black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

TINA LEIGH SCRIVANI

PRODUCER NON-RESIDENT

License Number:
PRN275770
Status:
First Licensure:
09/24/2016
Cancel Date:
None

Mailing:
SOUTHBRIDGE, MA 01550
Phone:
+1 (508) 659-2417
Fax:
+1 (860) 652-3236
Email:
tscrivani@smithbrothersusa.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 09/24/2016

Agency

Name Issue Date License Number Expiration Date Cancel Date
SULLIVAN GARRITY & DONNELLY INSURANCE AGENCY INC
06/10/2019 AGN44833 12/29/2020

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLMERICA FINANCIAL ALLIANCE INSURANCE COMPANY
12/01/2016 PCF75617 10/03/2017
ALLMERICA FINANCIAL BENEFIT INSURANCE COMPANY
12/01/2016 PCF145893 10/03/2017
CAMPMED CASUALTY AND INDEMNITY COMPANY INC
12/01/2016 PCF186224 10/03/2017
CITIZENS INSURANCE COMPANY OF AMERICA
12/01/2016 PCF937 10/03/2017
THE HANOVER AMERICAN INSURANCE COMPANY
12/01/2016 PCF197298 10/03/2017
THE HANOVER INSURANCE COMPANY
12/01/2016 PCF712 10/03/2017
MASSACHUSETTS BAY INSURANCE COMPANY
12/01/2016 PCF505 10/03/2017
PRIVILEGE UNDERWRITERS RECIPROCAL EXCHANGE
04/28/2020 PCF212805
VERLAN FIRE INSURANCE COMPANY
12/01/2016 PCF161934 10/03/2017

Authority

Description Issue Date Termination Date Status
CASUALTY 09/24/2016 Active
PROPERTY 09/24/2016 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
16964870

Other Addresses

Address Type
10 INSTITUTE RD
WORCESTER, MA 01609-2756
Office

An active license/permit may still be subject to limitations and restrictions as a result of disciplinary action imposed. Please contact the specific licensing board about specific disciplinary actions.

Date: 06/24/2025 12:47:14 AM