black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

FRED C CHURCH INC

NON-RESIDENT PRODUCER AGENCY

License Number:
AGN50941
Status:
Active
First Licensure:
08/28/1997
Cancel Date:
None
Renewal Date:
04/01/2027

Street Location:
41 WELLMAN ST
LOWELL, MA 01851-5161
Mailing:
41 WELLMAN ST
LOWELL, MA 01851-5161
Phone:
+1 (864) 626-5592
Email:
kathy.kelleysmith@assuredpartners.com

History
License Type Start Date End Date
NON-RESIDENT PRODUCER AGENCY 08/28/1997 04/01/2027

Alias, DBA or Trade Name
Name
DUBLE & O'HEARN INSURANCE

Employer
Name Issue Date License Number Expiration Date Cancel Date
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ACE AMERICAN INSURANCE COMPANY
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ACE PROPERTY & CASUALTY INSURANCE COMPANY
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AIG PROPERTY CASUALTY COMPANY
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AIU INSURANCE COMPANY
 04/24/2003 PCF308
ALLIED INSURANCE COMPANY OF AMERICA
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ALLMERICA FINANCIAL BENEFIT INSURANCE COMPANY
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AMERICAN FIRE AND CASUALTY COMPANY
 11/21/2014 PCF200822 11/10/2023
AMERICAN GUARANTEE & LIABILITY INSURANCE COMPANY
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AMERICAN HOME ASSURANCE COMPANY
 02/25/2006 PCF367
AMERICAN RELIABLE INSURANCE COMPANY
 12/08/2010 PCF45416 04/27/2021
AMERICAN ZURICH INSURANCE COMPANY
 07/22/2014 PCF914
AMTRUST INSURANCE COMPANY
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ANTHEM HEALTH PLANS OF MAINE INC.
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ANTHEM INSURANCE COMPANIES INC
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ANTHEM LIFE INSURANCE COMPANY
 04/15/2020 LHF70467 04/11/2025
ARCH INSURANCE COMPANY
 06/11/2019 PCF62719
THE AUTOMOBILE INSURANCE COMPANY OF HARTFORD, CONNECTICUT
 11/10/2016 PCF659
AXIS INSURANCE COMPANY
 03/02/2011 PCF134278 10/22/2024
BANKERS STANDARD INSURANCE COMPANY
 07/15/2009 PCF152165
BANNER LIFE INSURANCE COMPANY
 01/07/2008 LHF50047
BERKLEY INSURANCE COMPANY
 03/28/2025 PCF166289
BERKLEY REGIONAL INSURANCE COMPANY
 10/26/2021 PCF48727
CAMBRIDGE MUTUAL FIRE INSURANCE COMPANY
 11/08/2001 PCF396
THE CHARTER OAK FIRE INSURANCE COMPANY
 04/08/2005 PCF403
CHUBB INDEMNITY INSURANCE COMPANY
 03/28/2001 PCF591
CHURCH MUTUAL INSURANCE COMPANY, S.I.
 07/24/2012 PCF69099
THE CINCINNATI CASUALTY COMPANY
 02/13/2025 PCF137248
CITIZENS INSURANCE COMPANY OF AMERICA
 03/05/2004 PCF937
COMMERCE AND INDUSTRY INSURANCE COMPANY
 02/13/2014 PCF413
CONTINENTAL CASUALTY COMPANY
 01/22/2019 PCF420
CONTINENTAL INSURANCE COMPANY
 04/05/2016 PCF782
DRIVERS EDGE INSURANCE COMPANY
 09/11/2008 PCF364 03/07/2012
EMPIRE HEALTHCHOICE HMO, INC.
 11/11/2024 HMF285382 07/01/2025
EMPLOYERS ASSURANCE COMPANY
 06/23/2022 PCF285638 03/21/2024
EMPLOYERS COMPENSATION INSURANCE COMPANY
 06/23/2022 PCF285639 03/21/2024
EMPLOYERS FIRE INSURANCE COMPANY
 03/04/2009 PCF41 12/21/2010
