HomeMy WebLinkAboutResolution_56-98/99_09/21/1999 RESOLUTION NO. 56 -98/99
A RESOLUTION OF THE VILLAGE COUNCIL OF
THE VILLAGE OF TEQUESTA, PALM BEACH
COUNTY, FLORIDA, APPROVING A PROPOSAL
FROM ACORDIA SOUTHEAST, OF WEST PALM
BEACH, FLORIDA, FOR PROPERTY, LIABILITY
AND WORKERS' COMPENSATION INSURANCE IN
THE AMOUNT OF $192,634.00, HAVING A FY
99/00 BUDGET ALLOCATION FROM VARIOUS
FUNDS OF THE VILLAGE IN THE AMOUNT OF
$222,008.00 AND AUTHORIZING THE VILLAGE
MANAGER TO EXECUTE THE APPLICABLE
PROPOSAL 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 Preferred Governmental Insurance
Program Proposal from Acordia South East, West Palm
Beach, Florida, 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 same
on behalf of the Village of Tequesta.
THE FOREGOING RESOLUTION WAS OFFERED by Councilmember
Hansen , who moved its adoption. The motion was
seconded by Councilmember Capretta and upon being
put to a vote, the vote was as follows:
FOR ADOPTION AGAINST ADOPTION
Joseph N. Capretta
Basil B. Dalack
Carl C. Hansen
Ron T. Mackail
i
The Mayor thereupon declared the Resolution duly
• passed and adopted this 21 day of September, A.D.,
1999.
MAYOR OF TEQUESTA
Ron T. Mackail
ATTEST.
oann ManganidAlo
Village Clerk
MyDocuments \Resolutions \56 -98 -99
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•
PREFERRED GOVERNMENTAL
INSURANCE PROGRAM
PROPOSAL
FOR
VILLAGE OF
ON TEQUESTA
Effective: October 1, 1999
Presented by:
Brian Cottrell, CIC
Acordia,
West Palm Beach Division
ordla®
1 Acordia Southeast
Insurance • Bonding • Employee Benefits
TABLE OF CONTENTS
Overview 3
Florida Cities and Special Districts Insurance Program
Coregis Insurance Group
Miscellaneous Insurance Coverages
An Introduction to Your Service Team/Resumes
Property 6
Special Property Coverage and Extensions
General Liability, Law Enforcement & EMT /Paramedics 11
Coverage Extensions
Automobile Liability and Physical Damage 13
• Public Officials Liability 14
n Control Claims Administration and Loss Con o Sery ices 15
Broker Recommendation/Premium Recapitulation 16
ordia®
2 Aeordia Southeast
Insurance •Bonding • Employee Benefits
THE PROGRAM
The Preferred Governmental Insurance Program (PGI) is a fully insured - property and
casualty package program designed specifically for Florida's governmental agencies.
Underwritten by Coregis Insurance Group, the following coverages are available:
Property General Liability
Contractors Equipment EMT/Paramedic Professional Liability
Electronic Data Processing Law Enforcement Professional Liability
Miscellaneous Inland Marine Employee Benefits Administration Liability
Crime Automobile Liability and Physical Damage
Bonds (Employee Dishonesty) Public Officials Liability
Equipment Breakdown
Unlike some other state -wide insurance programs, the Preferred Governmental Insurance
Program does not "pool" losses. The Village of Tequesta is separately underwritten and
does not subsidize another entity's poor loss experience. Also, you cannot be assessed
additional premiums to make up for any funding deficit.
CQkor&a.
3 Acordia Southeast
Insurance • Bonding • Employee Benefits
COREGIS INSURANCE GROUP
Property and casualty coverages are fully insured by Coregis Insurance Group, a wholly
owned subsidiary of G. E. Capital. A. M. Best rates Coregis as "A IX" (excellent), which
reflects solid operating performance, strong capitalization, and a financially sound business
plan. Additionally, the state of Florida recognizes Coregis as an admitted carrier thereby
providing policyholders added protection through the State Guaranty Fund.
