Individual Information

REBECCA L SIVAK

Address:

TAMPA, FL 33647-3642

Status:

Active

Email:

rsivak@cbpinsure.com

Date:

07/29/2019

License Type	License Number	Original Issue Date	Status	Effective Date	Expiration Date
Non-Res Producer/Producer Firm	3459351	07/29/2019	Active	07/29/2019	07/31/2028

Qualification Type	Original Issue Date	Status	Effective Date
Casualty	07/29/2019	Active	07/29/2019
Health	07/29/2019	Active	07/29/2019
Life	07/29/2019	Active	07/29/2019
Property	07/29/2019	Active	07/29/2019

Company Name	Appointment Type	Status	Active Date
461
NATIONWIDE MUTUAL INSURANCE COMPANY	Casualty	Active	08/29/2019
	Health	Active	10/26/2023
	Property	Active	08/29/2019
692
Company Name	Appointment Type	Status	Active Date
UNITED STATES FIRE INSURANCE COMPANY	Casualty	Active	10/24/2023
	Health	Active	10/24/2023
	Property	Active	10/24/2023

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Organization	Association Type	Type	Beg dte	End dte
CO-ORDINATED BENEFIT PLANS LLC	Designated Resp Lic Prdcr	Agency	12/17/2024	-

1 - 1