FOCUS Packet 2025

FOCUS Adjusters Overview

FOCUS Adjusters 646 Plank Road, Ste. 209 Clifton Park, NY 12065 (800) 734-2102

CONFIDENTIALITY NOTICE

This following documents contain information belonging to Fort Orange Claim Service, Inc. dba FOCUS Adjusters which may be confidential and legally protected. This information is only for the use of the individual or entity to which it was intended. Any disclosure, copying, distribution, or action taken in reliance on the contents of the information contained in this message and any accompanying documents is strictly prohibited. If you are not an authorized recipient of this document please immediately delete from your system and contact our office immediately.

CONTACT Patrick L. Young , Chief Operating Officer ADDRESS: 646 Plank Road, Ste. 209 Clifton Park, New York 12065 PHONE: (800) 734-2102, ext. 1903 EMAIL: pyoung@focusadjusters.com

24/7 EMERGENCY RESPONSE CENTER PH: (800) 734-2102 NEW CLAIMS: hocp@focusadjusters.com

FOCUS Adjusters | 646 Plank Road, Ste. 209 Clifton Park, NY 12065 | (518) 383-2102

FOCUS Adjusters , proudly headquartered in New York State, is the premier independent (daily and catastrophe) adjusting firm and third party administrator operating throughout the Northeastern United States, Kansas and Florida. FOCUS offers comprehensive and fully customized loss adjustment programs that are tailored to the specific needs of our clients and their policyholders.

Our core-value commitment to traditional integrity based customer service models, unparalleled communication and utilization of InsurTech empowers FOCUS to be the industry leader in our service territories. Additionally, our team has extensive experience with highly complex first and third party claim matters and is a leader in Complex Claim/Large Loss Adjustment, Property Appraiser and Umpire services throughout the entire United States and U.S. Virgin Islands.

24/7 EMERGENCY RESPONSE CENTER PH: (800) 734-2102 NEW CLAIMS: hocp@focusadjusters.com

FOCUS Adjusters | 646 Plank Road, Ste. 209 Clifton Park, NY 12065 | (518) 282-2102

SERVICE TERRITORY Our Nationwide Network of Independent Contractors. Catastrophe Claims Support, Large/Complex Loss Team and Appraiser/Umpire Services available throughout the United States and US Virgin Islands.

24/7 EMERGENCY RESPONSE CENTER PH: (800) 734-2102 NEW CLAIMS: hocp@focusadjusters.com

CONTACT Patrick L. Young , Chief Operating Officer ADDRESS: 646 Plank Road, Ste. 209 Clifton Park, New York 12065 PHONE: (800) 734-2102, ext. 1903 EMAIL: pyoung@focusadjusters.com

FOCUS Adjusters | 646 Plank Road, Ste. 209 Clifton Park, NY 12065 | (518) 383-2102

FORTORA-01

SHOOK

DATE (MM/DD/YYYY)

CERTIFICATE OF LIABILITY INSURANCE

1/8/2025

THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s).

CONTACT NAME:

PRODUCER

Scalzo, Zogby, & Wittig, Inc. 120 Lomond Ct Utica, NY 13502

PHONE

FAX

(315) 792-0000

(315) 792-4637

(A/C, No, Ext): E-MAIL ADDRESS:

(A/C, No):

info@szwinsurance.com

INSURER(S) AFFORDING COVERAGE

NAIC #

Utica Specialty Risk Insurance Company Utica National Ins Co of Texas Utica National Ins of Ohio Arch Ins. Co.

43451 43478 13998 11150

INSURER A :

INSURED

INSURER B :

Fort Orange Claim Service Inc. PO Box 447 Clifton Park, NY 12065

INSURER C :

INSURER D :

INSURER E : INSURER F :

COVERAGES

CERTIFICATE NUMBER:

REVISION NUMBER:

THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.

POLICY EFF POLICY EXP (MM/DD/YYYY) (MM/DD/YYYY)

INSR LTR

ADDL SUBR INSD WVD

TYPE OF INSURANCE

POLICY NUMBER

LIMITS

1,000,000

A

X

COMMERCIAL GENERAL LIABILITY

EACH OCCURRENCE DAMAGE TO RENTED PREMISES (Ea occurrence) MED EXP (Any one person)

$

50,000 10,000

X

5683504

1/1/2025 1/1/2026

CLAIMS-MADE

OCCUR

$

$ PERSONAL & ADV INJURY $

1,000,000 2,000,000 2,000,000

GEN'L AGGREGATE LIMIT APPLIES PER:

GENERAL AGGREGATE

$

X

PRO- JECT

POLICY

LOC

PRODUCTS - COMP/OP AGG

$

OTHER:

$

1,000,000

B

COMBINED SINGLE LIMIT

AUTOMOBILE LIABILITY

$

(Ea accident)

X

5684626

1/1/2025 1/1/2026

ANY AUTO

BODILY INJURY (Per person) $

OWNED

SCHEDULED

AUTOS ONLY

AUTOS

BODILY INJURY (Per accident) $

PROPERTY DAMAGE (Per accident)

HIRED

NON-OWNED AUTOS ONLY

$

AUTOS ONLY

$

5,000,000

C

X

OCCUR

UMBRELLA LIAB EXCESS LIAB

EACH OCCURRENCE

$

5684631

1/1/2025 1/1/2026

CLAIMS-MADE

AGGREGATE

$

DED

RETENTION $

$

B

PER

OTH-

X

WORKERS COMPENSATION AND EMPLOYERS' LIABILITY

STATUTE

ER

Y / N

5684636

1/1/2025 1/1/2026

500,000 500,000 500,000

ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED?

