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HomeMy WebLinkAboutResolution_10-99/00_10/09/1999• • RESOLUTION NO. 10-99/00 A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF TEQUESTA, PALM BEACH COUNTY, FLORIDA, APPROVING THE INTERLOCAL AGREEMENT CREATING THE PREFERRED GOVERNMENTAL INSURANCE TRUST, AND AUTHORIZING THE VILLAGE MANAGER TO EXECUTE THE APPLICATION FOR MEMBERSHIP IN THE PREFERRED GOVERNMENTAL INSURANCE TRUST ON BEHALF OF THE VILLAGE. NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE COUNCIL OF THE VILLAGE OF TEQUESTA, PALM BEACH COUNTY, FLORIDA, AS FOLLOWS: Section 1. The Interlocal Agreement Creating the Preferred Intergovernmental Insurance Trust and the Participation Agreement Pertaining to the Same, Attached Hereto as Exhibit "A" and Incorporated by reference as Part of This Resolution, is Hereby Approved and the Village Manager of the Village of Tequesta is Authorized to Execute the Application for Membership in the Preferred Governmental Insurance Trust on behalf of the Village of Tequesta. THE FOREGOING RESOLUTION WAS Schauer who moved its seconded by Councilmember Car put to a vote, the vote was as FOR ADOPTION OFFERED by Councilmember adoption. The motion was retta ,and upon being follows: AGAINST ADOPTION • Dalack Hansen Schauer The Mayor passed and 1999. thereupon declared the Resolution duly adopted this 9th day of November, A.D., • MAYOR F TE ESTA Carl C. Hansen • ATTEST: ~~~, J oann Mangani to Village Clerk • EXHIBIT "A" • INTERLOCAL AGREEIVIENT CREATING THE PREFERRED GOVERNMENTAL INSURANCE TRUST This Interlocal Agreement creating the Preferred Governmental Insurance Trust is made and entered into this ls` day of September 1999, by and among the undersigned Local Governmental Entities, and all Local Govenuental Entities who hereafter become members of the Fund, for the purposes and subject to the conditions and restrictions, as hereinafter set forth. WITNESSETH: WHEREAS, Section 163.01, Florida Statutes, commonly known as the "Florida - Interlocal Cooperation Act of 1969", provides that Local Governmental Entities may enter into interlocal agreements in order to make the most efficient use of their powers by enabling them to cooperate with other Local Governmental Entities on a basis of mutual advantage, thereby providing services and facilities in a mamier, and pursuant to forms of governmental organization, that will best accord with geographic, economic, population, and other factors influencing the needs and development of Local Govermnental Entities; and WHEREAS, Section 624.4622, Florida Statutes, provides that any two or more Local Governmental Entities may enter into an interlocal agreement for the purpose of securing the payment of benefits under Chapter 440, Florida Statutes, provided such local governmental self- insurance fund created thereby has an annual normal premium in excess of five million dollars ($5,000,000.00), maintains a continuing program of excess insurance coverage, submits annual audited year-end financial statements, and has a governing body which is comprised entirely of local elected officials; and • 1 • WHEREAS, each of the undersigned Local Governmental Entities, and all subsequent Local Governmental Entities which become party to this Agreement, are public agencies as defined in Section 163.01, Florida Statutes, and are authorized to enter into. this Interlocal Agreement; and WHEREAS, each of the Local Governmental Entities which are a party to this Agreement have the powers and authorities to establish, operate and maintain their own individual self-insured programs for the purpose of securing. payment of benefits under Chapter 440, Florida Statutes; and WHEREAS, it is in the public interest, and in the best interest of the parties hereto, that they join together to establish the Fund as authorized by Section 624.4622, Florida Statutes, and comply with the requirements therein, which will provide a cooperative program of risk management, and provide for the payment of benefits under Chapter 440, Florida Statutes; and WHEREAS, the governing authority of each of the Local Governmental Entities which are a party to this Agreement have duly authorized the execution, delivery and performance of this Agreement; and WHEREAS, it is the intent of the undersigned Local Governmental Entities to allow participation by additional Local Governmental Entities in the self-insurance fund created hereby, pursuant to the terms and conditions of this Interlocal Agreement; NOW, THEREFORE, the parties hereto do hereby covenant and agree as follows: • 2 • SECTION I INCORPORATION OF RECITALS The foregoing WHEREAS clauses are incorporated in, and made a part of, this Interlocal Agreement. SECTION II DEFINITIONS The following definitions shall apply to the provisions of this Interlocal Agreement: 2.1 ADMINISTRATOR. An individual, partnership or corporation engaged by the Fund to carry out the policies of the Fund and provide the day-to-day executive management and oversight of the Fund's operations, including, but not limited to, marketing, underwriting, quoting, issuance, maintenance and auditing of coverage terms, coordinating other third party service providers retained by the Fund and ensuring that the policies and decisions of the Board of Trustees are implemented. 