EMPLOYERS INSURANCE COMPANY OF WAUSAU
 04/28/2011 PCF434
EMPLOYERS PREFERRED INSURANCE COMPANY
 06/23/2022 PCF285637 03/21/2024
EVEREST NATIONAL INSURANCE COMPANY
 07/28/2014 PCF99574 02/18/2019
EXCELSIOR INSURANCE COMPANY
 09/15/2003 PCF46786 05/09/2024
EXECUTIVE RISK INDEMNITY INC.
 03/28/2001 PCF42522
FARMINGTON CASUALTY COMPANY
 04/12/2006 PCF995 12/05/2009
FEDERAL INSURANCE COMPANY
 08/12/1998 PCF439
FIREMANS FUND INSURANCE COMPANY
 06/08/2004 PCF443 06/15/2005
FIREMANS FUND INSURANCE COMPANY
 08/02/2005 PCF443
FIRST LIBERTY INSURANCE CORPORATION
 04/28/2011 PCF31779
FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN
 01/13/2006 PCF445
GLOBE INDEMNITY COMPANY
 09/25/2003 PCF839 12/31/2004
GRAPHIC ARTS MUTUAL INSURANCE COMPANY
 05/28/2008 PCF453 10/27/2020
GREAT AMERICAN INSURANCE COMPANY
 11/01/2021 PCF764
GREAT NORTHERN INSURANCE COMPANY
 03/28/2001 PCF455
GUIDEONE INSURANCE COMPANY
 04/15/2011 PCF885 09/30/2021
GUIDEONE INSURANCE COMPANY
 07/17/2025 PCF885 09/16/2025
GUIDEONE SPECIALTY INSURANCE COMPANY
 04/15/2011 PCF511 09/30/2021
GUIDEONE SPECIALTY INSURANCE COMPANY
 07/17/2025 PCF511 09/16/2025
THE HANOVER INSURANCE COMPANY
 03/05/2004 PCF712
HARLEYSVILLE INSURANCE COMPANY
 08/26/2008 PCF129870
HARLEYSVILLE MUTUAL INSURANCE COMPANY
 08/26/2008 PCF74622 05/01/2012
HARLEYSVILLE PREFERRED INSURANCE COMPANY
 08/26/2008 PCF128998
HARLEYSVILLE WORCESTER INSURANCE COMPANY
 09/08/2003 PCF908
HARTFORD ACCIDENT & INDEMNITY COMPANY
 01/07/2016 PCF462
HARTFORD FIRE INSURANCE COMPANY
 06/16/2008 PCF464 06/19/2013
HARTFORD FIRE INSURANCE COMPANY
 12/24/2020 PCF464
HARTFORD LIFE & ACCIDENT INSURANCE COMPANY
 03/13/2006 LHF193
HARTFORD UNDERWRITERS INSURANCE COMPANY
 06/09/2009 PCF992 06/19/2013
HARTFORD UNDERWRITERS INSURANCE COMPANY
 08/12/2014 PCF992
HDI GLOBAL INSURANCE COMPANY
 08/07/2023 PCF167923
HUMANA INSURANCE COMPANY
 07/08/2010 LHF980 09/11/2010
HUMANA INSURANCE COMPANY
 09/21/2012 LHF980 04/14/2014
HUMANADENTAL INSURANCE COMPANY
 09/21/2012 LHF173873 04/14/2014
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 07/15/2009 PCF50104
LAMORAK INSURANCE COMPANY
 04/01/2002 PCF671 10/03/2003
LIBERTY INSURANCE CORPORATION
 04/28/2011 PCF999
LIBERTY MUTUAL FIRE INSURANCE COMPANY
 04/28/2011 PCF330
LIBERTY MUTUAL INSURANCE COMPANY
 04/28/2011 PCF331
LINCOLN NATIONAL LIFE INSURANCE COMPANY-THE
 08/21/2007 LHF619
LM INSURANCE CORPORATION
 04/28/2011 PCF31778
MAINE DENTAL SERVICE CORP
 06/01/2010 NPD29330
MAINE EMPLOYERS MUTUAL INSURANCE COMPANY
 07/04/2012 PCD35999
MASSACHUSETTS BAY INSURANCE COMPANY
 03/05/2004 PCF505
MERRIMACK MUTUAL FIRE INSURANCE COMPANY
 11/08/2001 PCF79
METLIFE INVESTORS USA INSURANCE COMPANY
 11/08/2005 LHF934 11/12/2009
METROPOLITAN LIFE INSURANCE COMPANY
 08/05/2003 LHF380
MIDDLESEX MUTUAL ASSURANCE COMPANY
 03/17/2006 PCF844 01/06/2014
MMG INSURANCE COMPANY
 09/12/2006 PCD5 03/14/2014
MMG INSURANCE COMPANY
 03/15/2014 PCD5
MOUNT VERNON FIRE INSURANCE COMPANY
 08/09/2010 PCF83792
NATIONAL FIRE INSURANCE COMPANY OF HARTFORD
 05/31/2017 PCF523
NATIONAL SURETY CORPORATION
