PASCO COUNTY BOARD OF COUNTY COMMISIONERSegov.pascocountyfl.net/Content/ECM/Consolidated... ·...

PASCO COUNTY BOARD OF COUNTY COMMISIONERS

PREMIUM SUMMARY

Notes and Highlights: 1. Premiums for the above policies are due and payable as billed, in full or as insurance

company installments. Premiums may be financed, subject to acceptance by an approved finance company. Note: Following acceptance, completion (and signature) of a premium finance agreement with the specified down payment is required.

2. Quote is valid until 10/01/08.

Expiring

$2,327,000

N/A

NIA

N/ A

$22,955.00

$12,945.17

$604,485.00

$36,149.00

$146,940.00

$2,429.05

$53,462.00

$14,584.00

$394,170.00

$40,326.27

$43,697.65

Coverages PASCO COUNTY BOARD OF COUNTY COMMISSIONERS Property

Primary Property - $50,000,000

Option 1 - $65,000,000 Wind

Option 2 - Increase Flood to $25,000,000

Option 3 - AOP of $1 00,000,000

Boiler & Machinery

Crime

Excess Liability I Excess Workers' Compensation

Accidental Death & Dismemberment

EMTISAVE Professional Liability

Marine - Hull

Pollution Liability

Storage Tank Liability

PASCO COUNTY RESOURCE RECOVERY

Property

General Liability

Umbrella

Renewal

$2,197,000.00

$90,000.00

$139,871 .OO

$50,000.00

$27,678.00

$12,948.20

$630,364.80

$36,149.00

$140,000.00

$2,429.05

$52,397.00

$1 7,536.00

$377,93 1 .OO

$40,243.73

$43,609.22

. .


,m BOILER & MACHINERY

Policy Period: 1 10/01/2008-10/01/2009

Company: I Travelers Property and Casualty Co of America

Covered Locations: Blanket locations (see Statement of Values) Specific Locations (listed below)

Business Income: 1 Included

Coverages and Limits:

Total Limit Per Breakdown:

Property Damage:

$50,000,000

Included

Spoilage Damage:

Utility Interruption:

Business Income "Period of Restorations" Extension:

Included

Included

30 Days

Utility Interruption Waiting Period:

Data or Media:

Error in Description:

4 Hours

Brands and Labels: f-

Contingent Time Element:

$500,000

Included

Included

$250,000

Expediting Expense:

Newly Acquired Locations:

Ordinance or Law:

Unnamed Locations:

Conditional and Optional Coverages:

Included

Included 365 Days

$1,000,000

Ammonia Contamination:

Hazardous Substances:

Water Damage:

Notice of Cancellation:

Included

$2,000,000

Included

Diagnostic Equipment:

Production Machines:

Computer Equipment: P-'

Deductible:

$1,000,000

90 days, except 10 for non-payment

Excluded

Included

Included

$1,000 Combined Deductible


Special Provisions:

Joint Loss Agreement:

New Generation:

Repair or Replacement:

Connected Ready for Use Requirement:

Covered Locations:

Included

Included

Included

None

Per submission statement of values


Policy Period:

Company:

Perils:

Property Covered:

PROPERTY PRIMARY $25,000,000

Lexington lnsurance Company

Landmark American Insurance Company

Risk of Direct Physical Loss or Damage Including Earthquake and Flood

Real and Personal Property of the Insured including Business Interruption with Extra Expense, Auto Physical (excluding over the road), Traffic Signals, Accounts Receivables, Valuable Papers, Contractor's Equipment, EDP, Antiques, and Communications TowersIEquipment, and Property in Transit and as more fully defined in the policy form.

