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Please confirm acceptance of this proposal by signing below and faxing to 415-
874-4811
I5$?4-4811 or email: Prt....ln'i ri:i" '� � �� ..r�ll� lax ��..;�� u�r l to Andrea Ferry at Alliant
Insurance Services prior to July 1, 2016..
Would you like to bind coverage as proposed below' Yes No I3
If yes, please select your options.
�n�°°�Property with Alliant Property Insurance Program (APIP): 75 Million
Dollars Aggregate, including Automobile Physical Damage coverage for annual
premium of$379,650.0O
Airport Liability with (old Republic Insurance Company: 10 Million Dollars
limit for annual premium of$4,108.00
Excess Workers' Compensation with Safety National: 25 Million Dollars
Aggregate for annual premium of$141,001.00
Conor Bou hy, ARM
Vice President, Alliant Insurance Services, Inc.
O6/2C/2016
Date
Mayor- Paul',. '. poster
City of edl nds
, x.
Cat
City Clerk Barn Avin
City of R Plarlds
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Date
This proposal does not const%tutu a binder of insurance. Binding is subject to final carrier approval.. The Actual
terms and conditions of the policy will prevail.