black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

CONNIE J. DIVELBISS

PRODUCER NON-RESIDENT

License Number:
PRN103899
Status:
Active
First Licensure:
05/25/2004
Cancel Date:
None

Mailing:
EDGEWOOD, WA 98372
Phone:
+1 (253) 529-2743
Fax:
+1 (253) 529-2773
Email:
connie_divelbiss@rpsins.com

History
License Type Start Date End Date
PRODUCER NON-RESIDENT 05/25/2004

Agency
Name Issue Date License Number Expiration Date Cancel Date
MUTUAL SERVICE CORPORATION
 06/24/2004 AGN104746 01/17/2012
RISK PLACEMENT SERVICES INC
 11/28/2011 AGN62458

Employer
Name Issue Date License Number Expiration Date Cancel Date
21ST CENTURY CENTENNIAL INSURANCE COMPANY
 05/25/2006 PCF880 01/06/2012
ACE AMERICAN INSURANCE COMPANY
 10/08/2013 PCF640
ACE FIRE UNDERWRITERS INSURANCE COMPANY
 05/04/2020 PCF43 08/14/2020
ACE PROPERTY & CASUALTY INSURANCE COMPANY
 05/04/2020 PCF44 08/14/2020
AIG PROPERTY CASUALTY COMPANY
 05/15/2009 PCF393
AIU INSURANCE COMPANY
 05/25/2006 PCF308
ALLIED WORLD SPECIALTY INSURANCE COMPANY
 02/26/2008 PCF108064
AMERICAN HOME ASSURANCE COMPANY
 05/25/2006 PCF367
AMERICAN RELIABLE INSURANCE COMPANY
 01/14/2005 PCF45416
BANKERS STANDARD INSURANCE COMPANY
 10/08/2013 PCF152165
DRIVERS EDGE INSURANCE COMPANY
 05/15/2009 PCF364 11/22/2011
FEDERAL INSURANCE COMPANY
 02/23/2006 PCF439
GREAT AMERICAN INSURANCE COMPANY
 07/16/2024 PCF764
INDEMNITY INSURANCE COMPANY OF NORTH AMERICA
 07/28/2015 PCF50104
MOUNT VERNON FIRE INSURANCE COMPANY
 02/20/2009 PCF83792
PACIFIC EMPLOYERS INSURANCE COMPANY
 07/28/2015 PCF546
RLI INSURANCE COMPANY
 02/29/2008 PCF695

Authority
Description Issue Date Termination Date Status
CASUALTY 05/25/2004 Active
HEALTH 05/25/2004 Active
LIFE 05/25/2004 Active
PROPERTY 05/25/2004 Active
SURPLUS LINES 11/29/2004 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
665107

Other Addresses
Address Type
ARTHUR J GALLAGHER SERVICE COMPANY
505 S 336TH ST STE 410
FEDERAL WAY, WA 98003-5946
 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: 05/13/2025 10:09:06 PM