black and white state seal

DEPARTMENT OF PROFESSIONAL AND FINANCIAL REGULATION
BUREAU OF INSURANCE

PAMELA J. CLARKE

PRODUCER LIMITED NON-RESIDENT

License Number:
PLN509148
Status:
First Licensure:
02/28/2025
Cancel Date:
None

Mailing:
THORNWOOD, NY 10594
Phone:
+1 (212) 640-1900
Fax:
+1 (212) 640-0405
Email:
aaclicensing@aexp.com

History

License Type Start Date End Date
PRODUCER LIMITED NON-RESIDENT 02/28/2025

Agency

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN EXPRESS TRAVEL RELATED SERVICES CO INC
02/28/2025 AGN15110

Employer

None.

Authority

Description Issue Date Termination Date Status
TRAVEL AND BAGGAGE 02/28/2025 Active

Responsible For

Name License Number
AMERICAN EXPRESS TRAVEL RELATED SERVICES CO INC STN512076

License/Disciplinary Action

None.

PRODUCER NON-RESIDENT

License Number:
PRN103607
Status:
First Licensure:
05/14/2004
Cancel Date:
None

Mailing:
THORNWOOD, NY 10594
Phone:
+1 (212) 640-1900
Fax:
+1 (212) 640-0405
Email:
aaclicensing@aexp.com

History

License Type Start Date End Date
PRODUCER NON-RESIDENT 05/14/2004

Agency

Name Issue Date License Number Expiration Date Cancel Date
AMERICAN EXPRESS TRAVEL RELATED SERVICES CO INC
05/14/2004 AGN15110 07/08/2014
AMERICAN EXPRESS TRAVEL RELATED SERVICES CO INC
12/23/2014 AGN15110
TRAVEL IMPRESSIONS
11/05/2008 AGN159973 06/30/2013

Employer

Name Issue Date License Number Expiration Date Cancel Date
AMEX ASSURANCE COMPANY
08/20/2004 PCF875
BALBOA LIFE INSURANCE COMPANY
08/24/2004 LHF1012 10/23/2006
BCS INSURANCE COMPANY
10/08/2012 PCF928
JEFFERSON INSURANCE COMPANY
10/08/2012 PCF488
NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA
12/23/2008 PCF527
TESLA INSURANCE COMPANY
08/24/2004 PCF50 10/23/2006
TRANSAMERICA CASUALTY INSURANCE COMPANY
03/04/2010 PCF50669 03/02/2020

Authority

Description Issue Date Termination Date Status
CASUALTY 05/14/2004 Active
HEALTH 05/14/2004 Active
LIFE 05/14/2004 Active
PROPERTY 05/14/2004 Active

Responsible For

Name License Number
AMERICAN EXPRESS TRAVEL RELATED SERVICES CO INC AGN15110

License/Disciplinary Action

None.

GENERAL INFORMATION

NAIC Information

National Producer Number (NPN):
2292490

Other Addresses

Address Type
UMC NY-01-31-10
200 VESEY ST FL 31
NEW YORK, NY 10285-1000
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: 05/17/2025 02:25:15 PM