E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE $ $

N / A

If yes, describe under (Mandatory in NH)

DESCRIPTION OF OPERATIONS below

E.L. DISEASE - POLICY LIMIT per occurence/aggreg

$

D Cyber Liability

C-4LPY-014596-CYBER-2024 1/2/2025

1/2/2026

1,000,000

DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required)

CERTIFICATE HOLDER

CANCELLATION

SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS.

Proof of coverage

AUTHORIZED REPRESENTATIVE

ACORD 25 (2016/03)

© 1988-2015 ACORD CORPORATION. All rights reserved.

The ACORD name and logo are registered marks of ACORD

Certificate of Liability Insurance Coverage provided by Claim Professionals Liabililty Insurance Company, RRG.This certificate is issued for information purposes only and confers no rights to or upon the Certificate Holder. It does not extend nor alter

the coverage under the policies itemized in this

PO Box 789

Certificate of Insurance.

Apex, NC 27502

Telephone: 714.731.7860 Certificate Holder

Fax: 714.731.4605 Additional Insured?

No

Named Insured

Fort Orange Claim Service, Inc.

Fort Orange Claim Service, Inc.

dba FOCUS Adjusters

dba FOCUS Adjusters

PO Box 447

PO Box 447

Clifton Park, NY 12065

Clifton Park, NY 12065

pyoung@focusadjusters.com

This is to certify that the policies of insurance described below have been issued to the insured named above for the policy period indicated below. The insurance afforded by the policies described by this certificate is subject to all the terms, conditions, and exclusions of such policies. Limits shown below may have been reduced by paid claims. Policy Policy Policy Type of Insurance Number Effective Date Expiration Date Limits Errors and Omissions, CP 40948-07 1/4/2025 1/4/2026 Each Occurrence

$2,000,000.00 $2,000,000.00

a Claims Made Policy

General Aggregate

$10,000.00

Deductible

Not Covered Not Covered

General Liability,

Each Occurrence General Aggregate

a Claims Made Policy

Deductible

Description of Insured's Operations Adjusting, investigation, surveying, umpire and damage appraisal of claims or losses for insurance companies and self-insured entities.

Cancellation Should any of the above policies be cancelled before the expiration date thereof, Claim Professionals Liability Insurance Company will endeavor to mail 30 days written notice to the certificate holder named herein, but failure to mail such notice shall impose no obligation or liability of any kind upon the company or its agents or representatives.

1/8/2025

Authorized Signature: ___________________________________________

Changes to this document are expressly forbidden unless specifically authorized by the Company.

Page 1 of 2

FORT ORANGE CLAIM SERVICE INC

FORT ORANGE CLAIM SERVICE INC PO Box 447 CLIFTON PARK, NY 12065

IA-706083 LICENSE NUMBER: General IS LICENSED AS AN INDEPENDENT ADJUSTER FOR

BY AND THROUGH THE SUBLICENSEES LISTED BELOW

UNLESS SOONER CANCELLED, SUSPENDED OR REVOKED EXPIRATION DATE: EFFECTIVE DATE: January 01, 2025 December 31, 2026

be affixed at the city of Albany I have caused my official seal to In Witness Whereof,

Adrienne A. Harris Superintendent

**SUBLICENSEES ARE CONTINUED ON THE NEXT PAGE**

Page 2 of 2

EXPIRATION DATE: IA-706083 LICENSE NUMBER: December 31, 2026 FORT ORANGE CLAIM SERVICE INC

FORT ORANGE CLAIM SERVICE INC PO Box 447 CLIFTON PARK, NY 12065

SUBLICENSEE(S) CONTINUED

LINE KEY 1 = Accident & Health 5 = Fidelity & Surety 7 = Inland Marine 3 = Automobile

2 = Aviation 4 = Casualty

6 = Fire

8 = General 9 = Auto Damage & Theft Appraisals 10 = Motor Vehicle No-Fault & Workers Comp Health Service Charges 11 = Federal Multi-Peril Crop

SUBLICENSEE(S)

CIURCZAK, STEPHEN G

8

Docusign Envelope ID: 898087C9-8454-4627-8A91-08988526C6A5

1/8/2025 | 9:29:06 AM PST

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