DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Black, Andre Leonard	DOIID	907789	NAIC NPN	17338936

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	2/24/2016		11/30/2026
Active	Non Resident	Agent	Property	2/24/2016		11/30/2026
* 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
Active	Essentia Insurance Company	300342	Agent - Casualty	3/21/2016
Active	Essentia Insurance Company	300342	Agent - Property	3/21/2016

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Hagerty Ins Agency LLC	541031	Agent - Property	3/21/2016
Active	Hagerty Ins Agency LLC	541031	Agent - Casualty	3/21/2016