Limits of Liability: $25,000,000 Per Occurrence, which in turn is excess of underlying deductibles

Sublimits: $15,000,000 $25,000,000 $ 5,000,000 $10,000,000 $10,000,000 $ 5,000,000

Flood -per occurrence and Annual Aggregate Earth Movement - per occurrence and Annual Aggregate Newly Acquired Property - 90 days report Business Income and Extra Expense combined Demolition & Increased Cost of Construction 25% of Loss or $5,000,000, whichever is greater for Debris Removal Professional Fees including Claim Preparation Account Receivables Valuable Papers Property in Transit Fire Brigade Charges & Extinguishing Expenses Miscellaneous Unnamed Locations Unintentional Errors and Omissions Civil Authority (14 days, lmile) IngressIEgress (14 days, 1 mile) EDP Equipment and Media Service Interruption-PD and TE (excluding T&D lines)

Deductibles: $50,000 All Perils Per Occurrence, except;

Flood Deductible

1. With respect to locations wholly or partially within Special Flood Hazard Areas (SFHA), areas of 100-year flooding, as defined by the Federal Emergency Management Agency (if these locations are not excluded elsewhere in this policy with respect to the peril of flood),

PASCO COUNTY BOARD OF COUNTY COMMISIONERS the deductible shall be 5% of the TIV per building involved in loss or

7' damage, subject to a minimum of $1,000,000 any one occurrence.

2. With respect to Named Storms (a storm that has been declared by the National Weather Service to be a Hurricane, Typhoon, Tropical Cyclone or Tropical Storm), the deductible shall be 5% of the TIV per building involved in loss or damage, subject to a minimum of $250,000 any one occurrence.

3. With respect to any other flood loss or damage the deductible shall be $250,000 per location, per occurrence.

Win dstorrn/lHail

1. With respect to Named Storms (a storm that has been declared by the National Weather Service to be a Hurricane, Typhoon, Tropical Cyclone or Tropical Storm), the deductible shall be 5% of the total values at the time per building involved in the loss, subject to a minimum of $250,000 for any one occurrence;

2. With respect to any other windstormlhail loss, the deductible shall be $50,000 any one occurrence.

Values:

Valuation:

Forms (Lexington):

F4

Earthquake With respect to any earthquake loss, the deductible shall be $50,000 any one occurrence.

Other: With respect to Contractor's Equipment, Electronic Data Processing, Antiques and Communications Towers/Equipment the deductible shall be $25,000 per occurrence unless caused by the perils of Flood, Earthquake, Windstorrn/Hail in which case the deductibles noted above will apply.

Service Interruption: 24-hour waiting period

$71 2,822,595

Replacement Cost for Real and Personal Property Actual Loss Sustained for Time Element Actual Cash Value for Vehicles and Mobile/Contractors Equipment

Lexington Manuscript Forms to include but not limited to the following endorsements and exclusions:

I Pollution and Contamination Exclusion

I Property Millennium Endorsement


Forms (Landmark):

Conditions:

Property Endorsement

MoldFungus Exclusion

Occurrence Limits of Liability Endorsement

Policyholder Notice

Contributing Insurance Endorsement

Standard Property Conditions

Joint Loss Agreement

Accounts Receivable coverage

OFAC Endorsement

Terrorism Exclusion

125% Margin Clause


Premium Swing Clause Endorsement

RSUI Expiring Carrier Forms to include but not limited to the following:

Exclusion & Limited Additional Coverage for Fungus

Exclusion and Limited Additional Coverage for Electronic Data

Scheduled Limit of Liability Endorsement

Exclusion or Pathogenic or Poisonous Biological or Chemical Material

Terrorism Exclusion

RSUI Deductible Endorsement

RSUI Schedule of Sublimits

Warranty Coverage Form

Warranty Schedule

125% Margin Clause

' Joint Loss Agreement


No Coinsurance (All Carriers)

35% Minimum Earned Premium (All Carriers)

Subject to Quarterly Reporting and Annual Adjustment

90 Days Notice of Cancellation except 10 Days for Non- Payment of Premium (All Carriers)


r" Premium: $1,889,000 annual layer premium plus applicable surplus lines taxes and fees plus Florida Hurricane Catastrophe Fund Emergency Assessment plus EMPA Fees and any other applicable Fees (to be filed by your office).

Terrorism: The premium charge to provide Terrorism coverage for Certified and Non Certified Acts of Terrorism for this insured is $71,782 and is in addition to the annual policy premium shown above. Please confirm acceptance or rejection of this coverage upon binding coverage.

