black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SELECTIVE INSURANCE COMPANY OF AMERICA

INSURANCE COMPANY

License Number:
PCF456095
Status:
First Licensure:
07/06/2023
Cancel Date:
None
Renewal Date:
08/10/2025
NAIC Code:
12572

Street Location:
40 WANTAGE AVE
BRANCHVILLE, NJ 07890-0001
Mailing:
40 WANTAGE AVE
BRANCHVILLE, NJ 07890-0001
Phone:
+1 (973) 948-3000
Email:
brooke.symons@selective.com

History

License Type Start Date End Date
INSURANCE COMPANY 07/06/2023 08/10/2025

Employee

Name Issue Date License Number Expiration Date Cancel Date
AMY R. ABBOTT
02/05/2024 PRR343961
ACRISURE GREAT LAKES PARTNERS INSURANCE SERVICES, LLC
03/18/2025 AGN450447
ACRISURE LLC
10/23/2024 AGN160630
ROGER MITCHELL ADAMS
04/04/2024 PRR472090
ALERA GROUP INC
10/01/2024 AGN280970
ALLEN AGENCY
03/01/2024 AGR29497
PHILIP MICHAEL ALLEN JR
02/16/2024 PRR18866
ALLIANT INSURANCE SERVICES INC
11/20/2024 AGN91433
KENNETH DUANE ANDERSON
11/06/2024 PRN263858
TOD C. ANDERSON
02/16/2024 PRN350895
VICTOR DAVID ANDRADE
03/10/2024 PRN36367
TAYLOR L. ANKERS
02/14/2024 PRR389284
ANDREW STEWART APPEL
11/29/2023 PRN286452
MALLORY PAIGE ARSENAULT
02/14/2024 PRR207517
ARTHUR J GALLAGHER RISK MANAGEMENT SERVICES LLC
03/26/2024 AGN37963
ASSURED PARTNERS NEW ENGLAND INC
06/27/2024 AGN37444
LAURIE G. AUDY
02/05/2024 PRN450495
KRISTEN BAKER
03/01/2024 PRR215841
THE BALDWIN GROUP SOUTHEAST, LLC
06/07/2024 AGN130456
JOEY LEE BARD
04/04/2024 PRR285430
DANIKA LYNN BATES
04/04/2024 PRR260321
MARK A. BATES
03/10/2024 PRN478654
AMY C. BATH
05/21/2024 PRR42873
BAY COAST INSURANCE LLC
04/25/2024 AGN210322
HEATHER J. BEDARD
02/01/2024 PRR263854
CHARLES H. BERNIER
07/09/2024 PRN58941
MARC R. BERUBE
03/03/2025 PRN65705
JOANNE M. BILLINGTON
02/14/2024 PRR56867
SUSAN RUTH BISHKOFF
04/04/2024 PRR453498
KELLY CHRISTINE BOLTON
03/27/2024 PRN154353
KELLIE A. BOSSE
04/04/2024 PRR122808
AMY E. BOWEN
02/14/2024 PRR225530
JAMES MICHAEL BRANDEMARTE
06/19/2024 PRN404924
CHAD M. BREWER
04/04/2024 PRR280760
KELLY KRISTINE BRODEUR
04/04/2024 PRR443971
KAREN ELIZABETH BROOKS
04/04/2024 PRR168340
MATTHEW S. BROOKS
12/19/2024 PRN471773
BROWN & BROWN INSURANCE SERVICES, INC.
05/06/2024 AGN36572
ANTHONY R. BRYAN
04/04/2024 PRR220245
ROBERT CHARLES BURSEY
06/27/2024 PRN108224
THERESA LENORE BUTLER
02/14/2024 PRR268779
KEVIN J. BYRNE
11/20/2024 PRN430026
LEANN D. CAILLER
02/14/2024 PRR91315
GINGER RAE CAMPBELL
04/04/2024 PRR104158
KRISTINA LEE CAMPBELL
02/14/2024 PRR127324
MADELYN C. CANCEL
02/05/2024 PRN311110
DOREEN ELAINE CARDONA
04/04/2024 PRR156555
SCOTT F. CARLSON
