DEPARTMENT OF INSURANCE

Affiliations

Name	Randy Faulkner LLC DBA : Mid South Insurance Agency	DOIID	725177	NAIC NPN	15713772

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Resident	Agent	Casualty	4/1/2010	3/31/2018
Inactive	Resident	Agent	Property	4/1/2010	3/31/2018
* 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	American Modern Home Insurance Company	300791	Agent - Casualty	4/13/2016	3/31/2018
Inactive	American Modern Home Insurance Company	300791	Agent - Property	4/13/2016	3/31/2018
Inactive	Bristol West Insurance Company	301655	Agent - Casualty	11/2/2011	5/9/2017
Inactive	Bristol West Insurance Company	301655	Agent - Property	11/2/2011	5/9/2017
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Casualty	2/22/2011	7/3/2013
Inactive	Hartford Accident and Indemnity Company	301917	Agent - Property	2/22/2011	7/3/2013
Inactive	Progressive Casualty Insurance Company	300696	Agent - Casualty	5/26/2010	9/26/2014
Inactive	Progressive Casualty Insurance Company	300696	Agent - Property	5/26/2010	9/26/2014
Inactive	Progressive Northern Insurance Company	301378	Agent - Casualty	5/26/2010	9/26/2014
Inactive	Progressive Northern Insurance Company	301378	Agent - Property	5/26/2010	9/26/2014
Inactive	SAFECO Insurance Company of America	300159	Agent - Casualty	7/8/2011	5/6/2015
Inactive	SAFECO Insurance Company of America	300159	Agent - Property	7/8/2011	5/6/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Casualty	7/8/2011	5/6/2015
Inactive	SAFECO Insurance Company of Illinois	301350	Agent - Property	7/8/2011	5/6/2015
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Casualty	2/22/2011	7/3/2013
Inactive	Sentinel Insurance Company, Limited	501696	Agent - Property	2/22/2011	7/3/2013
Inactive	Trexis Insurance Corporation	599902	Agent - Casualty	4/27/2010	4/18/2017
Inactive	Trexis One Insurance Corporation	684197	Agent - Casualty	4/27/2010	4/18/2017
Inactive	United Financial Casualty Company	301886	Agent - Casualty	5/26/2010	9/26/2014
Inactive	United Financial Casualty Company	301886	Agent - Property	5/26/2010	9/26/2014
Inactive	Universal Insurance Company	686754	Agent - Casualty	5/7/2010	11/8/2012
Inactive	Universal Insurance Company	686754	Agent - Property	5/7/2010	11/8/2012

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Faulkner, Randal L	330377	Agent - Casualty	4/1/2010	11/1/2015
Inactive	Faulkner, Randal L	330377	Agent - Property	4/1/2010	11/1/2015
Inactive	Lanphear, Erin Faulkner	706852	Agent - Casualty	1/11/2016	3/31/2018
Inactive	Lanphear, Erin Faulkner	706852	Agent - Property	1/11/2016	3/31/2018