FMCSA Motor Carrier. DBA (Doing-Business-As) Name. Addresses: Business Address:
|
|
|
- Clarissa Parks
- 7 years ago
- Views:
Transcription
1 Addresses: Business Business Phone: Mail 8600 LONG MEADOW DR JOHNSTON, IA (515) Business Fax: Fax: (515) Mail Phone: Mail Fax: Undeliverable Mail: NO Authorities: Common Authority: NONE Application Pending: NO Contract Authority: INACTIVE Application Pending: NO Broker Authority: NONE 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: $0 Cargo Exempt: NO Cargo Required: NO Cargo on File: NO BOC-3: YES Bond Required: NO Bond on File: NO Blanket Company: JOY B. FITZGERALD RESIDENT AGENT, INC. Comments: Active/Pending Insurance: Form: Type: Posted Date: Coverage From: $0 Effective Date: Cancellation Date: Rejected Insurances: Form: Type: Coverage From: Received: Rejected: Rejected Reason: $0 Page 1 of 6
2 GIC Coverage From 02/15/2011 To: 01/14/2012 GIC Coverage From 02/15/2011 To: 12/14/2011 GIC Coverage From 12/14/2011 To: 02/15/2012 GIC Coverage From 02/15/2012 To: 04/09/2012 Disposition: Name Changed Page 2 of 6
3 GIC Coverage From 02/15/2012 To: 03/06/2012 GIC Coverage From 03/06/2012 To: 02/15/ TRM Coverage From 02/15/2013 To: 07/23/ TRM Coverage From 02/15/2013 To: 06/17/2013 Page 3 of 6
4 02 TRM Coverage From 02/15/2013 To: 02/15/ TRM Coverage From 06/17/2013 To: 02/15/ /15/2014 To: 05/01/ /15/2014 To: 04/02/2014 Page 4 of 6
5 04/02/2014 To: 01/13/ /02/2014 To: 12/11/ /11/2014 To: 02/15/2015 PK2015MCA00611 Coverage From 02/15/2015 To: 02/15/2016 Page 5 of 6
6 Authority History: Sub No. Authority Type Original Action Disposition Action MOTOR PROPERTY CONTRACT CARRIER GRANTED 02/18/2011 REVOKED 02/22/2016 Pending Application: Authority Type Filed Status Insurance BOC-3 Revocation History: Authority Type 1st Serve Date 2nd Serve Date Reason CONTRACT 01/19/ /22/2016 INVOLUNTARY REVOCATION Page 6 of 6
FMCSA Motor Carrier. DBA (Doing-Business-As) Name. Addresses: Business Address:
Addresses: Business Business Phone: Mail 405 FARMER RD APT 3B ASHEBORO, NC 27203 (336) 521-1409 Business Fax: Fax: (336) 419-4400 Mail Phone: Mail Fax: Undeliverable Mail: NO Authorities: Common Authority:
FMCSA Motor Carrier. DBA (Doing-Business-As) Name JAGUAR MFG. Addresses: Business Address:
Addresses: Business Business Phone: Mail Mail Phone: 180134 GREY ROAD 9 DUNDALK, ON N0C 1B0 (519) 923-3879 Business Fax: Fax: (519) 923-3108 P O BOX 96 DUNDALK, ON N0C 1B0 Mail Fax: Undeliverable Mail:
FMCSA 184522 MC152156
Addresses: Business Business Phone: Mail Mail Phone: 100 KERO RD CARLSTADT, NJ 07072-2601 Business PO BOX 6550 CARLSTADT, NJ 07072-2601 Mail (201) 438-6466 Undeliverable Mail: NO Authorities: Common Authority:
Carrier Information Packet
Carrier Information Packet TM Operations/Customer Service General Contact: dispatch@shipfreightsecure.com Phone: 920-682-9600 Fax: 920-682-9606 Liz Strouf Ext. 208 Liz@shipfreightsecure.com Jen Christel
Motor Carrier Forms Bodily Injury and Property Damage Liability
ALPHABETICAL INDEX Forms are listed alphabetically by form title. Important Note: The forms shown herein for each state may not be a complete listing of all the motor carrier bodily injury and property
Student Blue Portal. Table of Contents
Student Blue Portal Introduction The Student Blue tool is used by students enrolled and who want to enroll in the Student Blue plan. Students will have the ability to manage the health coverage enrollment
304.20-040 Cancellation, nonrenewal, or termination of automobile insurance -- Definitions -- Scope -- Penalties. (1) As used in this section: (a)
304.20-040 Cancellation, nonrenewal, or termination of automobile insurance -- Definitions -- Scope -- Penalties. (1) As used in this section: (a) "Policy" means an automobile liability insurance policy,
General Introduction and Overview Webinar Briefing
FMCSA National Training Center Webinar General Introduction and Overview Webinar Briefing October 2013 Federal Motor Carrier Safety Administration Introduction What is the Unified Registration System (URS)?
