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SAUL, EWING. REMICK & SAUL. LLP
Paige Macdunald,Matthes. Esquire
Supreme Court ID No, 66266
Penn National Insurance Tower
2 North Second Street. 7th Floor
Ilarrisburg, PA 17101
(717) 257,7500
Attorneys for Atlantic Employers Insurance Company
JUN 2 6 200Q''1
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Plaintiff,
IN THE COURT OF (;OMMON PLEAS
CUMBERLAND COUNTY I
PENNSYLVANIA
ATLANTIC EMPLOYERS
INSURANCE COMPANY,
N
DOCKET NO.: 97-2166
v.
ATLANTIC FREIGHT SYSTEMS, INC.,
Defendant.
CIVIL ACTION - LAW
AND NOW, this z'l" day of
</l~
, 2000. upon
RULE
consideration of the Plaintiff's Motion to Compel Discovery and for Leave of Court to Contact
Defendant Directly and Independent of iTs Corporate Designee, a copy of which is attached
herelo, a Rule is issued upon Defendant Atlantic Freight Systems, Inc., and iTs corporate
designees, Ira H. Weinstock, EsqUire, and Excel Corporate Services (a/k/a Blumberg
Excelsior Corporate Services) to show cause, if any they have, why PlainTiff's Motion should
not be granted
Rule returnable 'Z (/
days from Ihe date of service.
BY THE COURT:
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SAUL, EWING, REMICK & SAUL. LLP
Paige Macdonald-Mallhes. Esquire
Supreme CourtlD ro;o, 66266
Penll Nalionalln.urancc Tower
2 Norm Second Streel, 7m Floor
Harrisburg. PA 17101
(717) 2S7-7500
AllOmeys for Atlantic Employers Ill.uranc. Company
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYLVANIA
ATLANTIC EMPLOYERS
INSURANCE COMPANY,
DOCKET NO.: 97-2166
v.
ATLANTIC FREIGHT SYSTEMS, INC.,
Defendant.
CIVIL ACTION - LAW
MOTION TO COMPEL AND FOR LEAVE OF COURT TO ISSUE SUBPOENA
DlRECTL Y TO DEFENDANT IN LIEU OF CORPORATE DESIGNEE
AND NOW, COMES the Plaintiff, Atlantic Employers Insurance Company by
and through its counsel, Saul, Ewing, Remick & Saul. LLP, and tiles its Motion to Compel
Discovery and for Leave of Court to Serve Subpoena upon Defendant directly in lieu of
corporate designee, and in support Ihereof avers as follows:
1. On April 25, 1997. the Plaintiff filed iTs Complaint against the Defendanl
al the above-referenced docket number.
2. On December 8, 1998, a Praecipe for Enlry of Default Judgment was
filed against the Defendant at Ihe above-referenced docket number.
3. On December 8, 1998, upon the Court's review of the docket, a
judgment by default was entered against the Defendant in the amount of $80,274.00 plus
interest on the amounl of $33,850.00 from April 27. 1993, and on the amount of $46,424.00
from April 27. 1994, plus costs in the amount of $76.04. A true and correct copy of the Order
of Judgment is allached hereto and marked as Exhibit" A".
111.!l6I 6i11.u)
4, In an allemptto enforce its judgment against Ihe Defendant, prepared
Interrogatories in Aid of Execution directed 10 Defendant, Atlantic Freight Systems, Inc. on or
about April 25, 2000.
5. Upon Plainliff's review of a Dun and BradsTreet (D&B) report, it was
revealed Ihat The corporate designee of the Defendant, Atlantic Freight Systems, Inc., is the
Law Office of Ira H. Weinstock in Harrisburg, Pennsylvania,
6. On or about April 25, 2000, Plaintiff's counsel contacted Ira H.
Weinstock, Esquire, to confirm thai Mr. Weinstock still continued to represent AIlantic Freight
Syslems, Inc. During this telephone communication, Mr, Weinstock indicated 10 Plaintiff's
counsel, thai the corporate designee was nol Ira H. Weinstock, but rather was Excel Corporate
Services (a/k/a Blumberg Excelsior Corporate Services). Mr. Weinstock further indicated that
his firm was retained by Excel Corporate Services for the sole purpose of tiling the Articles of
Incorporation.
7. On or about April 25, 2000, Plaintiff's counsel conlacled Mark Moel at
Excel Corporate Services 10 inquire whether Excel was slill Ihe corporale designee of Allantic
Freighl Systems, Inc. During this lelephone conversalion, Mark Mod referred Plaintiff's
counsel back 10 Ira H. Weinslock.
8. Upon receipt of conflicling information, on April 25, 2000, Plainliff's
counsel forwarded Plaintiff's Interrogalories in Aid of Execution directed to Defendant,
Allantic Freight Systems, Inc.. 10 both Ira H. WeinslSock, Esquire and Mark Moel at Excel
Corporale Services.
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9. As of Ihe date of this Motion, responses 10 Plaintiff's Interrogatories in
Aid of Execulion direcled to Defendant, Atlantic Freighl Systems, Inc., have not been
forthcoming from eilher the offices of Ira II. Weinstock, or Excel Corporate Services.
10. On or about June 6, 2000, Plaintiff's counsel forwarded correspondence
to both Excel Corporate Services and to Ira H. Weinstock inquiring when Plaintiff's counsel
could expect to receive Defendant's responses to Plaintiff's First Set of Interrogalories in Aid
of Execution. A lrue and correcl copy of Plaintiff's counsel's leller is auached hereto and is
marked as Exhibit "B".
II. Ira H. Weinstock has informed Plaintiff's counsel that he forwarded Ihe
discover requesls to Excel. Excel has informed counsel Ihat the discovery requests had been
forwarded to Defendant and that was the end of Excel's duties and responsibilities to
Defendant as far as they were concerned.
12. Plaintiff has been prejudiced as a direct and proximate result of
Defendant's (as well as ils corporate designees'), failure 10 comply with the Pennsylvania
Rules of Civil Procedure concerning the timely completion of discovery.
13. Plaintiff has been further prejudiced by the fact that neither Ira H.
Weinslock, nor Excel Corporale Services will confirm whether or nol the Defendant actually
received the Plaintiff's InlerrogalOries in Aid of Execulion which allegedly have been
forwarded to the Defendant by the corporate designee.
14. Wilhout having the information requested in the Plaintiff's
InterrogalOries in Aid of Execution, PlainTiff is unable to discover any property or assets of the
Defendant that may be used to salisfy Plaintiff's judgment in Ihis mailer.
1l711l'i 1C\-21 III
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15. As a direct and proximate result of Defendant's refusal to comply with
Plaintiff's discovery requests, Plaintiff has had to incur additional counsel fees in the
preparaTion and filing of this motion.
WHEREFORE, Plaintiff. Atlantic Employers Insurance Company respectfully
requests that this Honorable Court grant its Motion 10 Compel Discovery and direct
Defendant's corporate designees Excel Corporate Services and Ira H. Weinstock, Esquire, to
provide Plaintiff wilh answers to Iheir Interrogalories in Aid of Execulion forthwith; award
Plaintiff counsel fees and costs incurred in tiling of Ihis Motion in the sum of $525.00; and
further award Plaintiff all such other relief as is proper and just.
COUNT II
MOTION FOR LEAVE OF COURT TO SERVE DEFENDANT ATLANTIC FREIGHT
SYSTEMS, INC. INDEPENDENT OF ITS CORPORATE DESIGNEE
16. The averments set forth in paragraphs I through 15 are incorporated
herein by reference as if more fully set forth at length.
17. Since the date that default judgmenl was entered against the Defendant
Atlantic Freight Systems, Inc., December 8, 1999, Plainliffs have been unable to determine
who is currently acting as the corporale designee for Ihe named Defendant.
18. Plaintiff's counsel has had to spend an inordinate amount of time in
order to confirm whether Ira H. Weinstock, Esquire, or Excel Corporale Services (a/k/a
Blumberg Excelsior Corporation) is in fact acting as Defendant's corporale designee.
19. Neither Ira H. Weinstock, Esquire, nor Excel Corporale Services will
confirm 10 Plaintiff's counsel Ihat Defendant has actually received the discovery allegedly
forwarded by their offices to Defendant.
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20. Plaintiff believes and therefore avers that Atlantic Freight Systems, Inc.
is currently unrepresented by counsel, based on the represenlation of Ira H, Weinstock,
Esquire. However. Plaintiff does not know for sure whether Defendant has retained allernate
counsel.
21, Plaintiff believes and therefore avers Ihatthe process of obtaining
discovery from the Defendant will be expedited if this Honorable Court will permit Plainliff's
counsel to allemptto serve and contacl Defendant directly with the Interrogatories in Aid of
Execution, and wiTh a Notice of DeposiTion,
22. Plaintiff has and will continue 10 be prejudiced unless this Honorable
Court permits them 10 conlact Defendanl directly.
23. Plaintiff believes and therefore avers that the Defendant will not be
prejudiced in any way by this Honorable Court granting Plaintiff's request for leave to contact
Defendant directly. and independent of their corporale designee.
WHEREFORE, Plaintiff, Atlantic Employers Insurance Company respectfully
requests that this Honorable Court grant its MOlion for Leave of Court to contact Defendant
Atlantic Freight Systems, Inc. directly and independent of iTs corporate designee(s), award
1)71616/21100
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Plaintiff's coumel in the sum of $525.00 for the preparation and filing of this Motion and
further award Plaintiff all such other relief as proper and just.
Respectfully submitted,
SAUL, EWING, REMICK & SAUL LLP
~~~ -,...).~~.~
Paige Macdonald,Mallhcs
Allorney ID Nc. 66266
Saul, Ewing, Remick & Saul LLP
Penn National Insurance Tower
2 North Second Street, 7th Floor
Harrisburg, PA 17101
(717) 238-7675
Dale: June _.2000
Allorney for Allantic Employers Insurance
Company
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ATLANTIC EMPLOYERS INSURANCE ),
COMPANY )
)
Plaintiff )
)
v. )
)
ATLANTIC FREIGHT SYSTEMS, INC. )
)
Defendant. )
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY.
PENNSYLVANIA
CIVIL ACTION
NO. 97-2166
JUDGMENT
IT IS HEREBY ORDERED Ihat Judgment is entered in favor of Atlantic
Employers Insurance Company and against Atlantic Freight Systems, Inc., in the amount of
$30.274.00, plus interest on the amount of$33,850.00 from April 27, 1993, and on the amount of
$46,424.00 from April 27, 1994, plus costs in the amount of$76.04 ($45.50 Complaint filing
fee; $30.54 Sheriffs Service fee).
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VILC-
LAW OFFICES OF
SAUL. EWING. REMICK & SAUL LLP
PHILADILIIHIA, PINNSYLVANIA
PENN NATIONAL INSURANCE TOWER
2 NORTH SECOND STREET. 7th FLOOR
HARRISBURG. PA 17101
HIW VOAK, NEW YORK
,RINClTaH, NIW .lIRSIV
WILMINGTON, DIL.AWARI
IAI.TIMO"I, MARl'LAND
I."WVN, "."MSnVANIA
17171217.1'5QQ
INTlRNIT .MAIL
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'AlGI MACDONALO..,ATTOiU
DIrICI Dial: .'UJ n'.II71
Dlrul ,..: <<111) 211.1"1
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June Il, 2000
Atlantic Freight Systems, Inc.
c/o Mark Mael
Excel Corp. Services
62 White Street
New York, NY 10013
Re: Atlantic Employers Insurance Co. v. Atlantic Freight Systems, Inc.
Dear Mr. Moel:
As you will recall, on April 25, 2000 I forwarded to your attention Plaintiff's First Set
of Interrogatories in Aid of Execution Directed to Atlantic Freight Systems, Inc. I also served
a copy of these requests on Ira Weinstock, Esquire who directed that I should forward these
discovery requests to your attention, More Than thirty (30) days have elapsed and I still do not
have a response from either your company or Ira Weinstock, Esquire.
Kindly conlact me at the number referenced hereinabove to inform me of when I can
expect to receive your client's responses to these discovery requests. In the event that I do not
hear from you wiThin five (5) business days of This correspondence, I will proceed to me a
motion to compel with the Court.
Awaiting your prompt reply, I remain.
Very trUly yours,
"""5:.~~~""~.u;l
Paige Macdonald-Matthes.
LAW OFFICES OF
SAUL, EWING. REMICK & SAUL LLP
PHILAO'V"I., PINNSYL.VAHIA
IAlTIWORI, Y"'AYLANO
,,"WYH, 'I"NIYLVANIA
PENH NATIONAL INSURANCE TOWER
2 NORTH SeCOND STREET. 7th 'LOOR
HARRISBURG, PA t 71 0 I
HloN 'to"". N.J,W YOAK
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June 2,2000
VIA TELECOPIER AND REGULAR MAIL- (717) 238-6691
Ira H. Weinstock, Esquire
800 North Second Sueet
Harrisburg, PA 1710l
Re: Atlantic Employers Insurance Co. v. Atlantic Freight Systems, Inc.
Dear Mr. Weinstock:
As you may recall, I forwarded to your attention on Apri125, 2000 Plaintiffs'
Interrogatories in Aid of Execution directed to Atlantic Freight Systems, Inc. I also provided a
copy of these inlerrogatories to Excel Corp. Services in New York, at your direction. By my
calculations, and allowing time for mail delivery, I should have had your client's responses no
later than Friday, May 26, 2000.
Please advise when I can expect to re\:eive the answers to the interrogatories I have
served on you as regislered agent for the corporation at your earliest convenience.
Awaiting your timely reply, I remain.
Very truly yours,
~~~<~.
Paige Macdonald-Matthes
cc: Joyce Bernstein, ACE INA
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ATLANTIC EMPLOYERS INSURANCE
COMPANY
c/o The CIGNA Companies
Two Liberty Place
1601 Chestnut Street
Philadelphia. PA 19192
Plaintiff.
v.
ATLANTIC FREIGHT SYSTEMS, INC.
6th and Water Streets
New Cumberland, PA 17070
Defendant.
COMPLAINT
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IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY.
PENNSYLVANIA
CIVIL ACTION
NO.