02/14/2024 PRR187580
DENNIS MICHAEL CARON
04/04/2024 PRN260319
HOLLY B. CARTER
04/04/2024 PRR101034
ROBERT JOHN CASAZZA
09/17/2024 PRN149430
ERIK NORMAN CASPARIUS
03/01/2024 PRR233915
COLLIN L. CASSIDY
04/04/2024 PRR278623
KERI CATHCART
03/28/2024 PRN162685
CHALMERS INSURANCE AGENCY INC
02/16/2024 AGR4907
JAMES BRAITHWAITE CHALMERS
02/16/2024 PRR105847
PATRICK AUSTIN CHAMBERLIN
02/14/2024 PRR247524
TIFFANY CHANDLER
04/04/2024 PRR424738
CHARLES L CRANE AGENCY COMPANY
11/25/2024 AGN55101
CARISSA REISTEIN CHIPMAN
02/05/2024 PRR215306
CHOICE FINANCIAL GROUP LLC
05/06/2024 AGN375043
PETER JAMES CLAVETTE
03/01/2024 PRR114857
HEATHER CLEMENT
02/05/2024 PRN322374
JENNIFER COFFIN
02/14/2024 PRR95703
DONALD PEARCE CORCORAN
05/21/2024 PRN55328
BENJAMIN D. CORREIA
05/01/2025 PRN231270
AMANDA JEANNE CORSON
02/14/2024 PRR55181
LISA D. COTE
02/16/2024 PRN72845
STEVEN PAUL COTE
02/16/2024 PRN41463
ANN F. CROCKER
02/05/2024 PRR61321
CROSS INSURANCE WAKEFIELD INC
08/30/2024 AGN189165
CROSS INSURANCE, INC - RHODE ISLAND
07/12/2024 AGR211417
CROSS INSURANCE, INC. - CONNECTICUT
04/01/2024 AGR323202
CROSS INSURANCE, INC. - MAINE
03/01/2024 AGR19087
CROSS INSURANCE, INC. - MASSACHUSETTS
08/07/2024 AGR285962
CROSS INSURANCE, INC. - NEW HAMPSHIRE
04/01/2024 AGR136219
ROYCE MARVIN CROSS
03/01/2024 PRR4897
WOODROW WARREN CROSS II
06/06/2024 PRR140565
SARAH KATHLEEN CUMMINGS
02/05/2024 PRR163119
LAURIE ANN CYR
04/04/2024 PRR130793
DANIEL PERCY DAMON BOOKHAM
03/01/2024 PRR211802
MELISSA L. DAVENPORT
02/14/2024 PRR119591
DAVIS TOWLE MORRILL & EVERETT
03/28/2024 AGN42066
ANDREW JOEL DAVIS
09/18/2024 PRN345292
LIBBY ERIN DAVIS
02/14/2024 PRR135203
LORRAINE DECAESAR
01/02/2025 PRN425429
DELAND GIBSON INSURANCE ASSOCIATES INC
03/31/2024 AGN54375
JANE M. DELPONTE
04/04/2024 PRR42726
DIGITAL INSURANCE LLC
03/14/2025 AGN76969
TROY DILLOW
05/06/2024 PRN271285
ELIZABETH ROSE DONOVAN
02/05/2024 PRR459094
ROBERT BRUCE DORAN
02/16/2024 PRR8040
EDWARD JOSEPH DORSEY
03/01/2024 PRR40332
STEPHEN MICHAEL DORSEY
10/08/2024 PRR12493
CORIANNA DOUCETTE
02/14/2024 PRR347339
SEAN DOYLE
10/08/2024 PRR190801
DT WARLICK LLC
05/21/2024 AGN472813
JASON R. DUVAL
04/04/2024 PRR190416
TRAVIS MICHAEL DUVAL
03/01/2024 PRR149578
SUSAN M. DWELLEY
10/08/2024 PRR22058
TAMMI LYNN EASLER
04/04/2024 PRR441772
EATON & BERUBE INSURANCE AGENCY, LLC
03/03/2025 AGN326456
ECBM LP
07/09/2024 AGN115617
ERIC DANA EDDY
02/16/2024 PRR184141
ROBYN L. EDGECOMB
02/05/2024 PRR61328
EDGEWOOD PARTNERS INSURANCE CENTER
10/25/2024 AGN42693
KATHRYN T. ELA
03/28/2024 PRN157269
MELISSA D. ELDER
