Notification of Changes for Business Entity
General Information
Business Entity Name:	EDGEWOOD PARTNERS INSURANCE CENTER
Incorporation / Formation Date:
FEIN:	94-3195221
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	CA
County:	SAN FRANCISCO
Business Address
Address 1:	425 CALIFORNIA ST
Address 2:	24TH FLOOR
City:	SAN FRANCISCO
State:	CA
Zip:	94104
Phone:	9258229082
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	P.O. BOX 5668
Address 2:
City:	CONCORD
State:	CA
Zip:	94524
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
PHILIP REMIG	AGENT	2078421		YES	07/24/2018

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:	SANAZ TALEBZADEH
Title:	LICENSING COORDINATOR
Phone Number:	4153564807
Email Address:	SANAZ.TALEBZADEH@EPICBROKERS.COM