(Judge
)
NOW COMES the Plaintiff, Atlantic Employers Insurance Company
(" AEIC"), by and through its allorneys, Saul, Ewing, Remick & Saul. and for its Complaint
slates and avers as follows:
I. PARTIES
I. AElC is a corporalion organized under the laws of the State of New
Jersey with its principal place of business at c/o The CIGNA Companies, Two Uberty Place,
1601 Chestnut SIreet, Philadelphia, PA 19192.
2. Defendant Atlanlic Freight Syslems, Inc. ("Atlantic Freight"), is
incorporated under the laws of the State of New Jersey, wilh ils principal place of business at
6th and Water Streets, New Cumberland, Pennsylvania.
47Q)J.OI 4/H/Y7
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II. CAUSES OF ACTION
COUNT I -- BREACH OF CONTRACT
3. AEIC repeals and rea lieges paragraphs 1 Ihrough 2, above, as though
fully set forth, as paragraph 3 of Ihis, Count I.
4. On or about April 26, 1993, Atlantic Freight submiued an Application
for Designation of an Insurance Company (the "Application") for New Jersey Workers'
Compensation Insurance to the New Jersey Compensalion Rating and Inspection Bureau. A
lrue and correct copy of the Application is auached hereto as ExhibiT A and is incorporated
herein by reference,
5. In Ihe Application, Atlantic Freighl represented that its address was 403
Dultys Lane, Burlington, New Jersey 08016.
6. The Application was signed by Harry L. Grossman, as 100% owner of
Allantic Freight.
7. Atlantic Freight submiued a check in the amount of $ 938.44 as an
advance premium for issuance of a New Jersey workers compensation insurance policy.
8. On or abouI May 4, 1993, the New Jersey Compensation Rating and
Inspection Bureau issued its Notice of Designation, which specified that the Designated
Insurance Company for Atlantic Freight would be AEIC and which direcled AEIC to prepare
a workers' compensation insurance policy for Atlantic Freight wiTh an effective date of
April 27, 1993. A true and correct copy of the Notice of Designation is attached hereto as
Exhibit B.
419H.lH 4'25197
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.
9. Thereafter, in accordance with the Application submilled by Atlantic
Freight and the NOlice of Designation from the New Jersey Compensation Rating and
Inspection Bureau, AEIC issued a Workers Compensation and Employers Liability Insurance
Policy, naming AtlanTic Freight as the Insured, and bearing Policy No. C3 98 20 05 5
(hereinafter the" 1993 Policy"). A lrue and correct copy of the Policy is allached hereto as
Exhibit C and is incorporated herein by reference.
10. In accordance with the Application and the directions of the New Jersey
Compensation Rating and Inspection Bureau, AElC issued the 1993 Policy which specified a
Policy Period from April 27, 1993 to April 27, 1994.
11. AEIC relied upon the Application in preparing the 1993 Policy, and, in
, parlicular. AtlanTic Freight's representation that its business address was 403 Dultys Lane.
Burlington, NJ 08016, which is listed in the Application and on the Policy as the address of
the Insured.
12. In calculaling Ihe premiums for the 1993 Policy, AEIC relied upon
Atlantic Freight's represenlations in the Application that it was a New Jersey business and
therefore utilized New Jersey workers' compensalion insurance rates in determining Atlantic
Freight's annual premium.
13. Based upon Allanlic Freight's represenlalions in its Applicalion, AElC
calculated an estimated annual premium of $2,778,00. based upon New Jersey workers'
compensation insurance rales. fu Exhibit C.
14. Atlantic Freight paid the premium for the 1993 Policy determined by
AEIC based upon New Jersey workers' compensation insurance rates.
"'71~nlll "'2.~197
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.
15, AEIC renewed Atlamic Freight's Workers CompeJl~,llion and
Employers Liability Insurance Policy for lhe policy period from April 27. 1994 to April 27,
1995 and issued a new policy for lhat period. bearing Policy No. C4 08 43 498 (the" 1994
Policy"), A lrue and correct copy of lhe Declaration Page reflecling the renewal and
issuance of the 1994 Policy is allached hereto lIS Exhibit D and Is incorporated herein by
reference.
16. Based upon Atlantic Freighl's representations in ils Application, AEIC
calculated an estimaled annual premium for the 1994 Policy of $2.937.00, based upon New
Jersey workers' compensation insurance rales. Sl:l: Exhibit D.
17. Atlanlic Freighl paid lhe premium for the 1994 Policy determined by
AElC based upon New Jersey workers' compensation insurance rales.
18. On or about May 3, 1994, a representative of AEIC Iravelled 10 visit
Atlantic Freighl. at the address set forlh in Atlanlic Freight's Application and the 1993
Policy, for the purpose of conducting an audit of Atlantic Freight's records for the 1993
Policy.
19. AElC learned during ilS audit visit thai Atlantic Freight did not have a
real business operalion althe New Jersey address,
20. While there was a room at the New Jersey address wilh the Atlantic
Freight name on the door, it was the size of a closet or maintenance room, contained a
boiler/heating unit and was nol an office.
21. There were no employees at the New Jersey address and no books or
records for Atlantic Freight.
<419))_IH ~IH/91
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22. During its invcstigation, AEIC learned that Ihe dispalehers for Atlantic
Freight were located in New Cumberland, Pennsylvania and that Ihe majoriTy of Atlantic
Freight's business was hauling supplies for Ihe UniTed States Army at New Cumberland,
Pennsylvania.
23. AElC made numerous attempts, both by mail and by lelephone. to
obtain more detailed books and records from Atlantic Freight, however, Atlantic Freight
failed and refused to provide any information to AEIC supporting its use of a New Jersey
business address.
24. As a result of the audit, AEIC determined that Atlantic Freight was
operating iTs business out of New Cumberland, Pennsylvania, not Burlington, New Jersey.
25. AEIC notified the New Jersey Compensalion Rating and Inspection
Bureau of iTs findings during the audit.
26, The New Jersey Compensation Rating and Inspection Bureau conducted
an independent invesligation regarding Atlantic Freight.
27. A representalive of the New Jersey Compensalion Rating and Inspection
Bureau similarly travelled to the New Jersey address on Allantic Freight's Application. The
Bureau found a door wiTh Ihe Atlantic Freight name on it, whieh room was approximately six
feet by ten feet and which conlained a water heater and a sink. The Bureau found no
evidence of any business activiTies by Allantic Freighl at that address.
28. The New Jersey Compensalion Rating and Inspection Bureau concluded
that "there does nOl appear to be any ongoing business activily by this employer within the
Stale of New Jersey" and "[f]rom all indications, all activities of this risk emanate from New
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Cumberland, Pennsylvania." A true and correct copy of the New Jersey Compensation
Rating and Inspeclion Bureau's lindings is attached hereto as Exhibit E.
29. The New Jersey Compensation Raling and Inspection Bureau notified
AElC that in its view, "the formation of a New Jersey corporation and the lease or rental of
a mailing address does nOl constitute a business enterprise subject to the New Jersey Workers
Compensation Law (RSNJ 34: 15)." Sl:l: Exhibit E, page 2,
30. Because Atlantic Freight's business was op~rated in Pennsylvania rather
than New Jersey, AEIC was required to charge Atlantic Freight wiTh Pennsylvania workers'
compensation insurance rates rather than New Jersey rates.
31. During the relevant time period from 1993 through 1995, Pennsylvania
workers' compensation insurance rates were substantially higher than New Jersey rates.
32. Based upon its audit of the 1993 Policy, including the estimated number
of employees and drivers utilized by Atlantic Freight and applicable Pennsylvania workers'
compensation insurance rates, AEIC determined that an additional premium of $33,850.00
was due and owing from Allamic Freight for the 1993 Policy.
33. AEIC nOlified Allantic Freight of the additional premium amount due
and owing for the 1993 Policy and demanded paymem of Ihat amounT.
34. Despite due demand for payment, Atlanlic Freight failed, refused and
neglected to pay the amount due and owing to AEIC for the 1993 Policy.
35. As a result of Atlantic Freight's failure to pay the premium amount due
and owing for Ihe 1993 Policy, AEIC cancelled the 1994 Policy effective October 31, 1994.
36. AEIC also conducted an audit for the 1994 Policy.
047933.11I412.1197
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37. AEIC reached the same conclusions regarding Allantic Freighl's lack of
a New Jersey business operalion in conneclion with ils audil of lhe 1994 Policy.
38. Based upon AEIC's audit of the 1994 Policy, including the estimated
number of employees and drivers utilized by Allantic Freight. applicable Pennsylvania
workers' compensation insurance rales and the shorlened policy period due to the cancellation
of the 1994 Policy, AElC determined that an additional premium of $46,424.00 was due and
owing from Atlantic Freight for lhe 1994 Policy.
39. AEIC nOlified Atlantic Freight of lhe additional premium amounls due
and owing for the 1994 Policy and demanded payment of lhat amount.
40. Despile due demand for paymenl. Allantic Freight has failed. refused
and neglecled to pay Ihe amounts due and owing to AEIC.
41. AEIC has complied with all terms and conditions of the 1993 Policy
and the 1994 Policy.
42. AEIC has suffered damages as a result of the failure by Atlantic Freight
to pay AEIC the full amount due and owing for the 1993 Policy and the 1994 Policy.
419110l "Ill/In
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WHEREFORE, Plaintiff Atlantic Employers Insurance Company prays for
judgment in its favor and against "~fendant Atlantic Freight Systems. Inc.. in the amount of
$80.274.00. togelher with interest thereon. plus all reasonable costs and such other and
further relief as the Court deems just and proper under the circumstances.
~M
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Patricia A. Trujillo
Attorney ID No. 66562
Saul. Ewing. Remick & Saul
240 N. Third Street, Suite 700
Harrisburg, PA 17101
(717) 238-7675
Dated: April.2s;' 1997
Attorneys for Plaintiff.
Atlantic Employers Insurance Company
419JJ.1lI .'l.5/lj7
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VERIFICATION
I, Janet J. Pritcheu, am Senior Underwriter for Atlantic Employers Insurance
Company and I am authorized to make this Verification on behalf of Atlantic Employers
Insurance Company. I verify that I am acquainted with the facts and information set fonh in
the foregoing Complaint and that the same an: true and correct 10 Ihe best of my knowledge,
information and belief. This verification is made subject to the penallies of 18 Pa. Cons.
Stat. Ann. ~ 4904 relating to unsworn falsificatiun to authorities.
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Dated: April~ 1997
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DW-. Y. flUCMTI
BIIII COUNTY
GEORGIA
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COMPENS^TION RATING ^ND INSPECTION BUltEAll. 60 P^RK PI.<oCE. NEW^RK. NEW JERSEY,01101
(201t612.6014
AppUcation For Designation of an Insurance Company
In Iccordance with Ihe
New Jersey Workers' Compensation Insurance Plan
IMPORTANT
CompleCe ill Accordance with INlrucllol1l. Type or PrIoI.
The undenlgncd employer Is unable 10 purchuc Workers' ComperwUon and Employcn' llibWty Insurance (orlu
. UabWly under lhe New Se....y Worken' Compensallon Law and hereby appUe. (or the dcsf&nallon o( In Insurance company 10
provide In.urance In I=rdl/lce with Ihe New Seney Worken' Compen..Uon Imwl/lce PIlI1.
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Total Pumium Nbje~ 10 the experience modUlcatJan
PremJ.um modJfied to renec;t experience modl.Oc:atlon. of
;l. 0 Sol. .G.o
\ ?~.
Other
Premiu m
Oul,es
. 6 y7~ 1"".'4"3' r I F=SC
I y.. S-o
is".oO
?'!.<I(../O
Minimum Premium S
Loss and Elpcnsc Cansu,u 0900
Tot.a1 EJUrnUed Annu.aJ Premium
. Enter "None" i( employer nOlrubject to experience riling.
lJo"f. .,
8. Check in the .mount of 'I -;~. 1./'1 mlde paYlble 10 New Jellev Workell' Compenulion Insurance Pion representing .dvtn..
premium determined In accordance with Pangnph 3 o( the PLsn is .tl.cl,ro hereto.
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OWn."hip. Th. own." o( thll d. '''Illy and Ih. p.rc.nIlSe o( ownenhip o( cae ,.:
Nam. o( Own.r(sl <;l, o( Inl.r.1l
....................~..~.~.~l-....b...:....~..~..~.!.f..~.::...":'::................................................ .....................1..lJ..~..'::!.~......................
................................................................................................................................. .............................................................
................................................................................................................................ ........................................................\....
.....................,........................................................................................................... ...........................................................
................................................................................................................................. .............................................................
................................................................................................................................. ...........................................;.............
II. Previous Work.rs' Comp.nulion Insurance. Have you had a policy orWorke,,' Compenulion In:ur.ulC:e In errecl ourinS thf-'
lau Ihree '1.ars? .................~..~......9..p...~.~~.J...:.~.~.........,.................................................. ...... ...................................-
Name or lau insuranc. company ...........................................................,................................................................. . . ................
Polic'l Numb.r ............................................
Er(.cllve Dal. ....................................................
Ruson (or nling appllcalion '..'",......"..,.. ... ..... ..... .... ..................................... ,..... ....'......... ,... .......... ,.... .......... ............................
DIl.lnsuranc. is required ........,....".......",....,.............
. Is proor or maUlng r.c.lpt a\'tUlble? ........................,...................
12. Unpaid Work.,,' Comp.nution Inluranc. Pr.mium. Do you owe any broker ,as.nl orinsunnee company any unpl'd Workers'
Compenulion Inluran:. pr.mium incurred wilhin th. lall two years? ...........~../.A.......""."....."............"............................
13. Books and records r.n.cling payroll .xp.nditur.s. Wlutrecords m malntalned which r.nwllI PlY roll .xp.nditures?
..............f.I<-~/'r.,../.l.....:r..,",r..~..J...,................,......................................................................'......,........................................
.....;;;;<f...............................,..............".....,............"............................................................""'........"..".................,,....................
."
Th. books and r.cords o( the business or op.ntions may b. .xlJ11ln.d at .........f..~.~..~...............,......".......... ..... ... ..............
............................................................................................................................................................................... ..... ..............
14. Designaled Uc.nscd Produc.r.lf any: Nam. ........f..s.:..~..~.::.::.....!.~..L'::.~.~.~,~..!......A.~..!,~.!.y..,...!.::-.J.:...........................
N ?,:1.::l... ~'l.r~ '
F.d.ral Employ." Id.nllOcalion umb.r ...'...........'.......................... or SocW Securily Numb.r ........................................-..