2.2 CLAIMS MANAGEMENT. "Claims Management" shall mean the process of identifying, resolving and planning for the funding of eligible claims made by or against any Member of the Trust. 2.3 CONTRIBUTION(S). "Contribution(s)" shall mean any premium charge or other consideration imposed or collected by, or on behalf of the Trust, from its Members as determined and set by the Board of Trustees based on criteria adopted from time to time by the Board of Trustees. Contributions may be determined and set with respect to all Members, any individual Member or otherwise. The terms "Contribution(s)", "Premium(s)" and "Premium Contribution(s)" are used interchangeably and synonymously throughout this Agreement. 2.4 COVERAGE TERMS. "Coverage Terms" shall mean those terms and conditions attached hereto as Exhibit A which define the indemnification and financial protection to be provided by the Fund to its Members, as may be modified or altered from time to time with respect to all Members, any individual Member, or otherwise, within the applicable notice and procedural requirements as set forth herein, or in any other rules and regulations adopted by the Board of Trustees. • 3 FUND. "Fund" shall mean the group self-insurer's fu~OWri as thed Preferred • 2.5 u oses set forth herein, hereby created for the p rp ~, "Trust" and "Trust Fund" are Governmental Insurance Trust. The terms Fugnd ~ reement. used interchangeably and synonymous) tlirc u hout this Ag ,( [NFORMATION PAGE. "Information Page' shall m cnvides soummary coverage 2 which p y art hereof, p hereto, and ex ressl made a p the amount of premium information pertaining to a particular Member, including contribution and its method of calculation. 2,'] LOCAL GOVERNMENTAL ENTITY OR ENTITIES• efinedabG Sect one 163 O1(3)(b), Entities" shall mean any "public agency as d Y Florida Statutes. ,g MEMBER. "Member" shall mean a Local GovernmednWl h alltprov sionsaof tthis 2 executed this Agreement and otherwise has comp Agreement, and which thereafter is entitled to all to e o ed byntlus Agreementrthe by, and subject to all conditions and obligations p be ado ted by the Board Coverage Terms, or any rules and regulations which may p of Trustees. liance" shall mean the failure to comply with the 2,9 NON-COMPLIANCE. "Non-Comp rules and regulations which terms of this Agreement, the Coverage Terms, or any but only to the extent that such Non- may be adopted by the Board of Trustees, ~= Compliance is deemed material by, and within the sole discretion of, the Board of . Trustees. 2.10 PREMIUMS). "Premium(s)" shall mean "Contribution(s)". 2.11 PREMIUM CONTRIBUTION(S). "Premium Contribution(s)" shall mean Contribution(s). 2,12 RISK MANAGEMENT. "Risk Management" shal art of the M tubers exposuresngo evaluating, controlling, and transferring all or p loss arising out of the Florida Workers' Compensation Law, under Chapter 440, Florida Statutes. Claims Manager'' shall mean an 2.13 THIRD-PARTY CLAIMS MANAGER. "Third-Party individual or organization providing claims management services to the Fund. 2.14 TRUST. "Trust" shall mean the "Fund". 15 TRUSTEES. "Trustees" or "Board of Trustees" s the) Fund pi rsuant toi Section 2. --- charged with the operation and administration o 624.4622(d), Florida Statutes. • 4 2.16 TRUST FUND. "Trust Fund" shall mean the "Fund". SECTION III ESTABLISHMENT OF "PREFERRED GOVERNMENTAL INSURANCE TRUST" AS ASELF-INSURED FUND 3.1 ESTABLISHMENT. The Preferred Governmental Insurance Trust is hereby established and created pursuant to the provisions of Section 624.4622, Florida Statutes, for the purpose, and with the powers, duties and obligations, as herein set forth. 3.2 LOCATION. The location of the principal office of the Trust shall be determined from time to time by the Board of Trustees. 3.3 PURPOSES. This Interlocal Agreement is made and executed, and the Fund created hereby is established for, the purpose of pooling Member's resources to fulfill Members' obligations, including the payment of benefits under the Florida Workers' Compensation Law, and to minimize the cost of providing workers' compensation coverage by developing and refining specialized claim services, by developing and refining, internally or through third party service providers, a managed care system, together with the development and refining of loss prevention programs for the Members. This Agreement is not intended to create a partnership or other legal entity whereby one Member assumes the obligations of another Member, or the obligations of the Fund in general, except for the payment of premiums as herein provided. 3.4 NON-ASSESSABILITY. Should a deficit develop in the Trust, after excess reinsurance recoveries, whereby claims or other expenses cannot be paid, each individual Member shall assume liability for the costs of claims brought against that Member as if such Member were individually self-insured. Each individual Member shall thereafter be responsible for its individual costs including, but not limited to, claims administration and the payment of indemnity and medical expenses of injured Employees without an obligation to, or a right of contribution from, other Members. 