08/30/2024 PRN107146
ROBERT ANTHONY ELLIS
02/05/2024 PRR231960
FBINSURE LLC
05/09/2024 AGN148037
JOSHUA DAVID FEARON
06/10/2024 PRR135053
JOHN J. FEITELBERG
03/15/2024 PRN64228
LACEY NICOLE FENTON
08/20/2024 PRN492101
JENNIFER LYNN FIFIELD
02/14/2024 PRR60382
ERIN M. FITZGERALD
06/18/2024 PRR470179
JENNIFER A. FITZPATRICK
02/01/2024 PRR268885
JOHN SCOTT FLYNN
10/25/2024 PRN317977
TONYA FOX
03/28/2024 PRR86978
FRED C CHURCH INC
07/10/2024 AGN50941
DEBORAH J. FRENCH
04/04/2024 PRR139426
STEPHANIE M. FRENCH
02/14/2024 PRR191948
JAMES DAVID FREYER JR
03/27/2024 PRN53338
JESSICA LYNN FROST
02/05/2024 PRR368440
PAMELA JEAN FULLER
02/05/2024 PRR55088
PATRICK J. GAETANI
03/01/2024 PRR43735
PETER DUNCAN GAGE
11/13/2024 PRR118171
LINDA DEE GARCEAU
02/14/2024 PRR153665
CAMERON WILLIAM GARTLEY
02/14/2024 PRR266744
DAVID CHARLES GASH
06/10/2024 PRR283836
ZACHARY LEWIS GAYTON
02/16/2024 PRR216880
EDWARD HOYT GIBSON
03/31/2024 PRN287355
GLORIA E. GILBERT
10/08/2024 PRR105320
LUKE ELDON GOODINE
02/16/2024 PRR150723
NICOLE M. GOODINE
06/10/2024 PRR209045
KATHERINE J B GORNEAULT
04/04/2024 PRR280032
GRAND PYRAMID, LLC
08/20/2024 AGN374801
BRITTANY JO GRASS
04/04/2024 PRR191697
SAMUEL DUSTIN GRINNELL
02/14/2024 PRR442808
DIANE LORI GUERETTE
02/14/2024 PRR61662
RONALD GERARD GUERIN
03/01/2024 PRR34060
WANDA FAYE GUIGGEY
04/04/2024 PRR24795
GUY HURLEY, LLC
10/09/2023 AGN350440
CHRISTOPHER M. HADLEY
04/25/2024 PRN236320
TYLER HALSTEAD
03/26/2024 PRN332641
KATIE SUE HANDRAHAN
04/04/2024 PRR427612
SAVANNAH J. HARRIMAN
03/24/2025 PRN447553
KELLEE ANN HART
04/04/2024 PRR48778
HAYLOR FREYER & COON INC
03/27/2024 AGN54095
THE HDH GROUP INC
04/24/2025 AGN67262
KEVIN V. HEHER
09/14/2024 PRN159650
WILLIAM HOLDEN HENDRICKS
04/15/2025 PRN322632
LAURA BETH HERMAN STROHECKER
10/17/2024 PRN93995
CHRISTOPHER HEWEY
03/28/2024 PRN449560
HILB GROUP OF NEW ENGLAND LLC
03/27/2024 AGN279288
HOLLY B. HILL COOMBS
02/14/2024 PRR159454
HOGANS AGENCY INC
07/08/2024 AGN378954
MATTHEW D. HOGANS
07/08/2024 PRN378652
HOLLIS D SEGUR INC
11/13/2023 AGN60872
CHRISTINE H. HOLMAN
03/26/2024 PRN62595
ERIC D. HORNER
03/26/2024 PRN165920
HUB INTERNATIONAL NEW ENGLAND LLC
03/15/2024 AGN38279
SAMANTHA E. HUNTER
02/05/2024 PRR404772
MARGARET ANNE HUTCHINS
04/04/2024 PRR89492
ANDREW HYNDMAN
02/26/2025 PRN462783
INFINGER INS AGENCY INC
03/28/2024 AGN204756
DAVID GEORGE INFINGER
03/28/2024 PRN178472
NATHAN THOMAS INFINGER
03/28/2024 PRN78339
INSURANCE MARKETING AGENCIES INC
10/17/2024 AGN36981
INTEGRATED INSURANCE SOLUTIONS LLC
10/15/2024 AGN152889
LUKE ROBERT JACKSON