Option 2: Increase Flood Per Occurrence and Annual Aggregate to $25,000,000 for total layer price of $2,028,871 plus $60,866 for Terrorism, plus surplus lines taxes and fees.

-

PARTICIPATION

$15,000,000 per occurrence part of $25,000,000 per occurrence

$10,000,000 per occurrence part of $25,000,000 per occurrence

-. - -. .

COMPANIES PARTICIPATING

Lexington Insurance Company Non-admitted (A.M. Best Rated A+ XV)

Landmark American Insurance Company 3n-admitted (A.M. Best Rated A XII)

I

SHARE PREMIUM

Share Premium: $1,133,400 plus $34,002 for Terrorism

Share Premium: $755,600 plus $37,780 for Terrorism


Policy Period:

Company:

Perils:

Property Covered:

Limits of Liability:

Sublimits:

Deductibles: F-'

Values:

Valuation:

Forms (Max USA):

P

Forms (Lexington):

PROPERTY - FIRST EXCESS $10,000,000 XS $25,000,000

I Max Specialty Insurance Company

I Lexington Insurance Company

Risk of Direct Physical Loss or Damage Excluding Flood and Earthquake

Real and Business Personal Property of the Insured, including but not limited to: Business InterruptiodExtra Expense, Traffic Signals, Vehicles, Account Receivable, Property in Transit, Valuable Papers, EDP EquipmentIMedidExtra Expense, Contractors Equipment, Communication Towers~Equipment, Antiques and other coverages as more fully defined in the policy.

$1 0,000,000 per occurrence excess of $25,000,000 per occurrence, which in turn is excess of underlying deductibles

Per Primary Layer

Per Primary Layer

$712,822,595

Replacement Cost on Physical Damage

Actual Loss Sustained for Time Element

Max Specialty Excess Follow Forms to include but not limited to, the following endorsements and exclusions:

Priority of Payments

Broad Named Insured Endorsement

1 Premium Swing Endorsement


125% Margin Clause

Exclusion of all Foreign Locations and Exposures

Exclusion of Pollution/Contamination, Asbestos, Boiler & Machinery, Terrorism, Mold, Earthquake Sprinkler Leakage, Electronic DatdCyber Risk Losses and Related Computer Losses, War, Nuclear, Chemical and Biological Materials

Permission for Excess Endorsement

Occurrence Limit of Liability Endorsement

Lexington Excess Follow Forms to Include but not limited to:

Pollution and Contamination Exclusion


Conditions:

Subject to:

-~

Property Millennium Endorsement

Property Endorsement

MoldIFungus Exclusion

Occurrence Limits of Liability Endorsement

Policyholder Notice

Contributing Insurance Endorsement

Standard Property Conditions


OFAC Endorsement

Terrorism Exclusion

125% Margin Clause


25% Minimum Earned Premium except where Hurricane Minimum Earned Premium Endorsement applies

No Coinsurance (All Carriers)


90 Days Notice of cancellation except 10 Days for Non- Payment of Premium (All Carriers)

Signed and Dated Acords upon binding

Signed and Dated SOV due upon binding

Acceptable review of policy wording

Signed TRIA forms upon binding

Favorable Financials, Inspection Report(s) and compliance with recommendations (if requested)

Premium: $170,000 annual layer premium plus applicable surplus lines taxes and fees plus Florida Hurricane Catastrophe Fund Emergency Assessment plus EMPA Fees and any other applicable Fees (to be filed by your office).

Terrorism: The premium charge to provide Terrorism coverage for Certified Terrorism Acts for this insured is $6,800 and is in addition to the annual policy premium shown above. Please confirm acceptance or rejection of this coverage upon binding coverage.



