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Selected

Policy Details

Policy #

CI99H168690

Effective Date

12/1/1998

Cancel Date

DC Date

Carrier Name

ONE BEACON AMERICA INS CO

Carrier #

0255

Insured Details

Insured ID

328821000

Name

JEFF WYLER DEALER GROUP INC

Street Address

1154 BURLINGTON PIKE
FLORENCE , KY 41042

Locations
POC History

Location ID	Name	Industry	Address
L791386497	MERCEDES BENZ OF FORT MITCHELL	811191 - Automotive Oil Change and Lubrication Shops	1154 BURLINGTON PIKE FLORENCE , KY 41042
L791386521	JEFF WYLER DEALER GROUP INC	811191 - Automotive Oil Change and Lubrication Shops	1154 BURLINGTON PIKE FLORENCE , KY 41042
L790645363	JEFF WYLER DEALER GROUP INC	5531 - AUTO AND HOME SUPPLY STORES	JEFF WYLER SHELBYVILLE INC 700 TAYLORSVILLE ROAD SHELBYVILLE , KY 40065
L790825215	JEFF WYLER DEALER GROUP INC	811191 - Automotive Oil Change and Lubrication Shops	4136 SHELBYVILLE RD LOUISVILLE , KY 40207
L791386504	JEFF WYLER FORT MICHELL INC	811191 - Automotive Oil Change and Lubrication Shops	2520 TERRA CROSSING BLVD LOUISVILLE , KY 40245
L790154971	JEFF WYLER DEALER GROUP INC	811191 - Automotive Oil Change and Lubrication Shops	1154 Burlington Pike FLORENCE , KY 41042
L791386507	JEFF WYLER LOUISVILLE I INC	811191 - Automotive Oil Change and Lubrication Shops	204 VINE ST WILDER , KY 41076
L791386529	JEFF WYLER DEALER GROUP INC	811191 - Automotive Oil Change and Lubrication Shops	4136 SHELBYVILLE RD LOUISVILLE , KY 40207
L791386505	MERCEDES BENZ OF FORT MITCHELL	811191 - Automotive Oil Change and Lubrication Shops	2520 TERRA CROSSING BLVD LOUISVILLE , KY 40245
L791386503	MERCEDES BENZ OF FORT MITCHELL	811191 - Automotive Oil Change and Lubrication Shops	949 BURLINGTON PIKE FLORENCE , KY 41042

