W COLUMBIA ST SCHUYLKILL HAREN, PA (570) Business Fax: Fax: (570) P O BOX 268 POTTSVILLE, PA NO
|
|
- Mervyn Hubbard
- 5 years ago
- Views:
Transcription
1 Addresses Business Business Phone: Mail Mail Phone: W COLUMBIA ST SCHUYLKILL HAREN, PA (570) Business Fax: Fax: (570) P O BOX 268 POTTSVILLE, PA Mail Fax: Undeliverable Mail: NO Authorities: Common Authority: ACTIVE Application Pending: NO Contract Authority: ACTIVE Application Pending: NO Broker Authority: ACTIVE Application Pending: NO Property: YES Passenger: NO Household Goods: NO Private: NO Enterprise: NO Insurance Requirements: BIPD Exempt: NO BIPD Waiver: NO BIPD Required: BIPD on File: Cargo Exempt: NO Cargo Required YES Cargo on File: YES BOC-3: YES Bond Required: YES Bond on File: YES Blanket Company: NATIONAL RESIDENT AGENT SERVICE, INC. Comments: MCF-19439/TA FILED 6/20/89. Active/Pending Insurance: EDC : Effective Date: 06/28/2009 Cancellation Date: Posted Date: 06/22/2009 : NATIONAL INTERSTATE INSURANCE COMPANY ATTN: HOLLY HUMMEL 3250 INTERSTATE DRIVE RICHFIELD, OH US (800) Fax: (330) Form: 34 CARGO QT M253- Effective Date: 06/28/2008 : Cancellation Date: Posted Date: 06/25/2008 $5,000 : TRAVELERS PROPERTY CASUALTY CO. OF AMERICA PLEASE CONTACT YOUR LOCAL AGENT 1 TOWER SQUARE, 5GS HARTFORD, CT US Fax: Page 1 of 8
2 Active/Pending Insurance: Form: 84 SURETY Posted Date: 12/07/2004 S : $10,000 Effective Date: 09/20/2004 Cancellation Date: : WASHINGTON INTERNATIONAL INSURANCE COMPANY C/O ROANOKE TRADE, ATTN: STEVE KNUTSON 1475 E WOODFIELD RD., STE: 500 SCHAUMBURG, IL US (847) Fax: (847) Note: If a carrier is in compliance, the amount of coverage will always be shown as the required Federal minimum ($5,000 per vehicle, $10,000 per occurrence for cargo insurance and $10,000 for bond/trust fund). The carrier may actually have higher levels of coverage. Rejected Insurances: Form: : Received: Rejected: Rejected Reason: $0 Page 2 of 8
3 CL /12/1991 To: 04/17/1991 EMPIRE FIRE & MARINE INSURANCE CO. FOR CLAIMS CALL: FNB PKWY. OMAHA, NE US (888) Fax: DXA /28/1996 To: 08/22/1997 AMERICAN INSURANCE CO. CAROLYN NICHOLS 777 SAN MARIN DRIVE NOVATO, CA US (714) Fax: (415) LTI /28/2006 To: 06/28/2007 LTI /28/2006 To: 05/28/2007 Page 3 of 8
4 LTI /28/2007 To: 06/28/2008 LTI /28/2005 To: 06/28/2006 LTI /28/2005 To: 04/28/2006 ATM /28/1998 To: 06/28/2004 CLARENDON NATIONAL INS. CO. DANNY GREEN 466 LEXINGTON AVENUE, SUITE 1900 NEW YORK, NY US (212) Fax: (212) Page 4 of 8
5 LTI /28/2004 To: 09/29/2004 SLLTI /29/2008 To: 06/28/2008 STATE NATIONAL INSURANCE CO., INC. DEBBIE VANSANFORD 8200 ANDERSON BLVD. FORT WORTH, TX US (817) Fax: (817) SLLTI /28/2008 To: 06/28/2009 STATE NATIONAL INSURANCE CO., INC. DEBBIE VANSANFORD 8200 ANDERSON BLVD. FORT WORTH, TX US (817) Fax: (817) KX /28/1997 To: 06/28/1998 PROVIDENCE WASHINGTON INSURANCE CO. LINDA STORM P.O. BOX 518 PROVIDENCE, RI US (401) Fax: (401) Page 5 of 8
6 LTI /29/2004 To: 06/28/2005 Form: 34 IF /12/1990 CARGO To: 06/28/1996 $5,000 LEXINGTON INSURANCE COMPANY EDWARD T. FOX 100 SUMMER ST., 30THFLR BOSTON, MA US (617) Fax: (866) Form: /28/1996 CARGO To: 06/23/2000 $5,000 LEXINGTON INSURANCE COMPANY EDWARD T. FOX 100 SUMMER ST., 30THFLR BOSTON, MA US (617) Fax: (866) Form: /23/2000 CARGO To: 06/28/2008 $5,000 LEXINGTON INSURANCE COMPANY EDWARD T. FOX 100 SUMMER ST., 30THFLR BOSTON, MA US (617) Fax: (866) Page 6 of 8
