black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SAMUEL COSTELLO

PRODUCER NON-RESIDENT

License Number:
PRN206861
Status:
First Licensure:
08/30/2012
Cancel Date:
None

Mailing:
APPLETON, WI 54911
Phone:
+1 (920) 330-5191
Fax:
+1 (920) 330-5560
Email:
samuel.costello@connectbyamfam.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 08/30/2012

Agency

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN FAMILY CONNECT INSURANCE AGENCY INC
04/05/2013 AGN121078
APAC CUSTOMER SERVICES INC
10/09/2012 AGN49929 01/28/2013

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN FAMILY CONNECT PROPERTY AND CASUALTY INSURANCE COMPANY
04/04/2013 PCF120263 10/14/2024
AMERICAN MODERN HOME INSURANCE COMPANY
04/12/2013 PCF808 12/13/2024
AMERICAN MODERN SELECT INSURANCE COMPANY
04/19/2013 PCF123448 10/28/2021
AMEX ASSURANCE COMPANY
09/04/2012 PCF875 01/22/2013
BRISTOL WEST INSURANCE COMPANY
05/18/2022 PCF78370
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
04/16/2013 PCF445
HOMESITE INSURANCE COMPANY OF THE MIDWEST
10/23/2017 PCF116371 10/14/2024
MIDVALE INDEMNITY COMPANY
04/19/2019 PCF79410 10/14/2024
PROGRESSIVE NORTHERN INSURANCE COMPANY
04/19/2013 PCF51006 07/09/2018
PROGRESSIVE NORTHERN INSURANCE COMPANY
07/11/2018 PCF51006
PROGRESSIVE NORTHWESTERN INSURANCE COMPANY
04/19/2013 PCF27738 07/09/2018
PROGRESSIVE NORTHWESTERN INSURANCE COMPANY
07/11/2018 PCF27738
RLI INSURANCE COMPANY
04/08/2013 PCF695

Authority

Description Issue Date Termination Date Status
CASUALTY 08/30/2012 Active
HEALTH 08/30/2012 Active
PROPERTY 08/30/2012 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
16765614

Other Addresses

Address Type
CONNECT POWERED BY AMERICAN FAMILY INSURANCE
3500 PACKERLAND DR
DE PERE, WI 54115-9034
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: 10/28/2025 04:57:55 AM