Process Date	Triplicate Code	Description	Policy #	Effective Date	Audit #	Line #
12/4/2025	00-20-01	Renewal	WC11176251	12/4/2025	20251022-N0	1671
12/4/2024	00-20-01	Renewal	WC11176251	12/4/2024	20241022-N0	1040
12/4/2023	00-20-01	Renewal	WC10000044072023A	12/4/2023	20231120-N0	1919
12/4/2022	00-20-01	Renewal	WC10000044072022A	12/4/2022	20221201-N0	1512
12/4/2021	00-31-54	Add New Employer	WC10000044072021A	12/4/2021	20220128-N0	761
12/4/2021	00-20-01	Renewal	WC10000044072021A	12/4/2021	20211117-N0	2814
12/4/2020	00-41-59	Cancellation by Carrier / Non-Payment	WC10000044072020A	12/4/2020	20210513-N0	564
12/4/2020	00-31-54	Add New Employer	WC10000044072020A	12/4/2020	20210107-N0	671
12/4/2020	00-33-56	Delete Employer Location	WC10000044072020A	12/4/2020	20210107-N0	669
12/4/2020	00-20-01	Renewal	WC10000044072020A	12/4/2020	20201125-N0	1531
12/4/2020	00-70-01	Reinstatement	WC10000044072020A	12/4/2020	20210519-N0	428
12/4/2020	00-41-59	Cancellation by Carrier / Non-Payment	WC10000044072020A	12/4/2020	20210715-N0	336
12/4/2020	00-70-01	Reinstatement	WC10000044072020A	12/4/2020	20210726-N0	403
12/4/2019	05-32-85	Change Location Demographics (New Data)	WC10000044072019A	12/4/2019	20191218-N0	800
12/4/2019	00-33-56	Delete Employer Location	WC10000044072019A	12/4/2019	20201022-N0	415
12/4/2019	00-70-01	Reinstatement	WC10000044072019A	12/4/2019	20200826-N0	228
12/4/2019	05-32-85	Change Location Demographics (New Data)	WC10000044072019A	12/4/2019	20191218-N0	796
12/4/2019	04-32-85	Change Location Demographics (Old Data)	WC10000044072019A	12/4/2019	20191218-N0	798
12/4/2019	00-41-59	Cancellation by Carrier / Non-Payment	WC10000044072019A	12/4/2019	20200211-N0	472
12/4/2019	04-32-85	Change Location Demographics (Old Data)	WC10000044072019A	12/4/2019	20201022-N0	419
12/4/2019	00-41-59	Cancellation by Carrier / Non-Payment	WC10000044072019A	12/4/2019	20200811-N0	198
12/4/2019	04-32-85	Change Location Demographics (Old Data)	WC10000044072019A	12/4/2019	20191218-N0	794
12/4/2019	00-33-56	Delete Employer Location	WC10000044072019A	12/4/2019	20201022-N0	423
12/4/2019	00-20-01	Renewal	WC10000044072019A	12/4/2019	20191204-N0	1592
12/4/2019	05-32-85	Change Location Demographics (New Data)	WC10000044072019A	12/4/2019	20201022-N0	421
12/4/2019	00-70-01	Reinstatement	WC10000044072019A	12/4/2019	20200218-N0	397
12/4/2019	00-31-54	Add New Employer	WC10000044072019A	12/4/2019	20201022-N0	425
12/4/2018	00-20-01	Renewal	WC10000044072018A	12/4/2018	20181130-N0	1283
12/4/2018	00-70-01	Reinstatement	WC10000044072018A	12/4/2018	20190919-N0	163
12/4/2018	00-41-59	Cancellation by Carrier / Non-Payment	WC10000044072018A	12/4/2018	20190910-N0	117
12/4/2017	00-20-01	Renewal	WC10000044072017A	12/4/2017	20171122-E0	312
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180809-N0	309
12/4/2017	00-41-59	Cancellation by Carrier / Non-Payment	WC10000044072017A	12/4/2017	20180510-N0	417
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180809-N0	337
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180809-N0	293
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180809-N0	339
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180809-N0	305
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180809-N0	295
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180424-N0	682
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180809-N0	297
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180809-N0	299
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180809-N0	333
12/4/2017	00-31-54	Add New Employer	WC10000044072017A	12/4/2017	20180424-N0	686
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180809-N0	311
12/4/2017	00-70-01	Reinstatement	WC10000044072017A	12/4/2017	20180522-N0	342
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180809-N0	335
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180809-N0	331
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180809-N0	307
12/4/2017	05-32-85	Change Location Demographics (New Data)	WC10000044072017A	12/4/2017	20180424-N0	684
12/4/2017	04-32-85	Change Location Demographics (Old Data)	WC10000044072017A	12/4/2017	20180809-N0	329
12/4/2017	00-31-54	Add New Employer	WC10000044072017A	12/4/2017	20180416-N0	683
12/4/2016	00-20-01	Renewal	WC10000044072016A	12/4/2016	20161129-E0	61
12/4/2015	05-32-77	Change Location FEIN (New Data)	WC10000044072015A	12/4/2015	20160204-E0	138
12/4/2015	00-33-56	Delete Employer Location	WC10000044072015A	12/4/2015	20160204-E0	126
12/4/2015	00-31-54	Add New Employer	WC10000044072015A	12/4/2015	20151214-E0	442
12/4/2015	00-70-01	Reinstatement	WC10000044072015A	12/4/2015	20160421-E0	11
12/4/2015	00-33-56	Delete Employer Location	WC10000044072015A	12/4/2015	20151214-E0	444
12/4/2015	04-32-77	Change Location FEIN (Old Data)	WC10000044072015A	12/4/2015	20160204-E0	132