Coregis has the largest market share of public entity business in the U. S. This translates
into an expertise unparalleled by any other company. 170 public entity specialists work in
partnership with the Village of Tequesta to provide effective solutions to risk control,
claim handling, legal, and coverage challenges.
One of the ways Coregis has responded to clients' needs is by the addition of a new
marketing person who will personally call on you during the year. Mr. Ashley Bacot has
worked in an insurance agency as an underwriter, he holds a current property and casualty
insurance license and has been a risk manager for the City of Altamonte Springs. Ashley
is past president of the Central Florida Chapter of PRIMA (Public Risk Management
Association) and continues to actively participate in the association.
MISCELLANEOUS INSURANCE COVERAGES
To fully serve our clientele, Acordia -West Palm Beach can insure all of your remaining
exposures through our numerous "A" rated insurance companies. These coverages include:
Pollution Liability Accidental Death & Dismemberment
Fiduciary Liability Special Events
Excess Flood Airport Liability
Underground Tank Liability Workers' Compensation
Excess Workers' Compensation
The brief description of insurance coverage contained in this proposal is being provided
as an accommodation only and is not intended to cover or describe all policy terms. For
more complete and detailed information relating to the scope and limits of coverage,
please refer directly to the policy documents.
CQ4onfia.
4 Acordia Southeast
Insurance • Bonding • Employee Benefits
VILLAGE OF TEQUESTA
AN INTRODUCTION TO YOUR SERVICE TEAM
- SUSAN M. CASEY, ARM
Account Executive
Susan Casey has 30 years experience in Property and Casualty insurance having started her career with the
Aetna Casualty and Surety Insurance Company in Boston, MA. She moved over to the agency field holding
positions of Underwriter, Commercial Lines Manager, Marketing Director, and Account Executive. She
holds the designation of ARM, Associate in Risk management, and has completed INS classes (Program in
General Insurance), and will attain the designation of AIS, Associate in Insurance Services in 1998.
Since moving to Florida in 1988, she has been involved in the placement and servicing of the following
- governmental related accounts:
Palm Beach County
School District of Palm Beach County
Palm Beach County International Airport
- Palm Beach County Housing Authority
Palm Tran
Port of Palm Beach
Bay County
School District of Lee County
Shands Teaching Hospital and Clinics
University of Florida Tissue Bank
Susan has been employed as an Account Executive with Acordia (formerly Walton Insurance Services, Inc.)
I le since 1993.
JEAN HORNYAK, CPCU, AAI
Account Manager
Jean Hornyak, Account Manager at Acordia Southeast, Inc., West Palm Beach Division, started her insurance
career with an insurance agency in Rochester, NY and held a New York State Broker's license from 1951-
1955 and an Accident & Health license from 1953 -1955. She continued working in the agency field
handling varied Property and Casualty insurance accounts in Florida except for nine (9) years in an agency in
Washington, DC where she serviced General Aviation and related accounts and was a Virginia Insurance
Agent.
Since joining Acordia in 1986 (formerly Cornelius, Johnson & Clark) she assisted in the placement and
servicing of several municipal and governmental accounts including:
Village of Tequesta, Village of Tequesta, City of Palm Beach Gardens, Village of Palm Springs,
Village of Tequesta, Bal Harbour Village, South Broward Drainage District, Indian Trail
Improvement District, Town of Juno Beach, Lake Worth Drainage District, Old Plantation Water
Control District, Seacoast Utility Authority, Northern Palm Beach County Improvement District,
Loxahatchee Groves Water Control District, and South Indian River Water Control District
Jean has completed courses through the Insurance Institute of America for INS (Program in General
Insurance), AAI (Accredited Advisor in Insurance) and CPCU (Chartered Property Casualty Underwriter)
attaining the designation in 1984. She holds a Florida 220 (Property & Casualty) license.
CQkor&a.
5 Acordia Southeast
Insurance • Bonding • Employee Benefits
VILLAGE OF TEQUESTA
a PROPERTY
Term: 10/01/99-00
Co=m3L Coregis Insurance Group
(Rated A IX by A. M. Best)
Limits of Liability:
(Values for town only) $5,327,729 Blanket for Buildings and
Contents
Contractor's, Mobile Equipment $ 464,305
Electronic Data Processing $ 196,688 Hardware
$ Included - software, mechanical breakdown
$ Included - extra expense
Deductibles: $ 1,000 Buildings & Personal Property
• $ 250 Computers & Contractor's Equip
Coverages
max.
