black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

JEFFREY M. SAMUELS

PRODUCER NON-RESIDENT

License Number:
PRN329715
Status:
First Licensure:
04/17/2019
Cancel Date:
None

Mailing:
WESTON, CT 06883
Phone:
+1 (845) 304-7233
Fax:
+1 (646) 854-1058
Email:
jeff.samuels@cacspecialty.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 04/17/2019

Agency

Name Issue Date License Number Expiration Date Cancel Date
EMBROKER INS SERVICES LLC
04/17/2019 AGN258130
FRONTIER RISK INSURANCE SERVICES LLC
06/17/2023 AGN454451 08/30/2023

Employer

None.

Authority

Description Issue Date Termination Date Status
CASUALTY 04/17/2019 Active
PROPERTY 04/17/2019 Active
SURPLUS LINES 06/03/2023 05/07/2025 Terminated

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
17480310

Other Addresses

Address Type
WESTON, CT 06883
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: 03/17/2026 08:08:55 PM