Addr.ss.../?.Q..!}.p..I.-.....~..r.............................................A..'".J~..~.~.'::...................................J!...r.......,...!i?.t!.g,.f..........
No. SUta Town or City St"U( Lip
Telephon. Number ...\<&~ I ...f.'!.{,..::.J?,,'i::t.9...................
Area Code
IS. C.rlinealion
Th. und.nJgn.d .mpIQy.r c.rtifles Ihat Ih.y know the conl.nts of this application and Ihll 10 Ih. b.st o( Ih.ir
knowl.dge and b.Ii.( th.y are tNe, corr.ct and complel.. II is underslood Ihal the Compensation Rating and Insp.cllon
'Bur.au will r.ly upon such c.rtificalion in d.signaling a m.mb.r Insunnc. company to provide Insuranc. ill accordanc. with
Ih. N.w J.".y Work.rs' Compensalion Insuranc. PI.n and thai In aU mailers pertainins to IUch Insuranc..lhey wUl COOpelll.
fully with Ih. Insuranc. company so design.l.d and. (urlh.r, i( they h.v. Work.rs' Compensation UabUi,y under Ih. I.wl o(
any other statc. other aru.nge:me:nU will be ne:ccwry.
Signature .nd Tit I. ......./J.t.<=f'.;t; "..R.:>.'",~=,- "..,.,~, "",,: ,,,,,..............................,,.....,, o.,e ."", ,':!/.:2;<;/.?1........"".....
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Fonn P,201 (~I,al)
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COMPENSATlf~ ~ATI~G AND INSPEC( ON UUREAU
. STAT~ QF, ~~~ JERSEY 1,',>, ()~ll
I>EPAF.:l MI'::~'" 0F INSURANCI~ .,.......
'0 PARK PLA<:~;, NY.\YARK, N_'. 07101 .1/, "
Josq>h S. OIMarllno r/{ 2 . ", '; puld W. lIannum
C.",ulh.OI,,,,IOI Telephone (101) 611,6Il1~ S 1.9.9 51""111 Otpul, Commu.loncr
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,.,
I
Dureau
File Number
017212
MA Y 04. 1993
Ve:sl&nalcd
InsunnC1l
Company
ATLANTIC EMPLOYERS INS. CO.
MS. MANDY GOSSIiTr, MGR.
P 0 DOX 9010
MACON GA 31213
-
, EmplOYY ATLANTIC FRmGIITSYSTEMS~
403 OULTYS LANB
" DURLlNGTON NJ 08016 ~
-_.:.--=-- .:;::::'-"-
- --..
Oe:s/gn(}, S~'ARRA INS AGENCY INC ~\
Produ P 0 OOX 98 .
AUDUOON NJ 08106 .
'-.. - ,~;
..---
NOTICE OF
DESIGNA TION
NEW JERSEY WORKERS'
COMPENSA'I10N INSURANCE PLAN
TO TilE DESIGNATED INSURANCE COMPANY: Attached is a copy of lhe application med by thiS
employer for designation of an insurance company under lhe New Jersey Workers' Compensation
Insurance Plan, logether with a check representing advance premium payment. The eheck is iden-
lified by lhe following number, dale, and amount:
CHECK NUMBER
4909
CIIECK DATE
04/26/93
CHECK AMT,
S938
By provision of paragraph 3 of lhe Plan insurance is effective on 12:01 A,M. :J4r17/93
REMARKS: FOR POLICY PREPARATION SEE APPLICATION paR NAME OF INSURED.
PLEASE APPLY SURCHARGE RATE OFI0.46% OR ,1046 FOR TIlE 2ND INJURY :'l)~D
AND O.()O% OR .??oo FOR THE UNINSURED BMPLOYERS FUND PER ClftCULA:l. I nJ,
PLEASE APPLY nlE 1993 RATES APPLlCAOI.E TO TillS RISK. , I L/ V '.
q56 . l1 .:
Allachmenl
WCP., (5/91)
Jt
C ROOERTS,SMITH
UNDER WRITER
NOTE: A copy of this nolice also senl to the I:mployer and ('roducer, if any.
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I w~~ I L C3 .........1\., "Uft1Ulo" I -
98 20 05 !t'" I A TLAN rI C EMPLOYERS ( URANCE COMPANY I
IX! N.w: 0 R.n.w": 0 R.writ. ",: NCCI CARRIER COOE: 1 8618 -
IV" "'.VIOUI 'OLley NO. WORKERS COMPENSATION AND EMPLOYERS
I I LIABILITY INSURANCE POLICY
PAC.IIIINS "An'LAN 'IC.ACCT. SA'ITY OROUf TAltOn 'U5I( CO....MISSlON
VII I NO '.0.0. "'.'"H.ea.' ,(,UOD VIS I NO VIS I NO VIS NO I MJMftE" 'AII CLASS ,.,. CIHT AMOUNT
IX SAM r.~ I 12 I X IX I X I AR I 111 81
It.m 1. rATLANTIC FREIGHT SYSTEMS INC Int.r/lnttllc.al. Idlnli'lcllIon No.:
Th. 403 DULTYS LANE
In.....d BURLINGTON NJ 08016 ~ PIlC CODE. 42129
DIRECT BILLED
~lIng L ~~ 0)\ O~ L\?J ~q l.d"",II 0."......,.
Addr.1I t!J Co,pot.llon 0
Employ.", Idontllle.t1on No.:
Oth.r workplace. not shown above: STATE OF NEW JERSEY '.
It.m 2. Polley Porlod I,om 04-27-93 10 04-27-94 1 ~O, A.M. standard tlm. It thl insured's mailing addr.IL
It.m 3. A.Work.ra Camp.nllllon Inaurlne.: P..t On. 0' the policy applil' to the Worker. Comp.nuUon LIW 0' the lut.. IIsc.d h~<<
NEW JERSEY
B. Employor, Llllllllly Inlu'lneo: P.l Two 01 lh. polley oppli.. 10 wo,k In .sch ,ul. 111l.d in lI.m 3,A.
Th. limits af aur liability undlr Part Two are: Bodily Injury by Aeeid.nl I 100.000 .sch eeeld.nl
Bodily Injury by 01..... $ 500.000 policy IIml1
Bodily Inlury by Oi..... $ 1 00 . 000 .sch .mplov..
C. Olh.r StItes Insurance: Part Thr.. 0' th. policv Ippli.s to the SLates. if lilY. listed here: ALL STATES EXCEPT
AK,LA,ME.MN,NM,NV,ND,OH,RI,TX.HA,WI.WV,WY,STATES DESIGNATED IN ITEM 3.A
It.m 4. Th. premium for this pOlicy will be determined bV our M.".I 0' Aules. CIISSI'iclIlons, RilU and Altlng Plans. All inforrNlion
required below is subject to verification and chomge bv IUdil
CIIISiflcl1l0ns Premium Buis Aat.
Cod. EnilNted Total Per S 100 of EIIIIl\I1.d
No, Annu.l Rcmunerl1ion Remunerl1ion AnnUli Premium
CLERICAL OFFICE EMPLOYEES NOC 8810 24000. .36 86.
,
TRUCKING NOC & D ~ 7219 20000. 11.58 2316.
ESTIMATED STANDARD POLICY PREMIUM 2402.
( INCLUDED IN POLICY PREMIUM OF $2771 )
EXPENSE CONSTANT 0900 125.
TOTAL ESTIMATED PREMIUM 2521.
0935 SECOND INJURY FUND SURCHARGE (10. ~ 6%) 251.
0936 UNINSURED EMPLOYERS FUND SURe H (0.0 0%1 O.
Minimum Premium S 588. ToUI Estimated AMUII Premium S 2778.
If Indicated here, interim .djust- (PAGE 1 LAST PAGE
menls of premium will b. mlds: o Seml-AnnuIIIV o QUNIa,IV o Monthly Oeposit Premium S
This policy includes then endoruments Ind schedules: WC 000202 000110 000316 000318 290301
AGENCY NO. 984029 22-2338489 NJS
CIARRA INS AGENCY INC Counlersigned By
0 BOX 98 IAulhe(.ud Ag.nll
AUDUBON NJ 08106 MARKETING OFFICE: PICS RPTD
NA T IONAl WC. RE POOL 93161 DOC 6176A WCY
CKE-4266. Ptd. In U,S.A.
CepytlgM 1917 N'Ue",l Co~"c" on ComJN"ullon In.uunu COMPANY COPY
WC 00 00 01
,nee
ENDORSEMENT NO. 99~99~
REF. NO. 501
22-2338489
( (PAGE
1 LAST PAGEl
Nlmod Insured
ATLANTIC FREIGHT SYSTEMS INC
403 DULTYS LANE
Policy Symbol Policy Number Policy Porlod Elfecllvo Oate 01 Endorsement
HOC C3 98 20 05 5 04-27 93 TO 04-27-94 04-27-93
Issued BV
ATLANTIC EMPLOYERS INSURANCE COMPANY
The lbovels roq.irod 10 be canp!eled crly when Ihls endorlOmonlIs IlIued IlbloquonllO Ihe ptopltlllon 0/ the policy.
DIRECT BILLED
ADDITIONAL STATES EXCLUDED FROM COVERAGE
'-
WE ARE NOT PROVIDING ANY COVERAGE FOR THE FOLLOHING STATES.
MS
IF YOU NEED COVERAGE IN ANY OF THE ABOVE STATES YOU SHOULD CONTACT
THE APPROPRIATE STATE AUTHORITY TO OBTAIN COVERAGE, AS WE ARE NOT
PROVIDING ANY UNDER THIS POLICY.
~.
;
AGENT: SCIARRA INS AGENCY INC
SERVICE OFFICE: NA T I ONAL HC. RE POOL
NJS
(Ault>a1zlld AgenU
I G041 06/10/93
AUTOMATIC REG.
OMPANY copy
93161 DOC 6199 He'
WCOOOO9
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AMENDA TORY ENDORSEMENT
. ~,
_4In'''',4
ATLANTIC FREIGHT SYSTEMS INC
EndOt.ament ~!,~~:_'f:Hz'rT
Ellle1iv. Oat. .f EnWI.menl
04/27/93
Policy SymIIll Palley NI.ImIJ" Policy Pit lad
WOC C39820055 04/27/93 TO 04/27/94
1.....4 By ~. ,I In,,,,SIIC' e,~yl
INSURANCE COMPANY OF NORTH AMERICA
'lI.te lilt 'till' ........ r.. ".,114., .. ", 1.....,.1.. II t. II. ....111.. "1, .... IIIIt ....,...... It I..... .......... II I" 1(.,.,..1.. ., ra. ,.Ucy.
Worker.' Compenlltlon .nd Employere' LI.blllty Polloy
"
General S.ollon C. Worker. Compenlltlon L.w is replaced by the following:
C. Worker. Compenullon Law
Workers Compensation Law means the workers or workmen's compensation law Illd
occupational disease law of each stale or territory named in Item 3,A of the Information'
Page. II includes any amendments to that law which are in effect during the policy period II
.:loes not include any federal workers or workmen's compensation law. illY federal
occupational disease law or the provisions of any law that provide nonoccupatIonal disability
benefils.
The Insurance afforded by Part Two (Employers liability Insurancel Is subject to the following
additional provisions:
C. Exclusions
ThIs insurance does not cover:
7. damages arising out of coercion. criticism. demotion. evaluation. reasslgnm~lnt. discipline,
defamation. harassment. humiliation. discrimination against or termination of any employee.
or any personnel practices. policies. acls or omissions.
8. bodily injury to any person in work subject to the Longshore and Harbor Worker's
Compensation Act (33 USC Sections 90 1 -9501. the Nonapproprlated Fund
Instrumentalities Act 15 USC Sections 8171-8 I 73). the Outer Continental Shelf Lands Act ..
143 USC Sections 1331-13561. the Defense Base Act 142 use Sections 1651-1654).
the Federal Coal Mine Health and Safety Act of 1969 130 use Sections 901-942), any
other federal workers or workmen's compensation law or other federal occupational
disease law. or any amendments to these laws.
9. bodily injury to any person in work subject to the Federal Employers' Liability Act (45
USC Sections 5 1 -601. any other federal laws obligating an employer to pay damages to
an employee due to bodily injury arising out of or in the course of employment. or any
amendments to those laws,
10, bodily injury to a master or member of the crew of any vessel.
11. fines or penalilies imposed for violation of federal or state law,
12, damages awarded under the Migrant and Seasonal Agricultural Worker Protection Act 129
USC Sections 1801- 1872) and under any other federal law awarding damages for
violation of those laws or regulations issued thereunder. and any amendments to those
laws.
I. ActlonlJ Against Us is subject to the following additional provision:
The bankruptcy or insolvency of you or your estate will not relieve us of our obligations
under this Part
Part Three (Other States Insurancel is changed as follows:
A. How This Insurance Applies
2. If you begin work in anyone of those states and are not insured or are not
self-insured for such work. all provisions of thd policy will apply as though that state
were listed in Item 3,A of the Information Page,
4. If you have work on the effective date of this policy in any state not listed in Item 3,A
of the Information Page. coverage will not be afforded for that state unless we are
notified within thirty days,
1 of 2
eKE-1690 14I911 P'd on U,S.A.
CaOYfllihl 1991 N1110~1 CounCIl on Compenu11on Insurance.
we 00 03 11
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AMENC' " TOR { ENDORSEMENT
Nand Inlwt4
ATLANTIC FREIGHT SYSTEMS INC
Endou.mlftl Numb.,
Policy Symtaol Policy Nwnb.,
WOC C39820055
POliCY Ptflod Efftctin O.la of Endotsement
04/27/93 TO 04/27/94 04/27/93
Inuld By ~ 0' Insunnc:. Co~
INSURANCE COMPANY OF NORTH AMERICA
"11ft It. ..Uey ....", n. ,..,"4" .. III 1_....tI.. II II " ".,I.t.. fll, .... ItllI ,.."...... II II.... .......... " 1" "..."elM ., 0. ,.lIe,.
Worker.' Compensation and Employer.' LI.blllty Polley
'-
aener.l Section C. Worker. Companullon Law is replaced by the following:
C. Workar. Compan.atlon L.w
Workers Compensation Law means the workers or workmen's compensation law and
occupational disease law of each state or territory named in Item 3,A of the Information,
Page. It includes any amendments to that law which are in effect during the policy period It
does not include any federal workers or workmen's compensation law. any federal
occupational disease law or the provisions of any law that provide nonoccupational disability
benefits.