1. Special Form (formerly "All Risk "), subject to standard policy exclusions
2. Replacement Cost applicable to Building., Contents, & EDP only. All others paid on
Actual Cash Value.
3. Agreed Amount (no coinsurance penalty)
Covered Property:
Buildings or structures newly acquired, occupy or construct: $1,000,000
Personal Property newly acquired: $ 250,000
Personal Property temporarily away from premises: $ 100,000
Personal Property of Others: $ 50,000
(limited to $1,000 per volunteer, $2,500 per employee)
CQ/Confia.
6 Acordia Southeast
Insurance • Bonding • Employee Benefits
VILLAGE OF TEQUESTA
Notes of Importance:
1. A signed Schedule(s) of Property for all property to be insured is required within 30
days of binding. The following information should be included:
• Street address or plat description
• 100% replacement cost value of all property to be insured
• Brief description of the construction of all buildings or structures at each location
Note: Agent will provide statement of values for signature.
If a location is not included in the above Schedule, it will be considered as a newly
acquired location and covered as such.
2. Functional replacement cost applies to buildings over 65 years old or with
historical/landmark status
Coregis will be adding a Y2K endorsement to the policy at renewal, which
will give limited coverage for certain Y2K first party and third party claims.
C'Qkor&a.
7 Acordia Southeast
Insurance • Bonding • Employee Benefits
VILLAGE OF TEQUESTA
SPECIAL PROPERTY COVERAGES
Standard ISO property coverages are provided in the Preferred Governmental Insurance
Program, as well as the following:
COVERAGE LIMIT
1. "Business Income" $250,000
- 2. Extra Expense $250,000
3. "Valuable Papers" $100,000
4. Accounts Receivable $100,000
5. Computer Equipment and Electronic Media $100,000
6. Fine Arts (maximum per item $5,000) $100,000
7. Mobile, Portable or Contractor's Equipment $ 50,000
8. Miscellaneous Property (if included in Property Schedule) $ 25,000
9. Trees, Shrubs and Landscape Planting (maximum per tree $1,000) $ 25,000
• 10. Golf Course Greens and Tees (maximum any one green or tee $5,000) $ 50,000
11. Food Spoilage $ 10,000
12. Animals (maximum per animal $1,000) _. $ 25,000
13. Paved Surfaces $100,000
14. "Commandeered Property" or "Impounded Property" $100,000
15. "Emergency Service Portable Equipment" $250,000
16. Communications Equipment $ 50,000
17. "Vacant" Buildings Included
18. Buildings Under Construction $500,000
19. Money and Securities Within Premises $ 5,000
Money and Securities Away from Premises $ 2,500
Please refer to policy on how above coverages apply. Subject to Deductibles and certain
restrictions. Above coverages are provided to you as part of the blanket limit of insurance. If
higher limits are required, they should be stated in the property section of this proposal, but
will remain apart of the blanket limit of insurance.
C.Q/Confia.
8 Acordia Southeast
Insurance • Bonding • Employee Benefits
VILLAGE OF TEQUESTA
EXTENSIONS OF COVERAGE
Each of the Limits specified below is an additional amount of insurance to the `Blanket Limit of
Insurance" but are subject to the `Blanket Limit of Insurance" deductible shown in the Property
Section of this proposal:
COVERAGE LIMIT
1. Preservation of Property $100,000
2. Fire Department Service Charge $ 25,000
At 1 3. Repair of Theft Damage to Non -Owned Buildings $ 50,000
4. Taking Inventory After a "Loss Occurrence" $ 10,000
5. Debris Removal: The greater of 25% of Loss or $ 50,000
6. Demolition: The greater of 15% of the Value of Damaged Building or $500,000
7. "Increased Cost of Construction" Greater of 15% of Value of Damaged Bldg. or $500,000
8. Fire Protection Devices $ 10,000
9. Lock Replacement $ 500
10. "Pollutant" Clean Up and Removal - .Buildings and Personal Property $ 50,000
Expense Reimbursement to. extract pollutants from land or water $ 10,000
11. Arson and Crime Reward $ 10,000
12. Utility Interruption $100,000
13. Sewer Back Up During Flooding $ 25,000
Please refer to coverage form on how above coverages apply. Subject to deductibles and restrictions
as stipulated in policy. Coregis Insurance Company liability for loss or damage will be limited only
to the loss or damage due a Covered Cause of Loss.
