black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

SAMUEL MARC GOULET

PRODUCER RESIDENT

License Number:
PRR336088
Status:
First Licensure:
08/13/2019
Cancel Date:
None
Renewal Date:
07/31/2025

Continuing Education:
Required by 07/31/2025
Hours Required:
Ethics:
3
Total Required:
24
Hours Acquired:
Ethics:
0
Total Acquired:
0

Mailing:
LEWISTON, ME 04240
Phone:
+1 (207) 212-0238
Email:
sgoulet@ssasurety.com

History

License Type Start Date End Date
PRODUCER RESIDENT 06/02/2021 07/31/2025
*** NOT ACTIVE *** 03/18/2021 06/01/2021
PRODUCER RESIDENT 08/13/2019 03/17/2021

Agency

Name Issue Date License Number Expiration Date Cancel Date
SSI CROSS INC
06/02/2021 AGR212257

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN CONTRACTORS INDEMNITY COMPANY
12/02/2020 PCF81110 03/18/2021
BERKLEY INSURANCE COMPANY
11/13/2020 PCF166289 03/18/2021
CONTINENTAL INDEMNITY COMPANY
04/12/2023 PCF131045
CRUM & FORSTER INDEMNITY COMPANY
11/13/2020 PCF169608 03/18/2021
FRANKENMUTH INSURANCE COMPANY
11/13/2020 PCF83684 03/18/2021
HARCO NATIONAL INSURANCE COMPANY
12/02/2020 PCF325 03/18/2021
HARCO NATIONAL INSURANCE COMPANY
05/20/2024 PCF325
LEXINGTON NATIONAL INSURANCE CORPORATION
10/18/2022 PCF100664
MARKEL INSURANCE COMPANY
09/07/2021 PCF31382
MERCHANTS BONDING COMPANY (MUTUAL)
12/15/2020 PCF108067 03/18/2021
MERCHANTS BONDING COMPANY (MUTUAL)
03/07/2022 PCF108067
MERCHANTS NATIONAL BONDING INC
02/03/2022 PCF205259
NGM INSURANCE COMPANY
12/19/2022 PCF86
NORTH RIVER INSURANCE COMPANY
11/13/2020 PCF698 03/18/2021
OLD REPUBLIC INSURANCE COMPANY
02/12/2021 PCF543 03/18/2021
OLD REPUBLIC INSURANCE COMPANY
08/12/2021 PCF543
PENNSYLVANIA INSURANCE COMPANY
04/12/2023 PCF72859
PHILADELPHIA INDEMNITY INSURANCE COMPANY
12/17/2020 PCF46041 03/18/2021
SURETEC INSURANCE COMPANY
09/07/2021 PCF159187
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
12/02/2020 PCF974 03/18/2021
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
12/20/2021 PCF974
UNITED FIRE & CASUALTY COMPANY
02/12/2021 PCF258498 03/18/2021
UNITED FIRE & CASUALTY COMPANY
10/06/2021 PCF258498
UNITED STATES FIRE INSURANCE COMPANY
11/13/2020 PCF101256 03/18/2021
UNITED STATES SURETY COMPANY
12/02/2020 PCF115462 03/18/2021
US SPECIALTY INSURANCE COMPANY
12/02/2020 PCF31516 03/18/2021

Authority

Description Issue Date Termination Date Status
CASUALTY 06/02/2021 Active
PROPERTY 06/02/2021 Active
CASUALTY 08/13/2019 03/18/2021 Terminated
PROPERTY 08/13/2019 03/18/2021 Terminated

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
19256103

Other Addresses

Address Type
103 PARK ST
LEWISTON, ME 04240-7203
Office

CE Courses

None.

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: 05/21/2025 08:20:31 AM