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	Life	6/19/2013	3/31/2027
Active	Non Resident	Agent	Property	12/27/2007	3/31/2027
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	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.

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	01/16/2025	01/16/2025	Yes
Surplus Lines Broker	01/15/2025	03/31/2025	01/16/2025	01/16/2025	Yes

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