HomeMy WebLinkAbout000258.tiff e. Arthur J. Gallagher Risk Management Services, inc. -
July 28, 2007
Weld County Interagency Group
Attn: Don Warden
PO Box 758
Greeley, CO 80632
Re: Public Officials Professional Liability Policy 0202-1366
Dear Mr. Warden,
The Group's policy captioned above is enclosed and should be retained as a
permanent record. We have reviewed the policy for accurate issuance and
find it to be in order. A current summary of insurance is also enclosed for your
easy reference. It should be noted that the proposal indicated a $50,000 back
wages per claim and aggregate limit, and this is not correct. Any back wages
awards as a result of a covered claim are included within the $1,000,000
Employment Practices Each Wrongful Act limit.
We ask that you take a few minutes to review the policy and contact us with
any questions or corrections. We appreciate the continuing opportunity to
service the Group's insurance needs.
Best regards,
Mit.,q_
Cindy Hewett, CRM
Account Manager
Enclosure
6399 South Fiddler's Green Circle,Suite 200
Greenwood Village,CO 80111-4949
303.773.9999
Fax 303.773.9776
Toll Free 800.333.3231
.44p com 258
2007
PUBLIC OFFICIALS LIABILITY INSURANCE
CURRENT SUMMARY OF INSURANCE
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WELD COUNTY
INTERAGENCY OVERSIGHT GROUP
PRESENTED: FEBRUARY 7, 2007
POLICY EFFECTIVE DATE: 2/7/07 TO 2/7/08
INSURED MAILING ADDRESS: PO Box 758, GREELEY, CO 80632
PRESENTED BY:
PRISCILLA MCCOY, CIC, CRM
AREA SENIOR VICE PRESIDENT
CINDY HEWETT, CRM ANITA BRUNER, CISR
ACCOUNT MANAGER ACCOUNT ASSISTANT
Gallagher Public Entity and Scholastic Division
ARTHUR J. GALLAGHER RISK MANAGEMENT SERVICES, INC.
6399 S. FIDDLERS GREEN CIRCLE, SUITE 200
GREENWOOD VILLAGE, CO 80111
(303) 773-9999
WWW.AJG.COM IP The Knowledge Broker
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WELD COUNTY INTERAGENCY OVERSIGHT GROUP
EXPOSURE 8t PREMIUM SUMMARY
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WELD COUNTY INTERAGENCY OVERSIGHT GROUP
PREMIUM AND EXPOSURE SUMMARY
EXPOSURE SUMMARY
COVERAGE 2007
NUMBER OF GROUP MEMBERS 12
PREMIUM SUMMARY - INCLUDING THIRD PARTY LIABILITY
COVERAGE 2007
PUBLIC OFFICIALS LIABILITY $ 2,608.00
INSPECTION FEE $ 195.00
CO SURPLUS LINES TAX - 3% $ 84.09
TOTAL $ 2,887.09
Note: Premiums for the above policies are due and payable as billed, in full or as insurance
company installments. Premiums may be financed, subject to acceptable by an approved
finance company. Following acceptance, completion (and signature) of a premium finance
agreement with the specified down payment is required.
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WELD COUNTY INTERAGENCY OVERSIGHT GROUP rl/
COVERAGE SUMMARY
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WELD COUNTY INTERAGENCY OVERSIGHT GROUP
PUBLIC OFFICIALS LIABILITY - CLAIMS MADE
POLICY PERIOD: TBD
COMPANY: Darwin Select Insurance Co.
A.M. BEST'S RATING (EFFECTIVE DATE): A- VIII (12-21-2006)
ADMITTED/ NON-ADMITTED: Non-Admitted
POLICY FORM: DRWN POL 1005 and 1000
LIMITS OF LIABILITY: I $ 1,000,000 Each Wrongful Act
I $ 1,000,000 Employment Practices Each
Wrongful Act
I $ 1,000,000 Annual Aggregate
EPL SuBLIMITS I $ 50,000 Non-Monetary Defense per
claim
I $ 100,000 Non-Monetary Defense
Aggregate
DEDUCTIBLE: I $ 2,500 Each Claim Including Defense
Costs
RETROACTIVE DATE: I Policy Inception Date
INSURING AGREEMENTS AND DEFINITIONS:
COVERAGE A I Public Officials Professional Liability
COVERAGE B I Employment Practices Liability Wrongful Act
COVERAGE C I Non-Monetary relief paid on reimbursement basis,
Insured has a duty to defend these claims
DEFINITION OF PUBLIC OFFICIALS I Any actual or alleged act, error, omission,
WRONGFUL ACT misstatement, misleading statement or breach of
duty, including any Personal Injury; any actual or
alleged violation of civil rights , any matter claimed
against the insured solely by reason of his or her
status as an insured
DEFINITION OF EMPLOYMENT I Wrongful dismissal, discharge or termination of
PRACTICES WRONGFUL ACT employment, harassment (including sexual
harassment), discrimination, breach of any manual
of employment policies, retaliatory action,
misrepresentation, libel, slander, humiliation,
defamation, invasion of privacy, emotion distress or
mental anguish, wrongful failure to employ or
promote, wrongful deprivation of career
opportunity, including tenure, wrongful demotion
or evaluation or wrongful discipline
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WELD COUNTY INTERAGENCY OVERSIGHT GROUP C h
PUBLIC OFFICIALS LIABILITY - CLAIMS MADE
(CONTINUED)
DEFINITION OF INSURED I All past, present or future duly elected or appointed
or employed officials, directors, or members of
commissions, boards or other unites operated by the
named insured, employees and all persons providing
services to the Named Insured under a mutual aid or
any similar agreement
DEFINITION OF Loss I Damage, pre and post judgment interest, front pay
and back pay, judgments, settlements, punitive or
exemplary damages where insurable under
applicable law or other amounts that an Insured is
legally obligated to pay as a result of a claim. Loss
does not include Non-Monetary Relief or Defense
Expenses as defined in the policy
DEFINITION OF NON-MONETARY ► Relief or redress in any form other than
RELIEF compensatory or monetary damages, including but
not limited to (refer to policy for full definition): costs
of complying with any injunctive, declaratory or
equitable relief, remedy or order, Americans with
Disabilities Act compliance, or similar provision, any
award of claimant's or plaintiff's attorney fees or
costs but only with respect to Claims seeking such
non-monetary relief
TERMS AND CONDITIONS:
I Pay on Behalf of Form, Except Insuring Agreement C
I Defense Costs are in addition to the limits
DUTY To DEFEND I Insurer has a duty to defend claims under Insuring
Agreements A & B. The Insured has a duty to defend
claims under Insuring Agreement C.