The insurance afforded by Part Two (Employers liability Insurancel is subject to the following
additional provisions:
C. Exclu.lon.
This Insurance does not cover: :
7, damages arising out of coercion. criticism. damotion. evaluation. reassignment. discipline.
defamation. harassment, humiliation. discrimination against or termination of any employee,
or any personnel practices. policies. acts or omissions.
8. bodily injury to any person in work subject to the Longshore and Harbor Worker's
Compensation Act (33 USC Sections 90 1-9501. the Nonappropriated Fund
instrumentalities Act (5 USC Sections 8171-81731. the Outer Continental Shelf Lands Act,'
(43 USC Sections 133 1- 1 3561. the Defense 8ase Act (42 USC Sections 165 1- 16541.
the Federal Coal Mine Health and Safety Act of 1969 (30 USC Sections 901-9421. any
other federal workers or workmen's compensation law or other federal occupational
disease law. or any amendments to these laws,
9. bodily injury to any person in work subject to the Federal Employers' liability Act 145
USC Sections 51-601. any other federal laws obligating an employer to pay damages to
an employee due to bodily injury arising out of or in the course of employment. or any
amendments to those laws.
10. bodily injury to a master or member of the crew of any vessel.
I 1. fines or penalltles imposed for violation of federal or state law,
12. damages awarded under the Migrant and Seasonal Agricultural Worker Protection Act 129
use Sections 1801- 18721 and under any other federal law awarding damages for
violation of those laws or regulations issued thereunder. and any amendments to those
laws.
I. Actions Against Us is subject to the following additional provision:
The bankruptcy or insolvency 0 f you or your estate will not relieve us 0 f our obligations
under this Part
Part Three (Other States Insurance) is changed as follows:
A. How This Insurance Applies
2. If you begin work in anyone of those states and are not insured or are not
self-insured for such work. all provisions of the policy will apply as though that state
were listed in Item 3.A of the Information Page.
4. I f you have work on the effective date of this policy in any state not listed in Item 3A
of the Information Page. coverage Will not be afforded for that state unless we are
notified within thirty days,
1 of 2
eKE'1690 141911 PI~ ,n U,S-A.
Copyflqht 199 I NellQNI CounCIl on Campenution lnsur.-,ce.
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WORKERS COMPENSATION ANO EMPLOYERS LIABILITY INSURANce POUCY
WC 00 00 00 ,.
,
.~~ I
Effective April 1. 1992
WORKERS COMPENSATION AIm EMPLOYERS L1ABIUTY INSURANCE POUCY
In rBlum lor the payment 01 the premium and subjeel
to aJllerms 01 this policy. we agree with you as lollows:
GENERAl SECTION
A. The Policy
this polley Includes at Its effective date Ihe Inlor-
mation Page and all endorsements and schedules
listed there. It Is a conTract 01 Insurance between
you (the employer named In Item 1 01 the Inlorma-
tlon Page) and us (the Insurer named on the
Inlormatlon Page). The only agreements relating to
this Insurance are slated In this polley. The terms
01 this polley may not be changed or waived except
by endorsement Issued by us to be part 01 this
policy.
8.. Who Is Insured
You are Insured II you are an employer named In
Item 1 olths InlormatJon Page. II that employer Is
", a Partnership, and " you are one 01 Its partners,
you are Insured, bUl only In your capaciTy as an
employer 01 the Partnership's employees.
C. Worltera compensalfon Law
Workers Compensation Law means the workers or
worlanen's compensatJon law and occu~tional, '
dIseaSe .Iaw 01 !lach stale.or I~~)l~ Iii Iten't ~"
3^ ot -\he Inloqnatlon:- Page;' It,./nf;ltides i1hy ,,'
amendlTll!l1ts 10 thalla"'W/.1Iq~allilrj elfeel'dvrfng ,-y
the po!lcy per\!xI.~d~ I)OM1~Ill(ji)' anylederaJ' , : '
workers _ or, workmen s . Cclmpel\s~1on law, any :, .
lederal ~Ml\QO~ ~iseas.e law,or, lhe prOvi$lons ',,:
01 any law Itial,prQvide nonoccupational disability ~',
benefits.. . , "7,' , ,
D. Stat.
Slale means any. stale of the United Slales 01
America, and th~ Oiti,1rk:t of Colonibla. . '
, E. \.oc;.etION
ThIS policy Ct)vers all 0,1 your Workplaces listed In
Items 1 01' 4 of th!lln/()g)'latJon page: and It covers:
.; all OCher Workpl~~l\8(l1-;3.A...~~esllnle,ss you'
, ",:' haw OCheI:'ln8u1an<:8 or are self-Insured lor liUch
'o". wor1qllaces.' ~
.'
. 1"' ~ CounoI on Co~t.o" I~..
PART ONE
WORKERS COMi>ENSAnON INSUAAHce, I
A. How Thl. lnaurenct AppU.. f
This workers compensation Insurance appj'es to I
bodily Injury by accident or bodily Injury by dll-: '
ease. Bodily Injury Includes resulUng death. '" i
1. Bodily Injury by accident must occur during the ,
policy period.
2. Bodily Injury by disease must be caused or
aggravated by the condiUons of YOUf emplcy.
mant. The employee's last day 01 last exposure
10 Ihe conditions causing or aggravatJng sUCh
bodily Injury by disease must occur during the
policy period.
B. We WI~P.y
We w I y promPtly when due the benefits re-
quired f you by the workers compensalfon law.
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C. We WIll Delend ' , __
We have the right and duty 10 defend at our ex. '
pense any claim, prOCeeding Of suit against you lor '
benefits payable by this Insurance. We have the
righl 10 Investigate and settle these claims. pro-
ceedings or suits.
We liave no dutY to delend .8 clalm,proceedlng Of'
,Slllt that Is not covered, by this Insurance. . "',
. ..... 'I. . ": " . .
b. W. Will Also~y' ,'." . '
,.\-' .
We wlll also pay these CO$1.S. In, addiUon'to otrler
<Il11OUnts JlBYiIbI8Under; this I~ as part 01
any claim; ~lng or.SlJ/t WI' defend:' ,.
i.' rOa:$ooable ellj)enses.focU';'ed at our reques!.'
but not loss 01 earnlngsl'" "
2. pram/ums lor bonds to relGase alIachriliints
and lor awe<!I bOl]ds'lri bond ~nts up to '
the Bll1OI!nt payable ur\derth~'In:sutance( ,
3. lIt1ga1loo C08tS'~eda~i~: .,:. ",:
4.lnt9test on a jUdgn1eril:ili'req'bli8li by law unlfl
, " .:, 'We oIIerlhe8J1)OUntt1ue Ilnderlt1ls Insurance;
__ and'~';.."."":,::"', ...... ;:~':-1~~~:;~... ....-;
". 5. expenses welni:ur. ,': ':;' , .~"
E. Olher lilauta/1ce
We will nOt p.;ay more man our s,hare 01 ben8tlts
and costS covered by'thls IriSl.itiU:oce and other
1016
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WOAKEh.. COMPENSATION AND EMPLOYERS l!ABlUTY INSURANc;E pouey
, .
we 00 00 00 A
Standard
Eftoctlvo April 1, 1992
Insurance or sell~nsurance. Subject to any limits 01
liability that may apply, all shar83 will be equal until
Ihe loss Is paid. II any Insurance 0( sell-lnsurance
Is exhausted. the shares 01 all remaining Insurance
will be equal until the loss Is paid.
F. Paymenll You Must Maka
You are responsible 10( any payments In excess 01
the benefits regUlarly provided by the workers c0m-
pensation law Including those required because:
1. of your serious and willful misconduct:
2. you knowingly employ an employee In violation
01 law:
3. you laJllo comply wkh a health or salety law 0(
regulation: 0(
.c. you discharge, coerce 0( otherwise discrimI-
nate agalnsl any employoo In violation 01 the
workers compensallon law.
II we make any payments In excess 01 the bene!its
regularly provided by the workers compensation
law on your bohall, you will relmburse us promptly.
I
i G.. Reco....ry From Others' , 'i,.' '," - ,y ~
'e have your rights, and the rights 01 persons
entitled 10 the benefits of this Insurance, 10 recover
out payments from anyone liable for the InJury. You
will do everythIng necessary 10 protect those rights
fO( us and 10 help us enlO(ce them.
Statutory Provisions
These statements lIjJply where they are required by ,
I .. . 1 . I
aw. ,
1. As between 811 InJured wO(ker and us. we have
notice of the InJury'~e,? you liave nOllce. .'
2. Your dGtault orihe bankrUptcy 0(' Insolvency 01
you 0( your 1lS\llte, villi nOl ,ralJeve ~s 01 our
dutles under this Insurance lIIIer an InJUry
occurs.
3. We are directly and primarily liable to any
person enlltled 10 the benefila payable by this
Insurancs. Those 'persons may enfO(ce our
dutles: so may an agency authorized by law.
." II\Eftf<<cemOl11 may be against us 0( against you
: and us.o
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, A,,~lJt\sdlctlon over you Is jurlsdlcilon OVll( us fO(
, ~purposes 01 the WOl'k0f8,compensatlon law. Wo
, ,!atl~ !lound by decisions against you under that
',k\W, subJect to tho provisiOns of this policy Ihat
, ~e .I]ot In' connlcl wkh that law.
" . ,...)iThrs:rnsurance conlonns 10 tho partS of the
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1 st Reprfnt
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workers compensation law that apply 10:
a. benefila payable by this Insurance;
b. special taxes, payments Inlo security 0(
other specIal .funds, and wessmems
payable by us under that law.
6. Tenns 01 this Insurance that coonlct with the
workers compensallon law are changlld by this . .
stument 10 conlonn 10 that law.
Nothing In these paragraphs relieves you 01 your
dutles WIder this policy.
PART TWO
EW'l.OYERS UABIUTY INSURANce
A. How ThIs Insurance Appllea
This ~Ioyers liability Insurance applies 10 bodily
InJUry by accident 0( bodily InJury by disease.
-!lOdlly Injury Includes resultJng death.
1. The bodily InJury must arise out of and In the
", cOlne of the Injured employee's employmenl
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2. The employmeot must be necessary 0( I '
dflOOlllo your wOl'k In a stale orterrftory IlSI;;;r'
In Item 3.A. of the Informatlon Page.
3. BoliIy InJury by accident must occur durtng the
poley period.
4. Bodily InJUry by disease must be caused or
aQlJavated by 11111 j:onQltlona of your employ.
med. The employee's last day.of [esllllcposure
10 Ihe condltJons causing 0( aggravating such
bodiy Injury by disease must occur during the
poGcy period. . .
s. II you 'are sued, the original sUlt and any
relSled legal llC\lons 10( damages for bodily
InlllY by accJdent 0( by, disease must be
brought;ln the Unked States' Of Arnerlca, Its
lerrtorfes 0( poasesslona, 0( Canada.
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B. W. W1DPsy .
We wiI pay all sums you legallY must payes
damages because of bod!IY. inJury 10 your &rl1jiIoy.
1108, praylded the bodily IriJury Is CC'l'Ofod by this
Employura Uablllty Insurance. . . ','
The dlrnages we will pay, where recovery Is
permitted by law, Include d~:,
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1. fO( which ' you are liable 10 a third party by
reaaan of a claim 0( tuIt JgaInst Y9U, by Ihl" .
third party to rllCQV'llr 1M dam,,~ Clalllll
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. WORKERS COMPENSATION AND EMPLOYERS UABIUTY INSURANCE POUCY
we 00 00 00 A
Standlfd
~ Reprtnt
Elfecllve April 1, 1992
~
against such third pany as a resull 01 Injury 10 nental Shell Lands Act (043 use Secllons
your employee; 1331-1356), the Delense Base Act (42 use
2. 10( care and loss QI servlce.s; and SectJons 1651-1654), the Fed<<a1 Coal Mine
H8aIth and Safely Act of 1969 (30 USC Sec.
3, 10( consequenllal bodily Injury 10 a spouse, Ilona 901-1142), any other lederal workere 0(
child, parent, brothsr 0( slstor or the InJurOO workmen's compensaIlon law 0( other fOOer"
employee: occupallonal disease law, 0( any amendments
provldOO that these damagos are the direct conso- to these laws. ' -
quence of bodily Injury that arises out 01 and In the 9. bodily Injury to any person In work subject to
course 01 the InJuroo employee's employment by the Federal Employers' Uabl~ Act (45 use ~.
you; and SectJons 51-60), any other I erallaws oblJ.
4. because 01 bodily Injury to your employee that gallng an employer to pay damages to an em-
arises 0Ilt 01 and In the course 01 employment. ployee due to bodily Injury arising out of 0( In
claimed against you In a capacity other than as the course of employment, 0( any amendments
employer. to those laws.
e. Exclualona 10. bodily Injury to a master or member 01 Ihe
This Insurance does not cover: crew 01 any vessel.
1. liability assumed undQr a contract. This exclu- 11. fines 0( penallles Imposed 10( violation 01
slon does not apply to a warranty that your ; lederal 0( stale law.
work will be done In a workmanlike manner; 12. damages payable und<<lhe Migrant and
2. punltlve 0( exemplary damages because or Seasonal Agrlcultural Work<< Protection Act
bodily Injury to an employee employOO In (29 use Se..."tlons 1801-(872) and und<< any
v1olallon 01 law; other lederal law awarding damages fO( viola-
lion of those laws 0( rogula1lona Issued thero-
3. bodily Injury to an employee while employed In under, and any amendments to those laws.
vlolallon 01 law with your actual knowledge or D. We WIll Defend
the actual knowledge 01 any 01 your executive We have the rtght and duty to defend, at our
Officers;
4. any obllgallon Imposed by a workers compen- expense, any claim, prOCeeding 0( suit against you
10( damages payable by this Insurance. We have
satlon, occupational dlseaso, unemploymenT the right 10 Invesllgate and settle these claims,
compensation, O(dlsabllltybenefits law, 0( any proceedings and suits.
similar law: We have no duty to delend a claim, proceeding or
5. bodily Injury Inlenllonally caused or aggravated suit thatls not CO'IOI'OO by this Insurance. We have
by you; no duty 10 deland or conllnue defending after we
6. bodily Injury occurrtng outside Ihe United have paid our applicable Iimi\ 01 liability under this
States 01 America. Its torritorles or posses. Insurance. '
slons, and Canada. This exclusion does not E. We WIll Also PlY
apply to bodily Injury to a cltlzen or resident 01 We will also pay these costs, In addltlon to other
the United Slates 01 America or Canada who Is
temporarily outside these countries; amounts payable under this Insurance. as part 01
any claim, proceeding, or suit we defend:
7. damages arising out 01 coercion, crlllclsm. 1. reasonable expenses IncurrOC: at our request,
domotJon, evaluation. reassignment, discipline. but not loss of eamln{)S;' "
delamatlon, harassment, humiliation, dlscrlmi- ,
nallon against 0( termlna1lon 01 any employee, 2. premiums lor bonds to rel~e attachments
0( any personnel practlces, policies, acts or and lor appe;IJ bonds In bond amounts up to
omissions. the limit 01 our liability under this Insurance;
a. bodily Injury to any person In work subjact 10 3. Iltlgallon COSts taxed against you;
.,: . I, the Longshore and HaIbO( Workers' Com pen. 4. Intoreslon a judgment as requlrOO by law urnll
,~",),". satlon Act (33 USC SectJons 901-950), Ihe we offer the amourn due under this Insurance:
."'. . Nonappropriated Fund InstrumenlaJitlos Act and
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(5 USC SoctIons 8171-8173), the Outer ContI- 5. oxpenses we Inc'Jr,
3016
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(
WORKERS COMPENSATION AND EMPLOYERS UABlUTY INSURANt:E POUCY
....
