black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

TIFFANY BLACK

PRODUCER RESIDENT

License Number:
PRR482364
Status:
First Licensure:
04/23/2024
Cancel Date:
None
Renewal Date:
11/30/2025

Continuing Education:
Required by 11/30/2025
Hours Required:
Ethics:
3
Total Required:
24
Hours Acquired:
Ethics:
0
Total Acquired:
3

Mailing:
BANGOR, ME 04402
Phone:
+1 (207) 947-7345
Email:
licensing@crossagency.com

History

License Type Start Date End Date
PRODUCER RESIDENT 04/23/2024 11/30/2025

Agency

Name Issue Date License Number Expiration Date Cancel Date
CROSS INSURANCE, INC. - MAINE
04/23/2024 AGR19087

Employer

Name Issue Date License Number Expiration Date Cancel Date
ACADIA INSURANCE COMPANY
04/30/2024 PCF35064
ACE AMERICAN INSURANCE COMPANY
05/14/2024 PCF640
ACE FIRE UNDERWRITERS INSURANCE COMPANY
05/14/2024 PCF43
ACE PROPERTY & CASUALTY INSURANCE COMPANY
05/14/2024 PCF44
ACUITY A MUTUAL INSURANCE COMPANY
12/26/2024 PCF155357
AIG PROPERTY CASUALTY COMPANY
04/25/2024 PCF393
ALLIED PROPERTY AND CASUALTY INSURANCE COMPANY
04/23/2024 PCF223935
AMCO INSURANCE COMPANY
04/23/2024 PCF223938
AMERICAN CASUALTY COMPANY OF READING PENNSYLVANIA
04/25/2024 PCF358
ANSUR AMERICA INSURANCE COMPANY
04/29/2024 PCF95773
THE AUTOMOBILE INSURANCE COMPANY OF HARTFORD, CONNECTICUT
05/01/2024 PCF659
BANKERS STANDARD INSURANCE COMPANY
05/14/2024 PCF152165
CAMBRIDGE MUTUAL FIRE INSURANCE COMPANY
04/26/2024 PCF396
CASCO INDEMNITY COMPANY
04/26/2024 PCF921
THE CHARTER OAK FIRE INSURANCE COMPANY
05/01/2024 PCF403
CHUBB INDEMNITY INSURANCE COMPANY
05/14/2024 PCF591
CHUBB NATIONAL INSURANCE COMPANY
05/14/2024 PCF80404
THE CINCINNATI CASUALTY COMPANY
04/29/2024 PCF137248
THE CINCINNATI INDEMNITY COMPANY
04/29/2024 PCF137240
THE CINCINNATI INSURANCE COMPANY
04/29/2024 PCF989
COMMERCE INSURANCE COMPANY (THE)
04/25/2024 PCF53427
CONCORD GENERAL MUTUAL INSURANCE COMPANY
04/30/2024 PCF416
CONTINENTAL CASUALTY COMPANY
04/25/2024 PCF420
CONTINENTAL INSURANCE COMPANY
04/25/2024 PCF782
CONTINENTAL WESTERN INSURANCE COMPANY
04/30/2024 PCF673
DEPOSITORS INSURANCE COMPANY
04/23/2024 PCF223940
EMPLOYERS INSURANCE COMPANY OF WAUSAU
09/03/2024 PCF434
EXECUTIVE RISK INDEMNITY INC.
05/14/2024 PCF42522
FARMERS CASUALTY INSURANCE COMPANY
11/21/2024 PCF895
FARMERS DIRECT PROPERTY AND CASUALTY INSURANCE COMPANY
11/21/2024 PCF267721
FARMERS PROPERTY AND CASUALTY INSURANCE COMPANY
11/21/2024 PCF714
FEDERAL INSURANCE COMPANY
05/14/2024 PCF439
FIREMEN'S INSURANCE COMPANY OF WASHINGTON DC
04/30/2024 PCF35141
FIRST LIBERTY INSURANCE CORPORATION
09/03/2024 PCF31779
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
11/21/2024 PCF445
FRANKENMUTH INSURANCE COMPANY