GP4or&a.
9 Acordia Southeast
Insurance • Bonding Employee Benefits
VILLAGE OF TEQUESTA
MAJOR EXCLUSIONS
Property Not Covered:
1. Accounts, bills, currency, or other moneys, deeds, food stamps, or other evidences of debt,
scrip, notes or securities except under conditions described in "Special Property Coverages"
section of the policy.
2. Automobiles
3. Dams, levees, reservoirs, tunnels, bridges, roadways, walks, patios, or other paved surfaces
except under conditions described in "Special Property Coverages" section of the policy.
4. Contraband, or property in the course of illegal transportation or trade.
5. Cost of excavations, grading, backfilling, or filling.
6. Land, water, and growing crops.
7. Bulkheads, pilings, piers, wharves, or docks unless scheduled.
8. Property covered under another coverage form of this or any other policy in which it is more
specifically described.
9. Retaining walls that are not part of buildings you own.
10. Underground tanks, pipes, flues, sewers, or drains you own that are not located on
"premises" insured under this policy.
11. Electrical or communication lines, towers, and poles you own that are not located on a
• "premises" insured under this policy.
12. Buildings that are "vacant" except under conditions described in "Special Property
Coverages" section of the policy.
13. Watercraft not included in the schedule of property. or aircraft.
14. Personal property while airborne or waterborne via ocean or Great Lakes going vessel.
Excluded Risks of Direct Physical Loss:
1. Building Ordinance Enforcement
2. Earth Movement
3. Collapse
4. Water, except as provided under Extensions of Coverage
5. Utility Failure, except as provided under Special Property Coverages
6. Government Action
7. War and Military Action
8. Nuclear Reaction
9. Pollution, except as provided under Extensions of Coverage
10. Asbestos
CQ/Cor&a.
10 Acordia Southeast
Insurance • Bonding • Employee Benefits
VILLAGE OF TEQUESTA
GENERAL LIABILITY
Term: 10/01/99 -00
Company Coregis Insurance Group
(Rated A IX by A. M. Best)
Limits of Liability:
Primary Bodily Injury and Property $100,000 Per Person
Damage Liability — F.S. 768.28 (Note 1) $200,000 Per Occurrence
Excess Bodily Injury and Property $1,900,000 Total Amount Per Person
Damage Liability (Note 2) $1,800,000 Total Amount Per Occurrence
General Aggregate $6,000,000 Amount Annual
Deductible: $ None
lie Coverages:
1. Law enforcement operations'' 12. Additional persons insured
2. EMT/Paramedic professional 13. Extended bodily injury
services 14. Incidental medical malpractice
3. Premises operations 15. Employee benefits liability
4. Products and completed operations -Retro date Eff. Date: 10/01/98
5. Fire legal liability $50,000 16. No fault sewer back -up
6. Medical expense limit $5,000 ($5,000 per occurrence)
7. "Insured" contracts 17. Failure to supply $ 250,000
8. Host liquor law liability 18. Herbicide or Pesticide Application
9. Broad form property damage $250,000
10. Watercraft liability (under 51 feet) 19. Cemetery Liability $250,000
11. Limited worldwide coverage
Notes of Importance:
1. "Primary" bodily injury and property damage liability provides full tort liability based
- on Florida sovereign immunity limits under F.S. 768.28.
2. "Excess" bodily injury and property damage liability is limited to legislative "claims
bills" and claims subject to federal or out -of -state jurisdictions
• 3. Standard policy exclusions include, but are not limited to public officials liability;
pollution (including asbestos). See sample Policy for coverage terms and conditions.
