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Home My WebLink AboutContracts & Agreements_132-2017 >� fii T.i"� � i u a�.11�^ :uh ;i. 1,''i r•.. � ��.51�, .t^ ..}• Binding Requirements Recap Required no later than June 30 2017 • Signed and dated Request to Bind Coverage form (below) • Signed and dated Surplus Lines forms as required by your state and attached to this proposal* • Signed and dated APIP Claims Reporting Acknowledgement(s) Receipt Form • Signed and dated Terrorism Risk Insurance ACT of 2002 as amended (a k a TRIPRA 2015) * only required for coverage in the following states AR, CA, CT, FL, KS, MA, MT, NE, NY, NC, ND, OH, RI, WV,WY Request to Bind Coverage City of Redlands,CA We have reviewed the proposal and agree to the terms and conditions of the coverages presented This Authorization to Bind Coverage also acknowledges receipt and re view of all disclaimers, disc%sures, and loss notification requirements including exposures used to develop insurance terms, contained within this proposal �csl'-& ' -11, 6/aI17 Paul W Foster, Mayor /Date Attest Jolne Donaldson, City Clerk This proposal does not constitute a binder of insurance. Binding Is subject to final carrier approval The actua/terms and conditions ofthe po/icy wf//pfeval/ Date Issued June 7,2017 Alliant Insurance Services, Inc I www alliant.com l CA License No OC36861 Page 3 APIP Claims Reporting Acknowledgement(s) Receipt Form The Claims Reporting Forms are being included with your packet to ensure claims reporting procedures are known and available for future reference Please review the information We ask that you share these critical documents with all members of your team (and Pool Members and their staffs where applicable) We request that you review the items indicated as attached then complete the bottom portion, sign and submit to your Alliant Insurance Services representative either by a scanned a mad or mail to have it be included in your insurance records LSO APIP Property Claims Reporting Cyber Claims Reporting (thlslsa clalinsinadepollcj� if coverage is purchased 70 Pollution Liability Claims Reporting (thlsIsaclaliminadepollck if coverage is purchased Acknowledgement for Claims reporting procedures under Alliant Property Insurance Programs In effect. July 1,2017 until further notice I have read and been informed about these separate reporting requirements under the coverage pants that apply to our entity as indicated above and provided through APIP by Alhant Insured Entity Name City of Redlands, CA Authorized Signature Paul W Foster, Mayor Date j ('/2-1117 Attest Date J ne Donaldson, City Clerk Date Issued June 7 2017 Alhant Insurance Services, Inc I www alliant.com I CA License No OC36861 Page 5 NOTICE- 1. OTICE-1. THE INSURANCE POLICY THAT YOU ARE APPLYING TO PURCHASE IS BEING ISSUED BY AN INSURER THAT IS NOT LICENSED BY THE STATE OF CALIFORNIA. THESE COMPANIES ARE CALLED "NONADMITTED" OR "SURPLUS LINE" INSURERS. 2 THE INSURER IS NOT SUBJECT TO THE FINANCIAL SOLVENCY REGULATION AND ENFORCEMENT THAT APPLY TO CALIFORNIA LICENSED INSURERS. 