Notification of Changes for Business Entity
General Information
Business Entity Name:	ASSOCIATED INSURANCE MANAGEMENT, LLC
Incorporation / Formation Date:	05/23/1969
FEIN:	52-0893204
Ohio License Number:	31250
NPN:	2014438
DBA / Trade Name:
State of Domicile:	MD
County:	MONTGOMERY
Business Address
Address 1:	1300 SPRING STREET, STE. 300
Address 2:
City:	SILVER SPRING
State:	MD
Zip:	20910
Phone:	301-587-4200
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	1300 SPRING STREET, STE. 300
Address 2:
City:	SILVER SPRING
State:	MD
Zip:	20191
Indicate the type of change you are seeking
Address Change:	NO
Business Entity Name Change:	YES	Old Business Entity Name:	ASSOCIATED INS MANAGEMENT, INC
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:	NO

Licensed Producers
Name	Title	NPN	Add	Delete	Eff. Date

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)
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?
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 P. MARINACCIO
Title:	MANAGER
Phone Number:	301-587-4200
Email Address:	LPMARINACCIO@AIMCOMMERCIAL.COM