HomeMy WebLinkAbout474315 REVENUE RECOVERY GROUP INC AND DISCOVERY AU - INSURANCE CERTIFICATEA`CO,RO® CERTIFICATE OF LIABILITY INSURANCE
DATE/5/Z019YYY)
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 endorsement(s).
PRODUCER
Arthur J. Gallagher Risk Management Services, Inc.
C ACT
NAME- Renee Meaux
_
PHON_ F
235 Highlandia Drive, Suite 200
1CXE 225-906-1271 No : 225-292-3893
E-MAIL
AD Ess: renee meaux a' .com
Baton Rouge LA 70810
.. __INSURER(S) AFFORDING COVERAGE
NAIC #
INSURER A: American Fire and Casualty Company
24066
INSURED REVEREC-02
Revenue Recovery Group, Inc. and Discovery Audit
INSURER B : Ohio Casualty Insurance Company
--
24074
- --
19038
12012 Bricksom Avenue
INSURERc: Travelers Casualty and Surety Company
INSURER D:Illinois Union Insurance Company
27960
Baton Rouge, LA 70816
INSURER E :
INSURER F :
COVERAGES CERTIFICATE NUMBER:144855678 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.
WS'R ..___ ____... _ _._ _ _ _.,.._.__._. �0 6R .. _.___----�_.__— POLICYEEFFTPOLICYEXP
LTR TYPEOFINSURANCE POLICY NUMBER rMMIDD/YY MM/OD/YYYY — i — LIMITS
A
X COMMERCIAL GENERAL LIABILITY
CLAIMS -MADE %( OCCUR
BZA57693820
8/16/2019
6/16/2020
EACH OCCURRENCE
M1$ 2,000,000
pMI Fj)Rc�grrpnoo)
_
$ 50 000
MED EXP (Any oneperson)
$ 5 ODO
PERSONAL & ADV INJURY
$
GEN'L AGGREGATE LIMIT APPLIES PER:
X i POLICY JECOT LOC
---i
GENERAL AGGREGATE
PRODUCTS - COMP/OP AGG
__...
$ 4,000 D00
$ 4,000,000
- — -- --
OTHER:
Is
A
AUTOMOBILE LIABILITY
BZA57693820
6/16/2019
6/16/2020
COMBINED SINGLE LIMIT
$1,000,000
BODILY INJURY (Per person)
$
ANY AUTO
OWNED SCHEDULED
AUTOS ONLY AUTOS
X HIRED X NON -OWNED
AUTOS ONLY AUTOS ONLY
( BODILY INJURY (Per accident)
$
-
RYOAMAGE
�VLZ:Pi�ent _-,,___--__
$
$
B
X UMBRELLA LIAR X
' OCCUR
US057693820
6/16/2019
9/16/2020
EACH OCCURRENCE
$1,000,000
AGGREGATE
$1,000,0D0
EXCESS LIAB
CLAIMS -MADE
DED X !RETENTION $ in—��-
--------__-
_$—...__.___.
C WORKERS COMPENSATION
AND EMPLOYERS' LIABILITY YIN
ANYPROPRIETORIPARTNER/EXEC UTIVE
OFFICERIMEMBEREXCLUDED?
NiA
UBOL5678141942G
8/18/ZOf9
8/16/2020 IX PER TH-
r I STATI�TTE
E.L.,EACH ACCIDENT A
$1,000,000
(Mandatory in NH)
It yes, describe under
'DESCRIPTION OF OPERATIONS below
I
j
E,L_ DISEASE EA EMPLOYEE
E.L. DISEASE -POLICY LIMIT
$1,000,000 — —
$ 1,000,000
A Employee Benefits Liability
D Professional Liability
II
1
BZA57593820 6/16/2019 6/161202D Aggregate Limit
EONLAF112758374 6/16/2019 6/16/2020 Aggregate Limit
$2,000.000
$3,000,000
DESCRIPTION OF OPERATIONS! LOCATIONS) VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If 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..,
r I C nv6.Ur-n L A1YlorLLA I IUIN
City of Fort Collins
P.O. Box 590
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
01988-2015 ACORD CORPORATION. All rights reserved.
ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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