California Public Utilities Commission
California Public Utilities Commission Consumer Protection and Safety Division License Section Electronic Insurance Filing User Guide Table of Contents (Use Ctrl+Click to follow links.) Logging In... 5
InsuranceTek, Inc. 13300 Bothell-Everett Hwy #6129 Mill Creek WA 98012 Phone (888) 505-1555 * Fax (425) 357-1551 www.insurance-tek.
13300 Bothell-Everett Hwy #6129 Mill Creek WA 98012 Phone (888) 505-1555 * Fax (425) 357-1551 www.insurance-tek.com Mortgage Field Services Coverage > General Aggregate $2,000,000 Products/Completed Operations
DRIVER QUALIFICATION FILE CHECKLIST
DRIVER QUALIFICATION FILE CHECKLIST 1. DRIVER APPLICATION FOR EMPLOYMENT 391.21 2. INQUIRY TO PREVIOUS EMPLOYERS (3 YEARS) 391.23(a)(2) & (c) 3. INQUIRY TO STATE AGENCIES 391.23(a)(1) & (b) 4. MEDICAL
Canal Truck Insurance Application
Insurance Indemnity Sections 1 through 6 must be completed for a quote indication. Sections 7 through 9 must be completed in order to bind. 1. General Information Applicant Legal Name Company Name (DBA)
BRITTON TRANSPORT, INC., 1651 N 48th St., Grand Forks, ND 58203
BRITTON TRANSPORT, INC., 1651 N 48th St., Grand Forks, ND 58203 Grand Forks Customer Service Contacts: COMPANY AND CONTACT INFORMATION Phone: (701)772-6681 Fax: (701)746-6493 Jeff Lazur Reefer Ops/Sales
P.O. Box 78189, Nashville, TN 37207- (615) 271-2450 Toll Free 1-800-776-4004
Allow us to earn your respect P.O. Box 78189, Nashville, TN 37207- (615) 271-2450 Toll Free 1-800-776-4004 ATT: PHONE#: FAX#: In order to establish your company as an approved broker - carrier for Tennessee
South East of Process Main Building / 1F. North East of Process Main Building / 1F. At 14:05 April 16, 2011. Sample not collected
At 14:05 April 16, 2011 At 13:55 April 16, 2011 At 14:20 April 16, 2011 ND ND 3.6E-01 ND ND 3.6E-01 1.3E-01 9.1E-02 5.0E-01 ND 3.7E-02 4.5E-01 ND ND 2.2E-02 ND 3.3E-02 4.5E-01 At 11:37 April 17, 2011 At
TAG III - Application The Alliance Group of Associations Security Guard - PPO
Business Name Contact Name Applicant Name (owner/officer/partner) Contact Number Mailing Address Business Number City State Zip Fax Number Email Address Website Address Cell Number EIN/SSN Preferred Contact
IOWA PLUMBING & MECHANICAL SYSTEMS BOARD INSTRUCTIONS FOR APPLICATION FOR CONTRACTOR LICENSES
IOWA PLUMBING & MECHANICAL SYSTEMS BOARD INSTRUCTIONS FOR APPLICATION FOR CONTRACTOR LICENSES Submit completed applications with a check or money order to: Iowa Plumbing and Mechanical Systems Board Iowa
BUSINESS ENTITIES PART I LIMITED LIABILITY PARTNERSHIPS
BY-LAW 7 Made: May 1, 2007 Amended: June 28, 2007 September 20, 2007 (editorial changes) February 21, 2008 October 30, 2008 November 27, 2008 April 30, 2009 June 28, 2012 April 25, 2013 December 4, 2014
PART 387. Minimum Levels of Financial Responsibility for Motor Carriers. (Interstate and Intrastate Commerce)
PART 387 Minimum Levels of Financial Responsibility for Motor Carriers (Interstate and Intrastate Commerce) 27 Part 387 Minimum Levels of Financial Responsibility for Motor Carriers (Interstate and Intrastate
NC General Statutes - Chapter 20 Article 13 1
Article 13. The Vehicle Financial Responsibility Act of 1957. 20-309. Financial responsibility prerequisite to registration; must be maintained throughout registration period. (a) No motor vehicle shall