NOTICE OF CLAIM OR I Claim must be presented as soon as practicable and
CIRCUMSTANCE in no event later than 75 days after expiration of the
policy
EXTENDED REPORTING PERIOD/ I Extended Reporting Period must be requested in
DISCOVERY PERIOD writing within 30 days after the effective date of
termination. One year extension for 70% of annual
premium, Two year period 100% of annual
premium, Three year period 150% of annual
premium
CANCELLATION, NON-RENEWAL I 60 days notice by carrier of non-renewal and 20 days
for non-payment of premium. Policy cannot be
canceled by the Insurer except for non-payment of
premium.
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WELD COUNTY INTERAGENCY OVERSIGHT GROUP
PUBLIC OFFICIALS LIABILITY - CLAIMS MADE
(CONTINUED)
TERMS& CONDITIONS- I No act, error or omission of any Insured will be
CONTINUED imputed to any other Insured
I Endorsement: Coverage is limited to wrongful acts
associated with services provided by the Weld
County Interagency Oversight Group
I Hammer Clause — Settlement Provision: If insured
refuses a settlement, insurer's liability is limited to
the amount for which the claim could have been
settled plus defense expenses, plus the insured will
pay 50% of any Loss and Defense Expenses in
excess of the amount the insurer would have settled
the claim. The remaining Loss and/or Defense
Expenses will be carried at the Insured at its own risk
and will be uninsured.
MINIMUM EARNED PREMIUM I Greater of $1,500 or 25% of annual premium, no
flat cancellations
EXCLUSIONS INCLUDING BUT NOT LIMITED TO:
I Fines, Taxes or Penalties
I Insurer shall not pay a loss (but shall only pay
Defense Expenses) from any claim for willful
misconduct or dishonest, fraudulent, criminal or
malicious act, error or omission by an Insured, any
willful violation by an insured of any law, or
regulation or any insured gaining any profit or
advantage to which such insured is not legally
entitled
I Loss or Defense for violation of the Fair Labor
Standards Act, Consolidated Omnibus Budge
Reconciliation Act of 1985, OSHA, any workers'
compensation, unemployment, social security or
disability except as they apply to an Employment
Practices Wrongful Act
I Bodily injury, corporal punishment, sickness, disease
or death
I Sexual abuse or molestation
I Pollution liability
I ERISA Compliance
I Certified Acts of Terrorism or Terrorism
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WELD COUNTY INTERAGENCY OVERSIGHT GROUP
PUBLIC OFFICIALS LIABILITY - CLAIMS MADE
(CONTINUED)
EXCLUSIONS INCLUDING BUT NOT ► Fiduciary Liability
LIMITED TO: (CONTINUED)
1 Breach of Contract
1 Failure to Purchase or Maintain Insurance
1 Eminent Domain
War or Nuclear Liability
TERRITORY 1 Worldwide
LIST OF MEMBERS 1 Weld County Department of Social Service
19th Judicial District including Probation
Department
1 Weld County Department of Public Health &
Environment
1 North Range Behavioral Health
1 Northeast Behavioral Health, LLC
1 Centennial Board of Cooperative Educations
Services
1 Weld County School District #6
1 Island Grove Regional Treatment Center
1 Division of Youth Corrections, Northeast Region
1 Weld County Division of Human Services
1 19th Judicial District Attorney
I United Way of Weld County
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ddiWl Public Officials Professional Liability
darwrInsurance Policy Declarations
❑ Darwin National Assurance Company Policy Number: 0202-1366
® Darwin Select Insurance Company THIS IS A "CLAIMS MADE" POLICY
SUBJECT TO ITS TERMS, THIS POLICY PROVIDES COVERAGE FOR CLAIMS FIRST MADE DURING THE POLICY
PERIOD OR EXTENDED REPORTING PERIOD, IF APPLICABLE. PLEASE READ AND REVIEW THE POLICY
CAREFULLY.
Item 1. Name and Mailing Address of Named Insured: "This contract is delivered as a surplus line
coverage under the'Non-admitted Insurance
Weld County Interagency Oversight Group Act:The insurer issuing this contract is not
915 10th Street licensed in Colorado but is an approved non-
Greeley, CO 80631 admitted Insurer. There is no protection
under the provision of the Colorado Insurance
Guaranty Association Act."
