black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

ELLIOTT FISHER GOLDEN

PRODUCER NON-RESIDENT

License Number:
PRN418347
Status:
First Licensure:
05/11/2022
Cancel Date:
None

Mailing:
FREDERICKSBURG, VA 22407
Phone:
+1 (540) 785-0398
Fax:
+1 (540) 785-0398
Email:
compliance@manifestmarine.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 05/11/2022

Agency

Name Issue Date License Number Expiration Date Cancel Date
MANIFEST MARINE, LTD.
06/17/2022 AGN421321

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN MODERN PROPERTY & CASUALTY INSURANCE COMPANY
11/30/2023 PCF234561

Authority

Description Issue Date Termination Date Status
CASUALTY 05/11/2022 Active
PROPERTY 05/11/2022 Active

Responsible For

Name License Number
MANIFEST MARINE, LTD. AGN421321

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
18893528

Other Addresses

Address Type
604 STONEWALL LN
FREDERICKSBURG, VA 22407-7495
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: 05/25/2025 03:05:12 AM