02/05/2024 PRR212014
JOHN JAGGER
04/04/2024 PRR238746
KRISTEN LYNN JENKINS
06/10/2024 PRR393434
CARLA ANN JENNEY
05/12/2025 PRR36221
ETHAN ROBERT JOHNSON
02/16/2024 PRR181392
NEWTON SAMUEL JOHNSON
04/15/2024 PRN27206
PEGGY A. JOHNSON
03/26/2024 PRN303090
JOHNSON-WITKEMPER INC
09/11/2024 AGN490061
ERNEST E. JORDAN JR
02/01/2024 PRR8361
CARY RICE JUBINVILLE
07/16/2024 PRN34050
KANE INSURANCE LLC
01/23/2024 AGN115727
PATRICK J. KANE
01/23/2024 PRN52574
ELY KAPLANSKY
05/12/2025 PRN181539
KRISTINE L. KARLSSON
02/16/2024 PRR69261
AMANDA J. KEAVENEY
03/15/2024 PRN445094
SYLVIA SARAH KENNEDY
04/04/2024 PRR181023
BRIANNA KILLIP
06/25/2024 PRR292086
NICHOLE LYNN KINDELAN
02/14/2024 PRR59787
KING RISK PARTNERS, LLC
10/22/2024 AGN420896
MALCOLM CHARLES KING
11/12/2024 PRN419745
PAULA MARIE KIRKLAND
02/05/2024 PRR298410
HEIDI L. KIRKPATRICK
02/14/2024 PRR26675
NICOLE R. KNOWLES
04/04/2024 PRR299948
KORE INS HOLDINGS LLC
11/18/2024 AGN215484
TERESA A. KOWALSKI
06/10/2024 PRR41354
SCOTT WILLIAM KROUSE
04/04/2024 PRR450798
LAURIE A. LABBE
10/08/2024 PRR130530
SHAWNA MARIE LANCASTER
06/10/2024 PRR103199
SETH LANDRY
04/04/2024 PRR73082
GARY PAUL LAPIERRE
03/26/2024 PRR48118
JACOB GEORGE LAPLUME
06/10/2024 PRR440912
DANIEL LASSITER
02/05/2024 PRR425317
STACIE V. LEAVITT
02/05/2024 PRR54441
KASEY KATHERINE LECLERC
04/04/2024 PRR119761
CHRISTIAN D. LESLIE
02/01/2024 PRR108316
JENNIFER L. LETENDRE
03/26/2024 PRN77314
ALAN J. LEVITZ
06/03/2024 PRN62879
BONNIE SUE LEWIS
02/14/2024 PRR75930
LIBERTY FINANCIAL SERVICES INC
09/14/2024 AGN248239
ERIK C. LIGUORI
08/02/2024 PRN144872
JENNIFER LEIGH LOBENBERG
04/24/2025 PRN191139
KELLI LOCKE
06/10/2024 PRR230067
TIMOTHY J. LODGE
08/13/2024 PRN412555
ROBERT YORK LOGAN III
02/01/2024 PRR248025
PATRICK DALEY LONG
04/25/2024 PRN292460
LOPRIORE INS AGENCY INC
08/07/2024 AGN165853
JOHN PASQUALE LOPRIORE
08/07/2024 PRN99271
MEESHA G. LUCE
02/14/2024 PRR159455
JILLIAN L. LUKEGORD
11/06/2024 PRN225853
CASSANDRA J. LYNDS
04/04/2024 PRR417511
RYAN L. MADORE
03/01/2024 PRR102655
MINDY ANN MAHEU
02/14/2024 PRR95975
BELINDA L. MAILLET-BARDEN
04/04/2024 PRR73604
BASIL MAKRIS
03/26/2024 PRN334238
MICHAEL ANTHONY MANDRAVELIS
03/24/2025 PRR141223
LORI ANN MANK
02/14/2024 PRR59974
MICHAEL R. MANN
12/26/2024 PRN413327
MARSH & MCLENNAN AGENCY LLC
03/15/2024 AGN171044
CHRISTOPHER T. MASTERS
03/26/2024 PRN120648
TODD C. MC MAHON
12/31/2024 PRN171932
JENNIFER L. MCBREAIRTY
04/04/2024 PRR242165
DOMINIC G. MCCUMMINGS
08/23/2024 PRN376153
COURTNEY ELIZABETH MCDONALD
02/14/2024 PRR268390
DEBORAH LYNN MCDONALD
02/14/2024 PRR51498