Item 2. Policy Period:
(a) Inception Date: 02/07/2007
(b) Expiration Date: 02/07/2008
At 12:01AM Standard Time at the Mailing Address Shown Above
Item 3. Limits of Liability:
(a) Public Officials Professional Liability
$1,000,000 Insurer's maximum Limit of Liability for all Loss from each Claim under INSURING AGREEMENT I.A.
(b) Employment Practices Liability
$1,000,000 Insurer's maximum Limit of Liability for all Loss from each Claim under INSURING AGREEMENT I.B.
(c) Policy Aggregate
$1,000,000 Insurer's aggregate Limit of Liability for all Loss from all Claims under INSURING AGREEMENT I.A and
INSURING AGREEMENT I.B.
(d) Supplementary Payments
$50,000 Insurer's maximum Limit of Liability for all Defense Expenses from each Claim under INSURING
AGREEMENT I.C.
(e) Supplementary Payments Aggregate
$100,000 Insurer's maximum aggregate Limit of Liability for all Defense Expenses from all Claims under
INSURING AGREEMENT I.C.
Item 4. Retentions:
(a) $2,500 each and every Claim under INSURING AGREEMENT I.A. �1
PREMIUM v
(b) $2,500 each and every Claim under INSURING AGREEMENT I.B. TAX
STAMPING FEE
(c) $2,500 each and every Claim under INSURING AGREEMENT I.C. OTHER FEES.__
DRWN POL 1005 (6/2006)
Item 5. Notices Required to be Given to the Insurer Must Be Addressed to:
Darwin Professional Underwriters, Inc.
9 Farm Springs Road
Farmington, CT 06032
Item 6. Premium: $2,608.00
Total Policy Premium: $2,608.00
Item 7. Retroactive Date: 02/07/2007
Item 8. Endorsements Attached at Issuance:
See Schedule of Forms and Endorsements
THESE DECLARATIONS, THE POLICY FORM, ANY ENDORSEMENTS AND THE APPLICATION CONSTITUTE
THE ENTIRE AGREEMENT BETWEEN THE INSURER AND THE INSURED RELATING TO THIS INSURANCE.
In Witness Whereof, the Insurer has caused this Policy to be executed by its authorized officers.
This contract is delivered as surplus lines coverage under the
"Nonadmitted Insurance Act." The insurer issuing this contract is
not licensed in Colorado but is an approved nonadmitted insurer.
There is no protection under the provisions of the Colorado
Guaranty Association Act.
03/28/2007
Authorized Representative ' Date
DRWN POL 1005 (6/2006)
SCHEDULE OF POLICY FORMS AND ENDORSEMENTS
Form(s) and Endorsement(s) made a part of this policy at time of issue.
Form Number Edition Date Description
DRWN POL 1005 2006-06-01 Public Officials Professional Liability Insurance Policy Declarations
DRWN POL 1000 2006-10-01 Public Officials Professional and Employment Practices Liability Insurance Policy
SAA-100 1998-08-01 Schedule of Policy Forms and Endt's.
Manu 1366 2007-03-01 Coverage Limited to Specific Wrongful Acts
s1006 DSI 2005-04-01 Service of Suit
SAA-100 (8-98)
Public Officials Professional and Employment
daTWi
Practices Liability Insurance Policy
SUBJECT TO ITS TERMS, THIS POLICY PROVIDES COVERAGE FOR CLAIMS FIRST
MADE DURING THE POLICY PERIOD OR EXTENDED REPORTING PERIOD, IF
APPLICABLE. GENERALLY, DEFENSE EXPENSES ARE PAID IN ADDITION TO THE
LIMITS OF LIABILITY. PLEASE READ AND REVIEW THE POLICY CAREFULLY.
In consideration of the payment of the premium and in reliance upon all statements made and information
furnished to the Insurer, including the statements made in the Application, the Insurer and the
Insureds, subject to all of the terms, conditions and limitations of this Policy and any endorsements
thereto,agree as follows:
I. INSURING AGREEMENTS
A. Public Officials Professional Liability
The Insurer will pay on behalf of any Insured, subject to the Limit of Liability set forth
in ITEM 3(a)of the Declarations, Loss which the Insured is legally obligated to pay as a
result of any Claim first made against any Insured during the Policy Period or any
applicable Extended Reporting Period for a Public Officials Wrongful Act which
occurred on or after the Retroactive Date and before the end of the Policy Period.
B. Employment Practices Liability and Third Party Liability
The Insurer will pay on behalf of any Insured, subject to the Limit of Liability set forth
in ITEM 3(b) of the Declarations, Loss which the Insured is legally obligated to pay as a
result of any Claim first made against any Insured during the Policy Period or any
applicable Extended Reporting Period for an Employment Practices Wrongful Act or
Third Party Wrongful Act which occurred on or after the Retroactive Date and before
the end of the Policy Period.
In addition to the applicable Limits of Liability set forth in ITEM 3 of the Declarations, the
Insurer will have the right and duty to defend any Claim first made against any Insured for a
Wrongful Act which is covered under INSURING AGREEMENTS A. or B. of this Policy, even
if the allegations of such Claim are groundless, false or fraudulent.
C. Supplemental Payments
(I) The Insurer will reimburse the Insured, in addition to the Limits of Liability set
forth in ITEM 3(a), 3(b)and 3(c) of the Declarations, and subject to the Limits of
Liability set forth in ITEMS 3(d) and 3(e) of the Declarations,Defense Expenses
incurred in connection with a Claim exclusively seeking, and at all times
remaining a Claim exclusively seeking, Non-Monetary Relief, which is first
made against any Insured during the Policy Period or any applicable Extended
Reporting Period, and arising out of Wrongful Acts which occurred on or after
the Retroactive Date and before the end of the Policy Period.