3.5 POWERS. The Trust shall have all the rights, powers, duties and privileges as set forth in Sections 163.01, et seq. and 624.4622, Florida Statutes, which are necessary to accomplish the purposes described in Section 3.3, including but not limited to the following: • (a) Securing the payment of benefits under Chapter 440, Florida Statutes 5 • (b) To make, enter into, and arrange for insurance, reinsurance, excess insurance, catastrophic insurance, stop-loss insurance, or any other coverage as the Fund shall deem necessary and appropriate, without such purchase being deemed a waiver of sovereign immunity. (c) To pay, or approve the payment of, any expenses and fees associated with the operation of the Fund. (d) To indemnify and hold harmless any Trustee, officer of the Fund, or any person acting on behalf of the Fund, to the fullest extent such indemnification is permitted by law, against (1) reasonable expenses actually and necessarily incurred in connection with any threatened, pending or completed action, suit or proceeding, whether civil, administrative or civil investigative, including any action, suit or proceeding by or on behalf of the Fund, seeking to hold said person liable by reason of the fact that he or she was acting in such capacity, and (2) reasonable payments made by him or her in satisfaction of any judgment, monetary decree or settlement for which. he or she may have become liable in any such action, suit or proceeding by reason of the fact that he or she was acting in such capacity. This indemnification is not intended to, and does not, waive any immunities provided to Members of the Fund, Trustees serving in their capacity as Trustees to the Fund, or to officers or employees of the Fund, by virtue of the laws of the state of Florida, but is merely in addition to such rights, privileges and immunities. SECTION IV NUMBER. QUALIFICATION AND TERM OF OFFICE OF TRUSTEES 4.1 NUMBER AND OUALIFiCATION OF TRUSTEES. The operation and administration of the Trust shall be the joint responsibility of a Board of Trustees consisting of not less than five (5) and not more than nine (9) Trustees. No Trustee may be appointed who is, or continue to serve as a Trustee after becoming, an owner, officer, or employee of a service provider to the Fund. Each Trustee shall be a local elected official of a Member. No two (2) Trustees may be elected officials from the same Member. The initial Board of Trustees shall serve staggered terms of two (2), three (3) and four (4) years. Thereafter, each Trustee shall serve for a period of four (4) years, or the balance of such Trustee's term of office as an elected official of the Member, whichever shall first occur. Each and every Trustee named, and each successor Trustee, shall acknowledge and consent to their appointment as a Trustee by giving written notice of acceptance of such appointment to the chairman, or acting chairman of the Board of Trustees. • 4.2 RESIGNATION OF A TRUSTEE. A Trustee may resign and become and remain fully discharged from all further duties or responsibilities hereunder, by giving at 6 • _ least sixty (60) days prior written notice sent by certified mail, overnight delivery or other appropriate method of delivery to the chairman or acting chairman of the Board of Trustees. Such notice shall state the date said resignation shall take effect, and such resignation shall take effect on the date designated unless a successor Trustee has been elected at an earlier date as herein provided, in which event resignation shall take effect immediately upon the election of such successor Trustee. Additionally, oral notice of resignation may be given at any duly convened meeting of the Trustees, which said oral notice of resignation shall be incorporated, and made a part of, the minutes of such duly convened meeting. Any Trustee, upon leaving office, shall forthwith turn over and deliver to the chairman or the secretary of the Trustees at the principal office of the Trust any and all records, books, documents or other property in such Trustees possession, or under such Trustees control, which belongs to the Trust. 4.3 ELECTION OF SUCCESSOR TRUSTEES. Successor Trustees shall be elected by a majority vote of the Members of the Fund. Nominations for the election of Trustees maybe made by the Board of Trustees or any Member of the Fund. The written ballot containing such nominations shall be provided to each Member of the Fund by mail or other means of delivery best calculated to expedite the election of successor Trustees. In the event a Trustee duly elected to serve on the Board of Trustees shall die, resign, become incapacitated or refuse to act, and such event reduces the number of Trustees serving on the Board of Trustees below five (5) in number, then, and in such event, an interim Trustee may be ___ appointed by the Board of Trustees to serve the duration of the term of the departed Trustee. Appointment of such interim Trustee shall be subject to ratification by a majority vote of the Members of the Trust. 4.4 TRUSTEE TITLE. In the event of death, resignation, refusal or inability to act by any one or more of the Trustees, the remaining Trustees shall have all the powers, rights, estates and interests of this Trust and shall be charged with its duties and responsibilities; provided, however, that in such case(s), no action may be taken unless it is concurred in by a majority of the remaining Trustees. 