Notification of Changes for Business Entity
General Information
Business Entity Name:	CALLAHAN RISK AND INSURANCE SERVICES, INC.
Incorporation / Formation Date:	03/18/2004
FEIN:	20-0997299
Ohio License Number:	1149985
NPN:	8185925
DBA / Trade Name:
State of Domicile:	CA
County:	LOS ANGELES
Business Address
Address 1:	99 S RAYMOND AVE
Address 2:	STE 102
City:	PASADENA
State:	CA
Zip:	91105
Phone:	626-578-0606 X12
Fax:
Business Web Site Address:	WWW.CALLAHANRISK.COM
Business Email Address:	NRUEDA@CALLAHANRISK.COM
Mailing Address
Address 1:	PO BOX 351
Address 2:
City:	PASADENA
State:	CA
Zip:	91102
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

Members, Owners, Partners, Officers and Directors
Name	Title	Identifying #	Add	Delete	Eff. Date
NICOLAS RUEDA	VP BUSINESS OPERATIONS	549516209	YES		6/2/2017

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:	NICOLAS RUEDA
Title:	VP BUSINESS OPERATIONS
Phone Number:	6265780606 X 12
Email Address:	NRUEDA@CALLAHANRISK.COM