Max Specialty Ins. Co. Non-Admitted (A.M. Best Rated A- XIII)

Lexington Insurance Company Non-admitted (A.M. Best Rated A+ XV)

SHARE PREMIUM



- . . . . ,

PARTICIPATION

$5,000,000 per occurrence part of $10,000,000 per occurrence excess of

$25,000,000 per occurrence

$5,000,000 per occurrence part of $10,000,000 per occurrence excess of



Policy Period:

Company:

Perils:

Property Covered:


Sublimits:

Deductibles:

P Values: Valuation:

Forms (ACE):

PROPERTY - SECOND EXCESS $15,000,000 XS $35,000,000

I Landmark American Insurance Company

1 Westchester Surplus Lines Insurance Company

Risk of Direct Personal Loss or Damage Excluding Flood and Earthquake

Real and Business Personal Property of the Insure, and Business Interruption/Extra Expense, including Traffic Signals, Vehicles, Accounts Receivable, Property in Transit, Valuable Papers, EDP Equipment/Media/EE, Contractors Equipment, Communication Towers and Equipment, Antiques and as more hlly defined in the policy form

$15,000,000 Per Occurrence Excess of $35,000,000 Per Occurrence, which in turn is excess of underlying deductibles

Per Primary Layer

Per Primary Layer

$712,822,595

I Replacement Cost on Physical Damage;


ACE Excess forms to include, but not limited to, the following exclusions and endorsements:

Pollution and Contamination Exclusion

Cancellation Clause

Nuclear, Biological and chemical Exclusions

Hurricane Minimum Earned Premium Endorsement

Asbestos Exclusion

Terrorism Exclusion (Except as required by TRIA)

Disclosure Pursuant to Terrorism Risk Insurance Act

Cap on Losses fi-om Certified Acts of Terrorism

Electronic DataICyber Risk Exclusion

Fungus, Wet Rot, Dry Rot and Bacteria Exclusion

Newly Acquired Property Endorsement

Priority of Payments Endorsement


Definition of Occurrence Endorsement


/h

Forms (Landmark):

Conditions:

,'-

Subject to:

Premium:

Terrorism:


125% Margin Clause

RSUI Excess Physical Damage form to include, but not limited to:

Scheduled Limit of Liability Endorsement

Exclusion or Pathogenic or Poisonous Biological or Chemical Material Terrorism Exclusion

125% Margin Clause

90 Days Notice of Cancellation except 10 Days for Non- Payment of Premium


Priority of Payments (built into their Form)


35% Minimum Earned Premium, subject to Hurricane Minimum Earned Premium Endorsement

90 Days Notice of Cancellation except 10 Days for Non- Payment of Premium (All Carriers)

No Coinsurance (All carriers)


Signed and Dated Acords

Signed SOV by the Insured

Signed TRIA forms

Inspection and compliance with any recommendations deemed essential by the company

No additions without prior approval (may be subject to separate rating and/or may require a higher attachment point.)

$1 38,000 annual layer premium plus applicable surplus lines taxes and fees plus Florida Hurricane Catastrophe Fund Emergency Assessment plus EMPA Fees and any other applicable Fees (to be filed by your office).

The premium charge to provide Terrorism coverage for Certified and Non Certified Acts of Terrorism for this insured is $8,740 and is in addition to the annual policy premium shown above. Please confirm acceptance or rejection of this coverage upon binding coverage.


$5,000,000 per occurrence part of Landmark American Ins. Co, Share Premium: $46,000 $15,000,000 per occurrence excess of Non-Admitted (A.M. Best Rated A XI) plus $2,300 for Terrorism $35,000,000 per occurrence

Westchester Surplus Lines Ins. Co. $1 0,000,000 per occurrence part of Share Premium: $92,000 $15,000,000 per occurrence excess of



Policy Period:

Company:

Perils:

Property Covered:


Sublimits:

Deductibles:

Values: /"

Valuation:

Forms:

PROPERTY - OPTION 1 $15,000,000 XS $50,000,000

I Endurance American Specialty Insurance Company

Risk of Direct Personal Loss or Damage Excluding Flood and Earthquake

Real and Business Personal Property of the Insured, including but not limited to: Business InterruptionIExtra Expense, Traffic Signals, Vehicles, Account Receivable, Property in Transit, Valuable Papers, EDP EquipmentfMedia~Extra Expense, Contractors Equipment, Communication Towers/Equipment, Antiques and other coverages as more fully defined in the policy.