As used in 211 CMR 97.00, the following words mean:
211 CMR 97.00 PROCEDURES FOR CANCELLATION AND NON-RENEWAL OF MOTOR VEHICLE INSURANCE POLICIES Section 97.01: Purpose, Scope and Authority 97.02: Definitions 97.03: Policy Cancellation 97.04: Content of
Vehicle Registration and Insurance. Vehicle Registration and Insurance
Vehicle 7 Vehicle 165 7 Vehicle This chapter contains information on vehicle ownership and registrations. 166 Before you operate a vehicle on a highway in Nova Scotia, your vehicle must meet a number of
(1) General Regulations for Oversize/Overweight Permits. (A) In the design and fabrication of all vehicles, machinery, equipment, structures,
(1) General Regulations for Oversize/Overweight Permits. (A) In the design and fabrication of all vehicles, machinery, equipment, structures, buildings, or other units or components, careful consideration
How To Write A Property Broker Contract Carrier Agreement
Thank you for your interest in SIGNATURE LOGISTICS, INC. In order to set up your company in our carrier system the following information is needed. Signed Contract Carrier Agreement (return both pages)
DEPARTMENT OF THE SECRETARY OF STATE CORPORATIONS DIVISION
ITEM 47783. ADVANCE HEALTH CARE DIRECTIVE REGISTRY (ELECTRONIC) FILE Records in paper and electronic formats submitted for inclusion in the North Carolina Advance Health Care Directive Registry, a statewide
ANCILLARY PROVIDER APPLICATION FOR PARTICIPATION PHYSICIANS HEALTH PLAN PO Box 30377, Lansing, MI 48909-7877 517.364.8312
ANCILLARY PROVIDER APPLICATION FOR PARTICIPATION PHYSICIANS HEALTH PLAN PO Box 30377, Lansing, MI 48909-7877 517.364.8312 INSTRUCTIONS: Please provide answers to all questions. If the answer is none, or
REV. JULY 23, 2014 NEBRASKA DEPARTMENT OF MEDICAID SERVICES MANUAL LETTER #64-2014 HEALTH AND HUMAN SERVICES 471 NAC 27-000
MANUAL LETTER #64-2014 HEALTH AND HUMAN SERVICES 471 NAC 27-000 27-000 NON-EMERGENCY TRANSPORTATION (NET) SERVICES 27-001 Service Definitions: the following words, terms and phrases when used in this section
THE SCHOOL DISTRICT OF PALM BEACH COUNTY COMPREHENSIVE RETIREMENT SERVICES COMMITTEE FOR TAX SHELTERED ACCOUNTS (TSA)
THE SCHOOL DISTRICT OF PALM BEACH COUNTY COMPREHENSIVE RETIREMENT SERVICES COMMITTEE FOR TAX SHELTERED ACCOUNTS (TSA) 1. The Comprehensive Retirement Services Committee was established and constituted
DATE ISSUED: 7/24/2014 1 of 7
INSURANCE FOR Contracted projects of any size will be adequately insured. Anyone making a purchase and the purchasing department will verify coverage and will not waive any insurance requirements unless
Property and Casualty Review Standards Checklist
Property and Casualty Review Standards Checklist General Filing Requirements apply to all property and casualty lines of insurance. Once you have reviewed the general filing requirements, please page to
Request for Approval: To seek Charter Service Rule Exception or Exemption approvals please fill out all information below completely.
New York State Department of Transportation (NYSDOT) REQUEST TO PERFORM CHARTER SERVICES WITH FEDERALLY FUNDED EQUIPMENT The following is NYSDOT s policy for submitting, tracking and reporting Charter
Truck Based Transportation will need the following list of items to add you to our list of approved carriers.
