DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Farmington Administrative Services LLC	DOIID	564133	NAIC NPN	7569106

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Administrator	Not Applicable	1/24/2019		3/31/2025
* 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
Administrator	01/15/2025	03/31/2025

Designated Individuals

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	Mantz, Douglas R	535402	Administrator - Not Applicable	1/24/2019
Active	Pantalone, Louis J	310251	Administrator - Not Applicable	4/16/2021
Inactive	Rosenblatt, Carol S	567306	Administrator - Not Applicable	8/25/2005	8/31/2018