DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Haynes, Carmen	DOIID	899853	NAIC NPN	17764323

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Inactive	Non Resident	Agent	Personal Lines	4/10/2020	7/31/2021
Inactive	Non Resident	Staff Adjuster	Property & Casualty	11/23/2015	7/31/2021
* 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	Essentia Insurance Company	300342	Agent - Personal Lines	6/5/2020	7/31/2021

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Hagerty Ins Agency LLC	541031	Agent - Personal Lines	6/5/2020	7/31/2021