HomeMy WebLinkAbout474315 REVENUE RECOVERY GROUP INC AND KING WOOLF D - INSURANCE CERTIFICATEREVEN-1 . OP ID: DID
,a►�oRo CERTIFICATE OF LIABILITY INSURANCE
DAT12131112vv)
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 endorsements .
PRODUCER 225-927-0451
Henry Insurance Semice,inc. 225.926-6510
9624 Brookline Suite 200
Baton Rouge, LA 70809
Henry Insurance Service, Inc.
CONTACT
PHONE FAX
AIC No Eat : A/C No :
E- RIESS:
INSURERS AFFORDING COVERAGE
NAIC q
INSURER A: America First Insurance
12696
INSURED Revenue Recovery Group Inc and
INSURER B: Travelers
25666
King Woolf,
DISCOVERY AUDIT SERVICES, LLC
INSURER C: New Hampshire Insurance Co.
23841
12012 Bricksome Ave.
INSURER D :
INSURER E:
Baton Rouge, LA 70816
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.
INSR
LTR
TYPE OF INSURANCE
DL
SUER
POLICY NUMBER
M� DD/YYYY
MMIODIYYYY
- LIMITS
GENERAL LIABILITY
EACH OCCURRENCE
$ 1,000,000
A
COMMERCIAL GENERAL LIABILITY
BOP8815543
01/10/13
01/10/14
PREMISES Ea occurrence)
$ 60,000
CLAIMS MADE 171 OCCUR
MED EXP (Any one person)
$ 5,000
PERSONAL B ADV INJURY
S 1,000,00
X Business Owners
GENERAL AGGREGATE
$ 2,000,00
GENT AGGREGATE LIMIT APPLIES PER'.
PRODUCTS - COMPIOP AGO
$ 2,000,00
POLICY PRO LOC
$
AUTOMOBILE
LIABILITY -
-- -
COMBINED SINGLE LIMIT
. Ea accident
_ 11000,000
X
BODILY INJURY (Per person)
$
A
ANY AUTO
BA8399777
01/10/13
01/10/14
ALL OWNED SCHEDULED
AUTOS AUTOS
BODILY INJURY (Per accident)
$
PROPERTY DAMAGE
Peracddent
$
NON -OWNED
HIRED AUTOS AUTOS
UMBRELLA LIAR
OCCUR
EACH OCCURRENCE
$
AGGREGATE
$
EXCESS LIAB
CLAIMS -MADE
DED RETENTION$
$
B
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY
ANY PROPRIETORIPARTNER/EXECUTIVE YIN
OFFICER/MEMBER EXCLUDED?
(Mandatory in NH)
NIA
ICUB9A73207513
01/26/13
01126114
WC STATU- X OTH-
Y LI MIT ER
EL EACH ACCIDENT
$ 1,000,00
EL.DISEASE - EA EMPLOYEEI
$ 1,000,000
IDESCR PTION Odescribe P OPERATIONS below
E.L. DISEASE - POLICY LIMIT
$ 1,000,00
C
Professionial Lia
G24286940001
06/06/12
06/06/13
Aggregate 1,000,00
Ea. Claim 1,000,00
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required)
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
1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD