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AGREEMENT entered into by and between (name of client)
having its principle place of business in (city, state) hereinafter referred
to as the "CLIENT" and Premium Review Associates of Nashua,
New Hampshire hereinafter referred to as "PRA.
WHEREAS, PRA is in the business of obtaining Workers Compensation premium
savings due to the misapplication of rules, procedures, classifications,
experience ratings, audits, or other errors resulting in overcharges to
the CLIENT on its Workers Compensation policies; and
WHEREAS, PRA does not guarantee or warrant to CLIENT that it will discover
any overcharges of premium or that PRA will obtain an adjustment, refund
or credit for the benefit of CLIENT;
NOW, THEREFORE, in consideration of the mutual covenants hereinafter
contained, PRA and CLIENT hereby agree as follows:
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| 1. |
CLIENT shall provide and make available to PRA
all pertinent information, as PRA shall reasonably deem necessary
to analyze CLIENT's Workers Compensation Insurance premiums and
to implement a program for the recovery or reimbursement of insurance
overpayments. PRA may, at its sole discretion, review policies,
endorsements, rates, auditor's worksheets, experience rating data,
final audit invoices, retrospective rating adjustments and any other
documents or data to accomplish its review.
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| 2. |
CLIENT grants authority to PRA to contact CLIENT'S
insurance carrier, agent, broker or employees, as PRA shall reasonably
deem necessary, to confirm, discuss or assist in the recovery of
any premium adjustment, refund, or credit, by the insurance carrier,
agent, or broker.
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| 3. |
CLIENT agrees to compensate PRA for its services
and efforts at a sum of percent ( %) of all premium adjustments,
refunds, or credits applied to CLIENT'S account that stem from PRA's
efforts or information. CLIENT shall pay such compensation to PRA
within ten (10 ) days of receiving said premium adjustment, refund,
or credit. For the purpose of this AGREEMENT, a premium adjustment,
refund or credit shall be defined as the amount by which Earned
Premiums on past or current policies are reduced, whether by endorsement
or audit. Time is of the essence.
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| 4. |
PRA acknowledges that if CLIENT receives no premium
adjustment, refund, or credit as a result of PRA's efforts or information,
then PRA will be entitled to no compensation whatsoever, regardless
of the extent, nature, or scope of services performed.
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| 5. |
This AGREEMENT shall terminate when all pending
premium adjustments, refunds, or credits are received by CLIENT.
The obligation to compensate PRA in accordance with the stated terms
above shall survive any termination of this AGREEMENT.
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| 6. |
This AGREEMENT shall be governed and construed
in accordance with the laws of the State of New Hampshire. In the
event that PRA is required to institute any collection action against
CLIENT, CLIENT agrees to submit to the jurisdiction of the Courts
of competent jurisdiction in this state.
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| 7. |
CLIENT agrees that any premium adjustments, refunds
or credits received after commencement of work by PRA that relates
to the subject matter of PRA's review shall have resulted from PRA's
efforts or information.
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| 8. |
CLIENT agrees not to assign, pledge, or otherwise
encumber any and all premium adjustments, refunds, or credits received
from or paid by the CLIENT'S insurance carrier(s), agents or brokers
that may be due to CLIENT as a result of PRA's efforts or information.
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| 9. |
In the event that the CLIENT fails to pay PRA
its compensation, as provided herein, CLIENT agrees that PRA will
be entitled to charge interest on such compensation at the rate
of 1% per month on the unpaid balance due to PRA from its due date
until paid in full. In addition, if and when PRA is required to
turn this matter over to an attorney for collection, the CLIENT
agrees to pay to PRA any and all reasonable attorney fees and costs
in connection with the collection action.
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| 10. |
This AGREEMENT constitutes the full and complete
understanding of the parties, superseding any and all oral and prior
understandings and communications, and may only be amended by the
mutual consent of PRA and CLIENT, in writing. This AGREEMENT shall
be binding and inure to the benefit of the parties hereto, their
successors and assigns.
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