1 Per Primary Layer

I Per Primary Layer

$712,822,595

Replacement Cost on Physical Damage


Endurance American Specialty Insurance Company Excess Following Forms to include, but not limited to, the following endorsements and exclusions:

Absolute Mold Exclusion

Absolute Pollution Exclusion

Asbestos Exclusion

Minimum Earned Premium Clause

Service of Suit Endorsement

I Loss Adjustment Endorsement

Statement of Values

Earned Premium Windstorm Endorsement

War Terror Nuclear Exclusion

Electronic Data Computer Systems Exclusion

Notice of Loss

I Premium Swing Clause

1 125% Margin Clause


Conditions: rc*.

25% Minimum Earned Premium Except where Hurricane Minimum Earned Premium Endorsement applies

I No Coinsurance

I Subject to Quarterly Reporting and Annual Adjustment

90 Days Notice of Cancellation except 10 Days for Non- Payment of Premium

Subject to: I Signed and Dated Acords

Signed and Dated SOV due upon binding

Acceptable review of policy wording

Signed TRIA forms upon binding

Favorable Financials, Inspection Report(s) and compliance with recommendations (if requested)

Premium: $90,000 annual layer premium plus $150 Modeling Fee, Plus applicable surplus lines taxes and fees plus Florida Hurricane Catastrophe Fund Emergency Assessment plus EMPA Fees and any other applicable Fees (to be filed by your office).

Terrorism: The premium charge to provide Terrorism coverage for Certified + Terrorism Acts for this insured is $9,750 and is in addition to the annual

policy premium shown above. Please c o n f m acceptance or rejection of this coverage upon binding coverage.


Endurance American Specialty Insurance Company Non-Admitted (A.M. Best Rated A XV)

SHARE PREMIUM

Share Premium: $97,500 plus $150 Modeling Fee and $9,750 for Terrorism

PARTICIPATION

$15,000,000 per occurrence excess of S50,000,000 per occurrence

PASCO COUNTY BOARD OF COUNTY COMMISIONERS PROPERTY - OPTION 3 AOP

n $50,000,000 XS $50,000,000

Policy Period: 1 10/0112008-10/0112009

Company:

Perils:

Property Covered:


Deductibles:

Values:

Forms:

/."

Conditions:

Subject to:

I Great American Insurance Company

Risk of Direct Personal Loss or Damage Excluding Earthquake, Flood, Named Storms, and Equipment Breakdown

Real and Business Personal Property of the Insures including Business Interruption with Extra Expense, Auto Physical Damage (excluding over the road), Traffic Signals, Accounts Receivables, Valuable Papers, Contractor's Equipment, EDP, Antiques, and Communications TowersIEquipment, and Property in Transit and as more fully defined in the policy form.


Per underlying

$712,822,595

Follow Form to Primary except but not limited to the following conditions below:

$1 0,000 minimum earned premium

~ el^^^^^ Z:rism

Excludes Food, Earthquake, and Named Storm windhail

Excludes Equipment Breakdown

Limit of Liability Insurance Endorsement

125% Margin Clause

An acceptable loss prevention survey and compliance with any recommendations generated from such survey

Review and acceptability of the primary coverage form

Electronic DataICyber Risk Exclusion

Fungus, Wet Rot, Dry Rot and Bacteria Exclusion

Newly Acquired Property Endorsement

Priority of Payments Endorsement


Definition of Occurrence Endorsement

I Premium Swing Clause Endorsement

( 125% Margin Clause


P

Premium: $50,000 annual layer premium plus $3,004 Florida Surcharges.

Terrorism: Not Offered

- . -- . . , . .