7 Form: /20/1990 SURETY To: 09/20/2004 $10,000 OHIO CASUALTY INSURANCE CO. DENISE MACKENDIRCK 9450 SEWARD ROAD FAIRFIELD, OH US (513) Fax: (513) Form: 84 S /20/2004 SURETY To: 09/20/2004 $10,000 WASHINGTON INTERNATIONAL INSURANCE COMPANY C/O ROANOKE TRADE, ATTN: STEVE KNUTSON 1475 E WOODFIELD RD., STE: 500 SCHAUMBURG, IL US (847) Fax: (847) If a carrier is in compliance, the amount of coverage will always be shown as the required Federal minimum ($5,000 per vehicle, $10,000 per occurrence for cargo insurance and $10,000 for bond/trust fund). The carrier may actually have higher levels of coverage. If a carrier is in compliance, the amount of coverage will always be shown as the required Federal minimum ($5,000 per vehicle, $10,000 per occurrence for cargo insurance and $10,000 for bond/trust fund). The carrier may actually have higher levels of coverage. If a carrier is in compliance, the amount of coverage will always be shown as the required Federal minimum ($5,000 per vehicle, $10,000 per occurrence for cargo insurance and $10,000 for bond/trust fund). The carrier may actually have higher levels of coverage. Authority History: Sub No. Authority Type Original Action Disposition Action MOTOR PROPERTY CONTRACT CARRIER 05/30/ CONTRACT REJECTED 10/03/ BROKER 09/28/ CONTRACT DENIED 08/18/1988 Page 7 of 8
8 Authority History: Sub No. Authority Type Original Action Disposition Action 35 05/15/ /23/ /09/ /08/ /08/ /06/ /06/ /28/ /23/ /19/1980 Pending Application: Authority Type Filed Status Insurance BOC-3 Revocation History: Authority Type 1st Serve Date 2nd Serve Date Reason Page 8 of 8
FMCSA Motor Carrier. Legal Name: NORTH EAST FREIGHTWAYS, INC, Addresses Business Address:
Addresses Business Business Phone: Mail 1662 ELM STREET MANCHESTER, NH 03101 (603) 537-0164 Business Fax: Fax: (603) 537-0165 Mail Phone: Mail Fax: Undeliverable Mail: NO Authorities: Common Authority:
More informationFMCSA Motor Carrier. DBA (Doing-Business-As) Name. Addresses Business Address: 1107 E. ELM ST. #C FULLERTON, CA Business Phone: Mail Address:
Addresses Business Business Phone: Mail 1107 E. ELM ST. #C FULLERTON, CA 92831 (714) 322-2638 Business Fax: Mail Phone: Mail Fax: Undeliverable Mail: NO Authorities: Common Authority: INACTIVE Application
More informationNM. CHGED. FM. HAZEL MARSHALL, DBA, HAZEL'S HOT SERVICE, PENDING DECISION. FILED FOR GENERAL COMMODITY AUTH. IN 48 STATES IN SUB 1
FMCSA Motor Carrier USDOT Number: 213831 Docket Number: MC162341 Legal Name: HAZEL'S HOTSHOT, INC. DBA (Doing-Business-As) Name Addresses Business Address: Business Phone: Mail Address: Mail Phone: 2009
More informationOREGON INSURANCE DIVISION STATE PAGE LINE: PRIVATE PASSENGER AUTO PHYSICAL DAMAGE DOMESTIC
DOMESTIC 21636 FARMERS INSURANCE COMPANY OF OREGON OR 77,516,931 74,979,889 0 19,799,161 51,834,115 51,492,066 7,276,135 23892 NORTH PACIFIC INSURANCE CO. OR 13,380,874 13,276,253 0 3,964,570 8,063,971
More informationOREGON INSURANCE DIVISION STATE PAGE LINE: 16 - WORKERS' COMPENSATION DOMESTIC
DOMESTIC 18813 DENTISTS BENEFITS INSURANCE COMPANY (OR) OR 86,392 311,776 0-14,471 291,659 177,982 260,619 40541 GROCERS INSURANCE COMPANY OR 6,086,379 5,794,123 208,865 471,551 3,060,447 2,968,972 6,654,757
More informationATLAS TRUCKING AND LOGISTICS, LLC
Atlas is a privately-owned common carrier based in Taylor, Michigan that delivers truck-load freight across the continental United States and Ontario, Canada. We have a team of company drivers in trucks
More informationNON-FLEET TRUCKING APPLICATION NEW VENTURE (1 to 2 Power Units)
RLI Transportation 2970 Clairmont Rd., Suite 1000 Atlanta, GA 30329 A division of RLI Insurance Company P: 404-315-9515 F: 404-315-6558 www.rlitransportation.com NON-FLEET TRUCKING APPLICATION NEW VENTURE
More informationCase KG Doc 258 Filed 06/28/18 Page 1 of 8
Case 18-10182-KG Doc 258 Filed 06/28/18 Page 1 of 8 Ensequence, Inc. United States Bankruptcy Court for the District of Delaware Case number (if known): 18-10182 Be as complete and accurate as possible.
