DEPARTMENT OF INSURANCE

DEPARTMENT OF INSURANCE

Affiliations

Name	Tremblay, Donna Marie	DOIID	680226	NAIC NPN	9417630

License - Line of Authority Information

Status	Residency	Class	Line of Authority	Active Date	Inactive Date	License Expiration Date
Active	Non Resident	Agent	Life	5/12/2008		5/31/2025
Active	Non Resident	Agent	Health	5/12/2008		5/31/2025
* 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	Hartford Life and Accident Insurance Company	300878	Agent - Health	9/10/2008
Active	Hartford Life and Accident Insurance Company	300878	Agent - Life	9/10/2008

Designated to act on behalf of the following Business Entities

Status	Affiliation Name	DOI Number	Line of Authority	Active Date	Inactive Date
Active	CBIZ Benefits & Ins Services Inc	514101	Agent - Life	9/10/2008
Active	CBIZ Benefits & Ins Services Inc	514101	Agent - Health	9/10/2008