Great American Insurance Company of NY Admitted (A.M. Best Rated A+ XV)

-

SHARE PREMIUM

$50,000.00

- - -

PARTICIPATION

100%


f- PROFESSIONAL LIABILITY POLICY SPECIFIED MEDICAL PROFESSIONALS (EMT)

Policy Period: 1 10101 12008-1 0101 12009

Company: I Landmark American Insurance Company

Business Description:

Coverage Form:

Limits:

Per Claim:

Aggregate Limit:

Retroactive Date:

Deductible - Per Claim:

Defense Costs:

Policy Attachments: /h

Terms and Conditions:

Emergency Medical Technician and Paramedic Services & SAVE Program

RSG 5 1024 0208 Medical Professional Liability Claims-Made Coverage Form

$1,000,000

$2,000,000

October 29, 1989

Instructions for claims made coverage is below

$50,000 (Applies to Indemnity and Expense)

Within the policy limits

RSG 56010 0903 Biological Contaminants Exclusion

RSG 99022 1 106 Florida - State Fraud Statement

RSG 53006 0108 Florida Changes - Cancellation and Nonrenewal - Hospital, Med., Physicians, Surgeons Dentists

RSG 99003 0803 Florida Important Notice to Policyholders

RSG 99064 0106 Florida Surplus Lines Disclosure Notice

I RSG 54025 0405 Minimum Retained Premium I RSG 56058 0903 Nuclear Energy Liability Exclusion

RSG 54013 0405 Retroactive Date Amendatory Endorsement

I RSG 94022 0407 Service of Suit

Extended Reporting Period 12 months for premium not to exceed 100%




.- OCEAN MARINE (HULL)

Policy Period:

Company:

Coverages:

Hull:

Protection & Indemnity:

Medical Payments:

1 0/01/2008-10/01/2009

Hartford Insurance Co of the Southeast

Limit: $13,400

Deductible: $1,000

Limit: $500,000

Deductible: $1,000

Limit: $2,000

Deductible: Included

Schedule of Vessels 1 No. I Description Hull I Protection and I Hull

Indemnity I Deductible (

There are no changes in terms, limits or exclusions from the expiring term. In addition, the premium remains the same as the expiring term (prior to the application of the FL Hurricane Assessment).

1 2

1985 19' Monarch 1985 Evinrude 90HP Outboard

$8,000 $5.400

$500,000 $500.000

$1,000 $1 -000


F EXCESS LIABILITY

I Policy Period: 1 10/01/2008-10/01/2009 I Carrier:

COMMERCIAL GENERAL LIABILITY

Star Insurance Company

Limits of Liability: $1,000,000 Each Occurrence $2,000,000 General Aggregate Limit

Self Insured Retention:

Coverage Form:

Endorsements:

Exclusions: (including but not limited to)

Exclusions: (including but not limited to) (Continued)

$1,000,000 Per Occurrence

"Occurrence" - CGOOO1 (1 1/88) -IS0 Form

Nuclear Energy Liability Year 2000 Computer-Related problems Medical Payments Exclusion Self-Insured Retention Municipality Endorsement Limited Fungi or Bacteria Coverage $500,000 Per Occurrence, $500,000 Annual Aggregate Employee Benefits Liability

This insurance does not apply to any liability:

A. Arising out of or caused or contributed to by any ownership, maintenance, operation, use, loading, unloading or control of or responsibility for any aircraft;

B. Arising out of or caused or contributed to by any ownership, maintenance, operation, use or control of or responsibility for any airfield, airport, runway, hangar, building or other property or facility designed for, used, connected, associated or affiliated with or in any way related to aviation or aviation activities;

C. For BODILY INJURY or PROPETY DAMAGE if such BODILY INJURY or PROPERTY DAMAGE is due to any rendering of or failure to render any medical, surgical or dental service;

D. Actually or allegedly arising out of or caused or contributed to by or in any way connected with any principle or eminent domain, condemnation proceeding, inverse condemnation, dedication by adverse use or adverse possession, by whatever name called;

E. Arising out of, in connection with or caused or


-- --

Exclusions: (including but not limited to) (Continued)

contributed to by any failure or inability to supply or any interruption of any adequate quantity of power, steam, pressure, fuel or water;

F. Arising out of or caused or contributed to by any subsidence, erosion or earth movement;

G. Arising out of or caused or contributed to by any operation, maintenance, use, ownership or control of or responsibility for any hospital, treatment center or other medical, psychiatric or psychological facility or any facility which is similar or related to any of the foregoing, except as respects BODILY INJURY or PROPERTY DAMAGE arising out of fire, explosion, collapse or earthquake at such facility;

