Carrier:
Test Insurance Company
111 Main Street
Any City, AL 35801
Agent:
Florida Ins Agcy Inc
Policy Information:
GL SALES 1234567-89
General Liability
12/01/2014 to 12/01/2015
Audit ID: 184475
Audit Method: Physical
Audit Complete Type: Regular
Insured Name and Address:
ABC Seafood LLC
123 Any St
Tallahassee, FL 32308
Generated:
12/16/2015 3:23 PM
Completed By:
Rhonda Splear
SplearR@wis-inc.com
Wilkinson Insurance Services
5650 Sanderson Street Suite Q
Huntsville, AL 35805
12/16/2015
Audrey: 4.1, PID: 52
Description Of Operations ... Audit 184475
Legal Entity: LLCPolicy No(s): GL SALES 1234567-89Policy Period: 12/01/2014 to 12/01/2015

ABC Seafood LLC is doing business as a LLC in Tallahassee, FL.

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 has been deducted from the sales exposure.

The insured does not have internet sales.

There is no butchering done by the insured.

Officer 1 was excluded per premium basis.

Exposure Summary ... Audit 184475 ... 12/01/2014 to 12/01/2015 ... Policy GL SALES 1234567-89
Insured: ABC Seafood LLCPolicy Period: 12/01/2014 to 12/01/2015
 Audit Period: 12/01/2014 to 12/01/2015
Policy No(s): GL SALES 1234567-89Auditor: Rhonda Splear

State Code Classification Loc Basis Mod Exposure
FL 15223 Meat, Fish, Poultry or Seafood -Distributors Sales 3,130,032
Total Exposure: 3,130,032
Exposure Recap ... Audit 184475 ... 12/01/2014 to 12/01/2015
State Code Classification / Name Loc Basis Mod Exposure
FL15223 Meat, Fish, Poultry or Seafood -Distributors Sales 
  01 - Dec 14   258,290
  02 - Jan 15   279,554
  03 - Feb 15   220,177
  04 - Mar 15   241,311
  05 - Apr 15   139,078
  06 - May 15   384,692
  07 - Jun 15   483,388
  08 - Jul 15   292,735
  09 - Aug 15   268,777
  10 - Sep 15   273,894
  11 - Oct 15   359,208
  12 - Nov 15   276,570
  Sales Tax   0
    Sales tax (347,642)
  ---------------
3,130,032
==========
Total Exposure: 3,130,032
Worksheet3 ... Audit 184475
Name
Code Gross 12/1 - 12/1 Sales Tax
01 - Dec 14
15223 258,290 258,290  
02 - Jan 15
15223 279,554 279,554  
03 - Feb 15
15223 220,177 220,177  
04 - Mar 15
15223 241,311 241,311  
05 - Apr 15
15223 139,078 139,078  
06 - May 15
15223 384,692 384,692  
07 - Jun 15
15223 483,388 483,388  
08 - Jul 15
15223 292,735 292,735  
09 - Aug 15
15223 268,777 268,777  
10 - Sep 15
15223 273,894 273,894  
11 - Oct 15
15223 359,208 359,208  
12 - Nov 15
15223 276,570 276,570  
Sales Tax
15223 0 0 (347,642)
Totals:
  3,477,674 3,477,674 (347,642)
Adj:
  (347,642)    
Exposure:
  3,130,032    
General Liability Workers ... Audit 184475 ... 12/01/2014 to 12/01/2015
State Code / Name Classification Loc Basis Mod Adj Exposure
FL 15223 Meat, Fish, Poultry or Seafood -Distributors Sales   3,130,032
  Sales Tax Sales tax 347,642  
    Adjustments Total: 347,642  
Total Adjustments / Exposure: 347,642 3,130,032

Worksheet Gross Total Verification Source Total Audit Total
3,477,674 3,477,674 3,477,674
General Information ... Audit 184475
Insured: ABC Seafood LLC Phone: 850-123-4567
  123 Any St Fax:
  Tallahassee, FL 32308 Mobile:
  Contact: John Doe Email: jdseafood@test.com
Records Obtained From: John Doe
Phone: 850-123-4567
  123 Any St Fax:
  Tallahassee, FL 32308 Mobile:
    Email: jdseafood@test.com
Verification Source Record
ABC Seafood LLC
Verification Source Record: Profit & Loss
Employer's Federal ID No.: 98-7654321
1st Quarter 2015: 0
2nd Quarter 2015: 0
3rd Quarter 2015: 0
4th Quarter 2014: 0
Subtotal: 0
Add 12/01/2014 to 12/01/2015 3,477,674
Adjusted Subtotal: 3,477,674
Total: 3,477,674
General Liability Checklist
15 day rule observed for the audit period? YES Invoices reviewed for materials credit for uninsured subs? N/A
If employees were lumped, did you provide # of employees? N/A Was the total subcontractor cost considered? N/A
Did the subcontractors have adequate liability limits? N/A    
General Information Checklist
Are the records computerized? YES What is the condition of the records? GOOD
Were payroll journal records examined? N/A Were general ledger records examined? YES
Was the check book examined? N/A Were income tax return records examined? N/A
Were cash disbursement records examined? N/A Were 941 Returns examined? N/A
Were U/C Returns examined? N/A Were Certificates of Insurance examined? N/A
Were 1099 records examined? N/A What other records were examined? NONE
All locations/addresses shown verified/discussed on audit? YES Was the profit & loss statement reviewed? YES
Notes ... Audit 184475 ... Policy GL SALES 1234567-89
Test Insurance Company
Any City, AL
ABC Seafood LLC Tallahassee, FL
Rhonda Splear (800) 356-7346 Ext. 210

Percent difference between actual and estimated exposures (negative if est. > act.):
State Code Classification Prem Basis Location Est Act Pct Diff
No variances beyond line-item settings or 20% were found.

Exit Interview conducted on 12/16/2015 at 12:05 PM
  Interviewee: John Doe Title: Member  
  Records were
obtained from:
Title:  
 

Notes to Audit Department

Number of employees: 14.

Signature Form ... Audit 184475
Insured: ABC Seafood LLC
Policy No(s): GL SALES 1234567-89 Policy Period: 12/01/2014 to 12/01/2015
 
The undersigned acknowledges that a representative of was present on the date below for the purpose of conducting an insurance audit for the policy indicated above.
 
Insured's Authorized Representative: John Doe
Note: The signature is only viewable with Internet Explorer.
Signed: 12/16/2015 12:06:00 PM

A copy of this audit for the agent of record is approved.

Auditor: Wilkinson Insurance Services
5650 Sanderson Street Suite Q Huntsville, AL 35805
Progress ... Audit 184475
Test Insurance Company
Any City, AL
Insured: ABC Seafood LLC Tallahassee, FL
Policy No(s): GL SALES 1234567-89 Policy Period: 12/01/2014 to 12/01/2015
Auditor: Rhonda Splear (800) 356-7346 Ext. 210
 
Progress Entry: 11/17/2008 at 07:59:28 PM
Entered By: Test Insurance Company
Remarks:
1st Audit Transmittals Marked Printed
Progress Entry: 05/07/2010 at 09:37:33 AM
Entered By: Test Insurance Company
Remarks:
1st Audit Transmittals Marked Printed
Progress Entry: 02/19/2011 at 09:36:00 AM
Entered By: Rhonda Splear-Admin
Remarks:
1st Customer Satisfaction Surveys Marked Printed
Progress Entry: 04/27/2012 at 09:31:11 AM
Entered By: Test Insurance Company
Remarks:
1st Audit Transmittals Marked Printed