 06/08/2004 PCF689
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA
 08/28/2024 PCF527
NATIONWIDE ASSURANCE COMPANY
 01/22/2020 PCF38952
NATIONWIDE GENERAL INSURANCE COMPANY
 12/07/2018 PCF30
NATIONWIDE INSURANCE COMPANY OF AMERICA
 01/22/2020 PCF422
NATIONWIDE MUTUAL FIRE INSURANCE COMPANY
 12/07/2018 PCF31 01/01/2023
NATIONWIDE MUTUAL INSURANCE COMPANY
 04/25/2012 PCF32
NATIONWIDE PROPERTY & CASUALTY INSURANCE COMPANY
 01/22/2020 PCF151089
NETHERLANDS INSURANCE COMPANY
 09/15/2003 PCF827 05/10/2024
NORTHERN SECURITY INSURANCE COMPANY INC
 01/15/2007 PCF36
OHIO CASUALTY INSURANCE COMPANY
 12/29/2004 PCF73059
OHIO SECURITY INSURANCE COMPANY
 11/21/2014 PCF200581 11/10/2023
PACIFIC EMPLOYERS INSURANCE COMPANY
 07/15/2009 PCF546
PACIFIC INDEMNITY COMPANY
 03/28/2001 PCF547
PACIFIC LIFE INSURANCE COMPANY
 05/08/2019 LHF237
PATRIOT INSURANCE COMPANY
 11/01/2002 PCD208274 02/09/2005
PATRONS OXFORD INSURANCE COMPANY
 09/30/2002 PCD7
PEERLESS INSURANCE COMPANY
 09/15/2003 PCF548
PHILADELPHIA INDEMNITY INSURANCE COMPANY
 05/18/2021 PCF46041
THE PHOENIX INSURANCE COMPANY
 04/08/2005 PCF557
THE PIE INSURANCE COMPANY
 06/08/2004 PCF368 09/02/2022
PRAETORIAN INSURANCE COMPANY
 06/03/2009 PCF68207 08/26/2019
PRINCIPAL LIFE INSURANCE COMPANY
 10/30/1997 LHF406
PRIVILEGE UNDERWRITERS RECIPROCAL EXCHANGE
 12/13/2016 PCF212805
PROGRESSIVE NORTHERN INSURANCE COMPANY
 04/10/2006 PCF51006 07/23/2009
PROGRESSIVE NORTHERN INSURANCE COMPANY
 04/19/2010 PCF51006
PROGRESSIVE NORTHWESTERN INSURANCE COMPANY
 04/10/2006 PCF27738
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 04/10/2018 PCF47445
PROVIDENCE MUTUAL FIRE INSURANCE COMPANY
 03/17/2006 PCF562 10/29/2009
PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY
 05/15/2012 LHF250
PRUCO LIFE INSURANCE COMPANY
 07/11/2018 LHF768 12/20/2021
RED TREE INSURANCE COMPANY INC
 06/16/2022 LHF174438
RIVERPORT INSURANCE COMPANY
 03/28/2025 PCF129149
ROYAL INSURANCE COMPANY OF AMERICA
 09/25/2003 PCF684 12/31/2004
SAFECO NATIONAL INSURANCE COMPANY
 02/11/2020 PCF248658 11/10/2023
SAFETY INDEMNITY INSURANCE COMPANY
 07/01/2016 PCF246091
SAFETY INSURANCE COMPANY
 07/01/2016 PCF246090
SAFETY PROPERTY AND CASUALTY INSURANCE COMPANY
 07/01/2016 PCF246092
SECURITY NATIONAL INSURANCE COMPANY
 10/26/2017 PCF189490
SELECTIVE INSURANCE COMPANY OF AMERICA
 07/10/2024 PCF456095
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 07/26/2017 PCF437
SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA
 07/10/2024 PCF456097
SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST
 07/10/2024 PCF456098
SELECTIVE WAY INSURANCE COMPANY
 07/10/2024 PCF456096
SENTINEL INSURANCE COMPANY LTD
 06/09/2009 PCF84269 06/19/2013
SENTINEL INSURANCE COMPANY LTD
 08/17/2015 PCF84269
SEQUOIA INSURANCE COMPANY
 04/23/2020 PCF128467
ST. PAUL FIRE AND MARINE INSURANCE COMPANY
 11/20/2006 PCF575 06/09/2015
ST. PAUL GUARDIAN INSURANCE COMPANY
 11/20/2006 PCF701 06/30/2014
ST. PAUL MERCURY INSURANCE COMPANY
 11/20/2006 PCF576 06/30/2014
THE STANDARD FIRE INSURANCE COMPANY