4.5 TRUSTEE OFFICERS. The Trustees shall elect from among themselves a chairman, vice-chairman and secretary of the Board of Trustees. Such officers shall be elected annually at the end of the fiscal year of the Trust, and may succeed themselves. 4.6 POWER AND AUTHORITY. The Board of Trustees shall be the governing body of the Fund and shall manage and direct the business and affairs of the Fund, and shall have all the necessary and incidental power and authority to do so, including, but not limited to, the following: (a) Impose any qualifications for Membership and pass on the admissibility of • future Members. 7 • (b) Adopt rules and regulations which may be required in the operation and administration of the Fund; provided, however, such rules and regulations shall not become binding upon the Members until provided by certified mail or hand delivery. (g) Declare non-liquidating distributions to the Members and to make such distributions to the Members in a manner, subject to opinion of a qualified and independent actuary, calculated to protect the financial stability of the Fund. (c) Terminate and windup the affairs of the Fund. (d) Establish such committees it deems necessary and appropriate. (e) Determine who shall be authorized to sign documents, contracts, policies, instruments, checks, acceptances, endorsements and releases on behalf of the Fund. (f) Determine the manner of acquiring, holding and disposing of personal property and real property (and interests therein) used by or on behalf of the Fund. (g) Contract with third-party service providers to carry out the policies of the Board of Trustees and provide day to day management of the Fund, including, but not limited to, administration, marketing, underwriting, claims management, legal counsel, actuaries, loss control, auditors, engineers, private consultants, advisors, and other persons the Board of Trustees shall deem necessary to carry out the business of the Fund. (h) Perform any other function required by law. SECTION V MEMBERS 5.1 GENERAL CONDITIONS. By execution of this Interlocal Agreement, or by execution of a participation agreement agreeing to be bound by the terms and conditions of this Interlocal Agreement, each Member agrees: (a) The Trustees have the sole responsibility to govern and direct the affairs of the Fund pursuant to this Agreement. (b) The Members and the Trust agree that. any Member who formally applies for Membership in this Fund, and who is accepted by the Board - of Trustees, shall thereupon become a party to this Interlocal Agreement and shall 8 be bound by all of the terms and conditions contained herein. The application shall constitute a counterpart of this Interlocal Agreement. (c) To comply with the conditions of the Florida Workers' Compensation Law. (d) To be individually responsible for making the Premium Contribution in accordance with Exhibit "B"-Premium Contribution, attached hereto and made a part this Agreement. (e) The liability of the Fund is specifically limited to the discharge of the liability of its Members pursuant to this Agreement and Exhibit "A"-Coverage Terms, attached hereto and made a part of this Agreement. (f) The Members, through the Board of Trustees, do hereby appoint the Administrator of the Fund as its agent and attorney-in-fact, to act on their behalf and to execute all necessary contracts, reports, waivers, agreements, excess insurance contracts, service contracts, and other documents reasonably necessary to accomplish the purposes and to fulfill the responsibilities of the Trust; to make or arrange for the payment of claims, claim expenses, medical expenses, and all other matters required or necessary insofar as they affect the Members' liability under federal or Florida law or insofar as such matters are covered pursuant to the terms of this Agreement, or any other agreement, certificate, document, or other instrument executed by the Members and the Fund pursuant to this Agreement, and the rules and regulations now or hereafter promulgated by the Board of Trustees. (g) The Members agree to abide by all the terms and conditions of this Agreement, the Coverage Terms, any applicable rules and regulations that may be adopted from time to time by the Board of Trustees, and any other agreement, certificate, document, or other instrument executed by the Fund and the Members pursuant to this Agreement. (h) Each Member voluntarily transfers to the Trust any rights and privileges such Member enjoys under the laws of the State of Florida, including Sections 163.01, and 768.28, Florida Statutes, and specifically those statutory provisions pertaining to such Member's sovereign immunity and the applicable limitations of the Member's liability to $100,000.00 per individual claim, and to $200,000.00 for multiple claims, arising out of the same transaction. The purchase of insurance hereunder shall not be deemed or be construed as a waiver of sovereign immunity. 5.2 TERMINATION OF MEMBERSHIP. Each Member may terminate its participation in the Fund by giving not less than thirty (30) days prior written notice of its intent to so terminate such membership. 