WCOOOOOOA
, ,dard
EffoctJve ApOll. 1992
lit Reprint
Cj,
Other InaurlnC41
We will not pay more than our share 01 damages
and costs covered by this Insurance and other
Insurance or aell-lnsurance. Subject to any limits 01
liability that apply. all shares will be equal until the
loss Is paid. II any Insurance or sell-lnsurance Is
exhausted. the shares 01 all remaining Insurance
and sell-lnsurance will be equal until the loss Is
paid.
Umlt.l of Ulblllty
OUr liability to pay for damages Is IImlted. Our
IImlts 01 liability are shown In Item 3.8. 01 the
Inlormallon Page. They apply as explained below.
1. Bodily Injury by Accident. The IImlt shown lor
"bodily Injury by aceldent~ accldent' Is
the most we wUl pay for all damages covered
by this Insurance because 01 bodily InjUry to
one or more employees In anyone ace dent.
A disease Is not bodily Injury by accident
unless it results dlroctJy Irom bodily Injury by
accldent. , '
- ,- . .. -
2.;. Bodlly,lnJury by Disease. The IImlt shown lor
'bodily Injury by dlsease-pollcy IImlt' Is the
, most we will pay for all damages covered by
this Insurance and arising out 01 bodily Injury
by disease. regardless 01 The number 01 em-
ployees who sustain bodily Injury by disease.
The limit shov.n lor 'bodily Injury by disease-
each employee' Is the most we will pay for all
damages bocause of bodily Injury by disease
to anyone employee.
Bodily Injury by disease does not Incl'Jde
disease that results directly from a bodily Injury
by accident.
3. We will not pay any claims for damages after
we have paid the applicable limit 01 our liability
under this Insurance.
H. Rtcovery From Othel'l
We have your rights to recover our payment from
anyone liable for an Injury covered by this Insur.
ance. Y,9U wUl do everything necessary to protect
thOSe rfghts lor us and to help us enforce them.
I. Actlona Agllnat UI
There will be no rfgtit 01 actlon against us under
this Insurance unless:
. j:lt. You have complied with B1ITho terms '01 this
- policy; and
. '"1 twionaI CounoM eoft ~ \neunnM.
2. The amount you owe has been decermlnlld
with our consont or by actual trial and final
judgment.
this Insurance does not give anyone the right to
add us as a defendant In an action against you to
determine your liability. The bankruptcy or Insol-
vency of you or your estate will not relieve us of
our obllgatlons undet this Part.
PART THREE
OTHER STATES INSURANCE
A. How This lnaul'lnce Applin
1. this oth8f' stales Insurance applies only II one
or more Btales are shown In Item 3.C. 01 the
Inlormatlon Page.
2. II you begin work In anyone of those Stales
aftet the effective date of this polley and are
; not Insured ot ate not self-Insured for such
work, all provisions of the policy will apply as
Though that Stale were lIs1ed In Item 3.A. of the
'.',..Io"lnlom1atlon Page. .,'" folUJU
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3, We will relrrburse you lor the benefits requ~
, -, ,- by the workers compensation law or that 8Ib'
.. If we are not pormltted to - pay the benelits
directly to persons entitled to them.
4. II you have work on the effectlve date 01 this
policy In any Stale not listed In Item 3.A. 01 the
Information Page. coverage will not be af(orded
lor That Stale unless we are notlfted within
thirty days.
B. NotlC41
Tell us at once If you begln work In any state listed
In Item 3.0. of the Informatlon Page.
PART FOUR
YOUR DUTIes IF INJURY OCCURS
Tell us at once If Injury occurs that may be covered
by this policy. Your othet duties are listed here.
1. Provide for Immedl81e medical and other
seMces required by the workers compensation
law.
2. Give us or our agent the names and addresses
01 The Injured peraons and of witnesses, and
othet Informatlon we may need.
3. Prompdy give us all nodces, demands ~. ,
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WOR:<ERS COMPENSATION J.. "MPLOYERS UABIUTY INSURANce POUCY
tat Reprint
EHoctive April 1. 1992
legal papers related 10 lI1e Injury, claim, pro-
Ceeding or suit.
4. Cooperate with us and assist us. as we may
requesl, In the Investlgallon, settlemenr or d&o
lense 01 any clafm, prOCeeding or suit.
5. 00 nothing alter an injury occurs that would
Interfere with our right to recover Irom others.
6. 00 not voluntarily make paymenls, assumo
obligations or Incur expenses, except at your
own COSL
PART FIVE-PREMIUM
A. Our Manuala
All premium for this policy will be determined by
our manuals of rules. rates, rating plans and
classlflcatJons. We may change our manuals and
apply the changes to 1I11s policy II authorized by
law or a governmental agency regulating 1I11s
Insurance.
8. Classifications
lIem 4 of the Informatlon Page shows the rate and
premium basis for certain business or work classlfl.
cations. These classl1lcallons were assigned based
on an est/mate 01, ths exposures you would have
during the polley period. if your actual exposures
are not properly described by those classificatIons,
we will assign proper classlllcatlons, rales and
premium basis by endorsement to this policy.
C. Remuneration
Premium lor each work classillcatlon Is determined
by multiplying a rate 1I11le'1 a premium basis.
Remuneration Is the most common premium basis.
this premium basis Includes payroll and all other
remuneration pafd or payable during the policy
period for lI1e services ot
1. all your olrlCers and employees engaged in
work covered by this policy; and
2. all other persons engaged In work thai could
make us liable under Part One (Workers Com-
peIlSatjon Insurance) of II1Is policy. II you do
not>have payroll records lor these persons, the
contract price lor their SllIVices and materials
may be used as the premium basis. this para-
graph 2 will not !lPPly if you give us prool 1I1a1
the employers of these persons lawfully secured
their worl<ers compensatlon obligations.
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O. Premium paymenta
You will pay all premlum when due. You will pay! I
the premium even if part or all 01 a Wor1<ers com.: '
pensalJon law Is not valid.
E. Anal Premium
The premium shown on lI1e Infcnnatlon Page, I
schedules, and eodOfSemenrs Is an estimate, The I
final premium will be d81enn/ned after this policy j
ends by USIng lhe actual, not lhe estfmated, pram- t
lum basis and lhe proper cfassltlcatlons and tates
thai lawfully apply to the business and worl< cov.
ered by 1I11s policy. II the final pram/um Is more
than the pram/um you paid to us, you must pay us ,
the balance. lilt Is less, we will refund lI1e balance I .,
to you. The final premium will not be less than the
highest minimum premium for the classiflcatlons .
COV'llfed by this policy.
If II1Is policy Is canceled, final premium will be I
determined In the following way unlass our manu- I
als provide 0ltl8lWlse: I
1. It we cancel, nnal premium will be Calculated !
pro rata basad on lI1e limo this policy was In ' '
::~ ~e;~~ ':~I~~~~u~~ the !
2. It you cancet, final premum will be more than
rro rata; it will be based on tI1e llme lhls policy
was In force, and Increased by our shortofate
cancelation table and procedure. Anal premum
'Nill na be less than the mlnlrNJm premium.
F. Records
You will keep records ot Information needed to
cOl11jl(Jle premium. You will prOvide us with copies
of lI10se records when we ask for lhem.
G. Audit
You wllllet us examine and audit all your records
lI1at relate to this policy. These'records Include
ledgers, journals, raglstEVS, vouchers, contracts,
lax reportS, payroll and dlsbursemeot records, and
programs for storing and retr1eVing data. We may
conduct lhe audits during regular business hours
during the policy period and within II1ree year3
alter lI1e policy period ends.lnlormatlon developed
by audit will be used to detenn/ne flnal premlum.
Insorance rale sarvics organlzatlons have the
same rights we have under this provision.
5016
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WORKERS COMPENSATION ANO EMPLOYERS UABlUTY INSURANaa POUCY
we 00 00 00 A
~t.nd.rd
Effoctlve April 1. 1992
lit Reprint
PART SlX-CONomONS
A. lnepeetlon
We have the right. but are not obliged to Inspect
your workplaces at any time. Our Inspections are
not salety Inspections. They relate only to the
Insurablllty of the wOftqllaces and the premlums to
be charged. We may give you repotts on the
condltJona we find. We may also r~
changes. WhUethey may help reduce losses, we
do not undenake to perform the duty of any person
to provtde for the health 0( safety of your employ.
ees or the public. We do not warrant that your
worIcplaces are sale 0( healthful 0( that they
comply wlU1laws. regulations, codes 0( 81andards.
Insurance rate service O(ganlzatlons have the
same rights we have under this provision.
B. Long Tsnn Policy
If the policy period Is longer than one year and
slx1een daYll, all provlslons'of this policy will apply
as l110ugh a new policy were Issued on each
annual annlvecsary that this policy Is In force. '
~. Tranafer ot'YOUf R1ghta and Duties :
Your rfg/rts or dutles under this policy may not, be
transfecred without our written consent.
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II you die and we recelve nOllc8 within thirty days
alter your dea1l1. we will cover your legal represeo- .
tatlve as Insured.
O. Clncelstlon
1. You may canc&llIlls polley. You must mall 0(
deliver Idvance wrftten nOllc8 to us ltallng
when the cancelation Is to take 8tfect. ' .
2. We may cancel th1l policy. We must mall 0(
deliver to you not less than tan days lIdvanc8
wrftten nodee staling when the cancelallon Is
to take effoct. Milling lIlat notice to you at your
mailing address Ihewn In Item 1 of thelnfor.
madon Page will be suftlclent to prove notice.
3. The policy period will end on the day and hour
stated In the cancelation notice.
4. Arly 01 these provisions that confilc1 with a law
that controls the cancelation of the Insurance
In this polley Is changed by this statement to
compl}i with the law.
E. Soil Reprllllnlltlw
The Insured first named In Item 1 of the Informa-
L , ,don Page will lICt on behalf of all Insureds to
change this policy, receive retumpremlum. I
give 0( receive notlce 01 cancelaIIon.
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WORKERS COMPENSATION AND t;..PLOYERS UABIUTY INSURANCE POUCY
, -,
Ortgln./ Printing
EffoctJve Aprll 1, 1992
we 00 03 11 '
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General Secllon C. Workera Compenutlon Law Is replaced by the IoIlowIng:
C. Workera Compenullon Law
Workers Compensallon Law means the workers or workmeo's Compensation law IIld occupational disease law
of each state or territory named In Item 3,A. 01 the InlormatJon Page. It Includes any IIIl1endmeots to that law Which
are In effect during the policy period. It does nO/Include any lederal workers or worl<men'. compensallon law.
any ledElfal occupational disease law or the prOVIsions 01 any law that provide nonoccupational dlsabllllybeneftls.
The Insurance afforded by Part Two (Employers Uablllly Insurance) Is subject to the follOWing additional provisions:
e. exclusions
This Insurance does not cover:
7.
I. Actions Against Us Is subject to the lollowlng addillonal provision:
The bankruptcy or Insolvency 01 you or your eslale will nOl relieve us 01 our obllgallons under this Part.
Part Three (Other States Insurance) Is changed as follows:
A. How Thl. Insurance AppUe.
2. " you begin work In anyone 01 those Slales aller the effective date 01 this policy and are nO/Insured or are
not Self~nsured lor such work, all provisions 01 the policy will apply as Ihough that sllUe were listed In
lIem 3.A. 01 the Informallon Page.
4. " you have work on the effoctJve date 01 lhls policy In any 6tate nOl listed In hem 3.A. of the Inlormatlon Page,
l;9verage will not be afforded lor that state unless we are notitIed wilhln thirty days.
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AMENOATORYENOORSEMENT
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8.
damages arising out 01 coercion, crlllclsm, demotion. evaJUallon, reassIgnment, discIplIne, detamalJon, '" i
harassmenl, humillallon, discrimination agalnst or terminatJon 01 any employee, or any personnel practices,
policies, aCls or omissions.
bodily Injury 10 any person In work subject 10 the Longshoce and Hartlor Workers' Compensallon Act (33 use '
SoctJons 901-950), the Nonapproprfated Fund Instrumentalitles Act (5 use Sectlons 8171-8173), the Outer ;
Conlin ental Shelf lands Act (43 use SectJons 1331-1356), the Delense Base Act, (42 use SectIons
1651-1654). the Federal Coal Mine Health and Salety Act 01 1969 (30 use SecUons 901-942), any other
lederal workers or workmen's compensatJon law or other federal occupational disease law, or any
amendments to these laws.
bodily Injury 10 any person In work subject 10 the Federal Employers' Uablllty Act (45 use Sectlons 51-60).
any other lederal laws obllgallng an employer to pay damages 10 an employee due 10 bodily Injury arisIng
out 01 or In Ihe course of employment, or any amendments to those laws.
bodily Injury to a masler or member 01 the crew 01 any vessel.
lines or penalties Imposed lor vlolallon 01 lederal or slale law.
damages payable under the Migranl and Seasonal AgricuhuraJ Worker ProtectIon Act (29 use Sections
1801-1872) and under any olher lederal law awarding damages lor violallon 01 those laws or regulallons
Issued Ihereunoer. and any amendments 10 Ihose laws.
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10.
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. WORKERSCOLlPENSATlON AND EMPLOYERS UABlUTY INSURANCE POucy . D
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ATLANTIC EMPLOYERS INSUJANCE COMPANY
NCCI CAARIEA COllE: ~ ,18
WORKERS COMPENSATION An) EMPLOYERS
LIABILITY INSUf\AHCE POLICY
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403 DULTYS LANE
BURL! NGTON
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NO NUN""
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COMMISSION
'AI CLAU '.It CINT AMOUNT
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Inllf/lnll'nut. kS4ntl'ic.tlon No.:
NJ
08016
PIIC CODE. 42129
DIRECT BILLED
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Mailing
Addr... L
EmplOY.,'. Identlfic.tlon No.:
Olll., workploc.. nol .hown obo,': S TAT E 0 F NEW J E R S E Y
n.m 2. PoliCY p.rood from 04-21-94 10 04- 2 7-9 5 12:0 I A.M. surWd III"" II IN "',....d', milling oddr.... ,
II.m 3. A.Work... Comp.nullon In....snc.: P.-I On. 01 "'. policy ",pll" to ,he Work'" Camp.nulIO" Low of th. .W" Ii.ted hero:
NEW JERSEY
,1
B. Employ.rs liability InsutW\C<< Pwt Two of the policy appli.s to work In IlCh ItIt. lilted in hem 3.A
The IIm,t, 01 0'" liob.1I1Y und" p.-I Two .-0: Bod,ly Injury by Accidonl' 100.000 .."h occident
Bod,ly Injury by Oi..... . 500.000 policy limit
Bod,ly Injury by Oi...... 100.000 .och .mpIOY"
C. Other Sutes I"~uunc.: Pitt Ttv,. of the polley IPPhU to the sutes, II Mly. Iist.d here:
II.m 4. Th. prem'um fa' \II" policy w,i1 b. d.,.,m,n.d bv au' Monu>l 01 Aul". Clas.."u''''''. !\il.. .., A.t,ng PI",.. All 'nlOtll\lllOn-
reqlltred below IS lubjfct to ",en'icahon and chM\ge by IUdl~
Classl'icJlIOnS
Cod.
No.
Pram"..." EUsI'
ES1ItN1ed Toul
AMuaI fhlCTM.(l4rrtlon
RJt.
.--
h11mfted
Atlnuil P'emi",m
Per SIOO .f
RemlJ{ltf.lIon
TRUCKING NOC & D
1219
24000. .31
20000. 12.32
89.
2464.
CLERICAL OFFICE EMPLOYEES NOe
8810
ESTIMATED STANDARD POLICY PREMIUM
(INCLUDED IN POLICY PREMIUM OF
EXPENSE CONSTANT
TOTAL ESTIMATED PREMIUM
ANt lED""
S29 ate 10-5/
140.
2693.
0935 SECOND INJUKY FUND SURCHARGE
0936 UNINSURED EMPLOYERS FUND SUR
244.
O.
Minimum PremIum S 850.
II Indlcaled here. inlerim M1just-
ments of premium will be mlde: 0 Seml-AnnuJlly
This policy Includes lhese endorsemenls .,d IChedules:
o a_lo,ly
WC 290301
Tout E,tim,"d """...1 Promium . 2937
(PAGE 1 LAST PAG
o Monthly O'POSlt Premil.ln $
AGENCV NO, 964029 ZZ-2338489
CIARRA INS AGENCY INC
o BOX 98
UDUBON NJ 08106
NJS
Countersigned By
U,lIlhOI'U. ...,.ntl
O<..E-42GE.l Pld In uS.A.
MARKETING OfFIC~
NAT NA we.
COD,"~'>l .,8' 11I..0"" Co...neol on Com04"llllon 1"1\10'&"('
PICS RPTD
RE POOL 9~165 DOC 6176A WC~
COMPANY copy WC 00 00
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COMPENSATION RATING AND INSPECTION BUREAU
ST A TI:1 OF NEW JERSEY
DEPARTMENT OF INSURANCE
60 Park Place, Newark, NJ 07102
~
looepb S. Di MartiAo
~...UliYO DiroclDr
(WI) 622-6014
David W. H&IIlIum
Spoolal DepulY Commlllloncr
Bureau Pile: 017212
Seplember 9. 1994
'.
RECEIVED
,
Atlantic Employers Insurance Company
Ann: Ms. Janet J. Pritchett
P.O. Box 9010
Macon, Georgia 31213
SEP 121994
J. l'.1UTCHETT
RE: Atlantic Prelght Systems Inc
Policy # C40843498
Eff. 4n7/94 - 95
Dear Ms. Pritchett:
Your letter dated August II, 1994 to our Mr. Swan was given to me for review and
response.
In reviewing the information contained in the binder Included with your letter, as well
as the Information contained in our Bureau filr.s, we find no relationship between the Atlantic Freight
Systems In~ located in Burlington, NJ and the Atlantic Freight Systems lnc located In Brookfield, CT.
In order to independently verify your information, I visited the employers Cumberland,
NJ location on September 7, 1994. The prime occupant of this location is an entity named Sun Land
Distrll)ution CompUlY. In walking through the office area of the terminal building I found a door with
an Atlantic Freight Systems Inc sign on it. When I opened the door I found a room approximately 6 x
10' which contained a water heater and a sink. I questioned employees of another tenant In the building
about the operations of Atlantic Freight Systems Inc and was informed that I would have to speak to the
receptionist. I went to the reception area, which was empty. I then drove around the entire terminal
building in an effort to locate any Atlantic Freight Systems vehicles. There were none. Nor was there
any sign of the 1980 Mack tractor cited in your package.
Based on the information submitted and that \',hich I developed, other than the fact that
the risk In caption apparently is a New Jersey corporation, we agree there does not appear to be any
ongoing business activity by this employer within the State of New Jersey. Further, it does not appear
that the employer has any vehicles registered in the State of New Jersey, nor do they dispatch any
vehicles from the State of New Jersey.
From all indications, all activities of lhis risk emanate from New Cumberland,
Pennsylvania,
...
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Bureau File I: 017212
(2)
September 9, 1994
In our view, the formation of a New Jersey colllOralion and the lease or rental of a
mailing address does not consilUte a business enterprise subject to the New Jersey Workers Compensation ,
Law (RSNJ 34: 15).
While we caMot agree to a mid-term cancelation of a plan polley, unless the employer
can provide compelling contrary information to that developed by your office and confirmed by ours, we
agree to the non-renewal of the captioned policy effective 4127/95.
'-
"
Very truly yours,
Ron Brazda, Supervisor
Classi ficalion/lnspection
Ex!. /I 250
.'
RB/vr/2: DNT
CC: Sciarra Insurance Agency Inc
P.O. Box 98
Audubon, NI 08106
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SHERIFF'S RETURN - REGULAR
CASE NO, 1997-02166 P
CO""ONWEALTH OF PENNSYLVANIA'
COUNTY OF CU"BERLAND
ATLANTIC E"PLOYERS INSURANCE
VS.
ATLANTIC FREIGHT SYSTE"S INC
KATHY .1. CARPER -J Sheriff or Deputy Sheriff of
CU"BERLAND County, Pennsylvania, who being duly swprn aocording
to law, says, the within CO"PLAINT was served
upon ~TLANTIC FREIGHT SYSTE"S INC the
defendant, et --2~.lit!l1l HOURS, on the ~ day of "ay
19~ at CIO HARRY GROSS"AN 27~ HILLSIDE DRIVE
~W CU"BERLANO" PA 17070 JCU"BERLANO
County, Pennsylvania, by handing to SUSIE GROSS"AN. WIFE OF HARRY
GROSS"AN
a true and attested copy of the CO"PLAINT
and at the sa.e tiMe directing fuL~ attention to the contents thereof.
,
,
,
Sheriff's Costs,
Docketing
Service
Affidevit
Surcherge
18.00
10.~4
.00
2.00
So enewers, a/ ~
.-?'~-r.<...;:~ ~~
R. ThOMe. ~11ne, 5her1%%
5;;'rD.:)4
l:iAUL EWING
0~/16/1997
by
RE"ICK & SAUL
1~~-J'5h(~~
Sworn end subscribed to before .e
this /1. ~ dey of ,.,~(
I
19 q 1 A. D.
, /'
'#A'o...- U . nu..l~ up-Z;,
, Prothonotllry'
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ATLANTIC EMPLOYERS INSURANCE )
COMPANY )
)
PlaintilT )
)
~ )
)
ATLANTIC FREIGHT SYSTEMS, INC. )
)
Defendant. )
IN TIlE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL ACTION
NO. 97-2166
PRAECIPE FOR ENTRY OF DEFAULT JUDGMENT
TO THE PROTHONOTARY:
Please enler judgment in the above-caplioned case in the form attached hereto,
pursuant 10 Pa. R, Civ. P. 1037 for defendant's failure to tile a pleading to the Complaint. which
conlaincd a notice to defend, in the amount of $80.274,00, plus interest C'nthe amount of
$33,850,00 from April 27, 1993, and on Ihe amount 01'$46,424.00 from April 27, 1994, plus
cosls in the amount 01'$76.04 ($45.50 Complaint tiling fee; $30,54 Sherifrs Service fee).
The undersigncd hereby certities that a wrilten NOlice oflntcntion to Take Default
Judgmcnt was served pursuant to Pa. R. Civ. P. 237.lmorc than ten days prior 10 Ihe tiling of
this Praecipe. A true and correct copy of the Notice of Intention to Takc Default Judgment is
altached hereto as Exhibit A.
v;:L,i, c[?':;~t)
Patricia A. Trujillo .
Attorney ID No. 66562
Saul, Ewing, Remick & Suul LLP
Penn Nutionullnsuruncc Towcr
2 N. Second Street, 7th Floor
Harrisburg, I' A 17101
(717) 238-7675
Outed: December 7. 1998
Altorneys for PlaintitT
blNUllli7f1J1
CERTIFICATE OF SERVICE
I. Patricia A. Trujillo, atlorncy for I'laintilT Atlantic Employers Insurance
Company. do hereby certify that 011 this 7th day of December, 1998. I served a true and correct
copy of the foregoing Amended Praecipe for Entry of Default Judgment by U.S. First Class Mail,
postage prepaid, addressed as follows:
AtlanTic Freight Systems. Inc.
c/o Harry Grossman, President
275 Hillside Drive
New Cumberland, P A 17070
'-iJ~'L-~~
Patricia A. Trujillo
l1O'll9llV71V1
-2-
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ATLANTIC EMPLOYERS INSURANCE )
COMPANY )
)
Plaintiff )
)
~ )
)
ATLANTIC FREIGHT SYSTEMS,INC. )
)
Defendant. )
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL ACTION
NO. 97-2166
NOTICE OF INTENTION TO TAKE DEFAULT JlIDGMENT
YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A
WRITIEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE
IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO
THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN
TEN (10) DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT
MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU
MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU
SHOULD TAKE THIS NOTICE TO A LAWYER AT ONCE. IF YOU DO
NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR
TELEPHONE THE FOLLOWING OFFICE TO FIND OUT WHERE YOU
CAN GET LEGAL HELP.
COURT ADMINISTRATOR
Cumberland County Courthouse
Fourth Floor
Carlisle, PA 17013
(717) 240-6200
/
.,
~"~I'A ~iuliJ
Patricia A. Trujillo
Attorney ID No. 66562
Saul, Ewing, Remick & Saul
240 N. Third Street, Suite 700
Harrisburg, PA 17101
(117) 238-7675
Dated: August 7, 1997
Attorneys for Plaintiff
JOl9uanm
,I
CERTIFICATE OF SERVICE
I, Patricia A. Trujillo, attorney for Plaintiff Atlantic Employers Insurance
Company, do hereby certify that on this 7th day of August, 1997, I served a true and correct
copy of the foregoing Notice of Intention to Take Default Judgment by U.S. First Class Mail,
postage prepaid, addressed as follows:
Atlantic Freight Systems, Inc.
c/o Harry Grossman, President
275 Hl11side Drive
New Cumberland, PA 17070
a.o:"-o:;)'!~
. (
PatriCia A. Trujl110
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ATLANTIC EMPLOYERS INSURANCE )
COMPANY )
)
Plaintifi. )
)
v. )
)
ATLANTIC FREIGHT SYSTEMS, INC. )
)
DefendanT. )
IN TIlE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYLVANIA
CIVIL ACTION
NO. 97-2166
NOTICE OF ENTRY OF JUDGMENT
NOTICE IS HEREBY GIVEN in accordance with Pa. R. Civ. 1'.236 that a
Judgment in the above-caplioned mailer has been entered against you in the amount of
$80.274.00, plus interest on the amount of$33,850.00 from April 27, 1993, and on the amount of
$46,424.00 from April 27, 1994, plus costs in the amount of $76,04 ($45.50 Complaint filing
fee; $30.54 Sheriffs Service fee).
If you have any questions regllr .
olice, please contact:
Patricia A. Trujillo, Esquire
Saul, Ewing, Remick & Saul LLP
Penn National Insurance Tower
2 N. Second Street, 7th Floor
Harrisburg, PA 17101
(717) 238-7675
NOlice Sent To:
Atlantic Freight Systems. Inc.
clo Harry Grossman, President
275 Hillside Drive
New Cumberland. I' A 17070
fol,I'I''J Ill')itll
Patricia A. Trujillo
Saul, Ewing, Remick & Saul LLP
Penn National Insurance Tower
2 N. Second Street, 7th Floor
Harrisburg, I' A 1710 I
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SAUL, EWING. REMICK & SAUL, LLP
Paige Macdonald,Mallhes, Esquire
Supreme Court ID No, 66266
Penn National Insurance Tower
2 North Second Slreel, 7th Floor
Harrisburg. PA 17101
(717) 257.7500
Auomeys for Allanlic Employers Insurance Company
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYL V AN~A
ATLANTIC EMPLOYERS
INSURANCE COMPANY,
DOCKET NO.: !J7-2166
v.
ATLANTIC FREIGHT SYSTEMS, INC.,
Defendant.
