DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Clark Jr, Samuel Wayne	DOIID	600212	NAIC NPN	1616151

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	12/21/2004		12/31/2026
Active	Non Resident	Agent	Property	12/21/2004		12/31/2026
* 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
Agent	10/15/2026	12/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Casualty	8/26/2025
Active	Allmerica Financial Alliance Insurance Company	300823	Agent - Property	8/26/2025
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Casualty	8/26/2025
Active	Allmerica Financial Benefit Insurance Company	301223	Agent - Property	8/26/2025
Active	Berkley Regional Insurance Company	300920	Agent - Casualty	1/28/2022
Active	Berkley Regional Insurance Company	300920	Agent - Property	1/28/2022
Active	Hanover American Insurance Company (The)	300447	Agent - Casualty	8/26/2025
Active	Hanover American Insurance Company (The)	300447	Agent - Property	8/26/2025
Active	Hanover Insurance Company (The)	300508	Agent - Casualty	8/26/2025
Active	Hanover Insurance Company (The)	300508	Agent - Property	8/26/2025
Active	Massachusetts Bay Insurance Company	300898	Agent - Casualty	8/26/2025
Active	Massachusetts Bay Insurance Company	300898	Agent - Property	8/26/2025
Active	United States Fire Insurance Company	582240	Agent - Casualty	12/14/2023
Active	United States Fire Insurance Company	582240	Agent - Property	12/14/2023
Active	Verlan Fire Insurance Company	517102	Agent - Casualty	8/26/2025
Active	Verlan Fire Insurance Company	517102	Agent - Property	8/26/2025
Active	WCF National Insurance Company	300727	Agent - Casualty	8/10/2009

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	Dale Barton Agency	765836	Agent - Casualty	10/5/2011	3/31/2025
Inactive	Dale Barton Agency	765836	Agent - Property	10/5/2011	3/31/2025
Active	Hub International Ins Services Inc	609910	Agent - Casualty	3/5/2024
Active	Hub International Ins Services Inc	609910	Agent - Property	3/5/2024