9 • SECTION VI ACCOUNTING True and complete accounts shall be kept of all transactions and of all assets and liabilities of the Trust. The accounts of the Trust -shall be audited annually by a firm of independent certified public accountants, which shall be selected by the Board of Trustees. SECTION VII DURATION This Agreement shall continue in effect until it is terminated by the mutual consent of all the Members; provided, however, that this Section VII shall not be construed to preclude the termination and winding up of the Trust within the discretion of the Board of Trustees, or the amendment of this Agreement pursuant to Section VIII. SECTION VIII AMENDMENT This Agreement may be amended only upon the affirmative vote or written consent of at least two-thirds of the votes cast by Members at a meeting of Members. A copy of any amendment to this Agreement shall be delivered to each Member. All rights and obligations of the Members are subject to the reservations of the right to amend this Agreement. SECTION IX STATUTES, RULES AND REGULATIONS The Trust shall at all times act in accordance with the provisions of statutes, rules and regulations of the State of Florida. SECTION X MISCELLANEOUS PROVISIONS 11.1 PROHIBITION AGAINST ASSIGNMENT. No Member may assign any right, claim, or interest it may have under this Agreement, or any coverage term, and no creditor, assignee, or third-party beneficiary of any Member shall have any right, 10 • claim, or title to any part, share, interest, funds, or assets of the Trust except as specifically may be agreed to by the Trust. 11.2 APPLICABLE LAW. This Agreement shall be governed by and construed in accordance with the statutes, rules and regulations of the State of Florida. 11.3 ENFORCEMENT. The Trust and its Members shall have the power to enforce this Agreement by action brought in any court of appropriate jurisdiction within the State of Florida. 11.4 SEVERABILITY. If any term or provision of this Agreement, or the application of such term or provision to any person or circumstance, shall to any extent be invalid or unenforceable, the remainder of this Agreement and the application of such term or provision to persons or circumstances other than those to which it is held invalid or unenforceable shall not be effected, and each term or provision of this Agreement shall be valid acid enforceable to the full extent permitted by law. 11.5 INTEGRATION. This Agreement, Exhibit "A"-Coverage Ternis, Exlvbit "B"- Premium Contribution and any applicable rules and regulations that may be adopted from time to time by the Board of Trustees, constitute the full and complete terms of the Agreement among the Members and the Fund. There are no oral understandings or agreements not set forth in writing in this Agreement or in the Coverage Terms, or any applicable rules and regulations. This Agreement is binding on each Member and may be executed in multiple counterparts by each Member and the Fund. All such counterparts shall be deemed originals and together shall constitute one and the same agreement among the Members of the Trust. `~ 11 EXHIBIT A COVERAGE TERMS 1. Rights and Duties of the Fund The Fund has the right and duty to defend, at the Fund's expense, any claim, legal proceeding or suit against a Member for benefits payable under this Agreement, and the Fund has the right to investigate and settle such claims, legal proceedings or suits. The Fund, however, has no duty to defend a claim, legal proceedings or suit that is not covered by this Agreement, nor to defend or continue to defend the Fund or its Members after the Fund has paid its applicable limit of liability under the coverages involved. 2. Expenses Payabte by the Fund In addition to other amounts payable under this Agreement, the Fund will pay, as part of any claim, proceeding or suit the Fund defends: (1) reasonable expenses incurred a the Fund's requests, exclusive of loss of earnings; (2) premiums for bonds to release attachments and for appeal bonds in amounts up to the amounts payable under this Agreement; (3) all litigation costs taxed against a Member; (4) interest on a judgment as required by law until the Fund offers the amount due under this Agreement; and (5) any other reasonable and necessary expenses the Fund incurs. 3. The Fund's Right of Subrogation The Fund has the right, and is subrogated to the rights of persons entitled to the benefits of this Agreement, to recover its payments from anyone liable for a covered injury. Once the Fund has compensated, or is liable to compensate, an injured Employee for the full value of their claim as determined by settlement or a tribunal with jurisdiction to hear worker's compensation claims, the Fund is automatically subrogated to the injured Employee's rights under any other agreement, law, or pending or potential cause of action which would compensate the Employee for the same injury. The Fund is entitled to set-off any independent recovery by an injured Employee against any amounts due from the Fund under this Agreement. Where an Employee is entitled to ongoing benefits under this Agreement, any third party settlement for the same injury will be set- off such that future payments from other sources for the same injury are