Notification of Changes for Business Entity
General Information
Business Entity Name:	ASSOCIATED INSURANCE MANAGEMENT, INC.
Incorporation / Formation Date:	08/01/1969
FEIN:	52-0893204
Ohio License Number:	31250
NPN:	2014438
DBA / Trade Name:
State of Domicile:	MD
County:	USA
Business Address
Address 1:	1300 SPRING ST.
Address 2:	SUITE 300
City:	SILVER SPRING
State:	MD
Zip:	20910
Phone:	301-897-3570
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	1300 SPRING ST.
Address 2:	SUITE 300
City:	SILVER SPRING
State:	MD
Zip:	20910
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	NO	Old Business Entity Name:
New DBA/Trade Name:	NO	New DBA/Trade Name:
Amend DBA/Trade Name:	NO	Old DBA/Trade Name:
Add/Delete Producers, Members, Owners, Partners, Officers and/or Directors:	YES

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date
JOHN J. SCOTT	PRESIDENT	629582	YES		01/13/2017

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date

Title Business Entities Only
1. Is any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance? (i.e. banking, auto dealer, mortgage company)	NO
2. Has any member, producer, owner, share holder, manager, partner, officer or director currently engaged in deriving income from or affiliated with (other than as a customer) any business or profession other than insurance since the filing of the previous CN-65 or the original application?	NO
3. If the answer to questions #1 or #2 is yes, identify the business or profession and the nature of person's involvement

Submitted By
Submitted By:	LEONARD MARINACCIO
Title:	VICE PRESIDENT
Phone Number:	240-638-4022
Email Address:	LPMARINACCIO@AIMCOMMERCIAL.COM