DRWN POL 1000 (10/2006) Page 1 of 17
Subject to CONDITION B(3), it shall be the duty of the Insured, and not the
Insurer,to defend any Claim under INSURING AGREEMENT C(1).
(2) The Insurer will pay on behalf of any Insured, in addition to the aggregate
Limit of Liability set forth in ITEM 3(c) of the Declarations, all reasonable
expenses incurred by the Insured at the Insurer's request to assist the Insurer in
the investigation or defense of any Claim, including actual loss of earnings of
any Insured, because of time off from work; provided that the most the Insurer
shall pay shall be up to $250 per day, per Insured. Such "expenses", as used
herein, shall not include salaries of employees of the Named Insured.
II. DEFINITIONS
A. "Application" means the application submitted to the Insurer, any and all materials and
information submitted to the Insurer in connection with such application, and all
publicly available material that is created by the Insured about the Insured that the
Insurer obtained prior to the Inception Date of the Policy, all of which are deemed to be
on file with the Insurer and are deemed to be attached to, and form a part of,this Policy,
as if physically attached.
B. "Business Invitee" means a natural person, solely in their capacity as one who is invited
to enter into and remain on any premises owned or operated by the Named Insured for a
purpose directly or indirectly connected with the business or commercial dealings therein.
A "Business Invitee" shall not, under any circumstances, include a trespasser or any
other person who enters any premises of the Named Insured without its knowledge or
permission or any Employee.
C. "Claim" means:
(I) any written demand for monetary damages or Non-Monetary Relief;
(2) any written request to toll or waive any statute of limitations;
(3) any civil proceeding in a court of law or equity, including any appeal therefrom,
which is commenced by the filing of a complaint,motion for judgment,or similar
proceeding;
(4) any criminal proceeding which is commenced by the return of an indictment or
similar document;
(5) any administrative or regulatory proceeding or investigation, including a
proceeding brought by or before the Equal Employment Opportunity
Commission or similar state or local agency, commenced by the filing of a notice
of charges, formal order of investigation or similar document; or
(6) any arbitration proceeding, or any other alternative dispute resolution proceeding,
to which the Insured must submit or does submit with the Insurer's consent.
A Claim will be deemed to have been first made when an Insured receives notice of the
Claim.
DRWN POL 1000 (10/2006) Page 2 of 17
D. "Contaminant-Toxin" means any of the following:
(1) smoke, vapors, soot, fumes, acids, alkalis, toxic chemicals, liquids or gases,
waste materials (including medical or pharmaceutical supplies and materials
which are intended to be or have been recycled, reconditioned or reclaimed) or
other irritants,pollutants or contaminants;
(2) mold(s), mildew(s), fungi and/or spore(s); or any materials, goods or products
containing, harboring or nurturing any such mold(s), mildew(s), fungi and/or
spore(s);
(3) lead, silica or asbestos, whether or not airborne as a particle, contained in or
formed as part of a product, structure or other real or personal property, ingested
or inhaled or transmitted in any fashion,or found in any form whatsoever; or
(4) nuclear reaction, radioactive contamination or any radiation of any kind,
including but not limited to nuclear radiation and electromagnetic radiation.
E. "Defense Expenses" means reasonable legal fees and expenses incurred by or on behalf
of the Insured in the defense or appeal of a Claim; provided, however, that Defense
Expenses will not include the Insured's overhead expenses or any salaries, wages, fees,
or benefits of its Employees. Defense Expenses shall include the cost of any bond or
appeal bond required in any civil suit, but only for bond amounts within the applicable
Limit of Liability shown in ITEM 3 of the Declarations; provided that the Insurer shall
not be obligated to apply for or furnish any such bond.
F. "Employee" means the following natural persons, but only for Wrongful Acts
committed while acting within the scope of employment for the Named Insured:
(1) full-time,part-time, seasonal and temporary employees; and
(2) all persons who perform services on a volunteer basis for the Named Insured,
and under the direction and control of the Named Insured.
Employee shall not include persons providing services to the Named Insured under a
mutual aid agreement or any similar agreement.
G. "Employment Practices Wrongful Act" means any of the following, when alleged by
any past or present Employee of the Named Insured or any applicant for employment
with the Named Insured, in connection with that person's actual or proposed
employment relationship with the Named Insured:
(1) wrongful dismissal, discharge or termination of employment, whether actual or
constructive;
(2) harassment (including sexual harassment whether "quid pro quo", hostile work
environment or otherwise);
(3) discrimination based upon age, gender, race, color, national origin, religion,
sexual orientation or preference, pregnancy or disability or any basis prohibited
by federal, state or local laws;
DRWN POL 1000 (10/2006) Page 3 of 17
(4) breach of any manual of employment policies or procedures issued to the
Insureds by the Named Insured;
(5) retaliatory action in response to that Employee's:
(a) disclosure or threat of disclosure of any act by an Insured alleged to be a
violation of any federal, state, local or foreign law, common or statutory, or
any rule or regulation promulgated thereunder;
(b) actual or attempted exercise of any right that Employee has under law;
(c) filing of any Claim under the Federal False Claims Act or any other federal,
state,local or foreign"whistle-blower" law;
(6) misrepresentation, libel, slander, humiliation, defamation, invasion of privacy,
infliction of emotional distress or mental anguish; or
(7) wrongful failure to employ or promote, wrongful deprivation of career
opportunity, including tenure, wrongful demotion or evaluation or wrongful
discipline.
