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HomeMy WebLinkAbout474315 REVENUE RECOVERY GROUP INC - INSURANCE CERTIFICATE (19)ACORO® E DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 1/10DAT(MMIMM/ 12017 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 CONTACT NAME_ Renee Meaux Arthur J. Gallagher Risk Management Services, Inc, PHONE FAX 235 Highlandia Drive, Suite 200 _WC. No. Ext) 225 906 1271 (mac, Nol. 225 292 3893 Baton Rouge LA 70810 E-IL Drenee_meaux@ajg.com INSURED REVEREC-02 Revenue Recovery Group, Inc. and Discovery Audit S 12012 Bricksom Avenue Baton Rouge, LA 70816 COVERAGE INSURERA:Travelers Casualty and Surety Compa 19038 INSURERB:American Fire and Casualty Company 24066 INSURERc:Ohio Security Insurance Company 24082 INSURER n -Ohio Casualtv Insurance Comoanv 24074 F: r'rl1/FRGr:FR CFRTIFICOTF NIiRIl ?- 703735168 RFVISInN NIIMRFR- 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 WVD POLICY NUMBER POLICY EFF MMIDD/YYYY POLICY EXP MMIDDIYYYY LIMITS B X I COMMERCIAL GENERAL LIABILITY Y N BZA57693820 1/10/2017 1/10/2018 EACH OCCURRENCE $2,000,000 CLAIMS -MADE ❑X OCCUR $2,000,000 TO RENTED PREMISES Ea oc currence MED EXP (Any one person) $15,000 PERSONAL & ADV INJURY $ GENT AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 X POLICY PECOT- LOC $4,000,000 PRODUCTS - COMP/OP AGG $ OTHER: C AUTOMOBILE LIABILITY N N BAS57693820 1/10/2017 1/10/2018 GUMbIN0_M1RTE LIMIT Ea accident $1,000,000 BODILY INJURY (Per person) $ X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY (Per accident) $ HIRED NON -OWNED AUTOS ONLY AUTOS ONLY Er $ — PROPERTYD7TutAGE Peaccdent r D X UMBRELLA LIAB X OCCUR N Y US057693820 1/10/2017 1/10/2018 EACH OCCURRENCE $1,000,000 AGGREGATE _ $1,000,000 EXCESS LIAB CLAIMS -MADE DIED '': X RETENTION $10,000 $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? � (Mandatory in NH) NIA N UB4649T432 1/26/2017 1/26/2018 X PER OTH- STATUTE ER E.L. EACH ACCIDENT `— $1,000,000 --- --- $1,000,000 E.L. DISEASE - EA EMPLOYEE If yes, describe under DESCRIPTION OF OPERATIONS below $1,000,000 E.L. DISEASE - POLICY LIMIT B Employee Benefits Liability N N BZA57693820 1/10/2017 1/10/2018 Aggregate Limit 2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If nwe 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. See Attached... CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE James O'Neill Purchasing THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Fort Collins ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 580 Fort Collins CO 80522 USA AUTHORIZED REPRESENTATIVE * 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: REVEREC-02 LOC #: ACOOR" III. � ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY Arthur J. Gallagher Risk Management Services, Inc. NAMED INSURED Revenue Recovery Group, Inc. and Discovery Audit S 12012 Bricksom Avenue Baton Rouge, LA 70816 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Discovery Audit Services, LLC General Liability Endorsement: Additional Insured (Owners, Contractors or Lessors) - Blanket When Required by Written Contract - BP04020106 Commercial Umbrella Endorsement: Waiver Transfer Rights of Recovery Against Others - CU64951207 Commercial Auto Endorsement: Loss Payable Clause - CA99441293 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD