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Home My WebLink About474315 REVENUE RECOVERY GROUP INC - INSURANCE CERTIFICATERo® CERTIFICATE OF LIABILITY INSURANCE OP ID DD DATE(MMIDD/YYYY) 12/30 10 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER NAME: Henry Insurance Service , Inc . HONE ac, No, Ext : (AIC, No): ADDRESS: 9624 Brookline Suite 200 PRODUCER CUSTOMER ID #: REVEN-1 Baton Rouge LA 70809 Phone:225-927-0451 Fax:225-926-8510 INSURER(S) AFFORDING COVERAGE NAIC# INSURED INSURER A: America First Insurance 12696 Revenue Recovery Group Inc. P 0 Box 77738 INSURERB: La workers' Compensation Corp. 22350 INSURERC: Old Republic Insurance Company Baton Rouge LA 70879 INSURER D: American Safety Indemnity Co. INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: _. THIS IS TO.CERTIFY THAT -THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDD/YYYY) (MM/DDIYYYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE OCCUR X Business Owners BOP9673381 01/10/11 01/10/12 EACH OCCURRENCE $ 1000000 PREMISES (Ea occurrence) $ 50000 MED EXP (Any one person) $ 5000 PERSONAL & ADV INJURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: X POLICY PRO LOC JECT Ll PRODUCTS - COMP/OP AGG s2000000 $ A AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON -OWNED AUTOS BA8399777 01/10/11 01/10/12 COMBINED SINGLE LIMIT (Ea accident) $ lOOOOOO X BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LAB EXCESS LIAB OCCUR j I EACH OCCURRENCE $ HCLAIMS-MADE AGGREGATE $ DEDUCTIBLE RETENTION $ $ $ B_ C -WORKERS -COMPENSATION. _ AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIV YIN OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below NIA 84549A - - MWC11576902 01/26/11 - 01/26/11 01/26/12 01/26/12 W TATU- X TH- TORY LIMITS _ I ER E.L. EACH ACCIDENT _ $ 1000000 E.L. DISEASE - EA EMPLOYEE $ 1000000 E.L. DISEASE - POLICY LIMIT $ 1000000 D PROFESSIONAL LIAB 170PGlPF005102 06/06/10 06/06/11 Ea. claim 1,000,000 Aggregate 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) CERTIFICATE HOLDER CANCELLATION James O'Neill Purchasing City of Fort Collins P.O. Box 580 Fort Collins CO 80522 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are registered marks of ACORD A OR� CERTIFICATE OF LIABILITY INSURANCE OF ID KS DATEIMM/DDf/M- 03/24/11 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S(, AUTHORIZED_ REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. T: If the certificate holder is an ADDITIONAL INSURED, the po cy es must be endorsed. If SU13ROGATION IS WAJVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificates holder in lieu of such endorsement(s(. PRODUCER . ' - I'+ : I : it ` J '_-_ -Henry „Insurance: Service,Inc.I NAME: - AIC NO Ert: (AIC, No: - ) ADDRESS: �9624 -Brookline Buite 200 CUSTOMERID#: REVEN-1 Baton Rouge LA. 70609_ Phone:225-927-0451 Fax:225-926-8510 INSURER(S) AFFORDING COVERAGE NAICp INSURED INSURERA: America First Insurance 12696 Revenue Recovery Group Inc. P 0 Box 77738 INSURER B: La worker.• Ca r, ration Corp. 22350 INSURERC: Old Republic insurance Coopany Baton Rouge LA 70879 INSURER D: American Safety Indmnity Co. INSURER E : INSURER F COVERAGES. CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWTHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR TYPE OF INSURANCE INSR MC POLICYNUMBER (MM/DD/YYYY) (MWDDNYYY) LIMITS A GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS -MADE ❑ OCCUR X Business OVlners `r'r:' BOP9673381 / A^. 01/10/11 '�,+;. 01/10/12 - - EACH OCCURRENCE E 1000000 PREMISES (Ea occu ence) If 50000 MEDEXP(Any oneperson) s 5000 PERSONAL S ACV INJURY $1000000 - GENERAL AGGREGATE b 2000000 GENLAGGREGATE UMITAPPLIES PER'. ,�-_- RO LCC X POLICY JECT PRO_ PRODUCTS-COMP/OPAGG E2000000 It :A I AUTOMOBILE LIABILITY ,. ANY AUTO ., ALLOWNEDAIJTOSl SCHEDULED AUTOS _- HIRED AUTOS NON-OWNEDAUTOS ,... - . BA8399.777 � � - - 01/10/11 "" mho/1s ' COMBINED SINGLE LIMIT (Ea accident) m. 61000000 X BODILY INJURY (Per person) $ � - BODILY INJURY (Per $ PROPERTY DAMAGE (Per accident) 8 $ E UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE E DEDUCTIBLE RETENTION $ $ $ B C WORKERS COMPENSATION AND EMPLOYERS' LIABIUTY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE- OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below IA 84549A MWC11576902 01/26/11 01/26/11 01/26/12 01/26/12 XIOTH- TORY LIMITS ER E.L. EACH ACCI DENT $1000000 E.L. DISEASE - PA EMPLOYE $1000000 E.L. DISEASE - POLICY LIMIT $1000000 D PROFESSIONAL LIAB 170PGl PF005102 os/os/10 06/06/11 Ea. claim 1,000,000 Aaareciate 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more apace is required) CERTIFICATE HOLDER CANCELLATION CZTYOF2 I SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. City of Fort Collins Purchasing Division P.O. Box 580 [UOB AUUKU CORPORATION. All rights reserved. ACORD 25 (2009109) The ACORD name and logo are regist red marks of ACORD