H. Arising out of or caused or contributed to by or connected with any actual or alleged violation of the Employee Retirement Income Security Act of 1974 (Public Law 93-406) or any amendment thereto or any similar provision of any local, state or federal law, statutory or common;

I. Arising out of or caused or contributed to by any actual or alleged illegal discrimination, or

J. Arising out of or caused by or contributed to by any actual or alleged deterioration, bursting, breaking, leaking, inadequacy, design of, control of, maintenance of, or any other alleged responsibility for any structure device, or water course, natural or man- made, including, but not limited to, dams, reservoirs, levees, banks, embankments, gates, canals, ditches, gutters, sewers, aqueducts, channels, culvert, retaining walls, drains, tanks, watershed, or drains, a purpose of which is the containing, carrying, impeding, channeling, diverting, or draining of water or other liquid;

K. Arising out of the sale or distribution or handling of contaminants, or pollutants including but not limited to acids, alkylides, chemicals, metals or bacteria in water sold, handled or distributed by or on behalf of the NAMED INSURED;

L. Arising out of inhaling, ingesting or prolonged exposure to asbestos or goods or products containing asbestos, or the use of asbestos in constructing or manufacturing any good, product or structure, or the removal of asbestos from any good, product or structure, or the manufacture, sale, transportation, storage or disposal of asbestos or goods or products containing asbestos;

The coverage afforded by this policy does not apply to payment for the investigation or defense of any


AUTOMOBILE

P loss, injury or damage or any cost, fine or penalty or for any expense or claim or suit related to any of the above.


Coverage:

Vehicles:

Major Exclusions (including but not limited to):

Requirement:

$1,000,000 Per Occurrence

Business Auto Coverage Form - CAOOO 1 (1 2/92)

Owned, Hired and Non-Owned

Personal Injury Protection Uninsured Motorists Physical Damage

Florida Auto Supplemental - Rejection of Uninsured Motorists Coverage

WORKERS' COMPENSATION



Endorsement:


Statutory

$500,000 Per Occurrence

Florida Extension of General Liability - Excess Workers' Compensation Endorsement

A. LOSSES or CLAIM EXPENSES arising out of or caused or contributed to by any operations, which operations are insured or should have been insured under any other policy of direct insurance, or with or through any state fund, by whatever name called;

B. Bodily injury to or sickness, disease or death of any persons who were illegally employed by the INSURED with knowledge of such illegality by the INSURED or any of its officers, directors, trustees or representatives;

C. Liability assumed under a contract D. Punitive or exemplary damages; E. Any LOSS:

1. insured by full coverage workers' compensation or employers liability insurance policy;

2. payable under the workers' compensation law of any state which is not named in item 3. of endorsement SNS 1002, if the INSURED is

. -- - . . - - - - - - -

PASCO COUNTY BOARD OF COUNTY COMMISIONERS -


- protected from the loss by any other insurance; and

3. arising out of operations for which the INSURED has rejected any workers' compensation law;

F. any obligation imposed by an unemployment compensation or disability benefits law or similar law;

G. any assessment made upon self-insurers, whether imposed by statute, regulation or otherwise;

H. Bodily injury occurring outside the United State of America, its territories or possessions and Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America or Canada who is temporarily outside these countries;

I. damages arising out of coercion, criticism, demotion, evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination against or termination of any employee, or any personnel practices, policies, acts or omissions;

J. bodily injury to any person in work subject to the Longshore and Harbor Workers' Compensation Act (33 USC Sections 901 -950), the Nonappropriated Fund Instrumentalities Act (5 USC Sections 8 17- 8 173), the Outer Continental Shelf Lands Act (43 USC Sections 133 1 - 1 3 56), the Defense Base Act (42 USC Sections 165 1-1 654), the Federal Coal Mine Health and Safety Act of 1969 (30 USC Sections 901 -942), and any other federal workers' compensation law or other federal occupational disease law, or any amendments to these laws;

K. bodily injury to any person in work subject to the Federal Employers' Liability Act (45 USC Sections 5 1 -60), 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;

L. bodily injury to a master or member of the crew of any vessel;

M. fines or penalties imposed for violation of federal or state law; and

N. damages payable under the Migrant and Seasonal Agricultural Worker Protection Act (29 USC Sections 180 1-1 872) and under any other federal law awarding damages for violation of those laws or regulations issued thereunder, and any amendments to those laws.