H. "Insured" means:
(1) the Named Insured;
(2) all past,present or future duly elected, appointed or employed officials, directors,
or members of commissions, boards or other units operated by the Named
Insured and under its jurisdiction, within the apportionment of the Named
Insured's operating budget in the Application;
provided that "Insured" shall not include the following boards, commissions or
units, or any officials, directors, members or employees thereof: schools,
airports, transit authorities, hospitals, nursing homes, housing authorities, port
authorities or any type of utility companies, unless otherwise provided in an
Endorsement attached hereto;
(3) Employees; and
(4) all persons providing services to the Named Insured under a mutual aid or any
similar agreement; however, such persons are not Insureds with respect to
Claims for Employment Practices Wrongful Acts or Third Party Wrongful
Acts.
In the event of the death, incapacity or bankruptcy of an Insured individual, any Claim
against the estate, heirs, legal representatives or assigns of such Insured individual for a
Wrongful Act will be deemed a Claim against such Insured individual.
"Insurer" means the Company identified in the Declarations.
J. "Loss" means damages,pre-judgment interest,post-judgment interest, front pay and back
pay, judgments, settlements, punitive or exemplary damages where insurable under
DRWN POL 1000 (10/2006) Page 4 of 17
applicable law, or other amounts that an Insured is legally obligated to pay as a result of
a Claim. Loss will not include:
(I) Defense Expenses;
(2) Non-Monetary Relief;
(3) any amount representing the value of diminished or lost retirement, health care
or other benefits;
(4) fines, taxes,penalties; or
(5) the multiplied portion of multiplied damages;provided that Loss will include any
multiplied damages awarded pursuant to the Age Discrimination in Employment
Act or the Equal Pay Act ("Specified Multiplied Damages") that an Insured is
obligated to pay as a result of a Claim, but only if such Specified Multiplied
Damages are insurable under applicable law.
For the purpose of determining the insurability of punitive damages, exemplary damages
or Specified Multiplied Damages under this Policy, the laws of the jurisdiction most
favorable to the insurability of such damages shall control, provided that such
jurisdiction:
(1) is the location of the court which awarded or imposed such punitive or exemplary
damages;
(2) is where the Named Insured is incorporated or otherwise organized or has a
place of business;or
(3) is where the Insurer is incorporated or has its principal place of business.
K. "Named Insured" means the public entity set forth in ITEM 1 of the Declarations.
L. "Non-Monetary Relief' means relief or redress in any form other than compensatory or
monetary damages, including: the costs of complying with any injunctive, declaratory or
equitable relief, remedy or order; the costs of compliance with the Americans with
Disabilities Act or any similar provisions of federal, state or local statutory or common
law; and any award of claimant's or plaintiffs attorneys fees or costs, whether or not
provided for by statute, but only with respect to Claims seeking such non-monetary
relief.
M. "Personal Injury"means the following, when alleged against an Insured by an entity or
a person who is not a past or present Insured, or applicant for employment with the
Insured: libel, slander, or other defamation, invasion of privacy, false arrest, erroneous
service of process, wrongful detention or imprisonment, malicious prosecution, wrongful
entry or eviction, infringement of copyright or trademark, or other unauthorized use of
title, or plagiarism or misappropriation of ideas.
N. "Policy Period" means the period from the Inception Date of this Policy set forth, in
ITEM 2(a) of the Declarations, to the Expiration Date of this Policy set forth in ITEM
2(b)of the Declarations, or to any earlier cancellation date of this Policy.
DRWN POL 1000 (10/2006) Page 5 of 17
O. "Public Officials Wrongful Act" means:
(1) any actual or alleged act, error, omission, misstatement, misleading statement or
breach of duty, including any Personal Injury,by any Insured;
(2) any actual or alleged violation of civil rights protected under 42 USC 1981 et
seq., or any similar federal, state or local law, by any Insured;
(3) any matter claimed against an Insured solely by reason of his or her status as an
Insured during the Policy Period;
and committed in the performance of his or her duties for the Named Insured.
P. "Related Claims" means all Claims for Wrongful Acts based upon, arising out of,
resulting from, or in any way involving the same or related facts, circumstances,
situations, transactions or events or the same or related series of facts, circumstances
situations,transactions or events,whether related logically, causally or in any other way.
Q. "Retroactive Date"means the applicable date set forth in ITEM 7 of the Declarations.
R. "Sexual Abuse and Molestation" means any actual or alleged conduct, physical act,
gesture or spoken or written word of a sexual nature directed by an Insured, or by any
person for whom an Insured is legally responsible, toward any person under the care,
custody or control of any Insured, including without limitation any actual, alleged or
threatened sexual intimacy (even if allegedly consensual), molestation, assault or battery,
exploitation or any other sexual act.
S. "Terrorism"means activities against persons, organizations or property of any nature:
(1) that involve the following or preparation for the following:
(a) use or threat of force or violence; or
(b) commission or threat of a dangerous act; or
(c) commission or threat of an act that interferes with or disrupts an
electronic, communication,information,or mechanical system; and
(2) when one or both of the following applies:
(a) the effect is to intimidate or coerce a government or the civilian
population or any segment thereof, or to disrupt any segment of the
economy; or
(b) it appears that the intent is to intimidate or coerce a government, or to
further political, ideological, religious, social or economic objectives or
to express(or express opposition to) a philosophy or ideology.