deducted from those continuing benefits. In the event of payment of any loss by the Fund under this Agreement, the Fund shall be subrogated to the extent of such payment to all the rights of the Member against any person or other entity legally responsible for damages for such loss. The Member shall act reasonably to protect the Fund's right of subrogation. In the event that the Fund is subrogated to the Member's right, the Member agrees to render all reasonable assistance to effect recovery. • 12 • 4 Workers' Compensation's Compensation Coverage Provided by the Fund The workers'compensation coverages provided by the Fund covers bodily injury, including death by accident or disease, subject to the Florida Workers Compensation Law and as follows: (a) Time of Occurrence. A bodily injury is covered only if such injury occurs during the coverage period. A bodily injury by disease must be caused or aggravated by the conditions of an Employee's employment, and the Employee's last date of last exposure to the conditions causing or aggravating such injury by disease must occur during the coverage period. (b) Payment. The Fund will promptly pay when due the benefits required by the Florida Workers' Compensation Law. (c) Conditions. Bodily injury, including death, is covered only if (1) it arises out of, and in the course of, the Employee's employment by a Member; and (2) the employment is necessary to the Employee's work within the State of Florida. 1 Employer's Liability Coverage Provided by the Fund This employer's liability coverage applies to bodily injury, including death, by accident or disease subject to the following: (a) Time of Occurrence. A bodily injury is covered only if such injury occurs during the coverage period. A bodily injury by disease must be caused or aggravated by the conditions of an Employee's employment, and the Employee's last date of last exposure to the conditions causing or aggravating such injury by disease must occur during the coverage period. (b) Payment. The Fund will pay all sums a Member legally must pay as damages because of bodily injury to a Member's Employees, provided the injury is covered by this Employer's liability coverage. (c) Conditions. Bodily injury, including death, is covered only if (1) it arises out of and in the course of the Employee's employment by a Member; and (2) the employment is necessary or incidental to Employee's work within the State of Florida. (d) Damages. The damages the Fund will pay, where recovery is permitted by law, include damages: (1) for which a Member is liable to a third party by reason of a claim or suit against a Member by that third party to recover the damages claimed against such Member as a result of injury to an Employee; (2) for care and loss of services; (3) for consequential injury to a spouse, child, parent, brother or sister of the injured Employee, provided that these damages arise out of and in the course of the injured Employee's employment by a Member; and (4) claims against a Member in a capacity other than as employer resulting from injury to a Member's Employee that arises out of and in the course of employment. (e) Exclusion This coverage does not apply to: 1. liability assumed under a contract, except with regard to a warranty that a Member's work will be done in a workmanlike manner; 13 2. punitive or exemplary damages imposed because of bodily injury to an employee employed in violation of the law; 3. bodily injury to an Employee while employed, in violation of law, by a Member's executive officers; 4. any obligation imposed by worker's compensation, occupational disease, unemployment compensation, or disability benefit law, or any similar law; 5. bodily injury intentionally cause or aggravated by a Member, its officers, directors, or other persons serving in a supervisory capacity; 6. bodily injury occurring outside the United States 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; 7. 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; 8. 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 8171-8173), the Outer Continental Shelf Lands Act (43 USC Sections 1331-1356), the Defense Base Act (42 USC Sections 1651-1654), the Federal Coal Mine Health and Safety Act of 1969 (30 USC Sections 901-942), any other federal works or workmen's compensation law or other federal occupational disease law, or any amendments to these laws; 9. bodily injury to any person in work subject to the Federal Employers' Liability Act (45 USC Sections 51-060) 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; 10. bodily injury to a master or member of the crew of any vessel; 11. fines or penalties imposed for violation of federal or state law; and 12. damages payable under the Migrant and Seasonal Agricultural Workers' Compensation Protection Act (29 USC Sections 1801-1872) and under any other federal law awarding damages for violation of those laws or regulation issued thereunder, .and any amendments to those laws. (a) Limitation of Liability The Fund's liability to pay for damages is limited to the amounts shown on the Information Page. They apply as follows: ,~ 14 • 1. Bodily Injury by Accident. The limit shown for "Bodily Injury by Accident-each accident" is the most the Fund will pay for all damages covered by this Agreement because of bodily injury to one or more Employees in any one accident. 