PASCO COUNTY BOARD OF COUNTY COMMISSIONERS

Notes: This proposal is only a summary of the major terms in the policy. Please review the actual policy for a complete listing of the terms, conditions and exclusions.

Public Entity Excess Liability Program: General Liability Employee Benefits Liability Automobile Liability Workers' Compensation Program Total

Assessments and Fees

Total

Audit TermsIRates:

$624,000

$624,000

$6,364.80

$630,364.80

Flat - Not Subject to Audit

. .- - -- - -- -- -- - - - - - - . - - - - - - -- - - - - - - - - - . - - - - .


Policy Period:

Company:

CRIME

10/01/2008-10/01/2009

Travelers Casualty and Surety Co of America

./-- Endorsements: CR- 1002 0 1-89 Exclude Designated Persons/Classes

(Exclude Pasco County Sheriffs Department)

CR-1026 10-90 Include Non-Comp Officer and Directors

CR- 1044 12-93 Add Faithful Performance of Duty

DR-0206 06-95 FL Changes

F-2 145 0 1-99 Amendatory Cancellation Endorsement - From 30 to 60 Days

F-2562A 06-99 Subsidiary Endorsement

F-2693 10-0 1 Include Treasurer or Tax Collector

F-27 16 10-03 Amend Coverage Forms - Insuring Agreements (Adding Coverage Form B & D at Renewal)

ILT-5018 07-04 FL - Cancellation/Nonrenewal Full Cancellation - Insurer

Deductible Insuring Agreements Limit of Insurance

Option 1

B - Forgery Alterations

C1 - Money & Sec on Premises

C2 - Money & Sec - Messenger

D 1 - Other Property, Premises

D2 - Other Property, Messenger

F - Computer Fraud

0 - Public Emp. Dis. per Loss

R - Money Orders & Counterfeit Currency

$400,000.00

$400,000.00

$400,000.00

$400,000.00

$400,000.00

$750,000.00

$750,000.00

$50,000.00

$5,000.00

$5,000.00

$5,000.00

$5,000.00

$5,000.00

$7,500.00

$7,500.00

$2,500.00


b4 STORAGE

Policy Period:

Company:


Aggregate:

Each Incident:

Deductible:

Defense Costs:

Coverage Form and Endorsements:

TANK LIABILITY - FPLIPA

1010112008- 1010 112009

Commerce & Industry Insurance Company

$4,000,000

$1,000,000

$1 0,000

If restricted or inside the policy limits

Storage Tank Declarations Page Form #8 1206 (1 1102)

Table of Contents Form #83 1 15 (1 0103)

Storage Tank Policy Form #8 1 106 (1 0105)

Policy Signature Page Form #86697 (9104)

Site Schedule Form #8 1029 (1 0102)

Schedule of Covered Storage Tank Systems Form #%lo17 (10102)

Separation of Insureds Condition Endorsement Form #8 1026 (1 0102)

Florida Cancellation/Nonrenewal Endorsement Form #76 1 05 (5100)

Florida Addendum to the Declarations Form #74825 (210 1)

Florida Amendatory Endorsement Form #83 1 11 (1 0103)

UST I AST Dedicated Limits Endorsement Form #87408 (2105)

Coverage Territory Endorsement Form #89644 (7105)

Florida Notice of Loss Control Services Form #90231 (1 2/05)

If Terrorism Risk Insurance Act (TRIA) is rejected by the insured, Terrorism Exclusion - Certified Acts of Terrorism Exclusion Endorsement Form #8 1309 (2103) will be attached.

If Terrorism Risk Insurance Act (TRIA) is accepted, the Limitation of Losses for Certified Acts of Terrorism Endorsement #8 1290 (1 2102) will be attached.

Date post:	26-Jul-2020
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