	Agent - Property	12/28/2015	8/12/2021
Inactive	QBE Insurance Corporation	300515	Agent - Health	11/4/2013	9/11/2017
Inactive	Security National Insurance Company	301151	Agent - Casualty	12/28/2015	8/12/2021
Inactive	Security National Insurance Company	301151	Agent - Property	12/28/2015	8/12/2021
Inactive	Sequoia Insurance Company	628046	Agent - Casualty	5/5/2020	8/12/2021
Inactive	Sequoia Insurance Company	628046	Agent - Property	5/5/2020	8/12/2021
Active	Starr Indemnity and Liability Company	301685	Agent - Casualty	3/7/2012
Active	Starr Indemnity and Liability Company	301685	Agent - Property	3/7/2012
Inactive	Technology Insurance Company	613278	Agent - Casualty	12/28/2015	8/12/2021
Inactive	Technology Insurance Company	613278	Agent - Property	12/28/2015	8/12/2021
Inactive	Wesco Insurance Company	300534	Agent - Casualty	12/28/2015	8/12/2021
Inactive	Wesco Insurance Company	300534	Agent - Property	12/28/2015	8/12/2021
Active	Westchester Fire Insurance Company	300990	Agent - Casualty	8/21/2014
Active	Westchester Fire Insurance Company	300990	Agent - Property	8/21/2014

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Coffee, Malcolm Loyd	516749	Agent - Casualty	7/3/2013	10/15/2014
Inactive	Coffee, Malcolm Loyd	516749	Agent - Property	7/3/2013	10/15/2014
Inactive	Hildebrand, Allan Truman	757305	Agent - Casualty	10/11/2011	8/31/2015
Inactive	Hildebrand, Allan Truman	757305	Agent - Health	6/19/2013	8/31/2015
Inactive	Hildebrand, Allan Truman	757305	Agent - Life	6/19/2013	8/31/2015
Inactive	Hildebrand, Allan Truman	757305	Agent - Property	10/11/2011	8/31/2015
Inactive	Hildebrand, Allan Truman	757305	Surplus Lines Broker - Not Applicable	4/19/2012	8/31/2015
Inactive	Lucas, Darwin E	649122	Agent - Casualty	12/27/2007	10/11/2011
Inactive	Lucas, Darwin E	649122	Agent - Property	12/27/2007	10/11/2011
Inactive	Pulgine, Anthony S	656468	Agent - Casualty	7/15/2013	11/7/2019
Inactive	Pulgine, Anthony S	656468	Agent - Health	11/6/2015	11/7/2019
Inactive	Pulgine, Anthony S	656468	Agent - Life	11/6/2015	11/7/2019
Inactive	Pulgine, Anthony S	656468	Agent - Property	7/15/2013	11/7/2019
Inactive	Pulgine, Anthony S	656468	Surplus Lines Broker - Not Applicable	11/6/2015	11/7/2019
Denied	Rotolo, Raymond J	544600	Agent - Health
Denied	Rotolo, Raymond J	544600	Agent - Life
Active	Streich, David P	1018358	Agent - Health	11/7/2019
Active	Streich, David P	1018358	Agent - Life	11/7/2019
Active	Trinka, Mark C	685209	Agent - Casualty	11/7/2019
Active	Trinka, Mark C	685209	Agent - Property	11/7/2019
Active	Weiss, Howard A	720393	Agent - Casualty	11/25/2019
Active	Weiss, Howard A	720393	Agent - Property	11/25/2019
Active	Weiss, Howard A	720393	Surplus Lines Broker - Not Applicable	11/7/2019