2. Bodily Injury by Disease. The limit shown for "Bodily Injury by disease-policy limit" is the most the Fund will pay for all damages covered by this Agreement and arising out of bodily injury by disease regardless of the number of Employees who sustain bodily injury by disease. The limit shown for "Bodily Injury by disease-each employee" is the most the Fund will pay for all damages because of bodily injury by disease to any one Employee. Bodily injury by disease does not include disease that results directly from bodily injury by accident. 3. The Fund will not pay any claims for damages after 'the Fund has paid the applicable limit of its liability under this Agreement. (g) Conditions. There will be no right of action against the Fund under this Agreement unless: (1) the Member has complied with all the terms of this Agreement; and (2) the amount the Member owes has been determined with the Fund's consent or by actual trial and final judgement. This coverage does not give anyone the right to add the Fund as a defendant in an action against a Member to determine the Member's liability. 6. Duties of Members Each Member is obligated to: (1) pay premiums when due and as determined by the Fund including allowing the Fund or its designated agents access to information necessary to determine the final premium; (2) allow the Fund or the Administrator to visit its workplace(s) for purposes of assisting Members in operating in a manner which has the potential to result in lower premium rates; and (3) to provide a safe workplace as defined by applicable law or the Fund. Each Member is responsible for any payments in excess of the benefits regularly required by the Florida Workers' Compensation Law, including those required as a result of: (1) a Member's willful or grossly negligent misconduct; (2) a Member's knowingly employing an Employee whose employment is in violation of any local, state or federal law; (3) a Member failing to comply with a health or safety law or regulation; or (4) a Member discharging, threatening to discharge, coercing or otherwise discriminating against any Employee in violation of the Florida Workers' Compensation Law, or any other local, state or federal law. A Member shall promptly reimburse the Fund for any payments made on a Member's behalf, in excess of the benefits regularly provided by such law. If injury occurs to one of the Member's Employees entitled, or potentially entitled, to benefits under this Agreement, the Member shall: (1) provide for immediate • medical and other services required by applicable law; (2) promptly provide the Fund, the Administrator or its agents with the names and addresses of the injured persons and 15 • witnesses, and other information the Fund may need or require; (3) provide the Fund the Administrator or its agents with all notices, demands and legal papers related to the injury, claim, proceeding or suit; (4) cooperate with the Fund an assist the Fund, as the Fund may reasonably request, in the investigation, settlement or defense of any claim, proceeding or suit. No Member shall interfere with the Fund's right to recover payments from others nor shall any Member voluntarily make payments, assume obligations or incur expenses, except at the Member's own cost. 7. Workplace Access The Fund has the right, but is not obligated, to inspect a Member's workplace at any time. The Fund's inspections are not safety inspections and they relate only to the insurability of the workplaces and the premiums to be charged for workers' compensation. The Fund may provide a Member with reports on the findings of such inspections, and the Fund may also recommend changes that are calculated to reduce risk and which reduce premium. The Fund does not undertake to perform the duty of any person to provide for the health or safety of a Member's Employees or the public. The Fund does not warrant that a Member's workplace is safe or healthful or that it complies with law, regulations, codes or standards. Consequently, neither the Fund nor the Administrator shall be held liable to any person as a direct or indirect result of safety reviews or inspections conducted under this provision. If the coverage period is longer than one year, all provisions regarding coverage will apply as though a new agreement were entered into on each annual anniversary that this Agreement is in force. • 16 • EXHIBIT B PREMIUM CONTRIBUTION Each Member shall be individually responsible for paying premiums as provided herein. All premiums for the coverage described in this Agreement will be determined by the Fund's rules, rates, rating plans and classifications. The Fund may change its rules, rates, rating plans and classifications and apply the changes to this coverage. 1. Classifications The Information Page shows the rate and premium basis for applicable work classifications. A Member's classification is assigned based on an estimate of the exposures of the Member during the coverage period. If the Member's actual exposures are not properly described by those classifications, the Fund will assign proper classifications, rates and premium basis with notification to the Member. 