 04/12/2006 PCF584
STANDARD INSURANCE COMPANY
 05/16/2003 LHF991
SUN LIFE AND HEALTH INSURANCE COMPANY (US)
 09/10/2009 LHF857 08/10/2011
SUN LIFE ASSURANCE COMPANY OF CANADA - US BRANCH
 09/10/2009 LHF271
TECHNOLOGY INSURANCE COMPANY INC
 10/26/2017 PCF136874
TRAVELERS CASUALTY AND SURETY COMPANY
 01/17/2000 PCF348
TRAVELERS CASUALTY AND SURETY COMPANY OF AMERICA
 04/08/2005 PCF974
TRAVELERS CASUALTY COMPANY OF CONNECTICUT
 06/06/2002 PCF31810 12/05/2009
TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA
 04/12/2006 PCF935 07/07/2016
TRAVELERS CASUALTY INSURANCE COMPANY OF AMERICA
 07/31/2019 PCF935
TRAVELERS COMMERCIAL CASUALTY COMPANY
 08/03/2016 PCF83507
TRAVELERS COMMERCIAL INSURANCE COMPANY
 06/18/2007 PCF31811 06/30/2014
THE TRAVELERS HOME AND MARINE INSURANCE COMPANY
 12/09/2010 PCF56556
THE TRAVELERS INDEMNITY COMPANY OF AMERICA
 04/08/2005 PCF585 07/07/2016
THE TRAVELERS INDEMNITY COMPANY OF AMERICA
 04/27/2018 PCF585
THE TRAVELERS INDEMNITY COMPANY OF CONNECTICUT
 04/08/2005 PCF435
THE TRAVELERS INDEMNITY COMPANY
 01/17/2000 PCF602
TRAVELERS PERSONAL INSURANCE COMPANY
 01/15/2019 PCF201268
TRAVELERS PROPERTY CASUALTY COMPANY OF AMERICA
 01/17/2000 PCF711
TRAVELERS PROPERTY CASUALTY INSURANCE COMPANY
 06/06/2002 PCF31808 12/05/2009
TRUMBULL INSURANCE COMPANY
 07/31/2014 PCF47441
TWIN CITY FIRE INSURANCE COMPANY
 06/09/2009 PCF963 06/19/2013
TWIN CITY FIRE INSURANCE COMPANY
 03/11/2019 PCF963
UNION SECURITY INSURANCE COMPANY
 05/19/2006 LHF295 12/09/2020
UNITED FINANCIAL CASUALTY COMPANY
 08/11/2006 PCF61704 03/31/2012
UNUM LIFE INSURANCE COMPANY OF AMERICA
 05/15/2012 LHD145
UTICA MUTUAL INSURANCE COMPANY
 05/28/2008 PCF610 10/27/2020
VALLEY FORGE INSURANCE COMPANY
 07/27/2016 PCF612
VERMONT MUTUAL INSURANCE COMPANY
 01/15/2007 PCF37
VIGILANT INSURANCE COMPANY
 03/28/2001 PCF613
WAUSAU BUSINESS INSURANCE COMPANY
 04/28/2011 PCF47449 03/30/2015
WAUSAU UNDERWRITERS INSURANCE COMPANY
 04/28/2011 PCF833 08/27/2015
WESCO INSURANCE COMPANY
 10/26/2017 PCF49735
WEST AMERICAN INSURANCE COMPANY
 11/21/2014 PCF200576
WEST COAST LIFE INSURANCE COMPANY
 10/06/2004 LHF47439 08/10/2009
WESTERN SURETY COMPANY
 02/17/2003 PCF96
ZURICH AMERICAN INSURANCE COMPANY
 07/22/2014 PCF61397
ZURICH AMERICAN INSURANCE COMPANY OF ILLINOIS
 07/22/2014 PCF165251

Affiliated Agent
Name Issue Date License Number Expiration Date Cancel Date
WILLIAM LAWRENCE BURBINE
 05/09/2014 PRN105126
WAYNE J. GOLAB
 08/28/1997 PRN50212
GEORGE MICHAEL LUCAS
 05/09/2002 PRN85575
JAMES A. MAHER
 05/25/2004 PRN48156
MICHAEL S. REILLY
 01/10/2015 PRN244583
THOMAS F. ROGERS
 02/12/2004 PRN101528

Branch Office
Name Issue Date License Number Expiration Date Cancel Date
FRED C CHURCH INC (PORTSMOUTH NH)
 12/31/2008 BRN162083
FRED C CHURCH INC(ANDOVER MA)
 12/16/1999 BRN66683

Supervised Entity

None.

Responsible Individual
Name License Number
MICHAEL S. REILLY PRN244583

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
953570

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: 10/27/2025 01:30:53 AM