Notification of Changes for Business Entity
General Information
Business Entity Name:	AON ALBERT G. RUBEN INSURANCE SERVICES, INC.
Incorporation / Formation Date:
FEIN:	36-3737704
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	CA
County:	LOS ANGELES
Business Address
Address 1:	15303 VENTURA BOULEVARD, SUITE 1200
Address 2:
City:	SHERMAN OAKS
State:	IL
Zip:	91403
Phone:	(818)742-1400
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	4 OVERLOOK POINT
Address 2:
City:	LINCOLNSHIRE
State:	IL
Zip:	60069
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
JOHN J GALANIS	AGENT	8623142	YES		12/18/2017

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:	KATHI A. MESMER
Title:	SR. LICENSING ADMINISTRATOR
Phone Number:	847-442-1876
Email Address:	AGENCY.LICENSING.MAILBOX@AON.COM