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AUDIT GENERAL ACCIDENT GROUP 1 GENERAL ACCIDENT FIRE & LIFE ASSURANCE CORP., LTD. 2 POTOMAC INSURANCE COMPANY 3 THE CAMDEN FIRE INSURANCE ASSOCIATION 9 PENNSYLVANIA GENERAL INSURANCE COMPANY [[image]] CB 2/26/68 ENTRY MONTH POLICY NO U 340761 AGENT NEW YORK BR SCHIFF TERHUNE CO. NO. 1 AGENT'S CODE 67105 INSURED JACQUES SELIGMANN & CO., INC. AUDIT PEROID FROM 12-31-66 TO 12-31-67 ADDRESS 5 EAST 57TH. ST. NEW YORK N.Y. POLICY PERIOD FROM 12-31-66 TO 12-31-67 LOCATION AS ABOVE B. I. LIMITS P. D. SPECIAL CONDITIONS STATE N.Y. OTHER INSURED IS IND. PART. CORP. X OTHER AUDIT MONTHLY QUARTERLY SEMI. ANNUAL [[7 column table]] | CLASSIFICATION | CODE | ESTIMATED EXPOSURE PER $100 PAYROLL | RATE PER $100 PAYROLL | ADVANCE PREMIUM PER $100 PAYROLL | AUDITED EXPOSURE PAYROLL | AUDITED PREMIUM | |---|---|---|---|---|---|---| | ART GALLERY RATED: | 8017 | | .81 | | 30425 | 246.00 | | CLERICAL | 8810 | | .16 | | 28137 | 45.00 | | EXECUTIVE OFFICERS NOC NOT FOREMEN WORKMEN OR SALESMEN | 8809 | | .12 | | 100 | | | L.C. 4.00 | | | | | | 4.00 | | E.C. 10.00 | | | | | | 10.00 | | U.S. LONGSHOREMEN'S AND HARBOR WORKERS' COMPENSATION ACT END. N.Y TRANSITION CREDIT CR. LONGSHOREMEN AND HARBOR WORKERS INCR. RATE END NEW YORK 7.0% | 0076 | | | | | 49.00CR. | [[/table]] MINIMUM PREMIUM 27.00 INFORMATION FROM OR REPORT SIGNED BY- AUDITOR WHALEN BOT 2/8/68 DATE OF AUDUT REN U 293036 1 AS 3/8 TOTAL AUDITED PREMIUM 256.00 TOTAL ADVANCE PREMIUM 291.00 RETURN PREMIUM 35.00 FORM G-3436D REV. 1-65 EXPLANATION OF ABBREVIATIONS L.C. -LOSS CONSTANT E.C. -EXPENSE CONSTANT L.&E.C. - LOSS AND EXPENSE CONSTANT S/R -SHORT RATE P/R -PRO-RATA M.P -MINIMUM PREMIUM
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Reopened for Editing 2024-03-06 20:40:08
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Reopened for Editing 2024-03-09 08:49:36