CIVIL ACTION - LAW
RULE
AND NOW, this 2-~,lday of
\! .....nc-
, 2000, upon
consideration of the Plaimiff's Motion 10 Compel Discovery and for Leave of Court to Contact
Defendant Directly and Independem of its Corporate Designee, a copy of which is auached
hereto, a Rule is issued upon Defendant Atlantic Freight Systems, Inc., and its corporate
designees, Ira H. Weinstock, Esquire, and Excel Corporate Services (a/kla Blumberg
Excelsior Corporate Services) to show cause, if any they have, why Plaintiff's Motion should
not be granted
Rule returnable l. ..
days from Ihe date of service.
BY THE COURT:
"
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7)116 I 6r211OJ
- ~
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4. In an allemplto enforce its judgment against the Defendant, prepared
Interrogatories in Aid of Execution directed to Defendant. Atlanlic Freight Systems, Inc. on or
about April 25, 2000.
5. Upon Plaintiff's review of a Dun and Bradstreet (D&B) report, it was
revealed that the corporate designee of the Defendant, Allamic Freight Systems, Inc" is Ihe
Law Office of Ira H. Weinstock in Harrisburg, Pennsylvania.
6. On or about April 25, 2000, Plaintiff's counsel contacled Ira H.
Weinstock, Esquire, to confirm that Mr. Weinstock still continued to represent Atlantic Freight
Systems, Inc. During this telephone communication, Mr. Weinstock indicated to Plaintiff's
counsel, that the corporate designee was not Ira H. Weinstock, but rather was Excel Corporale
Services (a/kla Blumberg Excelsior Corporale Services). Mr. Weinstock further indicaled that
his firm was retained by Excel Corporate Services for Ihe sole purpose of filing the Articles of
Incorporation.
7. On or about April 25, 2000, Plaintiff's counsel contacted Mark Moel at
Excel Corporate Services 10 inquire whether Excel was still the corporate designee of AIlantic
Freight Systems, Inc. During Ihis telephone conversation, Mark Moel referred Plaintiff's
counsel back to Ira H. Weinstock.
8. Upon receipt of conflicting information, on April 25,2000, Plaintiff's
counsel forwarded Plainliff's Interrogatories in Aid of Execulion directed to Defendant,
Atlantic Freight Systems, Inc.. 10 both Ira H. WeinslSock, Esquire and Mark Moel at Excel
Corporate Services.
1)11616111100
-2-
9. As of the date of this MOlion, responses 10 Plaintiff's Interrogatories in
Aid of Execution directed to Defendant, Atlantic Freight Systems, Inc., have not been
forlhcoming from either the offices oflra II. Weinstock, or Excel Corporate Service3.
10. On or about June 6, 2000, PlainTiff's counsel forwarded correspondence
10 bolh Excel Corporate Services and to Ira H. Weinslock inquiring when Plaintiff's cOlmsel
could expect to receive Defendant's responses to Plainliff's First Set of Interrogatories in Aid
of Execution, A true and correct copy of Plaintiff's counsel's leTter is aTtached herelo and is
marked as Exhibit "B".
I I. Ira H. Weinstock has informed Plaintiff's counsel that he forwarded the
discover requests to Excel. Excel has informed counsel that the discovery requests had been
forwarded to Defendant and that was the end of Excel's duTies and responsibiliTies to
Defendant as far as they were concerned.
12. Plaintiff has been prejudiced as a direct and proximate result of
Defendant's (as well as its corporale designees'), failure to comply with the Pennsylvania
Rules of Civil Procedure concerning the timely completion of discovery.
13. Plaintiff has been further prejudiced by the fact that neither Ira H.
WeinsTOck, nor Excel Corporate Services will confirm whether or not the Defendant actually
received the Plaintiff's Interrogatories in Aid of Execution which allegedly have been
forwarded to the Defendant by Ihe corporate designee.
14. Without having Ihe information requested in the Plainliff's
Interrogatories in Aid of Execution. Plaintiff is unable to discover any property or assets of the
Defendant that may be used to salisfy PlainTiff's judgment in this matter.
1)71610.11/00
-3-
15. As a direct and proximate result of Defendant's refusal to comply with
Plaintiffs discovery requests, Plaintiff has had to incur addilional counsel fees in the
preparation and filing of this motion.
WHEREFORE. Plaintiff, Allantic Employers Insurance Company respectfully
requesls that this Honorable Court grant its Motion to Compel Discovery and direct
Defendant's corporale designees Excel Corporate Services and Ira H. Weinstock, Esquire, to
provide Plaintiff wilh answers to their Interrogatories in Aid of Execution forthwith; award
Plaintiff counsel fees and costs incurred in filing of this Motion in the sum of $525.00; and
further award Plaintiff all such other relief as is proper and JUST.
COUNT II
MOTION FOR LEAVE OF COURT TO SERVE DEFENDANT ATLANTIC FREIGHT
SYSTEMS, INC. INDEPENDENT OF ITS CORPORATE DESIGNEE
16. The averments set forth in paragraphs I through 15 are incorporated
herein by reference as if more fully set forth at length,
17. Since the date that default judgment was entered against the Defendant
Atlantic Freight Systems, Inc., December 8, 1999, Plaintiffs have been unable to determine
who is currently acting as the corporate designee for the named DefendanT.
18. Plaintiff's counsel has had to spend an inordinale amount of time in
order to confirm whether Ira H. Weinslock. Esquire, or Excel Corporate Services (alkla
Blumberg Excelsior Corporation) is in fact acting as Defendanl's corporate designee.
19. Neither Ira H. Weinslock, Esquire, nor Excel Corporate Services will
confirm to Plaintiff's counsel that Defendant has actually received the discovery allegedly
forwarded by their offices to Defendant.
1311616111,00
-4-
20. PlainTiff believes and Iherefore avers thai AtlanTic Freight Syslcms, Inc,
is currenTly unrepresented by counsel, hased on the representation of Ira H, Weinstock,
Esquire. However, Plaintiff does not know for sure whether DefendanT has retained alTernate
counse I.
2 I. Plaintiff believes and Iherefore avers that Ihe process of obtaining
discovery from the DefendanT will be expedited if this Honorable Court will permit Plainliff's
counsel to attempt to serve and contact Defendant directly with Ihe InTerrogatories in Aid of
Execution, and with a Notice of Deposition.
22. Plainliff has and will continue to be prejudiced unless this Honorable
Court permits them to COnTact Defendant directly.
23. Plainliff believes and therefore avers that the Defendant will not be
prejudiced in any way by this Honorable Court granting Plaintiff's request for leave to contact
Defendant direclly. and independent of their corporate designee.
WHEREFORE, PlainTiff, Atlantic Employers Insurance Company respectfully
requests that this Honorable Court grant its Motion for Leave of Court to COnTact Defendant
Atlantic Freight Systems, Inc. directly and independent of its corporale designee(s), award
1l716.160'1I,u,
-5-
Plaintiff's counsel in the sum of $525.00 for the preparation and filing of this Motion and
further award Plaintiff all such other relief as proper and just.
Respectfully submitted,
SAUL, EWING, REMICK & SAUL LLP
~~t. ~....\......n').~
Paige Macdonald-Matthes
Attorney 10 No. 66266
Saul, Ewing, Remick & Saul LLP
Penn National Insurance Tower
2 North Second Streel, 7th Floor
Harrisburg, PA 17101
(717) 238-7675
Date: June _, 2000
Attorney for Atlantic Employers Insurance
Company
1111616111100
-6-
CERTIFICATE OF SERVICE
I hereby certify that a copy of Ihe foregoing Malian To Compel And For Leave Of
Court To Issue Subpoena Direclly To Defendant In Lieu Of Corporate Designee, was served
on Defendant by firsl class mail on June ~, 2000, at the following address:
Atlantic Freight Systems. Inc.
cIa Mark Moel
Blumberg Excelsior Corporate Services
62 While Street
New York, New York 10013
(corporate designee for Atlantic Freight Systems, Inc.)
- and -
Ira H. Weinstock, Esquire
800 North Second Street
Harrisburg, PA 17102
(corporate designee for AIlantic Freight Systems, Inc.)
~:';~'-"~~.\\""~
Paige acdonald-Mallhes
lHI6I6.01lim
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LAW OFFICES OF
SAUL, EWING, REMICK & SAUL LLP
'HI\.ADI\.'HIA. '1NNI'I'I,VAHIA,
tAL TlWO"', ".UHAND
'U'WYH, ,.,.,..anV""I"
PENN NATIONAL INSURANCE TOWER
2 NORTN SECONO STREn. 7In HOOR
HARRISBURG, PA U101
HIW YO"lC, HIW VQIlII(
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WILMINQTON, DII.AWUI
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June 6, 2000
Atlantic Freight Systems, Inc.
c/o Mark Moel
Excel Corp. Services
62 White Street
New York, NY 10013
Re: Atlantic Employers Insurance Co. v. Atlantic Freight Systems, Inc.
Dear Mr. Moel:
As you will recall, on April 25, 2000 I forwarded to your attention Plaintiff's First Set
of Interrogatories in Aid of Execution Directed to Atlantic Freight Systems, Inc. I also serveci
a copy of these requests on Ira Weinstock, Esquire who directed that I should forward these
discovery requests to your attention. More than thirty (30) days have elapsed and I still do not
have a response from either your company or Ira Weinstock, Esquire.
Kindly contact me at the number referenced hereinabove to inform me of when I can
expect to receive your client's responses to these discovery requests. In the event that I do not
hear from you within five (5) business days of this correspondence, I will proceed to file a
motion to compel with the Court.
Awaiting your prompt reply, I remain.
Very truly yours,
.
~~e~~""'VW:t'\..v,l
Paige Macdonald-Matthes.
LAW OFFICES OF
SAUL, EWING, REMICK & SAUL UP
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PENN NATIONAL INSURANce TowER
2 NORTH seCONO STREET. 7tn FLOOR
HARRISBURG. PA 17101
N.W 'l'o.ue, Klw YORK
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June 2, 2000
VIA TELECOPIER AND REGULAR MAIL- (717) 238-6691
Ira H. Weinstock, Esquire
800 North Sccond Strect
Harrisburg, PA 17101
Re: Atlantic Employers Insurance Co. v. Atlantic Freight Systems,lnc.
Dcar Mr. Weinstock:
As you may recall, I forwarded to your attention on April 25, 2000 Plaintiffs'
Interrogatorics in Aid of Execution directed to Atlantic Freight Systems, Inc. I also provided a
copy of these interrogatories to Excel Corp. Services in New York, at your direction. By my
calculations, and allowing time for mail delivery, I should have had your client's responscs no
later than Friday, May 26, 2000.
Please advise when I can expect to receive the answers to the interrogatories I have
served on you as registered agent for the corporation at your earliest convenience.
Awaiting your timely reply, I remain.
Very truly yours,
~~~~.
Paigc Macdonald-Matthcs
cc: Joyce Bernstein, ACE INA
.~'
AUG 1 1 ?Onr-.
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""'1
SAUL, EWING. REMICK & SAUL, LLP
Paige Macdonald-Matthes. Esquire
Supreme Court lD No. 66266
PelUl N.tiol1llltnsurance Tower
2 North Second Streel, 7lh Floor
Harrisburg. PA 17101
(717) 257.7500
Attorneys for AII.ntic Employers Insurance Company
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYL VANIA
ATLANTIC EMPLOYERS
lNSURANCE COMPANY,
DOCKET NO.: 97-2166
v.
ATLANTIC FREIGHT SYSTEMS,INC.,
Defendant.
CIVIL ACTION - LAW
ORDER
AND NOW, this
day of August 2000, upon consideration of the Plaintifrs
Motion For Rule Absolute, and upon the Court's having determined that the Defendant and its
corporate designees have failed to respond to the previously-issued Rule of Court dated June 23,
2000,
IT IS HEREBY ORDERED that Plaintifrs Motion for Rule Absolute is
GRANTED. Defendant Atlantic Freight Systems, Inc., by and through its corporate designees
shall provide Plaintifrs counsel with its Answers to Interrogatories in Aid of Execution
forthwith, and Plaintiffs counsel is hereby granted leave of court to contact Defendant Atlantic
Freight Systems, Inc. by and through its President, Harry L. Grossman, directly in order to
schedule a deposition in aid of execution.
14.11 1 Ii9IOO
.
IT IS FURTHER ORDERED that Defendant Atlantic Freight Systems, Inc., shall
pay Plaintiff, Atlantic Employers Insurance Company the sum of $1,109.64, representing
counsel fees and costs incurred in the filing of its Motions;
BY THE COURT:
J.
it
141n,..'MlO
4. In an aUemptto enforce its judgment against the Defendant, prepared
Intcrrogatories in Aid of Execution directed to Defendant, Atlantic Freight Systems, Inc. on or
about April 25, 2000.
5. On or about April 25, 2000, Plaintiffs counsel contacted Ira H. Wcinstock,
Esquire, to conlinn that Mr. Weinstock still continued to represent Atlantic Freight Systems, Inc.
During this telephone communication, Mr. Weinstock indicated to Plaintiffs counsel, that the
corporate designee was not Ira H. Weinstock, but rather was Excel Corporate Services (aIkIa
Blumberg Excelsior Corporate Services). Mr. Weinstock further indicated that his finn was
retained by Excel Corporate Services for the sole purpose of filing the Articles of Incorporation
in Pennsylvania.
6. On or about April 25, 2000, Plaintiffs counscl contacted Mark Moel at
Excel COl"porate Services to inquire whether Excel was still the corporate designee of Atlantic
Freight Systems, Inc. During this telephone conversation, Mark Moel referred Plaintiffs counsel
back to Ira H. Weinstock, Esquire.
7. Upon receipt of conflicting infonnation, on April 25, 2000, Plaintiffs
counsel forwarded Plaintiffs Interrogatories in Aid of Execution directed to Defendant, Atlantic
Freight Systems, Inc., to both Ira H. Weinstsock, Esquire and Mark Moel at Excel Corporate
Services.
8. On June 22, 2000, Plaintiffs counsel filed a Motion to Compel and for
Leave of Court to Issue Subpoena directly to Defendant in lieu of Corporate Designee when it
appeared that no responses to the Interrogatories in Aid of Execution would be forthcoming from
either Ira Weinstock, Esquire or Excel Corporate Service.