T. "Third Party Wrongful Act" means any of the following, when alleged against an
Insured by a Business Invitee of the Named Insured:
(1) harassment(including sexual harassment);
DRWN POL 1000 (10/2006) Page 6 of 17
(2) discrimination based upon age, gender, race, color, national origin, religion,
sexual orientation or preference, pregnancy or disability or any basis prohibited
by federal, state or local laws; or
(3) humiliation, invasion of privacy, or infliction of emotional distress or mental
anguish.
U. "Wrongful Act" means any Public Officials Wrongful Act, Employment Practices
Wrongful Act or Third Party Wrongful Act.
III. EXCLUSIONS
A. The Insurer shall not pay Loss, but shall only pay Defense Expenses, from any Claim
brought about or contributed to in fact by:
(1) any willful misconduct or dishonest, fraudulent, criminal or malicious act, error
or omission by any Insured;
(2) any willful violation by any Insured of any law, statute, ordinance, rule or
regulation; or
(3) any Insured gaining any profit, remuneration or advantage to which such
Insured is not legally entitled.
The applicability of EXCLUSIONS A(1), A(2) and A(3)to any specific Insured may be
determined by an admission of such Insured, a finding, or a fmal adjudication in the
proceeding constituting the Claim or in a proceeding separate from or collateral to the
Claim. If any specific Insured in fact engaged in the conduct specified in
EXCLUSIONS A(1), A(2) or A(3), such Insured shall reimburse the Insurer for any
Defense Expenses advanced to or on behalf of such Insured.
B. The Insurer shall not pay any Loss or Defense Expenses from any Claim:
(1) under INSURING AGREEMENTS I.A. or I.B., if otherwise covered under
INSURING AGREEMENT I.C(1);
(2) by, on behalf of or in the name or right of:
(a) the Named Insured; or
(b) any duly elected, appointed or employed director or official of the
Named Insured, or any member of a commission, board or other unit
operated by the Named Insured and under its jurisdiction, and within
the apportionment of the Named Insured's operating budget in the
Application,unless in the form of a cross-claim or third-party complaint
arising from a Claim made against such director, official or member,that
is otherwise covered under this Policy;
(3) for actual or alleged violation of the Fair Labor Standards Act, the National
Labor Relations Act, the Consolidated Omnibus Budget Reconciliation Act of
1985, the Occupational Safety and Health Act, any workers' compensation,
DRWN POL 1000 (10/2006) Page 7 of 17
unemployment insurance, social security, or disability benefits law, other similar
provisions of any federal, state or local statutory or common law or any rules or
regulations promulgated under any of the foregoing, including,but not limited to,
any actual or alleged improper payroll practices, wage and hour policies, and
payment of overtime or vacation pay; provided, however, that this EXCLUSION
B(3) shall not apply to the extent that any Claim alleges an Employment
Practices Wrongful Act;
(4) for any actual or alleged express or assumed liability of any Insured under an
indemnification agreement; provided, that this EXCLUSION B(4) shall not apply
to any tort liability that would have attached to the Insured in the absence of
such agreement and is otherwise insured under this Policy;
C. The Insurer shall not pay any Loss or Defense Expenses from any Claim based on,
arising out of, directly or indirectly resulting from, in consequence of, or in any way
involving:
(1) any actual or alleged damage to, destruction of or loss of use of, any tangible
property;
(2) any actual or alleged bodily injury, corporal punishment, sickness, disease or
death;
(3) emotional distress or mental anguish,provided,however, this EXCLUSION C(3)
shall not apply to any emotional distress or mental anguish alleged in any Claim
for an Employment Practices Wrongful Act or Third Party Wrongful Act;
(4) any Sexual Abuse or Molestation, including without limitation any actual or
alleged liability for committing Sexual Abuse or Molestation or permitting or
failing to prevent, stop, detect or reveal Sexual Abuse or Molestation, whether
such liability is alleged as a violation of civil rights protected under 42 USC 1981
et seq. or any similar federal, state or local law, or as a tort or other breach of
duty;
(5) any actual, alleged or threatened exposure to, or generation, storage,
transportation, discharge, emission, release, dispersal, seepage, migration,
release, growth, infestation, spread, escape, treatment, removal or disposal of,
any Contaminant-Toxin, or any regulation,order,direction or request to test for,
monitor, clean up, remove, contain, treat, detoxify or neutralize any
Contaminant-Toxin, or any action taken in contemplation or anticipation of any
such regulation,order,direction or request;
(6) any of the responsibilities, obligations or duties imposed upon fiduciaries by the
Employee Retirement Income Security Act of 1974, or amendments thereto or
any similar provisions of state statutory law or common law;
(7) any actual or alleged liability of the Named Insured under any express contract
or agreement, unless such liability would have attached to the Named Insured in
the absence of such express contract or agreement. For the purposes of this
EXCLUSION C(7), an "express contract or agreement" is an actual agreement
among the contracting parties, the terms of which are openly stated in distinct or
explicit language, either orally or in writing, at the time of its making, but does
DRWN POL 1000 (10/2006) Page 8 of 17
not include any manual of employment policies or procedures issued to the
Insureds by the Named Insured;
(8) any actual or alleged failure to obtain, implement, effect, comply with, provide
notice under or maintain any form, policy, plan or program of insurance, stop
loss or provider excess coverage,reinsurance, self-insurance, suretyship or bond;
(9) any fact, circumstance, situation, transaction, event or Wrongful Act or series of
facts,circumstances, situations,transactions,events or Wrongful Acts:
(a) underlying or alleged in any mediation, arbitration, grievance