4. Defense costs and attorney's fees are paid in addition to the limits of liability.
5. Premium is not auditable. ordla®
- 11 Acordia Southeast
Insurance • Bonding • Employee Benefits
• VILLAGE OF TEQUESTA
LIABILITY COVERAGE EXTENSIONS
The following extensions significantly broaden coverage for your public entity. These
coverages are included at no additional cost to you.
1. "Bodily Injury" definition includes shock, mental anguish, mental injury and
humiliation.
2. "Personal Injury" includes false or improper service of process, violation of property
rights, discrimination, and violation of civil rights. Related to law enforcement, the
definition also includes assault and battery, and false or improper service of process.
i
3. Liability claims of inverse condemnation are covered. Sublimit - $1,000,000
4. Expanded definition of "Who is Insured" to include governmental subdivisions, elected
and appointed officials, employees, and volunteers.
5. Emergency Medical Technicians and Paramedics are covered for bodily injury,
property damage, and personal injury claims arising out of emergency health care
services provided by them.
• 6. Contractual liability assumed in any joint powers or mutual law enforcement
agreements.
7. Authorized secondary employment (moonlighting) for law enforcement officers.
MAJOR EXCLUSIONS
• Expected or Intended Injury • Aircraft and Airports
• Contractual Liability • Mobile Equipment
• Workers' Compensation & Similar • Damage to Property
Laws • Asbestos
• Employment- Related Practices • Nuclear
• Employer's Liability • Health Care Facility
• Pollution • Medical Professional Liability
• Auto or Watercraft • War
• For additional exclusions and more details on how they apply, please refer to coverage
form.
CQ4onfia.
12 Acordia Southeast
Insurance • Bonding • Employee Benefits
• VILLAGE OF TEQUESTA
AUTOMOBILE LIABILITY AND PHYSICAL DAMAGE
Term: 10/01/99 -00
Company Coregis Insurance Group
(Rated A IX by A. M. Best)
Limits of Liability:
Primary Bodily Injury & Property $100,000 Per Person
Damage Liability — F.S. 768.28 (Note 1) $200,000 Per Occurrence
Excess Bodily Injury and Property $1,900,000 Total Amount Per Person
Damage Liability (Note 2) $1,800,000 Total Amount Per Occurrence
Personal Injury Protection $10,000 (Statutory)
Uninsured Motorists $ None
Medical Payments $ N/A
Liability Deductible: $ None
Physical Damage: Comprehensive - # units —63
Collision - #units - 63
Deductible:
Comprehensive $ 250
Collision $ 500
Coverages and Notes of Importance:
1. "Primary" bodily injury and property damage liability provides full tort liability based
on Florida sovereign immunity limits under F.S. 768.28.
2. "Excess" bodily injury and property damage liability is limited to legislative "claims
bills" and claims subject to federal or out -of -state jurisdictions.
3. Defense costs and attorney's fees are paid in addition to the limits of liability.
4. Liability deductibles, if applicable, apply only to judgements or settlements.
5. Premium is not auditable.
6. Physical damage is paid based on actual cash value.
•
CQfcorcha.
13 Acordia Southeast
Insurance • Bonding • Employee Benefits
VILLAGE OF TEQUESTA
I PUBLIC OFFICIALS LIABILITY
DUTY TO DEFEND FORM
Term: 10/01/99-00
Compank Coregis Insurance Group
(Rated A IX by A. M. Best)
Limits of Liability $1,000,000 Each Loss
General Aggregate $1,000,000 Annual
Retention for Judgments or Awards: $ 10,000
Retention for Defense Costs: $ None
C overages:
1. Loss is covered as a result of Civil Claims made against the insured by reason of a
Wrongful Act.
2. Claims -made policy form with full "Prior Acts" coverage included:
3. Defense costs are paid in addition to the policy limit. The company appoints counsel.
4. Includes employment benefits (back wages, future wages, and salaries and bonuses).
5. Outside board activities extension.
Endorsements:
1. Enhanced Employment Liability- covers any Claim arising out of employee hiring,
advancement, remuneration, treatment, condition or termination of employment
(including sexual molestation).
