black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

DAVID J. MATHOG

PRODUCER NON-RESIDENT

License Number:
PRN185660
Status:
First Licensure:
12/17/2010
Cancel Date:
None

Mailing:
SOUTH WINDSOR, CT 06074
Phone:
+1 (206) 676-7466
Fax:
+1 (206) 676-7466
Email:
david.mathog@usi.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 12/17/2010

Agency

Name Issue Date License Number Expiration Date Cancel Date
USI INS SERVICES LLC
05/28/2013 AGN147905
USI INSURANCE SERVICES OF CONNECTICUT LLC
12/17/2010 AGN53714 12/31/2014

Employer

Name Issue Date License Number Expiration Date Cancel Date
EMPLOYERS INSURANCE COMPANY OF WAUSAU
02/27/2017 PCF434
OHIO SECURITY INSURANCE COMPANY
08/22/2022 PCF200581
SAFECO NATIONAL INSURANCE COMPANY
02/27/2017 PCF248658 11/10/2023

Authority

Description Issue Date Termination Date Status
CASUALTY 12/17/2010 Active
PROPERTY 12/17/2010 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
3536922

Other Addresses

Address Type
95 GLASTONBURY BLVD STE 406
GLASTONBURY, CT 06033-4412
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: 05/15/2025 05:40:55 PM