DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Samuels, Racquel	DOIID	882988	NAIC NPN	17288453

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Independent Adjuster	Workers' Compensation	7/13/2015	12/31/2021
Inactive	Non Resident	Independent Adjuster	Property & Casualty	7/13/2015	12/31/2021
* If a status Is Pending, Pending Replacement,Or the record displays Affidavit On File, click On them For more details.

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Broadspire Services, Inc.	396187	Independent Adjuster - Property & Casualty	1/7/2019	1/27/2019
Inactive	Broadspire Services, Inc.	396187	Independent Adjuster - Workers' Compensation	1/7/2019	1/27/2019