2. OPTIONAL: Non - Monetary Suit Defense Costs - reimburses the insured for incurred
defense costs up to $10,000 per Suit and $50,000 aggregate for non - monetary claims.
Please refer to specific endorsements for additional details on how coverage applies.
Notes of Importance:
1. The extended reporting period option is 12 months for 50% of the policy period
premium.
2. This quotation is subject to receipt and approval of completed and signed application
prior to binding.
CQkonfia.
14 Aeordia Southeast
Insurance • Bonding • Employee Benefits
• VILLAGE OF TEQUESTA
- FLORIDA CITIES AND SPECIAL DISTRICTS
CLAIMS ADMINISTRATION
Coregis administers and closely controls all claims from start to finish. Ms. Linda Clarke is
the Claims Coordinator for the Program and performs the initial review of all loss notices.
Out of a staff of 42 adjusters, nine are dedicated to Florida governmental agencies. This
team of full -time, licensed adjusters fully understands federal laws and state statutes
governing actions against public entities.
Outside independent adjusting companies are assigned field investigation and appraisal
services when needed. The fieldwork will be provided through Elliott Claims Service or
Ward North America. Both companies have nine offices throughout the state.
You will find our approach to be aggressive and protective of your entity's interests. We
take full advantage of rights afforded under the law. Setting a precedent of always settling
claims does not characterize the Program's position.
It is important for claims to be reported quickly and easily by your staff. To assist in this
area, every insured is provided with a claims kit. The kit includes standard ACORD Loss
Notice forms that have all the basic information completed: Also included are automobile
• accident kits and guidelines on filing a claim. Initial loss notices are submitted to Acordia
Southeast in West Palm Beach.
In case of a disaster, a 24 -hour claim hotline is available.
LOSS CONTROL SERVICES
The loss control services for Program members are designed to help educate and assist in
developing and implementing your own loss control program. The Coregis full time loss
control representative is available for consultations by phone, correspondence and in
person.
Some of the services provided at no extra cost are:
• Loss analysis of frequency or severity problems
• Access to the National Resource Safety Center video library containing over
6,000 titles
• Safety "self- inspection" checklists
• Safety bulletins ( Risk- Notes
• Quarterly safety publications ( The Shield
• Formulating and adopting a written safety manual
• Employee safety awareness
• • Defense driving programs
ordsa®
15 Acordia Southeast
Insurance • Bonding • Employee Benefits
SEP.- 16'99(THU) 11:35 ACORDIA LIFE /HEALTH TEL:561 -838 -9683 P.002
• VILLAGE OF TEQUESTA
PREMIUM RECAPITULATION
Revised as of 9/16/99
Property $ 11,140
Inland Marine $ 1,954
General Liability & Law;lpforceiperpt $ 40,550
Automobile Liability and Physical Damage $ 44,694
Total Coregis Package Premium: $ 98,338
Public Officials Liability
EMT Malpractice Liability $ 2,813 est.
• Boiler & Machinery with Hartford $ 1,314
AD &D with Hartford
a
Workers Compensation $ 83,481
Commercial Crime $ 454
Total All'Unes of Coverage $192
Total Premium For Last Yeac ��96,332
i1 i f
I
Notes o [Importance
This proposal is subject to approval of Y2K application:
Subject to Florida Surcharges equal to .001 of proposed' premiums excluding Automobile
premiums
s or&a.
