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Self-Insured Retention Program Self-Insured Retention Program Issuing Company: Argonaut Insurance Company Liability Insurance Proposal for: City of Stillwater, OK Liability - $2,000,000 xs $250,000 SIR Each Occurrence / Wrongful Act / Accident MISCELLANEOUS PROPOSAL INFORMATION Effective Date: July 1, 2021 – July 1, 2022 Proposal Prepared for: USI Southwest Dallas, TX 75254 Attention: Ray Butler Client Executive – USI Southwest Underwriter: Tonya McPherson Sr. Regional Underwriter 45 Nod Road Avon, CT 06001 E-mail: [email protected] Proposal Date: June 9, 2021 This quotation is valid until Wednesday, June 30, 2021 2 GENERAL CONDITIONS • This quotation represents the Company’s proposed terms and conditions, which may not include all of the requested terms and conditions. No warranty is made or implied with respect to the total compliance to bid specifications or applications. • Flat Annual Premium – non-auditable • Notice of cancellation - 90 days; 10 days for non-payment; in compliance with state law. • For liability, if more than one coverage part applies to the same occurrence or claim, the highest applicable limit and lowest retained limit apply. • Separate Limits apply to Auto Liability, General Liability, Law Enforcement, Public Officials Liability, and Employment Practices Liability. • TERRORISM – This quote includes coverage for TRIPRA (Terrorism Risk Insurance Program Reauthorization Act of 2019) legislation. The insured has the option to reject this terrorism coverage. If the insured rejects the coverage, a terrorism exclusion form must be completed and signed by the insured in order to do so. If the form is not returned to us upon the binding of coverage, the terrorism premium will be automatically included. 3 STANDARD POLICY EXCLUSIONS: Specifically excluded exposures include, but are not limited to the following: Asbestos, Lead, Silica or Silica-Related Dust, Nuclear Energy Liability, Pollution, Fungi/Bacteria, Electromagnetic Radiation, Communicable Disease, Virus or Bacteria, War and Military Action, Nuclear Device GENERAL: Detonation, Nuclear Hazard, Pathogenic or Poisonous Biological or Chemical Materials, Cyber Injury, Electronic Data, and Confidential or Personal Information AUTO Exclusions as stated on the Auto coverage form including racing, LIABILITY: Personal Injury Protection All exclusions as stated on the GL coverage form and endorsements including but not limited to: Aircraft, Eminent Domain/Inverse Condemnation, GL: Underground Storage Tanks, Employer’s Liability, Land Subsidence PD, Unmanned Aircraft Exclusions as stated on the Law Enforcement Coverage Form including Care, Custody, and Control (not applicable to property on persons at time of arrest), LEL: Injury to Auxiliary or Volunteer Officers, and Prior or Pending Legal Action or Litigation, Unmanned Aircraft All exclusions as stated on the Public Officials Liability Coverage Form and endorsements including but not limited to: Contractual Liability, Distribution of POL: Information, Eminent Domain/Inverse Condemnation, Employment Practices, Fiduciary, Labor Disputes, Law Enforcement, Non-Monetary Relief All exclusions as stated on the Employment Practices Liability Coverage Form EPL: and endorsements including but not limited to: Failure to Maintain Insurance, Violation of Laws, Non-Monetary Relief (exception for defense) Specific specimen exclusionary language will be provided upon request. 4 LIMITS AND RETENTIONS FOR BUSINESS COVERED BUSINESS SPECIFIC AGGREGATE UNDERLYING COVERAGE RETRO COVERED LIMIT LIMIT RETENTION TRIGGER DATE AUTOMOBILE $2,000,000 N/A $250,000 SIR Per Accident N/A LIABILITY • Pollution Clean Up and Removal as provided on the Coverage Form • Covered Autos includes owned, leased, rented, non-owned and borrowed autos and autos commandeered in emergency situations • Waiver of Subrogation as provided under the Coverage Form • Fellow Employee • Out-Of-State Coverage Extensions • Non-Owned and Hired Auto Liability AUTO UM/UIM $1,000,000 CSL $250,000 Per Accident N/A GENERAL $2,000,000 $2,000,000 $250,000 SIR Per N/A LIABILITY Occurrence • Personal and Advertising Injury: $2,000,000 Occurrence Limit (Subject to GL Aggregate Limit) • Products/Completed Operations: $2,000,000 Occurrence Limit / $2,000,000 Aggregate Limit • Employee Benefits Liability is included • Sexual Abuse or Molestation Occurrence Liability Sub-Limited Coverage: $250,000 Occurrence Limit / $250,000 Aggregate Limit • Blanket Additional Insured (AG-GL-RL E-002 (06-11) • Insured Contracts are covered as defined • Limited Liquor Liability as provided in coverage form • Limited Failure to Supply as provided in coverage form • Health Care Services are covered for your licensed nurse, psychologist, physical therapist, hearing, language or speech