Carrier
Test Insurance Company
111 Main Street
Any City, AL 35801
Agent
Florida Ins Agcy Inc
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Policy Information
GL SALES 1234567-89
General Liability
12/01/2006 to 01/15/2007
AuditID: 184475
Audit Method:
Physical
Audit Complete Type: Regular
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Insured Name and Address
ABC Seafood LLC
123 Any St
Tallahassee, FL 32308
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Completed By
Rhonda Splear
Wilkinson Insurance Services
5650 Sanderson Street Suite Q
Huntsville, AL 35805
Date Completed: 12/07/2006
FA Version: 3.0.5232 PID: 26
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| Description of Operations ... Audit 184475 ... Entity: ABC SEAFOOD LLC |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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The insured is an LLC located in Tallahassee, FL operating under the name of ABC Seafood LLC. The inured is a wholesale seafood dealer. Products are purchased from fisherman and other dealers. The insured delivers to restaurants and other dealers throughout Florida using their own trucks and hired trucking concerns. All products are flash-frozen and shipped in refrigerated transport units. Warehouse workers will receive bulk products from others and break that product down to smaller quantities for shipping purposes. Products sold include clams, oysters, soft shell crabs, blue crabs, and stone crabs (15223).
Sales tax is not included in the sales exposure.
The insured does not have internet sales.
There are no retail sales.
There is no butchering done by the insured.
Officer 1 was excluded per premium basis.
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| Exposure Summary ... Audit 184475 ... 05/01/2004 to 05/01/2005 ... Policy 123456789 - ABCDEFG |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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| State |
Code |
Classification |
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Premium Basis |
Exposure |
| FL |
15223 |
Meat, fish, poultry or seafood - distributors |
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Sales |
3,477,674 |
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| Principal’s Information ... Audit 184475 ... Entity: ABC SEAFOOD LLC |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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| Officer 1 |
Member |
Excluded |
| LLC |
FL 09 |
EXCLUDED |
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| Audit Period: 05/01/2004 to 05/01/2005 |
Total Amount: |
0 |
Included At: |
0 |
| Manages from the office. |
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| Exposure Recap ... Audit 184475 ... 05/01/2004 to 05/01/2005 |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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| State |
Code |
Classification |
Premium Basis |
| FL |
15223 |
Meat, fish, poultry or seafood - distributors |
|
Sales |
| |
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Meat/Poultry Distributor |
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3,477,674 |
| |
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Total: |
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3,477,674 |
| FL |
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EXCLUDED |
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|
| |
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*Officer 1 -Manages from the office. |
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0 |
| |
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Total: |
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0 |
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| Worksheet Stacked #1 ... Audit 184475 |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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| Date |
Gross |
Col 3 |
Col 4 |
Col 5 |
Col 6 |
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Sales |
EXCLUDE |
15223 Meat, fish, poultry or seafood - d |
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General Ledger |
Officer 1 |
Meat/Poultry Distributor |
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|
| |
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FL |
FL |
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| May 04: |
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258,290 |
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| Jun 04: |
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279,554 |
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| July 04: |
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220,177 |
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| Aug 04: |
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241,311 |
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| Sep 04: |
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139,078 |
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| Oct 04: |
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384,692 |
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| Nov 04: |
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483,388 |
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| Dec 04: |
|
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292,735 |
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| Jan 05: |
|
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268,777 |
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| Feb 05: |
|
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273,894 |
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| Mar 05: |
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359,208 |
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| Apr 05: |
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276,570 |
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|
| |
0 |
0 |
3,477,674 |
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| General Liability Verification ... Audit 184475 ... 05/01/2004 to 05/01/2005 |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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| State |
Code |
Classification |
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Exposure |
| FL |
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EXCLUDED |
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0 |
| |
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--------------- |
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Audit Total: |
0 |
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| Worksheet Gross Total: |
0 |
Verification Source Total: |
0 |
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End of Report -- Audit No: 184475; Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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| General Information ... Audit 184475 ... Policy 123456789 - ABCDEFG |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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Insured:
ABC SEAFOOD LLC
123 Any St Tallahassee, FL
Entity: ABC SEAFOOD LLC
Phone: 850-123-4567 |
Records obtained from:
John Doe
123 Any St Tallahassee, FL
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----------------Verification Source Record-----------------
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| Entity: ABC Seafood LLC |
| Verification Source Record: General Ledger |
| Employer’s Federal ID No.: 12-3456789 |
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| 1st Quarter 2005: |
0 |
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| 2nd Quarter 2004: |
0 |
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| 3rd Quarter 2004: |
0 |
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| 4th Quarter 2004: |
0 |
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| Grand Total: |
0 |
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| General Liability Checklist |
| Policy number and policy period match the request? |
YES |
General ledger or checkbook reviewed? |
YES |
| 15 day rule observed for the audit period? |
YES |
Invoices reviewed for materials credit for uninsured subs? |
N/A |
| If employees are lumped, did you provide # of employees? |
N/A |
G/L, did you include one principal? |
N/A |
| Was the total subcontractor cost considered? |
N/A |
Did the subcontractor(s) have adequate liability limits? |
N/A |
| General Information Checklist |
| Are the records computerized? |
NO |
What is the condition of the records? |
GOOD |
| Were payroll journal records examined? |
NO |
Were general ledger records examined? |
YES |
| Was the check book examined? |
NO |
Were income tax return records examined? |
NO |
| Were cash disbursement records examined? |
NO |
Were S/S Returns examined? |
NO |
| Were cash receipt records examined? |
NO |
Were Certificates of Insurance examined? |
NO |
| Were 1099 records examined? |
NO |
What other records were examined? |
NONE |
| All locations/addresses shown verified/discussed on audit? |
YES |
Were U/C Returnes examined? |
NO |
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| Notes To Audit Department ... Audit 184475 |
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Policy No(s): 123456789 - ABCDEFG; Policy Period: 05/10/2004 to 05/10/2005
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| Test Insurance Company |
Any City, AL |
| ABC SEAFOOD LLC |
Tallahassee, FL |
| ABC SEAFOOD LLC |
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| Auditor: Keith West Wilkinson Insurance Services, Inc. (256) 880-2900 |
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| Exit Interview conducted on: 07/21/2005 at 11:00:00 AM |
| Interviewee: John Doe |
Title: Office Manager |
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Notes To Audit Department-----------------------------------
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Website: www.abcseafood.com
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