16 Acordia Southeast
Insurance • Bnnding • Boeployre Benefits
j
'( i
i
PGIT - Preferred Governemntal Insurance Trust
i Premium Summary
Guaranteed Cost Plan
NAME: VILLAGE OF TEQUESTA POLICY DATE 10/01/99- 10/01/2000
MBR #:
AGENCY: Acordia Southeast, Inc. ANNIVERSARY 10/1/1999
501 S. Flager Dr. #600 RATING DATE
West Palm Beach, FL 33401
CLASS ESTIMATED ESTIMATED
CODE DESCRIPTION RATES PAYROLL PREMIUM
5509 CT- STREET /ROAD MAINTENANCE- MUNICIPAL,COU $ 8.34 182,595 $15,228
7520 WATERWORKS OPERATION & DRIVERS $ 5.68 342,903 $19,477
7704 FIREFIGHTERS & DRIVERS $ 8.86 648,314 $57,441
7720 POLICE OFFICERS & DRIVERS $ 8.17 844,108 $68,964
8810 CLERICAL OFFICE EMPLOYEES NOC $ 0.55 781,831 $4,300
9102 PARK NOC - ALL EMPLOYEES & DRIVERS $ 8.98 35,964 $3,230
9410 MUNICIPAL,TOWNSHIP,COUNTY OR STATE EMPLO $ 13.29 22,794 $3,029
TOTALS $2,858,509 $171,669
ESTIMATED MANUAL PREMIUM $171,669
EMPLOYERS' LIABILITY $171,669
$ 1,000,000/$1,000,000 /$1,000,000
DEDUCTIBLE $171,669
$171,669
SAFETY CREDIT 2.00% $3',433 $168,236
DRUG FREE WORKPLACE 5.00% $8,412 $159,824
EXPERIENCE MODIFICATION 0.83 7:,($27,170) $132,654
ESTIMATED MODIFIED PREMIUM $132,654
PGIT DISCOUNT 30.00% $39,796 $92,858
STOCK VOLUME DISCOUNT $9,577 $83,281
ESTIMATED DIRECT PREMIUM $83,281
EXPENSE CONSTANT $200
ESTIMATED TOTAL PREMIUM $83,481
Ex erience modification Factor is subject to verification.
The above quote may include Safety and /or Drug Free Workplace credits.
The final amount of credit is dependent upon compliance with program requirements.
Pa roll subject to Final Premium Audit.
Payment Plan: 25% Down and 9 equal installments
Due October 1 $21,020.28
9 monthly pmts @ $6,940.08
• Last pmt. Due 7/1/00
CQfc orda.
9 Aco / rdi 9 a So t east
Insurance • Bonding • Employee Benefits
SEP -16 -1999 THU 11 :26 AM FLORIDA LEAGUE OF CITIES FAX NO, 407 317 7181 P. 01/03
FLORIDA LEAGUE OF CITIES, INC.
il East colonial of ive ♦ P.O. Box 530065 ♦ oriando, FL 32853 -0065
(407) 425 -9142 ♦ Suncom 344 -0720
To: Name: Kim Bodinizzo
Company: Village of Tequesta
Fax Number: (561) 575 -6203
Voice Phone:
From: Name: Nancy Tinn
Fax Number. (407) 317 -7181
Voice Phone: (407) 425 -9142 ext. 308
Re: Workers' Compensation Proposal
Date of transmission: September 16, 1999
Number of pages including this cover sheet: 3
Dear Kim
Attached are the corrected pages to the proposal.
If you have any questions or would like additional information, please call me.
Thank you for your assistance.
Sincerely,
Nancy
•
SEP -16 -1999 THU 11:26 AM FLORIDA LEAGUE OF CITIES FAX NO. 407 317 7181 P. 02/03
• FLORIDA MUNICIPAL INSURANCE TRUST
WORKERS' COMPENSATION — 1999/00
VILLAGE OF TEQUESTA
Total Payroll: $2,858,509
Experience Modification: .90
*Drug Free Workplace Credit (5 %) -8,320
*Safety :Credit (2%) -3,161
Total Net Premium: $99,140
*Includes Eligible Credits for Adoption of Program(s):
Note: The Workers' Compensation premium is subject to adjustment
when the October 1, 1999 experience modification is received.
SEP -16 -1999 THU 11:26 AM FLORIDA LEAGUE OF CITIES FAX NO. 407 317 7181 P. 03/03
FLORIDA MUNICIPAL INSURANCE TRUST
Workers' Compensation -1999 -2000
Village of Tequesta
Class code Description Pavroll
5509 Street or Road Maintenance $145,784
7520 Waterworks Operations $445,927
7704 Firefighters $657,457
7720 Police $828,968
8810 Clerical $694,618
9102 Park N.O.C. $ 34,302
• 9410 MunicipaUTown /County /State N.O.C. $ 51,453
Total Payroll $2,858,509
• 3