therapist, EMT, paramedic, or athletic trainer • Broadcasting, Publishing, Telecasting offenses as covered under Personal Injury • Watercraft less than 51 feet in length and 100 horsepower or less • Pollution Exceptions for: Hostile Fire, Emergency Operations, Heating/Air Conditioning, Mobile Equipment, Road Treatment Chemicals, Pesticides/Herbicides, Water Treatment, Above Ground Tanks, Water/Sewage Operations • Cemetery Professional Liability (AG-GL-RL E-003 (06-10) • Watercraft Endorsement (AG-GL-RL E-019 (06-10) – 2000 Crestliner 1750 Sportfish Boat • Waiver of Transfer of Rights of Recovery Against Others To Us (RLE135-0416) • Exclusion – Subsidence (GLSUB 05-17) • Unmanned Aircraft Coverage (CG2450CW-0417) • Damage To Premises Rented to You (RLE142-0416): $100,000 Any One Premises • Schedule of Dam, Dike, Levee or Reservoir (AG-GL-RL E-026(06-11) – 3 Dams 5 LAW $2,000,000 $2,000,000 $250,000 SIR Per N/A ENFORCEMENT Occurrence LIABILITY • Care, Custody, Control covered for property on persons at time of arrest • Liability assumed in a Mutual Aid Agreement • Pollution coverage exception for Law Enforcement Activities • Animal Mortality up to $10,000 per occurrence annually • Unmanned Aircraft (CG2450CWLEL-0417) PUBLIC $2,000,000 $2,000,000 $250,000 SIR Claims-Made 11/01/1997 OFFICIALS LIABILITY • Coverage Extensions (not subject to Retained Limit): o Identity Theft Expense - $5,000 o Key Individual Replacement - $25,000 o Emergency Travel Reimbursement - $5,000 EMPLOYMENT $2,000,000 $2,000,000 $250,000 SIR Claims-Made 11/01/1997 PRACTICES LIABILITY 6 PROPOSAL FEATURES MAJOR POLICY FORMS: Argonaut Insurance Company – Admitted Paper TREATMENT OF ALAE: UNDERLYING RETENTION: Inside INSURER’S SPECIFIC LIMIT: Outside PREMIUM: $155,353 including Terrorism $153,048 excluding Terrorism FEES & SURCHARGES: N/A COMMISSION: 0% (Net) CLAIMS ADMINISTRATION: Claims are Self-Administered by the City of Stillwater (Any changes to the claims administration process must be approved by Trident Claims) SPECIFIC ADDITIONAL CONDITIONS REQUIRED AT THE TIME OF BINDING: • Completed, signed and dated “Request to Bind Insurance Coverage” form • Billing Selection (see attached “Bill It Now” flyer) 7 RISK CONTROL SERVICES Risk Management Consultation Send us a risk management question through our Ask-The-Risk Manager Portal on our website or emailing us directly at [email protected]. Our 24-Hour pledge to you is to provide you help within one business day. Risk Control Program Assessments The Risk Control team will provide surveys and assessments as needed to determine where you may need assistance based on your loss drivers. We can help to develop and implement best practices that fit your specific needs. Risk Control Newsletters and Online Resources Trident Risk Control produces monthly newsletters with topics of interest and emerging trends for the many diverse departments at your organization. Subscribe on our website and pass on to others or supply us with a list of employee emails for distribution. Our online resource library is targeted towards our most common loss drivers as well as emerging trends in the public sector. The resources include, sample best practices, whitepapers, inspection checklist and guides. Model Law Enforcement and Detention Center Policies and Procedures Trident partners with world-class law enforcement consultant OSS Law Enforcement Advisors to provide free model policies for use by law enforcement and detention center representatives. Trident University Trident Risk Control Services has over 200 training courses available online to help you meet that need. Our partner, LocalGovU, has worked with us to develop topics specifically for governmental entities. Trident Risk Control Website Trident Risk Control offers an easy-to-navigate, fully searchable website with an array of resources. Visit the Trident Risk Control website at: Trident Public Risk :: Paragon Insurance Holdings 8 REQUEST TO BIND INSURANCE COVERAGE In accordance with the insurance proposal, City of Stillwater, OK has accepted coverage with Argonaut Insurance Company Policy Effective: July 1, 2021 to July 1, 2022 COVERAGE GENERAL LIABILITY (INCLUDES EMPLOYEE BENEFITS LIABILITY) PUBLIC OFFICIALS LIABILTY EMPLOYMENT PRACTICES LIABILITY AUTOMOBILE LIABILITY UNINSURED/UNDERINSURED MOTORIST LAW ENFORCEMENT LIABILITY TERRORISM (optional) Yes No Please check ‘Yes’ or ‘No’ for the terrorism coverage Agent’s Signature Date Client’s Signature Date 9 POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE You are hereby notified that under the Terrorism Risk Insurance Act, as amended, you have a right to purchase insurance coverage for losses resulting from acts of terrorism. As defined in Section 102(1) of the Act: The term “act of terrorism”
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