DEPARTMENT OF INSURANCE

Affiliations

Name	Blaine, Bonnie J	DOIID	599436	NAIC NPN	7913451

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date
Inactive	Non Resident	Agent	Casualty	6/5/2009	12/31/2012
Inactive	Non Resident	Agent	Property	6/5/2009	12/31/2012
Inactive	Non Resident	Agent	Life	12/3/2004	12/31/2012
Inactive	Non Resident	Agent	Health	12/3/2004	12/31/2012
* 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	American Public Life Insurance Company	300252	Agent - Health	1/23/2007	10/25/2007
Inactive	American Public Life Insurance Company	300252	Agent - Life	1/23/2007	10/25/2007
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Casualty	6/24/2009	5/5/2011
Inactive	Empire Fire and Marine Insurance Company	300666	Agent - Property	6/24/2009	5/5/2011
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Casualty	6/30/2009	5/12/2011
Inactive	Fidelity and Deposit Company of Maryland	300976	Agent - Property	6/30/2009	5/12/2011
Inactive	Jefferson National Life Insurance Company	300258	Agent - Life	5/2/2005	6/8/2006
Inactive	National Guardian Life Insurance Company	300596	Agent - Health	10/24/2005	1/31/2007
Inactive	National Guardian Life Insurance Company	300596	Agent - Life	10/24/2005	1/31/2007
Inactive	National Union Fire Insurance Company of Pittsburgh, Pennsylvania	300959	Agent - Health	10/28/2008	12/31/2012
Inactive	Praetorian Insurance Company	301021	Agent - Casualty	10/6/2010	5/5/2011
Inactive	Praetorian Insurance Company	301021	Agent - Property	10/6/2010	5/5/2011
Inactive	QBE Insurance Corporation	300515	Agent - Casualty	2/17/2011	5/5/2011
Inactive	QBE Insurance Corporation	300515	Agent - Property	2/17/2011	5/5/2011
Inactive	Revol One Insurance Company	300681	Agent - Health	9/22/2006	10/5/2007
Inactive	Revol One Insurance Company	300681	Agent - Life	9/22/2006	10/5/2007
Inactive	Time Insurance Company	300683	Agent - Health	5/9/2007	5/28/2008
Inactive	Time Insurance Company	300683	Agent - Life	5/9/2007	5/28/2008
Inactive	United World Life Insurance Company	300532	Agent - Health	8/17/2007	12/15/2008
Inactive	Wilton Reassurance Life Company of New York	300163	Agent - Life	1/25/2005	6/8/2006

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Inactive	QBE First Enterprises LLC	610980	Agent - Health	7/14/2008	4/25/2011
Denied	QBE First Enterprises LLC	610980	Agent - Life
Inactive	QBE First Enterprises LLC	610980	Agent - Property	9/10/2009	4/25/2011
Inactive	QBE First Enterprises LLC	610980	Agent - Casualty	9/10/2009	4/25/2011