DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Staten, Randolph Wilbert	DOIID	882863	NAIC NPN	17533545

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	7/10/2015	7/31/2016
Active	Non Resident	Independent Adjuster	Property & Casualty	7/19/2023		7/31/2026
* 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
Independent Adjuster	05/15/2024	07/31/2024	06/25/2024	06/25/2024	Yes

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	First Liberty Insurance Corporation (The)	301060	Agent - Personal Lines	8/12/2015	5/9/2016
Inactive	LM General Insurance Company	300133	Agent - Personal Lines	8/12/2015	5/9/2016
Inactive	LM Insurance Corporation	301061	Agent - Personal Lines	8/12/2015	5/9/2016
Inactive	Liberty Insurance Corporation	300444	Agent - Personal Lines	8/12/2015	5/9/2016
Inactive	Liberty Mutual Fire Insurance Company	301913	Agent - Personal Lines	8/12/2015	5/9/2016
Inactive	Liberty Mutual Insurance Company	301159	Agent - Personal Lines	8/12/2015	5/9/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Red Ventures Ins LLC	794656	Agent - Personal Lines	3/28/2016	5/5/2016