3 THE INSURER DOES NOT PARTICIPATE IN ANY OF THE INSURANCE GUARANTEE FUNDS CREATED BY CALIFORNIA LAW. THEREFORE, THESE FUNDS WILL NOT PAY YOUR CLAIMS OR PROTECT YOUR ASSETS IF THE INSURER BECOMES INSOLVENT AND IS UNABLE TO MAKE PAYMENTS AS PROMISED 4. THE INSURER SHOULD BE LICENSED EITHER AS A FOREIGN INSURER IN ANOTHER STATE IN THE UNITED STATES OR AS A NON-UNITED STATES (ALIEN) INSURER. YOU SHOULD ASK QUESTIONS OF YOUR INSURANCE AGENT, BROKER, OR "SURPLUS LINE" BROKER OR CONTACT THE CALIFORNIA DEPARTMENT OF INSURANCE AT THE FOLLOWING TOLL-FREE TELEPHONE NUMBER: 1-800-927-4357. ASK WHETHER OR NOT THE INSURER IS LICENSED AS A FOREIGN OR NON-UNITED STATES (ALIEN) INSURER AND FOR ADDITIONAL INFORMATION ABOUT THE INSURER. YOU MAY ALSO CONTACT THE NAIC'S INTERNET WEB SITE AT WWW.NAIC.ORG 5. FOREIGN INSURERS SHOULD BE LICENSED BY A STATE IN THE UNITED STATES AND YOU MAY CONTACT THAT STATE'S DEPARTMENT OF INSURANCE TO OBTAIN MORE INFORMATION ABOUT THAT INSURER 6. FOR NON-UNITED STATES (ALIEN) INSURERS, THE INSURER SHOULD BE LICENSED BY A COUNTRY OUTSIDE OF THE UNITED STATES AND SHOULD BE ON THE NAIC'S INTERNATIONAL INSURERS DEPARTMENT {IID) LISTING OF APPROVED NONADMITTED NON-UNITED STATES INSURERS. ASK YOUR AGENT, BROKER, OR "SURPLUS LINE" BROKER TO OBTAIN MORE INFORMATION ABOUT THAT INSURER. 7. CALIFORNIA MAINTAINS A LIST OF APPROVED SURPLUS LINE INSURERS. ASK YOUR AGENT OR BROKER IF THE INSURER IS ON THAT LIST, OR VIEW THAT LIST AT THE INTERNET WEB SITE OF THE CALIFORNIA DEPARTMENT OF INSURANCE• WWW INSURANCE.CA.GOV. S. IF YOU, AS THE APPLICANT, REQUIRED THAT THE INSURANCE POLICY YOU HAVE PURCHASED BE BOUND IMMEDIATELY, EITHER BECAUSE EXISTING COVERAGE WAS GOING TO LAPSE WITHIN TWO BUSINESS DAYS OR BECAUSE YOU WERE REQUIRED TO HAVE COVERAGE WITHIN TWO BUSINESS DAYS, AND YOU DID NOT RECEIVE THIS DISCLOSURE FORM AND A REQUEST FOR YOUR SIGNATURE UNTIL AFTER COVERAGE BECAME EFFECTIVE, YOU HAVE THE RIGHT TO CANCEL THIS POLICY WITHIN FIVE DAYS OF RECEIVING THIS DISCLOSURE. IF YOU CANCEL COVERAGE, THE PREMIUM WILL BE PRORATED AND ANY BROKER'S FEE CHARGED FOR THIS INSURANCE WILL BE RETURNED TO YOU. Date: g/.Z.1/ ) 7 Named Insured: City of Redlands Authorized Signature�� Paul W Foster,Nlayor Attest Jea Donaldson,City Clerk D-1 (Effective July 21, 2011) 4 •„ ALLIANT INSURANCE SERVICES POLICYHOLDER DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE June 7, 2017 Named Insured City of Redlands,CA We are required to send you this notice pursuant to federal legislation concerning terrorism insurance You are hereby notified that under the Terrorism Risk Insurance Act of 2002 as amended, you have a right to purchase insurance coverage for losses resulting from acts of terrorism As definedin Section 102(1)of the Act, as amended The term `act of terrorism means any act that is certified by the Secretary of the Treasury, in consultation with the Secretary of Homeland Security and the Attorney General of the United States, to be an act of terrorism, to be a violent act or an act that is dangerous to human life, property, or infrastructure to have resulted in damage within the United States, or outside the United States in the case of certain air carrier or vessel or the premises of a United States mission, and to have been committed by an individual or individuals, as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion Any coverage you purchase for "acts of terrorism" shall expire at 12 00 midnight December 31 2020 the date on which the TRIA Program is scheduled to terminate or the expiry date of the policy whichever occurs first, and shall not cover any losses or events which arise after the earlier of these dates YOU SHOULD KNOW THAT COVERAGE PROVIDED BY THIS