DEPARTMENT OF INSURANCE

Affiliations

Name	Hazelton, Farah Qubain	DOIID	884115	NAIC NPN	17601037

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	License Expiration Date
Active	Non Resident	Agent	Property	7/22/2015	9/30/2024
Active	Non Resident	Agent	Casualty	7/22/2015	9/30/2024
* 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	07/15/2024	09/30/2024

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	10/23/2015
Active	ACE American Insurance Company	300625	Agent - Property	10/23/2015
Active	ACE Fire Underwriters Insurance Company	301679	Agent - Casualty	10/23/2015
Active	ACE Fire Underwriters Insurance Company	301679	Agent - Property	10/23/2015
Active	ACE Property and Casualty Insurance Company	300520	Agent - Casualty	10/23/2015
Active	ACE Property and Casualty Insurance Company	300520	Agent - Property	10/23/2015
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Casualty	10/28/2015
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Property	10/28/2015
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	10/28/2015
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	10/28/2015
Active	American Fire and Casualty Company	300567	Agent - Casualty	10/28/2015
Active	American Fire and Casualty Company	300567	Agent - Property	10/28/2015
Active	Bankers Standard Insurance Company	301620	Agent - Casualty	10/23/2015
Active	Bankers Standard Insurance Company	301620	Agent - Property	10/23/2015
Inactive	Consolidated Insurance Company	300943	Agent - Casualty	10/28/2015	4/26/2024
Inactive	Consolidated Insurance Company	300943	Agent - Property	10/28/2015	4/26/2024
Inactive	Great American Insurance Company	301586	Agent - Casualty	8/3/2015	7/23/2019
Inactive	Great American Insurance Company	301586	Agent - Property	8/3/2015	7/23/2019
Inactive	Great American Insurance Company of New York	301897	Agent - Casualty	8/3/2015	7/23/2019
Inactive	Great American Insurance Company of New York	301897	Agent - Property	8/3/2015	7/23/2019
Active	Hanover American Insurance Company (The)	300447	Agent - Casualty	10/28/2015
Active	Hanover American Insurance Company (The)	300447	Agent - Property	10/28/2015
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	10/28/2015
Active	Hanover Insurance Company (The)	300508	Agent - Property	10/28/2015
Active	Hartford Accident and Indemnity Company	301917	Agent - Casualty	4/24/2017
Active	Hartford Accident and Indemnity Company	301917	Agent - Property	4/24/2017
Active	Indemnity Insurance Company of North America	301760	Agent - Casualty	10/23/2015
Active	Indemnity Insurance Company of North America	301760	Agent - Property	10/23/2015
Inactive	Indiana Insurance Company	301909	Agent - Casualty	10/28/2015	2/3/2023
Inactive	Indiana Insurance Company	301909	Agent - Property	10/28/2015	2/3/2023
Active	Markel Insurance Company	301475	Agent - Casualty	10/22/2015
Active	Markel Insurance Company	301475	Agent - Property	10/22/2015
Active	Massachusetts Bay Insurance Company	300898	Agent - Casualty	10/28/2015
Active	Massachusetts Bay Insurance Company	300898	Agent - Property	10/28/2015
Active	NGM Insurance Company	583837	Agent - Casualty	10/29/2015
Active	NGM Insurance Company	583837	Agent - Property	10/29/2015
Inactive	Netherlands Insurance Company (The)	300339	Agent - Casualty	10/28/2015	4/26/2024
Inactive	Netherlands Insurance Company (The)	300339	Agent - Property	10/28/2015	4/26/2024
Active	Ohio Casualty Insurance Company	301492	Agent - Casualty	10/28/2015
Active	Ohio Casualty Insurance Company	301492	Agent - Property	10/28/2015
Active	Ohio Security Insurance Company	300622	Agent - Casualty	10/28/2015
Active	Ohio Security Insurance Company	300622	Agent - Property	10/28/2015
Active	Pacific Employers Insurance Company	301753	Agent - Casualty	10/23/2015
Active	Pacific Employers Insurance Company	301753	Agent - Property	10/23/2015
Active	Peerless Indemnity Insurance Company	571682	Agent - Casualty	10/28/2015
Active	Peerless Indemnity Insurance Company	571682	Agent - Property	10/28/2015
Active	Peerless Insurance Company	301910	Agent - Casualty	10/28/2015
Active	Peerless Insurance Company	301910	Agent - Property	10/28/2015
Active	Twin City Fire Insurance Company	300721	Agent - Casualty	4/24/2017
Active	Twin City Fire Insurance Company	300721	Agent - Property	4/24/2017
Active	West American Insurance Company	301112	Agent - Casualty	10/28/2015
Active	West American Insurance Company	301112	Agent - Property	10/28/2015

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mcgriff Insurance Services, LLC	400877	Agent - Property	9/25/2015
Active	Mcgriff Insurance Services, LLC	400877	Agent - Casualty	9/25/2015