04/29/2024 PCF83684
GEICO MARINE INSURANCE COMPANY
01/16/2025 PCF103315
GREAT NORTHERN INSURANCE COMPANY
05/14/2024 PCF455
GREEN MOUNTAIN INSURANCE COMPANY INC
04/30/2024 PCF73
INDEMNITY INSURANCE COMPANY OF NORTH AMERICA
05/14/2024 PCF50104
LIBERTY INSURANCE CORPORATION
09/03/2024 PCF999
LIBERTY MUTUAL FIRE INSURANCE COMPANY
09/03/2024 PCF330
LM INSURANCE CORPORATION
09/03/2024 PCF31778
MAIN STREET AMERICA ASSURANCE COMPANY
04/25/2024 PCF997
MAIN STREET AMERICA PROTECTION INSURANCE COMPANY
04/25/2024 PCF235440
MERRIMACK MUTUAL FIRE INSURANCE COMPANY
04/26/2024 PCF79
MIDVALE INDEMNITY COMPANY
04/25/2024 PCF79410
MMG INSURANCE COMPANY
05/02/2024 PCD5
NATIONWIDE MUTUAL INSURANCE COMPANY
04/23/2024 PCF32
NGM INSURANCE COMPANY
04/25/2024 PCF86
NORTHERN SECURITY INSURANCE COMPANY INC
06/04/2024 PCF36
PACIFIC EMPLOYERS INSURANCE COMPANY
05/14/2024 PCF546
PACIFIC INDEMNITY COMPANY
05/14/2024 PCF547
PATRIOT INSURANCE COMPANY
04/29/2024 PCD208274
THE PHOENIX INSURANCE COMPANY
05/01/2024 PCF557
PROGRESSIVE NORTHERN INSURANCE COMPANY
05/10/2024 PCF51006
PROGRESSIVE NORTHWESTERN INSURANCE COMPANY
05/10/2024 PCF27738
ST. PAUL FIRE AND MARINE INSURANCE COMPANY
05/01/2024 PCF575
THE STANDARD FIRE INSURANCE COMPANY
05/01/2024 PCF584
STATE MUTUAL INSURANCE COMPANY
04/30/2024 PCD102
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
05/01/2024 PCF974
THE TRAVELERS HOME AND MARINE INSURANCE COMPANY
05/01/2024 PCF56556
THE TRAVELERS INDEMNITY COMPANY OF AMERICA
05/01/2024 PCF585
THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT
05/01/2024 PCF435
THE TRAVELERS INDEMNITY COMPANY
05/01/2024 PCF602
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
05/01/2024 PCF711
TRI STATE INSURANCE COMPANY OF MINNESOTA
04/30/2024 PCF146321
UNION INSURANCE COMPANY
04/30/2024 PCF141739
UNION MUTUAL FIRE INSURANCE COMPANY
05/01/2024 PCF95
UNITED OHIO INSURANCE COMPANY
04/26/2024 PCF192494
VERMONT ACCIDENT INSURANCE COMPANY INC
04/30/2024 PCF883
VERMONT MUTUAL INSURANCE COMPANY
06/04/2024 PCF37
VIGILANT INSURANCE COMPANY
05/14/2024 PCF613
WESTCHESTER FIRE INSURANCE COMPANY
05/14/2024 PCF177973

Authority

Description Issue Date Termination Date Status
CASUALTY 04/23/2024 Active
PROPERTY 04/23/2024 Active

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
21150197

Other Addresses

Address Type
491 MAIN ST
BANGOR, ME 04401-6296
Office

CE Courses

Date Description Course Number Content Areas
02/19/2025 FRAME CONSTRUCTION: OVERVIEW OF UNDERWRITING CONCERNS (1HR) 29314
1
credits in General Education
Total:
1
12/14/2024 ACSR 321 - BECOMING A SUCCESSFUL CSR 28938
2
credits in General Education
Total:
2

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 05:35:46 PM