POLICY FOR LOSSES CAUSED BY CERTIFIED ACTS OF TERRORISM IS PARTIALLY REIMBURSED BY THE UNITED STATES UNDER A FORMULA ESTABLISHED BY FEDERAL LAW HOWEVER, YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, SUCH AS AN EXCLUSION FOR NUCLEAR EVENTS UNDER THIS FORMULA, THE UNITED STATES PAYS 85% THROUGH 2015 84% BEGINNING ON JANUARY 1 2016 83% BEGINNING ON JANUARY 1 2017, 82% BEGINNING ON JANUARY 1 2018, 81% BEGINNING ON JANUARY 1, 2019 AND 80% BEGINNING ON JANUARY 1, 2020, OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED DEDUCTIBLE PAID BY THE INSURER(S) PROVIDING THE COVERAGE YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT AS AMENDED CONTAINS A USD100 BILLION CAP THAT LIMITS U S GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS USD100 BILLION IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED USD100 BILLION, YOUR COVERAGE MAY BE REDUCED THE PREMIUM CHARGED FOR THIS COVERAGE CAN BE REQUESTED BELOW AND WILL NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT Alliant Insurance Services, Inc • 100 Pine St 11th Floor San Francisco, CA 94111 2711• PHONE(415)403-1400 FAX(415)402 0773• www alliant corn • License No OC36861 SELECT/ON ORREJECT/ON OF THE TERROR/SMR/SK/NSURANCEACT of2002 asAMENDED (A/CA -TR/PRA 2015) WHAT YOU NEED TO DO NOW THIS COVERAGE IS OUTSIDE OF THE PROGRAMS TERRORISM COVERAGES AND LIMITS IT IS PROVIDED AND OVERSEEN BY THE U S GOVERNMENT THIS COVERAGE IS RESTRICTIVE COMPARED TO APIP TERRORISM LIMITS AND COVERAGES THIS ACT DOES NOT FOLLOW OUR PROGRAM S TERRORISM POLICIES PLEASE PLACE AN "X" IN ONE OF THE BOXES BELOW AND RETURN THIS FORM TO YOUR INSURANCE REPESENTATIVE I am interested in receiving a quote for Terrorism Risk Insurance Act coverage as required by law to be offered under the last amended Act Please provide me with a quote I decline to purchase the Terrorism Risk Insurance Act coverage as required by law to be offered under the last amended Act Paul W Foster, Mayor ate Attest �0,9/It..c.. �.fiC1✓n � Je�rfjKe Donaldson, City Clerk Ginty/of Redlands, CA Ailiant Insurance Services Inc• 100 Pine St 11th Floor San Francisco, CA94111-27110 PHONE(415)403 1400 FAX(415)402-0773• www alliant.com • License No OC36861 Affiant : . COVERAGE REQUEST . - BINDING IS SUBJECT TO FINAL CARRIER APPROVAL Please confirm acceptance of this proposal by signing below and faxing to 415-874-4811 or email- aferrv(ti),alliant com to Andrea Ferry at Alliant Insurance Services prior to July 1, 2017 Would you like to bind coverage as proposed below, effective 7/17/17 to 7/1/18? Yes *O/No 0 If yes, please select your option r'(fyExcess Liability ($500,000 SIR Option) $25 Million Dollars Excess General Liability of $ 1 Million Dollar Self Insured Retention with CSAC EIA for an annual premium of$610,000 Or 0 Excess Liability($1,000,000 SIR Option) $25 Million Dollars Excess General Liability of $ 1 Million Dollar Self Insured Retention with CSAC EIA for an annual premium of$485,000 A list of participating insurance carriers is provided on the following page Conor Boughy, ARM — ! Vice TttNAIliant Insurance Services, Inc D e 06/14/2017 Paul Barich, Mayor Pro Tempore City of Redlands Date 6 /20//17 Att Jeanne Donaldson, City Clerk City of Redlands Date (�o /-20/( -7 This proposal does not constitute a binder of insurance Binding is subject to final carrier approval The Actual terms and conditions of the policy will prevail