proceeding, litigation or administrative or regulatory proceeding brought
prior to and/or pending as of the Inception Date set forth in ITEM 2(a) of
the Declarations:
(i) to which any Insured is or was a party; or
(ii) with respect to which any Insured, as of the Inception Date set
forth in ITEM 2(a) of the Declarations, knew or should
reasonably have known that an Insured would be made a party
thereto;
(b) which was the subject of any notice given prior to the Inception Date set
forth in ITEM 2(a) of the Declarations under any other policy of
insurance or plan or program of self-insurance; or
(c) which was the subject of any Claim made prior to the Inception Date set
forth in ITEM 2(a)of the Declarations;
if, however, this Policy is a renewal of one or more policies previously issued by
the Insurer to the Named Insured, and the coverage provided by the Insurer to
the Named Insured was in effect, without interruption, for the entire time
between the inception date of the first such other policy and the Inception Date of
this Policy, the reference in this EXCLUSION C(9) to the Inception Date will be
deemed to refer instead to the Inception Date of the first policy under which the
Insurer began to provide the Named Insured with the continuous and
uninterrupted coverage of which this Policy is a renewal;
(10) any lockout, strike, picket line, hiring of replacement workers, riot or civil
commotion, or other similar actions in connection with labor disputes or labor
negotiations;
(11) any activities of any law enforcement agency or law enforcement personnel,
including the operation of any jail cell,holding cell, detention or lock up facility;
(12) eminent domain, adverse possession, dedication by adverse use, inverse
condemnation or condemnation proceedings;
(13) debt financing, including but not limited to bonds, notes, debentures and
guarantees of debt;
DRWN POL 1000 (10/2006) Page 9 of 17
(14) the formulation of tax rates, the collection of taxes and/or the disbursement of tax
refunds;
(15) any procurement, service, construction, architectural or engineering contract;
(16) construction, architectural, engineering, legal or other professional services
rendered by an Insured for an individual or entity other than the Named
Insured;
(17) war, whether or not declared, or any act or condition incidental to war, including
civil war, insurrection,rebellion or revolution; or Terrorism.
IV. CONDITIONS
A. Limits of Liability,Retentions:
Regardless of the number of Claims brought under this Policy, the number of persons or
entities included within the definition of Insured, or the number of claimants, the
Insurer's liability is limited as follows:
(1) Public Officials Professional Liability
Subject to the Policy Aggregate Limit of Liability, the amount set forth in ITEM
3(a) of the Declarations shall be the maximum Limit of Liability of the Insurer
for all Loss in excess of the applicable Retention set forth in ITEM 4 of the
Declarations, resulting from each Claim under INSURING AGREEMENT I.A
for which this Policy provides coverage.
(2) Employment Practices Liability and Third Party Liability
Subject to the Policy Aggregate Limit of Liability, the amount set forth in ITEM
3(b) of the Declarations shall be the maximum Limit of Liability of the Insurer
for all Loss in excess of the applicable Retention set forth in ITEM 4 of the
Declarations, resulting from each Claim under INSURING AGREEMENT I.B
for which this Policy provides coverage.
(3) Policy Aggregate
The amount set forth in ITEM 3(c) of the Declarations shall be the maximum
aggregate Limit of Liability of the Insurer for all Loss resulting from all Claims
under INSURING AGREEMENT I.A and INSURING AGREEMENT LB for
which this Policy provides coverage.
(4) Supplemental Payments
Subject to the INSURING AGREEMENT I.C(1). Aggregate Limit of Liability,
the amount set forth in ITEM 3(d) of the Declarations shall be the maximum
Limit of Liability of the Insurer for all Defense Expenses resulting from each
Claim under INSURING AGREEMENT 1.C(1).
DRWN POL 1000 (10/2006) Page 10 of 17
(5) Supplemental Payments Aggregate
The amount set forth in ITEM 3(e) of the Declarations shall be the maximum
aggregate Limit of Liability of the Insurer for all Defense Expenses resulting
from all Claims under INSURING AGREEMENT 1.C(1).
(6) Except as provided in CONDITION A(7) below, Defense Expenses payable
under INSURING AGREEMENTS I.A or I.B are paid in addition to the
applicable Limits of Liability set forth in ITEMS 3(a), (b) or (c) of the
Declarations, and payment of Defense Expenses by the Insurer will not reduce
such applicable Limit of Liability.
(7) The Insurer shall not be obligated under the Policy to pay more than the
applicable Limit of Liability set forth in ITEM 3(c)of the Declarations, for all
Defense Expenses resulting from Claims for which the resulting Loss is wholly
excluded from coverage under EXCLUSION A of this Policy.
(8) In the event that any Claim for which coverage is provided under INSURING
AGREEMENT I.C(1) subsequently becomes a Claim for both monetary and
Non-Monetary Relief for which coverage is provided under INSURING
AGREEMENT I.A or I.B, such Claim shall become subject to the increased
Retention and Limit of Liability applicable under INSURING AGREEMENT I.A
or I.B. Defense Expenses already reimbursed in connection with such Claim by
the Insurer shall be applied against the applicable Retention, and deemed to
reduce the applicable Limit of Liability,under either INSURING AGREEMENT
I.A. or I.B.
(9) The obligation of the Insurer to pay Loss or Defense Expenses,or to defend any
Claim, under INSURING AGREEMENTS I.A, I.B or I.C(1), will only be in
excess of the applicable Retention set forth in ITEM 4 of the Declarations. The
Insurer will have no obligation whatsoever, either to the Insureds or to any
other person or entity, to pay all or any portion of any Retention amount on
behalf of any Insured, although the Insurer will, at its sole discretion, have the
right and option to advance such amount, in which event the Insureds agree to
repay the Insurer any amounts so advanced.