More informationORDER GRANTING 242ND OMNIBUS OBJECTION TO CLAIMS (Contingent Co-Liability Claims)
UNITED STATES BANKRUPTCY COURT SOUTHERN DISTRICT OF NEW YORK ---------------------------------------------------------------x : In re : Chapter 11 Case No. : MOTORS LIQUIDATION COMPANY, et al., : 09-50026
More informationOREGON INSURANCE DIVISION STATE PAGE LINE: COMMERCIAL AUTO NO-FAULT DOMESTIC
DOMESTIC 23892 NORTH PACIFIC INSURANCE CO. OR 166,373 169,516 0 81,309 93,871 74,879 12,095 20338 NORTHWESTERN PACIFIC INDEMNITY COMPANY OR 699 614 0 185 0-51 362 14907 OREGON MUTUAL INSURANCE COMPANY
More informationNORTH CAROLINA DEPARTMENT OF INSURANCE NORTH CAROLINA PROPERTY AND CASUALTY - HOMEOWNERS MUTIPLE PERIL BUSINESS FOR THE YEAR ENDED DECEMBER 31, 2011
Rank Name NORTH CAROLINA DEPARTMENT OF INSURANCE Cumulative 1 25143 State Farm Fire & Cas Co Property and Casualty IL 383,175,444 383,577,608 362,634,220 378,864,013 19.5% 19.5% 2 14842 North Carolina
More informationOREGON INSURANCE DIVISION STATE PAGE LINE: 24 - SURETY FOREIGN
22950 ACSTAR INSURANCE COMPANY IL 56,410 49,910 0 8,153 0 11,222 89,396 19097 ALLIED MUTUAL INSURANCE COMPANY IA 115,811 115,599 0 51,718 2,885 14,885 14,530 19232 ALLSTATE INSURANCE COMPANY IL 2,466 3,122
More information2019 MARKET SHARE REPORT
2019 MARKET SHARE REPORT (FEATURING 2015, 2016 AND 2017 DIRECT WRITTEN PREMIUM DATA SOURCED FROM A.M. BEST- ALL ANALYSIS DONE BY IIABA) INTRODUCTION This reports contains information on select property/casualty
More informationThe Lincoln National Life Insurance Company Term Portfolio
The Lincoln National Life Insurance Company Term Portfolio State Availability as of 7/16/2018 PRODUCTS AL AK AZ AR CA CO CT DE DC FL GA GU HI ID IL IN IA KS KY LA ME MP MD MA MI MN MS MO MT NE NV NH NJ
More informationNORTH CAROLINA DEPARTMENT OF INSURANCE NORTH CAROLINA PROPERTY AND CASUALTY - HOMEOWNERS MUTIPLE PERIL BUSINESS FOR THE YEAR ENDED DECEMBER 31, 2012
Rank Name NORTH CAROLINA DEPARTMENT OF INSURANCE Cumulative 1 25143 State Farm Fire & Cas Co Property and Casualty IL 364,370,408 357,927,119 212,536,302 204,188,431 18.2% 18.2% 2 14842 North Carolina
More informationFILED: NEW YORK COUNTY CLERK 12/12/ :42 PM INDEX NO /2016 NYSCEF DOC. NO. 6 RECEIVED NYSCEF: 12/12/2016 EXHIBIT E
FILED: NEW YORK COUNTY CLERK 12/12/2016 01:42 PM INDEX. 160396/2016 NYSCEF DOC.. 6 RECEIVED NYSCEF: 12/12/2016 EXHIBIT E Continental Express Inc. 2650 Ocean Parkway #1 08 Brooklyn, NY 11235 Tel: (917)
More informationPUBLIC TRANSPORTATION FLEET APPLICATION CHECKLIST (5 or more Revenue Units)
RLI Transportation 2970 Clairmont Rd., Suite 1000 Atlanta, GA 30329 A division of RLI Insurance Company P: 404-315-9515 F: 404-315-6558 www.rlitransportation.com PUBLIC TRANSPORTATION FLEET APPLICATION
More informationUniversity of Houston System Office of the Treasurer. Annual Investment Information Disclosure. Fiscal Year 2007
University of Houston System Office of the Treasurer Annual Investment Information Disclosure Fiscal Year 2007 Investment questions should be directed to: Raymond S. Bartlett, Treasurer Phone: 713-743-8781
More informationImportant -- To avoid delays in the processing of your documents, please review and follow the steps below.
CLIENT DIRECTED SALE FORM Purchaser must provide the following to complete the transaction: o Signed dated Sale Form (page 3) with Purchaser's name, address, phone number, completed odometer, and email
More informationAttachment C Expiring Policy ITB W Contractors Equipment Insurance
Attachment C Expiring Policy ITB 15-84131510-W Contractors Equipment Insurance Account Name: STATE OF FLORIDA Proposal Date: 06/27/2016 Quote Number: 001-001 Proposed Effective Date: 07/01/2016 Proposed
More informationAUTO LEASE Insurance Program
P.O. Box 701 Valley Forge, PA 19482 Tel 800-722-3229 Fax 610-933-4993 www.gmi-insurance.com AUTO LEASE Insurance Program CONTINGENT COVERAGES AVAILABLE FOR AUTO LESSORS LESSORS CONTINGENT LIABILITY $100,000
More informationCompany Profile Firhill Dr Abbotsford BC V2T 5L4 Ph Fax website
3319 Firhill Dr Abbotsford BC V2T 5L4 Ph. 604-776-2277 Fax. 604-776-2278 Email. Info@rtinc.ca website www.rtinc.ca Company Profile Company Legal Name: Rocket Transport Inc. Address Physical: 3119 Firhill
More informationOREGON INSURANCE DIVISION STATE PAGE LINE: COMMERCIAL AUTO PHYSICAL DAMAGE DOMESTIC
DOMESTIC 40541 GROCERS INSURANCE COMPANY OR 72,599 70,657 0 33,463 26,063 42,797 51,885 23892 NORTH PACIFIC INSURANCE CO. OR 3,127,965 3,094,116 0 1,515,358 2,072,401 1,921,749 135,527 20338 NORTHWESTERN
More informationApplication Trade Credit Insurance Multi Buyer
Chubb Global Markets Political Risk & Credit 1133 Avenue of the Americas New York, NY 10036 (212) 835-3138 (NY) (312) 612-8827 (Chicago) (213) 612-5512 (Los Angeles) Application Trade Credit Insurance
More informationRLI TRANSPORTATION A Division of RLI Insurance Company 2970 Clairmont Road, Suite 1000 Atlanta, GA Phone: Fax:
RLI TRANSPORTATION A Division of RLI Insurance Company 2970 Clairmont Road, Suite 1000 Atlanta, GA 30329 Phone: 404-315-9515 Fax: 404-315-6558 AGENCY/BROKER PROFILE Please type your answers. Use a separate
More informationPublicis Benefits Connection Benefits Program Administrative Information Summary Plan Description January 1, 2016
Publicis Benefits Connection Benefits Program Information Summary Description January 1, 2016 Information The Publicis Benefits Connection Health and Group Benefits Program (the Program) is governed by
More informationACORD Forms Updated in AMS R1
ACORD Forms Updated in AMS360 2017 R1 The following forms will use the ACORD form viewer, also new in this release. Forms with an indicate they were added because of requests in the Product Enhancement
More informationACORD Forms in ebixasp (03/2004)
ACORD Forms in ebixasp (03/2004) Form number Form Name Edition Date 1 Property Loss Notice 2002/1 2 Automobile Loss Notice 2002/1 3 General Liability Notice of Occurrence/Claim 2002/1 4 Workers Compensation
More informationMARKEL INSURANCE COMPANY WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE
MARKEL INSURANCE COMPANY WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY INFORMATION PAGE Issued January 14, 2015 1.The Insured s Name and Mailing Address: CAMP LIVE OAK, INC. 1131 NE 45th
More informationThe Acquisition of Regions Insurance Group. April 6, 2018
The Acquisition of Regions Insurance Group April 6, 2018 Forward-Looking Statements This presentation contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform
More informationAuditor Current Duplicate 2001
008-10037225 - 062 ADVANTA BUSINESS SVC CORP %C BIZ PROP TX SOL PMB308 4151 BELTLINE RD STE 124 ADDISON TX 75001-0000 008-10105317 - 001 AMERICAN TOWER MGMT INC 1101 PERIMETER DR STE 225 SCHAUMBURG IL
More informationBenefits Handbook Date March 1, Contact Information Marsh & McLennan Companies
Date March 1, 2018 Marsh & McLennan Companies For questions not answered in this handbook, or to follow up on a claim, learn more about a network, etc., please use the contact information below. Medical
More informationBenefits Handbook Date September 1, Contact Information Marsh & McLennan Companies
Date September 1, 2018 Marsh & McLennan Companies For questions not answered in this handbook, or to follow up on a claim, learn more about a network, etc., please use the contact information below. Medical
More informationProperty and Casualty Companies
Abstract the Annual Statement as XL Insurance America, Inc. 70 Seaview Avenue Seaview House Stamford CT 06902 Total $ 674,094,240 428,797,875 5,000,000 240,296,365 245,296,365 Total $ 674,094,240 company
More informationDemographic Information. Is the business entity affiliated with a financial institution/bank? Yes No