LYNNSEY MCDONOUGH
06/10/2024 PRR169144
TIMOTHY JOHN MCGONAGLE
03/01/2024 PRR61501
HOUSTON J. MCGUIRK
02/14/2024 PRR404054
KARIE A. MICHAUD
04/04/2024 PRR68956
SALLY MARIE MILES
02/14/2024 PRR229070
CHRISTOPHER MARK MILLER
04/04/2024 PRN472885
JESSICA MAE MILTON
04/04/2024 PRR394235
MARY G. MITCHELL
02/05/2024 PRR44500
TRACY L. MORIN
04/04/2024 PRR148745
MORROW INSURANCE AGENCY INC
04/15/2025 AGN323893
MORSE INSURANCE AGENCY INC
11/12/2024 AGN100891
DANIEL TIMOTHY MORSE
11/12/2024 PRN98069
MICHAEL MUHA
05/06/2024 PRN433223
LENA JEANNETTE MURCH
02/05/2024 PRR27680
DEANNA TROI MURCHIE
04/04/2024 PRR260393
JUSTIN LAWRENCE MURPHY
04/04/2024 PRR288963
JOHN F. MURRAY
03/12/2024 PRN83457
MVGA INS INC
11/06/2024 AGN265611
ANNE M. NARTOWICZ
02/05/2024 PRN436756
NFP PROPERTY & CASUALTY SERVICES INC
03/12/2024 AGN50943
PATRICK VAL O FARRELL
05/24/2024 PRN450585
BETTY-JO OLIVER
04/04/2024 PRR65335
OTTERSTEDT INS AGENCY INC
09/17/2024 AGN149563
FELICIA CAROLINE OUELLETTE
04/04/2024 PRR211813
JAMES DUBORD OUELLETTE
04/04/2024 PRR457756
PAQUIN & CARROLL LLC
06/10/2024 AGR245816
MARY PARLOCK
05/12/2025 PRN215294
ALICIA MARIE PASIEKA
09/27/2024 PRR444746
ERIC BRIAN PELTON
03/28/2024 PRN16847
JOY CHRISTINE PERRY
04/04/2024 PRR157174
PHILLIPS INS AGENCY INC
12/24/2024 AGN180782
JOSEPH M. PHILLIPS
12/09/2024 PRN180611
JEREMY CLARK PICKFORD
02/14/2024 PRR262540
PIERCE AGENCY OF PORTSMOUTH INC
03/10/2024 AGN66545
EDWARD B. PIERCE JR
02/28/2024 PRN85450
SARAH MARIE PIERCE
03/01/2024 PRR243154
KATIE LOUISA PIPER
02/16/2024 PRR96615
THERESA LYNN POMEROY
04/04/2024 PRR63947
MYRANDA MAE POTTER
02/14/2024 PRR313278
VERNON PROCTOR
11/13/2023 PRN333616
THOMAS QUENTIN
06/10/2024 PRR349209
BILL RAFUSE
02/14/2024 PRR178246
SARAH EC RANDALL
07/09/2024 PRR339651
KAREN ANN REDMAN
02/14/2024 PRR214169
KAREN LEE REED
02/14/2024 PRR34011
MICHAEL TRACY REEDY
11/25/2024 PRN459497
MICHAEL S. REILLY
07/10/2024 PRN244583
RELATION INSURANCE SERVICES SELECT, INC.
11/18/2024 AGN374268
RICHARDS INC
04/01/2024 AGN71788
PETER T. RICHARDS
04/01/2024 PRN374990
GREGG THOMAS RITTER
03/15/2024 PRR94250
PAUL ROBERSON
03/26/2024 PRN221096
DAVID THOMAS ROBINSON
06/10/2024 PRN209893
REBECCA ANN ROBINSON
02/14/2024 PRR101751
VALERIE J. ROBINSON
02/14/2024 PRR149075
CHAD ROGER
02/14/2024 PRR317998
BRIAN E. ROGERS
11/18/2024 PRN159970
NOVILLA HAYWARD ROLLINS
04/04/2024 PRR35935
LAWRENCE MICHAEL ROSE
01/24/2024 PRN468705
MICHAEL ROBERT ROSS
06/20/2024 PRN448089
JOELLA LOUISE ROSSIGNOL
02/14/2024 PRR48006
LAURA M. ROWE
03/01/2024 PRR75126
LISA MARGUERITE ROY
04/04/2024 PRR22782
MATTHEW JAMES RUNGI
04/04/2024 PRR97121
JAMES BRIAN SANBORN
03/01/2024 PRR43206
SARAH SARGENT
04/04/2024 PRR461811
BRIAN CHRISTOPHER SARISKY
02/06/2024 PRN183432
TODD DAVID SAUCIER
04/04/2024 PRR251105
DEREK MICHAEL SCHULTZ
10/15/2024 PRN152762
KAYLA R. SHAFER
04/01/2024 PRN427811
CHRIS O. SHARPE
04/01/2024 PRN204593
SCOTT PATRICK SHEA
03/12/2025 PRN120344
HOLLY JO SHIELDS
03/01/2024 PRR111359
MICHAEL SILBERBERG
04/08/2025 PRN418229
SUSANNE SMITH PINKHAM
05/07/2024 PRR74840
BETH SUSAN SMITH
04/04/2024 PRR47671
PHILLIP SMITH
06/11/2024 PRR188099
DAVID SOLIMINE
11/18/2024 PRN198179
COURTNEY ANNE SPARKS
03/28/2024 PRR357747
HEATHER ANN SPAULDING
10/08/2024 PRR168190
TRICIA JOLINE SPENCER
04/04/2024 PRR78120
SRM INSURANCE BROKERAGE LLC
02/06/2024 AGN63906
LINDA MCELROY ST CLAIR
02/14/2024 PRR24586
TROY A. STAPLES
10/09/2023 PRN353848
STARKWEATHER & SHEPLEY INSURANCE BROKERAGE INCORPORATED
05/07/2024 AGN51221
SUNSTAR INSURANCE GROUP LLC
08/30/2024 AGN292933
TAPLEY INSURANCE AGENCY INC
03/24/2025 AGR45123
WENDY J. TAPLEY
03/24/2025 PRR19273
ERINN HEATHER TARDIFF
04/04/2024 PRR110122
THAKKAR INSURANCE AGENCY, LLC
05/10/2024 AGN361326
JENISH SANJAY THAKKAR
05/10/2024 PRN361190
EDMUND CHARLES THERRIEN JR
04/04/2024 PRR100922
GANNON FRENCH THERRIEN
04/04/2024 PRR409475
MARLENE K. THIBEAULT
10/15/2024 PRR269269
KIRK ALAN THOMAS
09/11/2024 PRN266998
KEVIN A. THORSTENSON
04/04/2024 PRR138089
ANDREA KAY TODD
06/10/2024 PRR38691
ADAM PHILIP TRIVILINO
03/05/2025 PRN469903
NICOLE LYNN TURCOTTE
04/04/2024 PRR137621
JODI L. TURNER
02/05/2024 PRR148689
SCOTT BRADLEY TWITCHELL
04/04/2024 PRR89387
UIG INC
03/01/2024 AGR123009
USI INS SERVICES LLC
12/31/2024 AGN147905
WENDY M. VANANTWERP
02/14/2024 PRR43398
VARNEY AGENCY INC
03/25/2024 AGR12271
MICHAEL WILLIAM VARNEY
03/05/2024 PRR180154
MELINDA ALEXIS VOISINE
11/22/2024 PRR182126
SARA THERESE VON TERSCH
01/07/2025 PRN342684
MEAGHAN SUE WALKER
04/01/2024 PRN235428
CHRISTINE JAYE WARNER
03/24/2025 PRR69126
MARTHA JEAN WENTWORTH
02/14/2024 PRR46928
PETER JOHN WERNER
03/14/2025 PRN49567
REBECCA LYNN WHITE
04/04/2024 PRR141122
DOUGLAS ARTHUR WILLETT
06/10/2024 PRR95449
KRISTINA LEE WILLETT
04/04/2024 PRR84747
PETER MANNING WILLIAMS
02/14/2024 PRR22093
CHRISTINE MARIE WILSON
02/14/2024 PRR47400
KIMBERLY WOOD
03/28/2024 PRN246836
JEFFREY L. WOODBURY
02/16/2024 PRR121341
WORLD INS ASSOC LLC
02/27/2024 AGN304312
JA'SHONTE WRIGHT-MCLEISH
08/14/2024 PRR491401
MICHAEL BRUCE YAROSEVICH
04/01/2024 PRN326784
JODI LYNN YOUNG
04/04/2024 PRR161403
PATRICIA E. ZERFOSS
04/04/2024 PRR86285

