HomeMy WebLinkAbout474315 REVENUE RECOVERY GROUP INC - INSURANCE CERTIFICATE (9)ACOR" CERTIFICATE OF LIABILITY INSURANCE
DATE(MMDO`YYYv)
10/16/2018
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 have ADDITIONAL INSURED provisions or 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
Arthur J Gallagher Risk Management Services Inc
235 Highlandia Drive Suite 200
Baton Rouge LA 70810
CONTACT
NAME: Renee Meaux
PHONE 225-906-1271 arc. No): 225-292-3893
E-MAIL
ADDRESS: renee meaux a com
INSURERS AFFORDING COVERAGE
NAIC #
INSURER A: American Fire and Casualty Company
! 24066
INSURED REVEREC-02
Revenue Recovery Group, Inc Discovery Audit Sery
12012 Bricksom Avenue
INSURER 6 : Ohio CasualtyInsurance Cam a
24074
INSURER c : Travelers Casualty and Surety Company
19038
INsupEan: Illinois Union Insurance_Cotry�any_ _
27960_
Baton Rouge, LA 70816
INSURER E :.
INSURER F :
COVERAGES CERTIFICATE NUMBER: 423155062 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 INSD VwV0 POLICYNUMBER M/DD/YYYV I WDD/YYYY LIMITS
A
X
COMMERCIAL GENERAL LIABILITY
Y
N
BZA57693820
6/16/2018
611612019
EACH OCCURRENCE $2.000000
I CLAIMS -MADE i X I OCCUR
_
AMAGE TO RENTED
PREMIXE_S-tEa 9ggq rence�.,__ ,, ffi 50 000
MED EX" (Any one person) $ 5.000
PERSONAL & ADV INJURY
LIMIT SPER:
GCN'LAGGREGATCJECT APPLIES
GENERAL AGGR EGATE j $aaoD.oa�
r
�~ PRO -
POLICY LOC
PRODUCTS COMP+OPAGG $4000.000
!
$
OTHER.
A
AUTOMOBILE LIABILITY
BZA$M.3920
611612018
6/16/2019
COMBINED SINGLE LIMIT $1 000 000
ANY AUTO
i
BODILY INJURY {Per persons $
OWNED SCHEDULED
AUTOS ONLY AUTOS
,
BODILY INJURY {Per accident) $
PROPERTY DAMAGE
Per aCciden!}
$
I HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
I
e
X !UMBRELLA LIAR X
OCCUR
N
Y
U5057693820
6/16/2018
6116/2D19
EACH OCCURRENCE
I $1.000,000
AGGREGATE
1,000,000
EXCESS LIAB
CLAIMS -MADE
DED X RETENTION
I $
i�
WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN-
ANYPROPRIETORiPARTNER'EXECUriVE NtA
OFFICERWEMBEREXCLUDED'
(Mandatory In NH)
It yyes, describe undet
N
U80L06075118A2G
6116/2018 6l1a1?p19
!
X PTA O -
---
E.LEACHACCIDENT
_.-_ e_...__ ____, ._._
E.L. DISEASE - EA EMPLOYEE1
`$1000000
$1 000.000
QESCRIPTION OF OPERATIUNS below
E.L DISEASE POLICY LIMIT
$ 1,000.000
A 1
D i
Employee Benetits Llalihty N
Protesstonal Liability
I
I
N
BZA57693820 6/16/2018 16/2019 Aagreyate Limit
EONLAF112158374 611612018 5/1612019 ^,WtOgate Limit
$2000.000
$3,000,000
DESCRIPTION OF OPERATIONS! LOCATIONS VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required)
Complete Named insured for the Liability Policy
Revenue Recovery Group, Inc and King Woolf
Discovery Audit Services, LLC
Complete Named Insured for the Workers Compensation Policy
Revenue Recovery Group, Inc,
Discovery Audit Services, LLC
See Attached
City of Fort Collins
PO Box 580
Fort Collins CO 80522
USA
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
C 1988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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