Prospective Carrier, Truck Based Transportation will need the following list of items to add you to our list of approved carriers. Please return the following information in person, fax or mail in order
MISCELLANEOUS PROFESSIONAL LIABILITY / GENERAL LIABILITY APPLICATION
MISCELLANEOUS PROFESSIONAL LIABILITY / GENERAL LIABILITY APPLICATION COVERAGE PART A PROFESSIONAL LIABILITY INSURANCE COVERAGE THIS APPLICATION IS FOR A CLAIMS MADE INSURANCE POLICY Please read your policy
Motor Carrier Leads Website Database Field Codes. Carrier Software, LLC
Motor Carrier Leads Website Database Field Codes Ph: Jan. 2013 Field Name Description Docket Number FHWA assigned number identifying each motor carrier, MC=motor carrier, FF=freight forwarder, MX=Mexican
CLIENT INTERVIEW FORM - FAMILY LAW CLIENT IDENTIFICATION
CLIENT INTERVIEW FORM - FAMILY LAW Date: Lawyer: Referred By: Legal Assistant: CLIENT IDENTIFICATION Full Name: Home Address: Mailing Address: Home Phone: Work: Fax: Mobile: Email: Date of Birth: Surname
NC General Statutes - Chapter 55 Article 14 1
Article 14. Dissolution. Part 1. Voluntary Dissolution. 55-14-01. Dissolution by incorporators or directors. (a) The board of directors or, if the corporation has no directors, a majority of the incorporators
REQUEST FOR PROPOSALS
THE JOB COUNCIL REQUEST FOR PROPOSALS PROFESSIONAL PROPERTY/CASUALTY AND WORKERS COMPENSATION INSURANCE BROKER OF RECORD The purpose of the Request for Proposal is to select the broker best qualified to
MORTGAGE LOAN ORIGINATOR LICENSE MAINTENANCE, RENEWAL, AND SURRENDER FREQUENTLY ASKED QUESTIONS
MORTGAGE LOAN ORIGINATOR LICENSE MAINTENANCE, RENEWAL, AND SURRENDER FREQUENTLY ASKED QUESTIONS I. Updating Information on the Individual License Form Q. What types of events or circumstances require a
SOUTH CAROLINA AUTO SUPPLEMENT
AGENCY AGENCY CUSTOMER ID: SOUTH CAROLINA AUTO SUPPLEMENT APPLICANT/NAMED INSURED POLICY NUMBER CARRIER NAIC CODE. OFFER OF ADDITIONAL UNINSURED MOTORIST COVERAGE AND OPTIONAL UNDERINSURED MOTORIST COVERAGE
Application for Consumer Finance License
NC Office of the Commissioner of Banks Location: 316 W. Edenton Street, Raleigh, NC 27603 Mail Address: 4309 Mail Service Center, Raleigh, NC 27699-4309 Telephone: 919/733-3016 Fax: 919/733-6918 Internet:
STEPHEN FREDERICK LOGISTICS CARRIER QUALIFICATIONS CHECKLIST
STEPHEN FREDERICK LOGISTICS CARRIER QUALIFICATIONS CHECKLIST Required Items: Signed copy of Motor Carrier Agreement Proof of Insurance (requested from Insurance Agent) Carrier Profile Information Taxpayer
PLEASE ASK ABOUT OUR QUICKPAY OPTIONS. WE ALSO HAVE A FACTORING DIVISION READY TO HELP WITH ANY AND ALL FINANCING NEEDS.
PLEASE ASK ABOUT OUR QUICKPAY OPTIONS. WE ALSO HAVE A FACTORING DIVISION READY TO HELP WITH ANY AND ALL FINANCING NEEDS. 6871 W Soldier Creek Ave, Rathdrum ID 83858 Phone: 888-253-0430 X. 1 Fax: 208-439-3152
60 Doughboy Road, Gillett, AR 72055 Phone: 870 946 8880 Fax: 866 530 2702
60 Doughboy Road, Gillett, AR 72055 Phone: 870 946 8880 Fax: 866 530 2702 Carrier Information Sheet Please use your company s legal name AND DBA name if one exists. Carrier Name: DBA Name: Mailing Address:
(www.irponline.org), or the Virginia DMV website (www.dmvnow.com) for information regarding the differences between these two plans.
Virginia Department of Motor Vehicles P. O. Box 27412 Richmond, Virginia 23269-0001 Motor Carrier Guidelines For the International Registration Plan (IRP), International Fuel Tax Agreement (IFTA), Unified
TABLE OF CONTENTS Self-Insurance Certification
Workers Compensation Commission Sec. 31-284 page 1 (3-99) TABLE OF CONTENTS Self-Insurance Certification Definitions... 31-284- 1 Application process... 31-284- 2 Partial self-insurance... 31-284- 3 Delayed
AIASS Alarm, Fire Extinguisher & Fire Protection Application. Applicant Information. City State Zip Cellular Number: Year Started Business
Applicant Information Business Name: Applicant Mailing Address Contact: Contact Number Business Number: City State Zip Cellular Number: Web-Site Email Organization Type (Individual/Partnership/Corporation/LLC)
TRANSPORTATION NETWORK COMPANIES S.B. 184: SUMMARY OF INTRODUCED BILL IN COMMITTEE
TRANSPORTATION NETWORK COMPANIES S.B. 184: SUMMARY OF INTRODUCED BILL IN COMMITTEE Senate Bill 184 (as introduced 3-9-15) Sponsor: Senator Rick Jones Committee: Regulatory Reform Date Completed: 3-25-15
STATE OF NEVADA DEPARTMENT OF BUSINESS AND INDUSTRY REAL ESTATE DIVISION 2501 East Sahara Avenue, Suite 102 * Las Vegas, NV 89104-4137 *(702) 486-4033
NEVADA OUT-OF-STATE COOPERATIVE CERTIFICATE CHECKLIST AND APPLICATION Cooperative Certificates are for A SINGLE TRANSACTION ONLY and NOT MEANT for conducting general real estate business on a day-to-day
SUBCHAPTER H. CANCELLATION, DENIAL, AND NONRENEWAL OF CERTAIN PROPERTY AND CASUALTY INSURANCE COVERAGE 28 TAC 5.7001, 5.7002, AND 5.
Part I. Texas Department of Insurance Page 1 of 18 SUBCHAPTER H. CANCELLATION, DENIAL, AND NONRENEWAL OF CERTAIN PROPERTY AND CASUALTY INSURANCE COVERAGE 28 TAC 5.7001, 5.7002, AND 5.7009 1. INTRODUCTION.
Attachment 4: Insurance Requirements
The prospective awardee shall be required to procure, at its sole cost and expense, all insurance required by this Section and, unless otherwise required by this Section, provide proof of the same within
Attachment 04 Contractor s Insurance Requirements
GROUP 31503 BITUMINOUS CONCRETE Page 1 of 5 Attachment 04 Contractor s Insurance Requirements The prospective awardee shall be required to procure, at its sole cost and expense, all insurance required
08 LC 28 4169S. The House Committee on Rules offers the following substitute to SB 113: A BILL TO BE ENTITLED AN ACT
0 LC S The House Committee on Rules offers the following substitute to SB : A BILL TO BE ENTITLED AN ACT 0 To amend Article of Chapter of Title of the Official Code of Georgia Annotated, relating to agents,
Policy Expiration Date as of 12:01 a.m.:
POST OFFICE RECEIPT SECURED [maildate] [fullname] [mailing add] Policy Number: [number] Name and Address of Insurance Company: NOTICE OF EXPIRATION OF POLICY ASSIGNMENT MASSACHUSETTS PRIVATE PASSENGER
A-One Commercial Insurance Risk Retention Group, Inc. Auto Liability Application GENERAL INFORMATION
Agency Producer Email Name: DBA (if any): GENERAL INFORMATION Business Entity: Individual Sole Proprietor Corporation Partnership LLC Other: Effective Date: US DOT: SSN or FEIN: Yrs in business: Yrs in
STRATFORD INSURANCE COMPANY OFFER OF OPTIONAL ADDITIONAL UNINSURED MOTORISTS COVERAGE AND OPTIONAL UNDERINSURED MOTORIST COVERAGE
STRATFORD INSURANCE COMPANY OFFER OF OPTIONAL ADDITIONAL UNINSURED MOTORISTS COVERAGE AND OPTIONAL UNDERINSURED MOTORIST COVERAGE Automobile liability insurance coverage pays other motor vehicle drivers
Are you a broker or carrier and have registered? Click the Log In link from the top of the page and enter your User Name and Password.
Welcome to DAT Onboarding Are you a broker or carrier and have registered? Click the Log In link from the top of the page and enter your User Name and Password. Are you a carrier and need to create a profile?
A-One Commercial Insurance Risk Retention Group, Inc. Auto Liability Application GENERAL INFORMATION BILLING OPTIONS. Coverage and Limits Information
Agency Producer Email GENERAL INFORMATION Name: DBA (if any): Business Entity: Individual Corporation Partnership LLC Other: Effective Date: US DOT: SSN or FEIN: Yrs in business: Yrs in Trucking Industry:
INSURANCE AGENTS CHAPTER 10 LICENSING OF INSURANCE PRODUCERS
IAC 1/13/99 Insurance[191] Ch 10, p.1 IAC 1/13/99 INSURANCE AGENTS CHAPTER 10 LICENSING OF INSURANCE PRODUCERS 191 10.1(522) Purpose and authority. 10.1(1) The purpose of these rules is to govern the qualifications
Individual LLC Partnership Corporation Joint Venture Trust Principal or Majority Owner (please include all principals)
Insurance Indemnity Sections 1 through 6 must be completed for a quote indication. Sections 7 through 9 must be completed in order to bind. 1. General Information Applicant Legal Name Company Name (DBA)
PROPOSED RULES NORTH DAKOTA ADMINISTRATIVE CODE ARTICLE 45-09 REGULATION OF UNAUTHORIZED INSURERS AND INSURANCE
11/3/11 PROPOSED RULES NORTH DAKOTA ADMINISTRATIVE CODE ARTICLE 45-09 REGULATION OF UNAUTHORIZED INSURERS AND INSURANCE Chapter 45-09-01 Surplus Lines Insurance CHAPTER 45-09-01 SURPLUS LINES INSURANCE
Medicare Supplement Coverage Change Form
Medicare Supplement Coverage Change Form Please use this form for any of the following changes: o Change in Personal Information - Complete Sections 1 and 3 o Change Medicare Supplement Plan - Complete
Small Fleet Truckers (6-19 Revenue Units) Underwriting Checklist
Small Fleet Truckers (6-19 Revenue Units) Underwriting Checklist Fleet: City, State: Insured s Email Address: Expiration Date: Proposed Effective Date: Date Quote Required: Broker: Producer(s): Producer
Administrative Procedures for the Safe Driver Insurance Plan (SDIP)
Administrative Procedures for the Safe Driver Insurance Plan (SDIP) Prepared By: Merit Rating Board Date Updated: April 17, 2014 Table of Contents Chapter 1 INTRODUCTION... 1 Authority... 2 Merit Rating
SCHEDULE 5 INSURANCE TABLE OF CONTENTS 1. INSURANCE REQUIREMENTS... 1
SCHEDULE 5 INSURANCE TABLE OF CONTENTS 1. INSURANCE REQUIREMENTS... 1 1.1 Project Specific Construction Period Insurance... 1 1.2 Additional Construction Period Insurance... 1 1.3 Operating Period Insurance
MANAGED COMPETITION NEW BUSINESS PROCESSING
MANAGED COMPETITION NGM Insurance Company utilizes the Automobile Insurers Bureau of Massachusetts (AIB) advisory rule manual effective April 1, 2009 as its base manual. NGM files company specific rates
BROKER - CARRIER AGREEMENT
BROKER - CARRIER AGREEMENT This Agreement is entered into this day of, 20, by and between ("BROKER"), a Registered Property Broker, Lic. No. MC-, and, a Registered Motor Carrier, Permit/Certificate No.
Attestation of Eligibility for an Enrollment Period
301 S. Vine St., Urbana, IL 61801 Attestation of Eligibility for an Enrollment Period Typically, you may enroll in a health plan only from November 1 to January 31. There are exceptions that may allow
RETURN ALL CARRIER SET UP PAPERWORK TO FAX: (888)367-7595
1302 24th Street West, Suite 305 Tel: (888) 228-1055 - Fax: (888) 367-7595 www.bigskytransport.com Dear Carrier Partner Big Sky Transportation, LLC an established freight brokerage and logistics provider
APPLICATION FOR ATHLETIC TRAINER LICENSURE INSTRUCTION TO APPLICANTS
Judith Griffen, Administrative Assistant ATHLETIC TRAINER APPLICATION FOR ATHLETIC TRAINER LICENSURE INSTRUCTION TO APPLICANTS A. LICENSE BY EXPERIENCE: Applicants must submit the following: 1. Complete
1.1 The Scheme shall be cited and referred to as the Waste Management Fees and Charges (Scotland) Scheme 2015 ( the Scheme ).
The Scottish Environment Protection Agency, in exercise of its powers under Section 41 of the Environment Act 1995 and in accordance with Section 42 thereof HEREBY with the approval of the Scottish Ministers,
PART II. AUTOMOBILE INSURANCE
PART II. AUTOMOBILE INSURANCE Chap. Sec. 61. NOTICES FOR AND APPEALS OF CANCELLATIONS AND REFUSAL TO RENEW CERTAIN AUTOMOBILE INSURANCE POLICIES... 61.1 62. MOTOR VEHICLE PHYSICAL DAMAGE APPRAISERS...
SOUTH CAROLINA OFFER OF ADDITIONAL UNINSURED MOTORISTS COVERAGE AND OPTIONAL UNDERINSURED MOTORISTS COVERAGE
IL U 007 01 07 SOUTH CAROLINA OFFER OF ADDITIONAL UNINSURED MOTISTS COVERAGE AND OPTIONAL UNDERINSURED MOTISTS COVERAGE Policy Number: Policy Effective Date: Company: Producer: Applicant/Named Insured:
Example Oregon carrier. The answer is no.
How Unified is the base Carrier state Registration determined? 1. Does the registrant have its principal place of business located in a participating state? AL, AR, CO, CT, GA, IA, ID, IL, IN, KS, KY,
VERMONT DEPARTMENT OF BANKING, INSURANCE, SECURITIES AND HEALTH CARE ADMINISTRATION INFORMATION FOR COMPLETING BIOGRAPHICAL REPORT
Attachment B (5/2000) VERMONT DEPARTMENT OF BANKING, INSURANCE, SECURITIES AND HEALTH CARE ADMINISTRATION INFORMATION FOR COMPLETING BIOGRAPHICAL REPORT Biographical Reports must be filed by each director,
Submitting Insurance for UIIA Participants
Submitting Insurance for UIIA Participants Certificate of Insurance Form Requirement As of August 1, 2012 agents that submit paper certificates to the UIIA via e-mail, fax or mail are required to utilize
STATE OF SOUTH CAROLINA DEPARTMENT OF INSURANCE SCDOI FORM NUMBER 2006 [REVISED JANUARY 1, 2007]
![STATE OF SOUTH CAROLINA DEPARTMENT OF INSURANCE SCDOI FORM NUMBER 2006 [REVISED JANUARY 1, 2007]](/thumbs/33/16166863.jpg "STATE OF SOUTH CAROLINA DEPARTMENT OF INSURANCE SCDOI FORM NUMBER 2006 [REVISED JANUARY 1, 2007]")
STATE OF SOUTH CAROLINA DEPARTMENT OF INSURANCE SCDOI FORM NUMBER 2006 [REVISED JANUARY 1, 2007] OFFER OF ADDITIONAL UNINSURED MOTORIST COVERAGE AND OPTIONAL UNDERINSURED MOTORIST COVERAGE Automobile liability
Billing and Company Information
Billing and Company Information Warren Logistics, Inc. PO Box 30 Blanchard, ID 83804 Phone (888) 253-0430 Fax (208) 962-6741 quote@warrenlogistics.com www.warrenlogistics.com S Corporation, Idaho State
MARYLAND PERSONAL AUTO SUPPLEMENT
MARYLAND PERSONAL AUTO SUPPLEMENT AGENCY NAMED INSURED(S) POLICY NUMBER EFFECTIVE DATE CARRIER NAIC CODE Mandatory Offer of Increased Liability Coverage for Claims of Family Members at an Additional Premium
$&71R SENATE BILL NO. 1105 (SUBSTITUTE FOR SENATE BILL 812 BY SENATOR SCHEDLER)
Regular Session, 2001 $&71R SENATE BILL NO. 1105 (SUBSTITUTE FOR SENATE BILL 812 BY SENATOR SCHEDLER) BY SENATOR SCHEDLER AN ACT To enact Part XXV of Chapter 1 of Title 22 of the Louisiana Revised Statutes
TOP 20 GENERAL RULES. Automatic Driver's License Suspension Provisions Page 1 AND FREQUENTLY ASKED QUESTIONS
TOP 20 GENERAL RULES AND FREQUENTLY ASKED QUESTIONS 1. WHAT ARE THE TYPES OF SUSPENSIONS? (Driver s License Suspension Guide) a. Automatic Suspensions on conviction: i. 21 years of age or older. TEX. TRANSP.
DEPARTMENT OF CORRECTIONS Human Resources
DEPARTMENT OF CORRECTIONS Human Resources Title: Commercial Driver License Management DOC Policy: 20.5.22 Supersedes: None Applicability: All employees required to have a CDL and their supervisors. Directives
GUIDE TO HEALTH CARE REFORM S TAX PENALTIES
The GUIDE TO HEALTH CARE REFORM S TAX PENALTIES Calculate Your Health Insurance Tax Penalty 2 Introduction The Affordable Care Act (ACA) requires certain employers and employees to purchase health insurance
ADMIRAL INSURANCE COMPANY 1255 Caldwell Road, Cherry Hill, NJ 08034 Phone: 856-429-9200 - Fax: 856-429-8611 Internet: http://www.admiralins.
ADMIRAL INSURANCE COMPANY 1255 Caldwell Road, Cherry Hill, NJ 08034 Phone: 856-429-9200 - Fax: 856-429-8611 Internet: http://www.admiralins.com APPLICATION FOR INSURANCE AGENT'S AND BROKER'S PROFESSIONAL
FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES
FLORIDA DEPARTMENT OF AGRICULTURE AND CONSUMER SERVICES ADAM H. PUTNAM COMMISSIONER HOUSEHOLD MOVING SERVICES REGISTRATION APPLICATION Chapter 507, Florida Statutes Rule 5J15.001, Florida Administrative
CITY OF WABASHA REQUEST FOR PROPOSALS FOR LEGAL SERVICES
CITY OF WABASHA REQUEST FOR PROPOSALS FOR LEGAL SERVICES 2014 Wabasha City Hall 900 Hiawatha Drive East Wabasha, Minnesota, 55981 Office of the City Administrator Subject: City of Wabasha Legal Services
DEPARTMENT OF CORPORATIONS
STATE OF CALIFORNIA -- BUSINESS, TRANSPORTATION AND HOUSING AGENCY DEPARTMENT OF CORPORATIONS EDMUND G. BROWN Jr., Governor INSTRUCTIONS FOR COMPLETING THE 2012 ANNUAL REPORT FOR LENDERS AND BROKERS LICENSED
Department of Commerce
Department of Commerce COMMONWEALTH OF THE NORTHERN MARIANA ISLANDS Caller Box 10007 CK, Saipan, MP 96950 Telephone: (670) 664-3064/3000 Fax: (670) 664-3067 Email: commerce@pticom.com Website: www.commerce.gov.mp/
MISSISSIPPI GARAGE DEALER / NON - DEALER APPLICATION
MISSISSIPPI GARAGE DEALER / NON - DEALER APPLICATION CANAL INSURANCE COMPANY CANAL INDEMNITY COMPANY Quotation No. New Policy No. Renewal /Rewrite No. Bound by SGA? Yes No Policy Period From AM/PM on /
Additional Permitted Election Changes for Health Coverage under 125 Cafeteria Plans
Additional Permitted Election Changes for Health Coverage under 125 Cafeteria Plans Notice 2014-55 PURPOSE This notice expands the application of the permitted change rules for health coverage under a
Request for Proposals for Upgraded or Replacement Phone System
City of Bandon Request for Proposals for Upgraded or Replacement Phone System 7/17/2015 Phone System Request for Proposal Page 1 NOTICE The City of Bandon is accepting Proposals for an upgraded or replacement
HR Partner Services. Cornerstone. Applicant Tracking System User Guide
HR Partner Services Cornerstone Applicant Tracking System User Guide Table of Contents USER- Logging into Cornerstone ATS... 2 Creating a Requisition for Posting... 3 General section... 3 Job Ad... 7 Applicant
APPLICATION CHECKLIST - IMPORTANT - Submit all items on the checklist below with your application to ensure faster processing.