Supervised Entity

None.

Authority

Description Issue Date Termination Date Status
FIRE 07/06/2023 Active
ALLIED LINES 07/06/2023 Active
HOMEOWNERS MULTIPLE PERIL 07/06/2023 Active
COMMERCIAL MULTIPLE PERIL 07/06/2023 Active
INLAND MARINE 07/06/2023 Active
WORKERS COMPENSATION 07/06/2023 Active
OTHER LIABILITY 07/06/2023 Active
PRODUCTS LIABILITY 07/06/2023 Active
AUTO LIABILITY 07/06/2023 Active
AUTO PHYS DAMAGE 07/06/2023 Active
FIDELITY 07/06/2023 Active
SURETY 07/06/2023 Active
BURGLARY AND THEFT 07/06/2023 Active
BOILER AND MACHINERY 07/06/2023 Active

Contacts

Type Contact
WORKERS COMPENSATION CLAIMS BRAD FAULER
SELECTIVE INSURANCE COMPANY OF AMERICA
40 WANTAGE AVE
BRANCHVILLE, NJ 07890-0001
Phone: +1 (704) 916-1735
Fax: +1 (855) 283-6879
Email: brad.fauler@selective.com
PRODUCER LICENSING CONTACT BROOKE SIMMONS
BROOKE SIMMONS
40 WANTAGE AVE
BRANCHVILLE, NJ 07890-0001
Phone: +1 (973) 948-3000
Email: brooke.simmons@selective.com
SERVICE OF PROCESS CORPORATION SERVICE COMPANY
45 MEMORIAL CIR
AUGUSTA, ME 04330-6400
Phone: +1 (800) 927-9800
Fax: +1 (302) 636-5454
Email: sop@cscglobal.com

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN)

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 05:52:45 PM