DEPARTMENT OF INSURANCE

PUBLIC PROTECTION
CABINET

DEPARTMENT OF INSURANCE

Affiliations

Name	Carl, Derek	DOIID	811664	NAIC NPN	16914012

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Casualty	6/5/2013		5/31/2026
Active	Non Resident	Agent	Property	6/5/2013		5/31/2026
* 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	03/15/2026	05/31/2026

Appointments with the following Insurers

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Casualty	6/3/2016
Active	American Family Connect Property and Casualty Insurance Company	622403	Agent - Property	6/3/2016
Active	American Modern Home Insurance Company	300791	Agent - Casualty	9/27/2023
Active	American Modern Home Insurance Company	300791	Agent - Property	9/27/2023
Inactive	Amica Mutual Insurance Company	301405	Agent - Casualty	6/10/2013	4/11/2016
Inactive	Amica Mutual Insurance Company	301405	Agent - Property	6/10/2013	4/11/2016
Active	Bristol West Insurance Company	301655	Agent - Casualty	11/27/2023
Active	Bristol West Insurance Company	301655	Agent - Property	11/27/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Casualty	11/27/2023
Active	Foremost Insurance Company Grand Rapids, Michigan	301027	Agent - Property	11/27/2023
Active	Homesite Insurance Company	301139	Agent - Casualty	9/7/2022
Active	Homesite Insurance Company	301139	Agent - Property	9/7/2022
Active	Homesite Insurance Company of the Midwest	874850	Agent - Casualty	9/7/2022
Active	Homesite Insurance Company of the Midwest	874850	Agent - Property	9/7/2022
Active	Midvale Indemnity Company	300292	Agent - Casualty	9/7/2022
Active	Midvale Indemnity Company	300292	Agent - Property	9/7/2022

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Property	8/15/2023
Active	American Family Connect Insurance Agency, Inc.	619157	Agent - Casualty	8/15/2023