1 of 6 State of Florida Department of Business and Professional Regulation Florida Real Estate Commission Application for Real Estate Company Form # DBPR RE 7 APPLICATION CHECKLIST - IMPORTANT - Submit
Part I. Texas Department of Insurance Page 1 of 15 Chapter 5. Property and Casualty Insurance.
Part I. Texas Department of Insurance Page 1 of 15 SUBCHAPTER H. CANCELLATION, DENIAL, AND NONRENEWAL OF CERTAIN PROPERTY AND CASUALTY INSURANCE COVERAGE 28 TAC 5.7001, 5.7002, AND 5.7009 1. INTRODUCTION.
APPLICATION FOR INSURANCE AGENTS AND BROKERS ERRORS AND OMISSIONS COVERAGE
APPLICATION FOR INSURANCE AGENTS AND BROKERS ERRORS AND OMISSIONS COVERAGE (Claims Made Basis) APPLICANT S INSTRUCTIONS: 1. Answer all questions. If the answer requires detail, please attach a separate
HOW TO READ A 39 MONTH UNCERTIFIED MOTOR VEHICLE RECORD
HOW TO READ A 39 MONTH UNCERTIFIED MOTOR VEHICLE RECORD This document is intended to explain how to read a 39 Month Uncertified Driver License Motor Vehicle Record (MVR). The table below is a sample Motor
COLORADO DEPARTMENT OF REGULATORY AGENCIES. Public Utilities Commission 4 CODE OF COLORADO REGULATIONS (CCR) 723-6
COLORADO DEPARTMENT OF REGULATORY AGENCIES Public Utilities Commission 4 CODE OF COLORADO REGULATIONS (CCR) 723-6 Decision No. R13-0943. Attachment B Hearing Exhibit 10 Page 1 of 77 PART 6 RULES REGULATING
INVESTMENT ADVISORY AGREEMENT
INVESTMENT ADVISORY AGREEMENT This Investment Advisory Agreement (the "Agreement") is made and entered into this day of, 20, by and between Bahl & Gaynor, Inc. (the "Advisor"), having its principal place
RULES OF TENNESSEE DEPARTMENT OF LABOR DIVISION OF WORKER S COMPENSATION CHAPTER 0800-02-01 GENERAL RULES OF THE WORKERS COMPENSATION PROGRAM
RULES OF TENNESSEE DEPARTMENT OF LABOR DIVISION OF WORKER S COMPENSATION CHAPTER 0800-02-01 GENERAL RULES OF THE WORKERS COMPENSATION PROGRAM TABLE OF CONTENTS 0800-02-01-.01 Purpose and Scope 0800-02-01-.15
State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE
State of Wisconsin / OFFICE OF THE COMMISSIONER OF INSURANCE Jim Doyle, Governor Sean Dilweg, Commissioner Wisconsin.gov 125 South Webster Street P.O. Box 7873 Madison, Wisconsin 53707-7873 Phone: (608)
Employee Enrollment Form for Thrift Plans and Consent to Receive Electronic Documents (edocuments)
320 PARK AVENUE NEW YORK NY 10022-6839 800 468 3785 OR CALL YOUR LOCAL REGIONAL OFFICE Employee Enrollment Form for Thrift Plans and Consent to Receive Electronic Documents (edocuments) EMPLOYER S NAME