12/4/2015	04-32-77	Change Location FEIN (Old Data)	WC10000044072015A	12/4/2015	20160204-E0	136
12/4/2015	00-41-59	Cancellation by Carrier / Non-Payment	WC10000044072015A	12/4/2015	20160411-E0	45
12/4/2015	05-32-77	Change Location FEIN (New Data)	WC10000044072015A	12/4/2015	20160204-E0	130
12/4/2015	04-32-77	Change Location FEIN (Old Data)	WC10000044072015A	12/4/2015	20160204-E0	128
12/4/2015	05-32-77	Change Location FEIN (New Data)	WC10000044072015A	12/4/2015	20160204-E0	134
12/4/2015	00-20-01	Renewal	WC10000044072015A	12/4/2015	20151130-E0	97
12/4/2014	00-32-84	Change Insured Demographics	WC10000044072014A	12/4/2014	20150514-E0	40
12/4/2014	00-32-84	Change Insured Demographics	WC10000044072014A	12/4/2014	20150407-E0	145
12/4/2014	00-20-01	Renewal	WC10000044072014A	12/4/2014	20141121-E0	40
12/4/2013	00-32-84	Change Insured Demographics	WC10000044072013A	12/4/2013	20140502-E0	239
12/4/2013	00-31-54	Add New Employer	WC10000044072013A	12/4/2013	20140502-E0	240
12/4/2013	00-32-84	Change Insured Demographics	WC10000044072013A	12/4/2013	20140502-E0	238
12/4/2013	00-31-54	Add New Employer	WC10000044072013A	12/4/2013	20140507-E0	109
12/4/2013	00-31-54	Add New Employer	WC10000044072013A	12/4/2013	20140507-E0	107
12/4/2013	00-31-54	Add New Employer	WC10000044072013A	12/4/2013	20140502-E0	242
12/4/2013	00-20-01	Renewal	WC10000044072013A	12/4/2013	20131115-E0	119
12/4/2013	00-32-84	Change Insured Demographics	WC10000044072013A	12/4/2013	20140326-E0	275
12/4/2013	00-32-84	Change Insured Demographics	WC10000044072013A	12/4/2013	20150115-E0	103
12/4/2012	00-20-01	Renewal	WC10000044072012A	12/4/2012	20121205-E0	112
12/4/2012	00-31-54	Add New Employer	WC10000044072012A	12/4/2012	20130208-E0	145
12/4/2012	00-32-84	Change Insured Demographics	WC10000044072012A	12/4/2012	20121218-E0	1800
12/4/2012	00-32-84	Change Insured Demographics	WC10000044072012A	12/4/2012	20130207-E0	313
12/4/2011	00-20-01	Renewal	WC10000044072011A	12/4/2011	20111129-E1	259
12/4/2011	00-60-64	Non-Renewal by Carrier / Underwriting Discretion	WC10000044072011A	12/4/2011	20121120-E0	25
12/4/2011	00-70-01	Reinstatement	WC10000044072011A	12/4/2011	20121204-E0	8
12/4/2010	00-20-01	Renewal	WC10000044072010A	12/4/2010	20101201-E0	85
12/4/2010	00-60-64	Non-Renewal by Carrier / Underwriting Discretion	WC10000044072010A	12/4/2010	20111121-E0	34
12/4/2010	00-70-01	Reinstatement	WC10000044072010A	12/4/2010	20111128-E0	29
12/4/2009	00-32-84	Change Insured Demographics	WC10000044072009A	12/4/2009	20100120-E0	170
12/4/2009	00-70-01	Reinstatement	WC10000044072009A	12/4/2009	20101130-E0	13
12/4/2009	00-60-64	Non-Renewal by Carrier / Underwriting Discretion	WC10000044072009A	12/4/2009	20101122-E0	38
12/4/2009	00-20-01	Renewal	WC10000044072009A	12/4/2009	20091120-E0	37
12/4/2008	00-20-01	Renewal	WC10000044072008A	12/4/2008	20081202-E0	220
12/4/2007	04-32-85	Change Location Demographics (Old Data)	WC10000044072007A	12/4/2007	20081111-E0	112
12/4/2007	00-32-84	Change Insured Demographics	WC10000044072007A	12/4/2007	20090205-E1	92
12/4/2007	04-32-85	Change Location Demographics (Old Data)	WC10000044072007A	12/4/2007	20081111-E0	104
12/4/2007	04-32-85	Change Location Demographics (Old Data)	WC10000044072007A	12/4/2007	20081111-E0	108
12/4/2007	05-32-85	Change Location Demographics (New Data)	WC10000044072007A	12/4/2007	20081111-E0	114
12/4/2007	05-32-85	Change Location Demographics (New Data)	WC10000044072007A	12/4/2007	20081111-E0	106
12/4/2007	04-32-85	Change Location Demographics (Old Data)	WC10000044072007A	12/4/2007	20090205-E1	88
12/4/2007	00-70-01	Reinstatement	WC10000044072007A	12/4/2007	20081126-E1	9
	00-20-01	Renewal	WC10000044072007A	12/4/2007	20071120-E0
12/4/2007	00-60-64	Non-Renewal by Carrier / Underwriting Discretion	WC10000044072007A	12/4/2007	20081120-E1	2
12/4/2007	05-32-85	Change Location Demographics (New Data)	WC10000044072007A	12/4/2007	20081111-E0	110
12/4/2007	05-32-85	Change Location Demographics (New Data)	WC10000044072007A	12/4/2007	20090205-E1	90
	05-32-85	Change Location Demographics (New Data)	WC10000044072006A	12/4/2006	20080311-E0
	00-32-84	Change Insured Demographics	WC10000044072006A	12/4/2006	20080311-E0
	00-20-01	Renewal	WC10000044072006A	12/4/2006	20061128-E0
	00-32-84	Change Insured Demographics	001000004407105A	12/4/2005	20070418-E0
	00-60-64	Non-Renewal by Carrier / Underwriting Discretion	001000004407105A	12/4/2005	20061120-E1
	00-70-01	Reinstatement	001000004407105A	12/4/2005	20061127-E0
	00-20-01	Renewal	001000004407104	12/4/2004	20050203-U0
	00-20-01	Renewal	001000004407103	12/4/2003	20031120-U0
	00-33-56	Delete Employer Location	001000004407103	12/4/2003	20080317-C0

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Coverage Details

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