Notification of Changes for Business Entity
General Information  
Business Entity Name: CAI INSURANCE AGENCY INC.
Incorporation / Formation Date: 02/25/1955
FEIN: 31-0572951
Ohio License Number: 672
NPN: 1701865
DBA / Trade Name:  
State of Domicile: OH
County: HAMILTON
Business Address  
Address 1: 2035 READING ROAD
Address 2:  
City: CINCINNATI
State: OH
Zip: 45202
Phone: 513-221-1140
Fax: 513-872-7519
Business Web Site Address:  
Business Email Address:  
Mailing Address  
Address 1: 2035 READING ROAD
Address 2:  
City: CINCINNATI
State: OH
Zip: 45202
   
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
KATHERINE GREENE PRODUCER-CSR 17359851   YES 4/12/2017
SARA O. COPE PRODUCER-CSR 18361260 YES   4/12/2017
GAELYN CROUCHER PRODUCER-CSR 8103792 YES   4/12/2017
JAMES D. HERRMANN PRODUCER 2223582 YES   4/12/2017
RYANN MICHELE LITTEL PRODUCER-CSR 17359241 YES   4/12/2017
JULIE L. PERRY PRODUCER-CSR 1810338 YES   4/12/2017
           
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)
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: PATTI YOUNG
Title: LICENSING CO-ORDINATOR
Phone Number: 513-221-1140
Email Address: LICENSING@CAI-INSURANCE.COM