black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SRM INSURANCE BROKERAGE LLC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN63906
Status:
First Licensure:
08/04/1999
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
40 WANTAGE AVE
BRANCHVILLE, NJ 07890-0001
Mailing:
40 WANTAGE AVE
BRANCHVILLE, NJ 07890-0001
Phone:
+1 (973) 948-1022
Fax:
+1 (855) 789-2796
Email:
melissa.fairweather@selective.com

History

License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 08/04/1999 04/01/2027

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN ALTERNATIVE INSURANCE CORP
04/01/2000 PCF381 09/30/2003
SELECTIVE INSURANCE COMPANY OF AMERICA
02/06/2024 PCF456095
SELECTIVE INSURANCE COMPANY OF NEW YORK
12/15/2003 PCF437
SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA
02/06/2024 PCF456097
SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST
02/06/2024 PCF456098
SELECTIVE WAY INSURANCE COMPANY
02/06/2024 PCF456096

Affiliated Agent

Name Issue Date License Number Expiration Date Cancel Date
ALLISON L. PAULSON
04/06/2019 PRN329114
BONNIE PERNICE
12/03/2024 PRN502634
BRIAN CHRISTOPHER SARISKY
10/19/2010 PRN183432

Branch Office

None.

Supervised Entity

None.

Responsible Individual

Name License Number
BRIAN CHRISTOPHER SARISKY PRN183432

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
3198415

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 01:09:02 AM