2. Premium Premium for each classification is determined by multiplying a rate by a premium basis. Remuneration is the most common premium basis. This premium basis includes a payroll and all other remuneration, as defined by applicable Florida Workers' Compensation Law, paid or payable during the applicable period for the services of: (a) all the Member's Employees engaged in work coverage by this Agreement; and (b) all other persons engaged in work that could make the Fund liable for the workers' compensation coverage provided by this Agreement. If the Member does not have the payroll records for these persons, the contract price may be used as a premium basis. This paragraph (b) will not apply if the Member gives the Fund proof that the employers of these persons lawfully secured their workers' compensation obligations. 1. Payment Members shall pay all premiums when due. Failure to properly and timely pay premiums will result in appropriate legal action by the Fund. Should a legal cause of action be filed to collect premiums due, it is agreed that proper venue is . the county in which the office of the Administrator is located. 17 • 2. Final Premium Determination The premium shown on the Information page, premium summary, schedules, and endorsements is an estimate. The final premium will be determined after each coverage period ends by using the actual premium basis, proper classifications, experience modifications and rates that lawfully apply to the Member covered by this Agreement. If the final premium is more than the premium a Member has paid to the Fund, the Member must pay the Fund the balance. If the fmal premium is less than the premium a Member has paid to the Fund, -the Fund will refund or credit the balance to the Member. The final premiums will not be less than the highest minimum premium for the governing classification covered by this Agreement. If this Agreement is canceled, final premium will be determined subject to the applicable Florida Workers' Compensation Law. 3. Records The Member will keep records needed to compute premium and will provide the Fund with copies of those records upon request. Additionally, the Member will permit the Fund to examine and audit all of the Member's records that relate to this Agreement, including ledgers, journals, payroll and disbursement records, and programs for storing and retrieving data. The Fund may conduct the audits during regular business hours during the coverage period and within three years after the coverage period ends. Information developed by audit will be used to determine the final premium. The Administrator as well as insurance rate service organizations have the same rights as the Fund under this provision. 4. Member's Continuing Obligation to Pay Premiums A Member's failure to pay the full amount of a premium that is due shall be default of their obligation under this Agreement. The default of any Member, or group of Members, shall not relieve any other Member of its obligation to pay premiums as they become due. In the event of a Member's default, the Board of Trustees or the Administrator may take any lawful action to protect the Fund from loss. If suit is brought against the defaulting Member, the defaulting Member shall be liable to the Fund for the costs of collection, including but not limited to audit costs, court costs and attorneys' fees. The Board of Trustees, or the Administrator acting under the Administrative Agreement, may terminate a defaulting Member. • 18 SEP.-24'99(FRI) 10:46 ACORDIA (ADMIN) TEL: 561 838 9604 PARTICIPATION AGREEMENT Application for Membership in the Preferred Govemmental Insurance Trust P. 002 The undersigned local govemmental entity, as a public agency of the State of Florida as defined in Section 163.01, Florida Statutes, hereby formally applies for continuing workers compensation coverage through membership in the Preferred Govemmental Insurance Trust, to be effective 12:01 a.m. October 1, 1999, and if accepted by the Fund's duly authorized representative, does hereby agree as follows: (a) To accept and be bound by the provisions of the Florida Workers' Compensation Act; (b) That, by this reference, the terms and provisions of the Interlocal Agreement creating the Preferred Govemmental Insurance Trust are hereby adopted, approved and ratified by the undersigned local governmental entity. The undersigned local govemmental entity certfies that it had received a copy of the aforementioned Interlocal Agreement and further agrees to be bound by the provisions of the Interlocal Agreement, including its obligation to pay premium contributions as required by the Fund; (c) To abide by the rules and regulations adopted by the Board of Trustees of the Fund; (d) That should the undersigned local govemmental entity desire to cancel coverage, it will give not less than thirty (30) days .prior written notice of cancellation; (e) That all information contained in the underwriting application provided to the Fund as a condition precedent to participation in the Fund is true, correct and accurate in all respects. itnes i n tore . ! ~' .I rinted me Village of Teauesta (Name of Local Govemmental Entity) Signature ToRrvN MAN 6-A~v ~ to G[.O Printed Name Title: ~~'iryGr v~Lt,AG~~ ~yAwA66'!e_. •