9. On June 23 2000, this Honorable Court issued a Rule to Show Cause upon
Defendant Atlantic Freight Systems, Inc. and its corporate designees, Ira H. Weinstock, Esquirc
"4111110'9.000
-2-
and Excel Corporate Services (aIkIa Blumberg Excelsior Corporate Services) to show cause, if
any they had, why Plaintifrs MOlion should not be granted. A true and correct copy of this
Honorable Coun's Rule dated Junc 23, 2000 is attached hereto and marked as Exhibit "A".
10. On Junc 29, 2000, PlaintitTs counsel provided Defendant Atlantic Freight
Systems, Inc. and its corporate designees with a copy of this Honorable Court's Rule to Show
Cause via ccrtificd mail.
11. On June 29, 2000, Plaintifrs counsel also providcd notice of this
Honorable Court's Rule to Show Cause to Joseph Milizio, Esquire, of Lake Success, New York,
who had contacted PlaintiITs counsel in the interim, to notify Plaintifrs counsel of his possible
reprcsentation of Defendant. I
12. As of the date of this Motion, no response has been filed to PlaintiITs
Motion, and Plaintifrs counsel has not received the responses to its Interrogatories in Aid of
Execution from either Defendant, Defendant's counsel, or its corporate designee(s).
13. Plaintiff has been and will continue to be prejudiced as a direct and
proximate result of Defendant's (as well as its corporate designces') failure to comply with the
Pennsylvania Rules of Civil Procedure concerning the timely completion of discovery.
14. Plaintiff has been further prejudiced by the fact that neither Ira H.
Weinstock, Esquire, Excel Corporate Services will definitively confinn whether or not
Defcndant actually received Plaintifrs Interrogatories in Aid of Execution which allegedly have
been forwarded to the Defendant by thc corporate designees.
Attorney Milizio has since conrmncd via letter dated August 4, 2000 that he doc. not represent thE
Derendant corporation in que.tion.
1.&1111"''''00
-3.
IS. Without having the information rcqucstcd in Plaintifrs Interrogatories in
Aid of Execution, Plaintiff is unable to discover any property or assets of the Defcndant that may
be used to satisfy the Plaintifrs Judgment in this mailer.
16. As a direct and proximate result of Defendant's refusal to comply with
Plaintifrs discovery requests, as well as the two (2) motions that Plaintifrs has counsel has filed
in order to obtain said discovcry, Plaintiff has had to incur additional counsel fees in the
preparation and filing ofthc two (2) motions. Specifically, Plaintiff has incurred counsel fees
and costs incurred in the filing of this Motion as well as the prcvious Motion in the sum of
51,109.64.
WHEREFORE, Plaintiff, Atlantic Employers Insurance Company respcctfully
requests that this Honorable Court grant its Motion For Rule Absolute and direct Dcfendant and
Defendant's corporate designees Excel Corporate Services, and Ira H. Weinstock, Esquire to
provide Plaintiff with Defcndant's Answers to their Interrogatories in Aid of Execution
forthwith; award Plaintiff counscl fees and costs incurred in the filing of this Motion as well as
the previous Motion in the sum of $1, 109.64 and furthcr award Plaintiff all such othcr relief as is
proper and just.
..\
'.'1711/9.'00
.4.
Rcspcctfully sllbmilled,
SAUL, EWING, REMICK & SAUL LLP
~L~ LV,^N;l..'~Ci~,\..o:tlt.~
Paigc Macdonald.Mallhes
Attorney ID No. 66266
Penn National Insurance Tower
2 North Second Strect, 7th Floor
Harrisburg, PA 17101
(717) 238-7675
Date: August 9, 2000
Attorney for Atlantic Employcrs Insurance
Company
""11~
-6-
CERTIFICATE OF SERVICE
I hereby certify that a copy of the foregoing Motion To Compel And For Leave Of
Court To Issue Subpoena Directly To Defendant In Lieu Of Corporate Designee, was served
on Defendant's Corporate Designees by first class mail on August 9il1, 2000, at the following
addresses:
Atlantic Freight Systems, Inc.
c/o Mark Moel
Blumberg Excelsior Corporate Services
62 White Street
New York, New York 10013
(corporate designee for Atlantic Freight Systems, Inc.)
- and -
,\
Ira H. Weinstock, Esquire
800 North Second Street
Harrisburg, PA 17102
(corporate designee for Atlantic Freight Systems, Inc.)
- and -
(with courtesy copy to)
Joseph Milizio, Esquire
3000 Marcus A venue
Suite lE9
Lake Success, NY 10042
~~ Jo'<'n"~",,,,~...t-N\+I1..,~
Paige Macdonald-Matthes
nll1.11/9IOO
Paige Macdonald-Mallhcs, Esq.
Pcnn Nationallnsursncc Tower
2 North Sccond Street, 7lh Floor
Harrisburg, P A 1710 1
AlIomey for Plaintiff
Ira H. Weinstock, Esq.
800 North Second Street
Harrisburg, P A 17102
(corporate designec f(1r Atlantic Frcight
Systcms, Inc.)
Atlantic Freight Systcms, Inc.
Sixth and Water Streets
New Cumberland, PA 17070
Exccl Corporatc Services
aIkIa Blumberg Excelsior
Corporate Services
c/o Mark Moel
62 White Street
New York, NY 10013
;rc
"
AUG ] 1 lOon
''J
'v)
SAUL, EWING, REMICK & SAUL, LLP
Paige Macdollllld.Matthes. Esquire
Supreme Court ID No. 66266
PeM National !lUurance Tower
2 North Second Sire. I, 71h Floor
Harrisburg. PA 17101
(717) 257- 7500
Attorney. ror Atlantic Employers In.urance Company
Plaintiff,
IN TilE COURT OF COMMON PLEAS
CUMBERLAND COUNTY,
PENNSYLVANIA
ATLANTIC EMPLOYERS
INSURANCE COMPANY,
DOCKET NO.: 97.2166
v.
ATLANTIC FREIGHT SYSTEMS, INC.,
Defendant.
CIVIL ACTION - LAW
MOTION FOR RULE ADSOLUTE
AND NOW, COMES thc Plaintiff. Atlantic Employcrs Insurance Company by
and through its counscl, Saul. Ewing, Rcmick & Saul, LLP. ami filcs its Motion For Rule
Absolute for Lcave of Court to Scrvc Subpocna upon Dcfcndant dircctly in lieu of Corporate
Designee, and for counsel fecs, un in support thcreof avcrs as follows:
1. On April 25, 1997, the Plaintiff filcd its Complaint against the Defendant
at the above-refcrenccd docket number.
2. On Dccembcr 8, 1998. a Praccipc for Entry of Default Judgment was filcd
against the Defendant atthc above-refcrenced docket number.
3, On Dcccmber 8. 1998, ajudgmcnt by dcfault was entered against the
Defendant in thc amount of$80,274.00 plus intcrest on thc amount of$33,850.00 from April 27,
1993, and on thc amount of $46,424.00 from April 27. 1994. plus costs in the amount of $76.04.
A true and correct copy of the Order of Judgment is attached hcrcto and marked as Exhibit "A".
'''111''900
4. In an atlemptto enforce its judgment against the Defendant, prepared
Interrogatories in Aid of Execution directed to Defendant, Atlantic Freight Systems, Inc. on or
about April 25, 2000.
5. On or about April 25, 2000, Plaintil1's counsel contacted Ira H. Weinstock,
Esquire, to confirm that Mr. Weinstock still continued to represent Atlantic Freight Systems, Inc.
During this telephone communication, Mr. Weinstock indicated to Plaintifrs counsel, that the
corporate designee was not Ira H. Weinstock, but rather was Excel Corporate Services (alk/a
Blumberg Excelsior Corporate Services). Mr. Weinstock further indicated that his firm was
retained by Excel Corporate Services for the sole purpose of filing the Articles of Incorporation
in P:nnsylvania.
6. On or about April 25, 2000, Plaintifrs counsel contacted Mark Moel at
Excel Corporate Services to inquire whether Excel was stillthc corporate designee of Atlantic
Freight Systems, Inc. During this telephone conversation, Mark Moel referred Plaintil1's counsel
back to Ira H. Weinstock, Esquire.
7. Upon receipt of conflicting information, on April 25, 2000, Plaintil1's
counsel forwarded Plaintiffs Interrogatories in Aid of Execution directed to Defendant, Atlantic
Freight Systems, Inc., to both Ira H. Weinstsock, Esquire and Mark Moel at Excel Corporate
Services.
8. On June 22, 2000, Plaintifrs counselliled a Motion to Compel and for
Leave of Court to Issue Subpoena directly to Defendant in lieu of Corporate Designee when it
appeared that no responses to the Interrogatories in Aid of Execution would be forthcoming from
either Ira Weinstock. Esquire or Excel Corporate Service.
9. On June 23 2000, this Honorable Court issued a Rule to Show Cause upon
Defendant Atlantic Freight Systems, Inc. and its corporate designees, Ira H. Weinstock, Esquire
7UIlIJ.'1lllJ
-2-
15. Without having the infomlation requested in Plainti rrs Interrogatories in
Aid of Execution, Plaintiff is unable to discover any property or assets of the Defendant that may
be used to satisfy the Plaintifrs Judgment in this mailer.
16. As a direct and proximate result of Defendant's refusal to comply with
Plaintitfs discovery requests, as well as the two (2) motions that PJaintifrs has counsel has filed
in order to obtain said discovery, Plaintiff has had to incur additional counsd fees in the
preparation and filing of the two (2) motions. Spccifically, Plaintiff has incurred counsel fees
and costs incurred in the filing of this Motion as well as the previous Motion in the sum of
$1,109.64.
WHEREFORE, Plaintiff, Atlantic Employers Insurance Company respectfully
requests that this Honorable Court grant its Motion For Rule Absolute and direct Defendant and
Defendant's corporate designees Excel Corporate Services, and Ira H. Weinstock, Esquire to
provide Plaintiff with Defendant's Answers to their Interrogatories in Aid of Execution
forthwith; award Plaintiff counsel fees and costs incurred in thc filing of this Motion as well as
the prcvious Motion in thc sum of $1, 109.64 and further award Plaintiff all such other relief as is
proper and jus!.
741nl"~OO
.4-
COIINT II
MOTION FOR RULE OF ABSOLUTE
FOR LF.A VE OF COURT TO SERVE
DEFENDANT ATLANTIC FRF.IGIIT SYSTEMS. INC.
INDEPENDENT OF ITS CORPORATE DESIGNEES
17. The avennents sct forth in paragraphs I through 16 are incorporated
herein by reference as ifmore fully set forth at length.
18. Since the date that defaultjudgmcnt was entered against the Defendant
Atlantic Freight Systems, Inc. (Deccmber S, 1999), Plaintiffs have been unable to detennine who
is currently acting as the corporate designee for the namcd Dcfendanl.
19. Plaintifrs counsel has had to spend an inordinate amount of time in order
to confinn whether Ira H. Weinstock, Esquirc, Excel Corporate Services (aIkIa Blumberg
Excelsior Corporation), or Joseph Milizio, Esquire are in fact acting as Defendant's corporate
designee(s).
20. Plaintiff believes and therefore avers that the process of obtaining
discovery from the Defendant will bc expedited if this Honorable Court will pennit Plaintiff's
counsel to attempt and contact Defendant directly with the aid of execution and with a Notice of
Deposition.
21. Plaintiff has been and will continue to be prejudiced unless this Honorable
Court grant Plaintifrs Motion for Rule Absolute.
WHEREFORE, Plaintiff, Atlantic Employers Insurance Company respectfully
requests that this Honorable Court grant its Motion for Rule Absolute and enter an Order
pennitting Plaintiff's counsel to contact Defendant Atlantic Freight Systems, Inc. directly, by and
through its President, Harry L. Grossman, and independent of its corporate designee(s), and
further award Plaintiff all such othcr relief as proper and just.
,.." I L~1Xl
.5.
CERTIFICATE OF SERVICE
I hereby certify that a copy of the foregoing Motion To Compel And For Leave Of
Court To Issue Subpoena Directly To Defendant In Lieu Of Corporate Designee, was served
on Defendant's Corporate Designees by first class mail on August 9'\ 2000, at the following
addresses:
Atlantic Freight Systems, Inc.
c/o Mark Moe\
Blumbcrg Excelsior Corporate Services
62 White Street
New York, New York 10013
(corporate designec for Atlantic Freight Systems, Inc.)
- and -
Ira H. Weinstock, Esquirc
800 North Second Street
Harrisburg, PA 17102
(corporate designee for Atlantic Freight Systems, Inc.)
- and -
(with courtesy copy to)
Joseph Milizio, Esquire
3000 Marcus A venue
Suite lE9
Lake Success, NY 10042
.---.,
\:"';t.cU.clQ .."'<'",...,':)'\,V"t.(J:.J'l...-.......ll~:\ ...~
Paige Macdonald-Matthes
74111.1"",{I)
Wo/Z~g 9/~ $:&7'
ATTORNEYS AT LAW
3000 M.t.IIcus AVENUE. SUlTII IE9. LAu SUCCl!S8. NEW YOIlll 11042
TllLI516.437.4385 P... 1516. 437.439~
HOWARD CAPELL
BERNARD VISHNICK
ALAN RooD POLLACK
BIlBNABD F. McGovERN
JOSEPH G. MILlZIO
PHILIP J. CAPIU.L
CHRISTOPHER J.L. DEZIEL
MoRRIS s..BBAOH
GRIlOORY L. MATALON
ERIK ORTMANN
CHRISTOPHER D. HcDoNALD
ROSANNA MJST1CONI
CARL C FIORIl
GENIlVA M.JOHNSON
EoWABD M. DWECE
118.8.18811
0' COUNSeL
RoBUT S. BABllllTJ'
RoBERT S. FADER
STUART H. ScUOENI'IlLD
August 29, 2000
VIA FEDERAL EXPRESS
Mr. Mark Moe!
Blumberg/Excelsior
62 White Street, 2nd Floor
New York. NY 10013
Re: Atlantic Freight Systems, Inc.
Dear Mark:
As we advised you, IlIumberg is not agent for service of process for Atlantic Freight
Systems, Inc.. the judgment debtor, nor do we represent this entity. You were the agent for, and we
did represent Atlantic Freight Services, Inc. , a Pennsylvania corporation.
1 am enclosing the original correspondence which we received from your office regarding
an action against Atlantic Freight Systems, Inc. Please do not forward any correspondence regarding
this entity to our oflice and instruct your personnel not to accept any further correspondence for this
Pennsylvania entity.
Very truly yours,
JGM:mp
Enclosure
, "
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