black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SAMUEL TUCKER OLSEN

PRODUCER NON-RESIDENT

License Number:
PRN279017
Status:
First Licensure:
11/22/2016
Cancel Date:
None

Mailing:
NORTH PLAINS, OR 97133
Phone:
+1 (314) 493-8000
Fax:
+1 (336) 435-0750
Email:
sam.olsen@ngic.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 11/22/2016

Agency

Name Issue Date License Number Expiration Date Cancel Date
AFFINITY BROKERAGE LLC
11/22/2016 AGN55398
CWI LLC
11/30/2016 AGN173565 04/23/2024
NATIONAL GENERAL INSURANCE MARKETING INC
11/30/2016 AGN43510

Employer

Name Issue Date License Number Expiration Date Cancel Date
ALLIED INSURANCE COMPANY OF AMERICA
12/13/2016 PCF216138 02/14/2023
ALLIED PROPERTY AND CASUALTY INSURANCE COMPANY
12/13/2016 PCF223935 02/14/2023
ALLSTATE FIRE AND CASUALTY INSURANCE COMPANY
01/24/2025 PCF864
ALLSTATE INDEMNITY COMPANY
01/24/2025 PCF522
ALLSTATE INSURANCE COMPANY
01/24/2025 PCF354
ALLSTATE NORTH AMERICAN INSURANCE COMPANY
01/24/2025 PCF401026
ALLSTATE PROPERTY AND CASUALTY INSURANCE COMPANY
01/24/2025 PCF84066
AMCO INSURANCE COMPANY
12/13/2016 PCF223938 02/14/2023
DAIRYLAND INSURANCE COMPANY
12/06/2016 PCF721
DEPOSITORS INSURANCE COMPANY
12/13/2016 PCF223940 02/14/2023
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
12/21/2016 PCF445
INTEGON NATIONAL INSURANCE COMPANY
11/29/2016 PCF310
INTEGON PREFERRED INSURANCE COMPANY
01/17/2024 PCF873
NATIONAL GENERAL INSURANCE COMPANY
11/29/2016 PCF647
NATIONWIDE GENERAL INSURANCE COMPANY
08/28/2018 PCF30 02/14/2023
NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
08/28/2018 PCF31 02/14/2023
NATIONWIDE MUTUAL INSURANCE COMPANY
12/13/2016 PCF32 02/14/2023
PROGRESSIVE NORTHERN INSURANCE COMPANY
03/02/2017 PCF51006
PROGRESSIVE NORTHWESTERN INSURANCE COMPANY
03/02/2017 PCF27738

Authority

Description Issue Date Termination Date Status
CASUALTY 11/22/2016 Active
PROPERTY 11/22/2016 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
18193650

Other Addresses

Address Type
NORTH PLAINS, OR 97133
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 01:48:13 AM