(10) Related Claims will be deemed a single Claim, and only one "Each Claim"
Limit of Liability,and only one Retention,will apply.
B. Defense and Settlement of Claims:
(1) No Insured may incur any Defense Expenses or admit liability for, or settle, or
offer to settle, any Claim without the Insurer's written consent.
(2) The Insurer will have the right to make investigations and, solely with respect to
INSURING AGREEMENTS I.A and I.B, conduct negotiations and enter into the
settlement of any Claim as the Insurer deems appropriate, with the consent of
the Insured. If the Insured refuses to consent to a settlement acceptable to the
claimant in accordance with the Insurer's recommendation, then, subject to the
applicable Limit of Liability set forth in ITEM 3 of the Declarations, the
Insurer's liability for such Claim will not exceed:
DRWN POL 1000 (10/2006) Page 11 of 17
(a) the amount for which such Claim could have been settled by the Insurer
plus Defense Expenses up to the date the Insured refused to settle such
Claim;plus
(b) fifty percent (50%) of any Loss and/or Defense Expenses in excess of
the amount in clause (a) above, incurred in connection with such Claim.
The remaining Loss and/or Defense Expenses will be carried by the
Insured at its own risk and will be uninsured.
(3) It shall be the duty of the Insured, and not the Insurer, to defend any Claims
under INSURING AGREEMENT LC(1). The Insured shall have the right to
select defense counsel for the investigation and defense of any such Claim,
subject to the consent and approval of the Insurer, which shall not be
unreasonably withheld.
(4) The Insurer will have no obligation to pay Loss or Defense Expenses, or to
defend or continue to defend any Claim, under INSURING AGREEMENTS I.A
or I.B, after the applicable Limit of Liability, as set forth in ITEM 3 of the
Declarations, has been exhausted by the payment of Loss. If the Insurer's
maximum aggregate Limit of Liability, as set forth ITEM 3(c) of the
Declarations, is exhausted by the payment of Loss, the entire premium will be
deemed fully earned.
(5) The Insurer will have no obligation to reimburse Defense Expenses in
connection with any Claim under INSURING AGREEMENT I.C(1) after the
Insurer's aggregate Limit of Liability, as set forth in ITEM 3(e) of the
Declarations,has been exhausted by the reimbursement of Defense Expenses.
C. Other Insurance:
(1) All Loss payable under this Policy will be specifically excess of and will not
contribute with other valid insurance (whether collectible or not), including but
not limited to any other insurance under which there is a duty to defend, unless
such other insurance is specifically stated to be in excess of this Policy. This
Policy will not be subject to the terms of any other insurance. Other insurance
includes, but is not limited to, coverage or benefits provided by self-insurance
arrangements,pools, self-insurance trusts, captive insurance companies,retention
groups, reciprocal exchanges or any other plan or agreement of risk transfer or
assumption.
(2) Notwithstanding CONDITION C(1) above, with respect to any Claim under this
Policy for which coverage is available under any insurance policy which applies
to claims for bodily injury and/or property damage,the Insurer will have no duty
to defend such Claim, or to pay Defense Expenses incurred by or on behalf of
any Insured in connection with such Claim or to contribute to any defense
provided to any Insured under such other insurance policy, or to reimburse any
other insurer, in whole or in part, for Defense Expenses incurred in connection
with such Claim.
D. Cooperation; Subrogation:
DRWN POL 1000 (10/2006) Page 12 of 17
In the event of a Claim, the Insured will provide the Insurer with all information,
assistance and cooperation that the Insurer reasonably requests, and will do nothing that
may prejudice the Insurer's position or potential or actual rights of recovery. At the
Insurer's request, the Insured will assist in any actions, suits, or proceedings, including
but not limited to attending hearings,trials and depositions,securing and giving evidence,
and obtaining the attendance of witnesses, and will also assist in making settlements. In
the event of payment, the Insurer will be subrogated to the extent of any payment to all
of the rights of recovery of the Insured. The Insured will execute all papers and do
everything necessary to secure such rights, including the execution of any documents
necessary to enable the Insurer effectively to bring suit in their name. The obligations of
the Insured under this CONDITION D will survive the expiration or cancellation of the
Policy.
E. Extended Reporting Period:
(1) If either the Insurer or the Named Insured cancels,refuses or declines to renew
this Policy for any reason other than nonpayment of premium, and, within thirty
(30)days of the end of the Policy Period, the Named Insured elects to purchase
the Extended Reporting Period Policy pursuant to one of the available options as
set forth below, then the coverage otherwise afforded by this Policy will be
extended to apply to Loss or Defense Expenses from Claims first made during
the Extended Reporting Period, but only if such Claims are for Wrongful Acts
committed before the end of the Policy Period or the date of any conversion of
coverage under CONDITION I, whichever is earlier. The Extended Reporting
Period does not increase or reinstate any Limit of Liability and may only be
purchased if all premiums and retentions due under the Policy have been paid.
Once purchased, the Extended Reporting Period may not be canceled and the
premium shall be deemed fully earned.
(2) Extended Reporting Period Options:
(a) a one (1) year extended reporting period for an additional premium of
seventy percent (70%) of the Premium set forth in ITEM 6 of the
Declarations;
(b) a two (2) year extended reporting period for an additional premium of
one hundred percent (100%) of the Premium set forth in ITEM 6 of the
Declarations; or
(c) a three (3) year extended reporting period for an additional premium of
one hundred and fifty percent (150%) of the Premium set forth in ITEM
6 of the Declarations.
F. Notice; