Notification of Changes for Business Entity
General Information
Business Entity Name:	FOCUS INSURANCE SERVICES
Incorporation / Formation Date:	12/12/2006
FEIN:	20-8542484
Ohio License Number:	1079831
NPN:	17686073
DBA / Trade Name:
State of Domicile:	FL
County:	BROWARD
Business Address
Address 1:	1300 SAWGRASS CORPORATE PARKWAY
Address 2:	300
City:	SUNRISE
State:	FL
Zip:	33323
Phone:	954-331-4800
Fax:	954-331-4850
Business Web Site Address:	HTTPS:TEAMFOCUSINS.COM
Business Email Address:	SKIP.WHITLOCK@TEAMFOCUSINS.COM
Mailing Address
Address 1:	1300 SAWGRASS CORPORATE PARKWAY
Address 2:	SUITE 300
City:	SUNRISE
State:	FL
Zip:	33323
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
STEPHANIE AYERS	AGENT	1149553	YES		7.18.17
JANE FOGEL	MANAGER	1135019	YES		7.18.17
CAROL WALKER	AGENT	1084752	YES		7.18.17
CAROL UTER-MUNROE	AGENT	1134840	YES		7.18.17
JESSICA HARRIS	AGENT	1145822	YES		7.18.17
JESSICA VARGAS	AGENT	1134843	YES		7.18.17
KATE WALLACE	AGENT	1153448	YES		7.18.17
MICHAEL MARTINEZ	AGENT	1143719	YES		7.18.17
ODALYS GONZALEZ	AGENT	1150872	YES		7.18.17
REINA SWEARINGEN	AGENT	1084859	YES		7.18.17
MICHAEL D. HUNT JR	DIRECTOR	1084387		YES	7.18.17
CANDACE HOWER	MANAGER	936450		YES	7.18.17

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

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:	STEPHANIE AYERS
Title:	LICENSING COORDINATOR
Phone Number:	9543314800
Email Address:	STEPHANIE.AYERS@TEAMFOCUSINS.COM