(Please Print or Type) Check appropriate box for license requested. Resident License Non-Resident License o Identify Home State: o Identify Home State License #: Demographic Information 1 Business Entity
More information2018 National Electric Rate Study
2018 National Electric Rate Study Ranking of Typical Residential, Commercial and Industrial Electric Bills LES Administrative Board June 15, 2018 Emily N. Koenig Director of Finance & Rates 1 Why is the
More informationReport to Board of Administration
Report to Board of Administration Agenda of: DECEMBER 12, 2017 From: Thomas Moutes, General Manager ITEM: IV-I SUBJECT: DISCLOSURE REPORT OF FEES, EXPENSES, AND CARRIED INTEREST OF ALTERNATIVE INVESTMENT
More informationFlexible Mortgage Solutions for Extraordinary People. Multi-Family. Investor 1-4. Mixed-Use. Commercial
Multi-Family Investor 1-4 Mixed-Use Commercial Flexible Mortgage Solutions for Extraordinary People Velocity Mortgage Capital is a nationwide, direct portfolio lender focused exclusively on financing residential
More informationTRX LOCATIONS & SUBSIDIARIES
TRX LOCATIONS & SUBSIDIARIES TRX, INC Corporate Administration/Sales: Phone Fax Cleveland, OH 8777 Rockside Rd, Cleveland, OH 44125 Pricing/Sales/Operations: Pricing@TRXTrucking.com Accounts Receivable:
More informationIMPORTANT TAX INFORMATION
IMPORTANT TAX INFORMATION To set up and maintain your account with WestconGroup, we require you to provide us valid Resale Certificates for all states that you are located in, as well as for any other
More informationDemographic Information. 17 Business Web Site Address 18 Business Address ( ) -
(Please Print or Type) Check appropriate boxes for license requested. Resident License Non-Resident License o Identify Home State: o Identify Home State License #: New Application Additional Line(s) of
More informationIRS ISSUES AUTOMATIC ROLLOVER RULES
JANUARY 14, 2005 IRS ISSUES AUTOMATIC ROLLOVER RULES By Laura D. Sanborn, Esq. In Notice 2005-5 issued on December 28, 2004, the Internal Revenue Service ( IRS ) has provided time-critical guidance on
More informationNEW CONTRACT CARRIER QUESTIONNAIRE
E REQUESTED EFFECTIVE DATE: *Please note that we cannot backdate coverage prior to date of receipt of application. For Coverage Questions, please call 800.852.1968 or fax to 707.252.5905 Email To: BizChoiceTransportation@paulhanson.com
More informationFlorida 1/1/2016 Workers Compensation Rate Filing
Florida 1/1/2016 Workers Compensation Rate Filing Kirt Dooley, FCAS, MAAA October 21, 2015 1 $ Billions 4.0 3.5 3.0 2.5 2.0 1.5 1.0 0.5 0.0 Florida s Workers Compensation Premium Volume 2.368 0.765 0.034
More informationehealth, Inc Fall Cost Report for Individual and Family Policyholders
ehealth, Inc. 2010 Fall Cost Report for and Family Policyholders Table of Contents Page Methodology.................................................................. 2 ehealth, Inc. 2010 Fall Cost Report
More informationBenefits Handbook Date March 1, Contact Information Marsh & McLennan Companies
Date March 1, 2016 Marsh & McLennan Companies For questions not answered in this handbook, or to follow up on a claim, learn more about a network, etc., please use the contact information below. Medical
More information1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65 66 67 68 69 70
More informationehealth Inventory Report of Major Medical Health Plans Available Off of Government Exchanges
ehealth Inventory Report of Major Medical Health Available Off of Government Exchanges February 2014 Introduction Beginning January 1, 2014, all new major medical health insurance plans were required to
More informationFOR HIRE/TRUCKERS APPLICATION
8877 Gainey Center Dr. Scottsdale, Arizona 85258 Buschbach Insurance Agency, Inc. 5615 W. 95 th Street P. O. Box 5000 Oak Lawn, IL 60455-5000 708-423-2350 Fax: 708-425-5077 FOR HIRE/TRUCKERS APPLICATION
More informationOlder consumers and student loan debt by state
August 2017 Older consumers and student loan debt by state New data on the burden of student loan debt on older consumers In January, the Bureau published a snapshot of older consumers and student loan
More informationOneAmerica Annuity Product Training
OneAmerica Annuity Product Training * All required training must be completed prior to writing any business with this carrier. Failure to do so could result in business being returned* Annuity producers
More informationANNUAL REPORT CANAL ZONE INSURANCE BUSINESS 19^4- DURING THE CALENDAR YEAR CANAL ZONE GOVERNMENT. Of Insurance Companies.
CZ I.*? ' 19^4- CANAL ZONE GOVERNMENT ANNUAL REPORT OF INSURANCE BUSINESS transacted in the CANAL ZONE DURING THE CALENDAR YEAR 1964 Including Laws Concerning Licensing Of Insurance Companies CANAL ZONE
More informationTouring Entertainers Application
About This Program This application is used to insure touring musical groups, entertainers and performers, as well as house bands and cover bands. Required Documents The following documents are required
More informationNon-Financial Change Form
Non-Financial Change Form Please Print All Information Below Section 1. Contract Owner s Information Administrative Offices: PO BOX 19097 Greenville, SC 29602-9097 Phone number (800) 449-0523 Overnight
More informationCase MFW Doc 980 Filed 07/26/13 Page 1 of 12 UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF DELAWARE : : : : : : :
Case 12-13398-MFW Doc 980 Filed 07/26/13 Page 1 of 12 UNITED STATES BANKRUPTCY COURT FOR THE DISTRICT OF DELAWARE -------------------------------------------------------------x In re THQ INC., et al.,
More informationTRUCKERS APPLICATION
DEEP SOUTH TRUCKERS APPLICATION PROPOSAL FORM - PRIMARY COVERAGE/COMMERCIAL TRUCKMEN REQUIRED FOR 10 OR MORE POWER UNITS THAT ARE ICC REGULATED **IMPORTANT - PLEASE NOTE** ALL ITEMS MUST BE COMPLETED IN
More informationBrian Shlissel President, JPMorgan Funds
JPMORGAN TRUST III JPMorgan Multi-Manager Alternatives Fund 270 Park Avenue New York, New York 10017 Toll-Free (800) 480-4111 February 21, 2017 Dear Shareholder, The enclosed information statement contains
More informationShell Corps Application
About This Program This application is used to insure an incorporated entertainment industry person such as an actor, director, producer, writer, cameraman, musician, athlete, or similar individual. Required
More informationSTATE MOTOR FUEL TAX INCREASES:
STATE MOTOR FUEL TAX INCREASES: 2013-2018 Since 2013, 27 states have increased or adjusted taxes on motor fuel to support needed transportation investments. Twenty-four of those states increased their
More informationFORM G-37. Name of Regulated Entity: J.P. Morgan Securities LLC. Report Period: Fourth Quarter of 2016
Name of Regulated Entity: J.P. Morgan Securities LLC Report Period: Fourth Quarter of 2016 I. CONTRIBUTIONS made to officials of a municipal entity (list by state) Complete name, title (including any city/county/state
More informationPFG Marketing Group, Inc. Is Now Offering SureLC Contracting
CONTRACTING INSTRUCTIONS: 1. Print this entire document 2. Choose the insurance carriers below you wish to be contracted with 3. Choose the states below you wish to be appointed in 4. Complete all areas
More informationPresented by: Matt Turkstra
Presented by: Matt Turkstra 1 » What s happening in Ohio?» How is health insurance changing? Individual and Group Health Insurance» Important employer terms» Impact small businesses that do not offer insurance?
More informationCOMBINED ANNUAL STATEMENT
COMBINED ANNUAL STATEMENT OF THE LIBERTY MUTUAL INSURANCE COMPANY and its affiliated property and casualty insurers of TO THE Insurance Department OF THE FOR THE YEAR ENDED December 31, 2014 PROPERTY AND
More informationRobert L. Young President, JPMorgan Funds
JPMORGAN TRUST III JPMorgan Multi-Manager Alternatives Fund 270 Park Avenue New York, New York 10017 Toll-Free (800) 480-4111 March 7, 2016 Dear Shareholder, The enclosed information statement contains
More informationD E E P S O U T H O F T E N N E S S E E
5 410 MARYLAND WAY, SUITE 41 0, B RENTWOOD, TN 3 7027 P H O N E : 6 1 5. 8 3 2. 8 9 0 0 o r 8 8 8. 8 3 2. 8 9 0 0 F A X : 6 1 5. 8 3 2. 5 4 3 4 o r 8 8 8. 8 3 2. 8 9 0 1 TRUCKERS APPLICATION PROPOSAL FORM
More informationEVIDENCE OF PROPERTY INSURANCE
Quail Creek La Paz Condominium Association 29b Technology Drive Suite 100 Irvine, CA 92618- EVIDENCE OF PROPERTY INSURANCE THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY
More informationFORM G-37. Name of Regulated Entity: Ascensus Broker Dealer Services, LLC. Report Period: First Quarter of 2018
Name of Regulated Entity: Ascensus Broker Dealer Services, LLC Report Period: First Quarter of 2018 I. CONTRIBUTIONS made to officials of a municipal entity (list by state) RI Complete name, title (including
More informationFORM ADV UNIFORM APPLICATION FOR INVESTMENT ADVISER REGISTRATION AND REPORT BY EXEMPT REPORTING ADVISERS
FORM ADV UNIFORM APPLICATION FOR INVESTMENT ADVISER REGISTRATION AND REPORT BY EXEMPT REPORTING ADVISERS Primary Business Name: INVESTMENT ADVISORS ASSET MANAGEMENT, CRD Number: 128716 LLC Annual Amendment
More informationFlexible Mortgage Solutions for Extraordinary People. Multi-Family. Investor 1-4. Mixed-Use. Commercial
Multi-Family Investor 1-4 Mixed-Use Commercial Flexible Mortgage Solutions for Extraordinary People Velocity Mortgage Capital is a nationwide, direct portfolio lender focused exclusively on financing residential
More informationAuditor Current Duplicate 2002
008-10037225 -062 ADVANTA BUSINESS SVC CORP PO BOX 1228 1020 LAUREL OAK RD VORRHEES NJ 08043-0000 008-10105317 -001 AMERICAN TOWER MGMT INC PO BOX 990431 BOSTON MA 02199-0431 008-10032051 -001 ARAMARK
More informationSpecial Events Application
About This Program This application is used to insure a single event taking place in the United States or Canada. Required Documents The following documents are required to apply for coverage: This application
More informationRequired Minimum Distribution Election Form for IRA s, 403(b)/TSA and other Qualified Plans
Required Minimum Distribution Election Form for IRA s, 403(b)/TSA and other Qualified Plans For Policyholders who have not annuitized their deferred annuity contracts Zurich American Life Insurance Company
More informationWhat in the World is IRP?
2014 IFTA / IRP Managers & Law Enforcement Workshop Kansas City, MO What in the World is IRP? Presented by: Deb Hill CA Renée Kyser - AL Long, long ago Early 1900s How do we Finance? Structured Taxes 1
More informationJH Insurance Licensing Guide
JH Insurance Licensing Guide Insurance policies and/or associated riders and features may not be available in all states. Life insurance is underwritten by John Hancock Life Insurance Company (U.S.A.),
More informationAge of Insured Discount
A discount may apply based on the age of the insured. The age of each insured shall be calculated as the policyholder s age as of the last day of the calendar year. The age of the named insured in the
More informationIRA Distribution Form
Use this form to request distributions from your IRA account and to close an IRA. Instructions 1. Complete the form and include any necessary supporting documents. 2. Sign and send us the completed form.
More informationInstructions for Completing the UNIFORM SALES & USE TAX CERTIFICATE MULTIJURISDICTION
Instructions for Completing the UNIFORM SALES & USE TAX CERTIFICATE MULTIJURISDICTION 1. Complete the Uniform Sales & Use Tax Certificate Multijurisdictional form in it entirety. 2. Be sure to complete
More informationFinancial Transaction Form for IRA and Non-Qualified Contracts Only
Financial Transaction Form for IRA and Non-Qualified Contracts Only (Note: See Form ZA-8642 dealing with Financial Transactions for 403(b)/TSA s) Please Print All Information Below Zurich American Life
More informationFORM ADV UNIFORM APPLICATION FOR INVESTMENT ADVISER REGISTRATION AND REPORT BY EXEMPT REPORTING ADVISERS
FORM ADV UNIFORM APPLICATION FOR INVESTMENT ADVISER REGISTRATION AND REPORT BY EXEMPT REPORTING ADVISERS Primary Business Name: QUADRANT REAL ESTATE ADVISORS LLC CRD Number: 138077 Annual Amendment - Item
More informationBenefits Handbook Date July 1, Administrative Information Marsh & McLennan Companies
Date July 1, 2018 Marsh & McLennan Companies This section provides administrative details about how the benefits plans are structured and administered including: plan funding and claims administration
More informationCancellation Protection Plans Your Protection Worldwide Frequently asked questions
Cancellation Protection Plans Your Protection Worldwide Frequently asked questions Why should I purchase one of Holland America Line s Cancellation Protection Plans (CPP)? CPP can help protect your cruise
More informationThe California State University Office of the Chancellor 401 Golden Shore Long Beach, California (562)
The California State University Office of the Chancellor 401 Golden Shore Long Beach, California 90802-4210 (562) 951-4411 Date: Code: TECHNICAL LETTER HR/Benefits 2004-14 To: Human Resources Directors
More informationCOMMERCIAL INLAND MARINE APPLICATION
PO BOX 3867, Bellevue, WA 98009 P: 800.562.8095 I F: 425.453.8696 submissions@gogus.com COMMERCIAL INLAND MARINE APPLICATION (Animal Floater, Golf Carts, Signs) Applicant s Name: Agency Name: Agent: Mailing
More informationSincerely, Scott A Holtzner. Scott A Holtzner 111 Schilling Road, MS B1825 HUNT VALLEY, MD Phone: (443)
Scott A Holtzner 111 Schilling Road, MS B1825 HUNT VALLEY, MD 21031 Phone: (443) 353-2252 Email: SHOLTZNE@travelers.com Kevin Drews BIN INS HOLDINGS LLC 30 N LASALLE STE 2500 CHICAGO, IL 60602 RE: Insured
More informationSTATE MOTOR FUEL TAX INCREASES:
Since 2013, 26 states have increased or adjusted taxes on motor fuel to support needed transportation investments. Twenty-three of those states increased their state gas tax, while three states Kentucky,
More informationCONTINGENT COVERAGES AVAILABLE FOR AUTO LESSORS
CONTINGENT COVERAGES AVAILABLE FOR AUTO LESSORS LESSORS CONTINGENT LIABILITY $100,000 per person, $300,000 per occurrence, Bodily Injury; and $50,000 per occurrence, Property Damage ($100/300/50). As the
More informationS. DAKOTA License Fee $ The Representative must complete and mail the resident South Dakota license application to NMC.
S. DAKOTA License Fee $25 Total Licensing Fees: $25 Resident License 1. The Representative must complete and mail the resident South Dakota license application to NMC. 2. The Licensing Department processes
More informationTomorrow s World Conference December 2013
www.pwc.com Tomorrow s World Asia Pacific Real Estate Conference 2013 6 December 2013 www.pwc.com Breakout Session 2: Real Estates Investments in U.S. Byron Carlock Adam Handler Miranda Tse Agenda Market
More informationBenefits Handbook Date November 1, Contact Information Marsh & McLennan Companies
Date November 1, 2013 Marsh & McLennan Companies For questions not answered in this handbook, or to follow up on a claim, learn more about a network, etc., please use the contact information below. Medical
More informationREVERSE MORTGAGE. Line of Credit Guide ENHANCE. your retirement PLAN
REVERSE MORTGAGE Line of Credit Guide ENHANCE your retirement PLAN (800) 355-1993 Line of Credit Fact: The available funds in your line of credit can increase in value over time. (800) 355-1993 WHAT'S
More information50-State Property Tax Comparison Study: For Taxes Paid in Executive Summary
50-State Property Tax Comparison Study: For Taxes Paid in 2017 Executive Summary By Lincoln Institute of Land Policy and Minnesota Center for Fiscal Excellence April 2018 As the largest source of revenue
More informationINSURANCE AGENT & BROKER PROFESIONAL LIABILITY APPLICATION
INSURANCE AGENT & BROKER PROFESIONAL LIABILITY APPLICATION Instructions: Please answer all questions. If the answer is none, state none. If the answer is not applicable state N/A. If the space provided
More informationSystematic Distribution Form
Systematic Distribution Form (To be used for all Qualified Plans, IRA s and Non-Qualified Plans) (This form is not applicable to a Required Minimum Distribution ( RMD ). If you are older than 70 ½, refer
More informationFORM G-37. Name of Regulated Entity: Loop Capital Markets, L.L.C. Report Period: Third Quarter of 2017
Name of Regulated Entity: Loop Capital Markets, L.L.C. Report Period: Third Quarter of 2017 I. CONTRIBUTIONS made to officials of a municipal entity (list by state) Complete name, title (including any
More informationAviva Announcing Changes to Products and Annuity Rates
September 9, 2011 Aviva Announcing Changes to Products and Annuity Rates This field update contains information on product and rate changes effective September 16, 2011. We want to thank you for all of
More information3 address of organization: 4 Date organization was formed: 03/27/2000. San Francisco, CA 94105
A For the period beginning 05/01/2004 and ending 05/31/2004 B Check applicable box: Initial report Change of address Amended report Final report 1 Name of organization Employer identification number SIERRA
More informationSales Factors Based on the Benefit Received
Sales Factors Based on the Benefit Received ABA Tax Section Meeting San Diego, CA February 17, 2012 Giles Sutton, Partner Grant Thornton Robert Mahon, Partner Perkins Coie LLP 704.632.6885 206.359.6260
More informationPlease complete, sign, and return the attached application and additional documents, when required, to the fax number or address shown above.
20225 N Scottsdale Rd, Dept 50005 * Scottsdale, AZ 85255 * Phone: (888)943-9707 * Fax: (855)231-1343 Email: ar@discounttire.com Thank you for your interest in setting up an account. Please complete, sign,
More informationTo file a complaint please contact Moneydart Global Services Inc. Call Centre at before contacting your jurisdiction with a complaint.
COMPLAINT RESOLUTION To file a complaint please contact Moneydart Global Services Inc. Call Centre at 1-866-372-3874 before contacting your jurisdiction with a complaint. After contacting Moneydart Global
More informationBenefits Handbook Date January 1, Contact Information MMC
Date January 1, 2011 MMC For questions not answered in this handbook, or to follow up on a claim, learn more about a network, etc., please use the contact information below. Benefits Handbook Date January
More information