Notification of Changes for Business Entity
General Information
Business Entity Name:	MARSH & MCLENNAN AGENCY LLC
Incorporation / Formation Date:
FEIN:	263237576
Ohio License Number:
NPN:
DBA / Trade Name:
State of Domicile:	OH
County:	CLERMONT
Business Address
Address 1:	6279 TRI-RIDGE BLVD,
Address 2:	SUITE 400
City:	LOVELAND
State:	OH
Zip:	45140
Phone:	513-338-5767
Fax:
Business Web Site Address:
Business Email Address:
Mailing Address
Address 1:	6279 TRI-RIDGE BLVD,
Address 2:	SUITE 400
City:	LOVELAND
State:	OH
Zip:	45140
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
CRAIG CAREY	PRODUCER	17696212		YES	10/04/2017
GERARDO RAMUNDO	PRODUCER	1085468		YES	10/04/2017
SHELBY FERGUSON	TECHNICAL ASSISTANT	17637066		YES	09/15/2017
ANDRA CANNON	TECHNICAL ASSISTANT	274-92-3566	YES		09/20/2017

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:	SHARON FOGELMAN
Title:	LICENSING COORDINATOR
Phone Number:	513-338-5767
Email Address:	SHARON.FOGELMAN@MMA-MW.COM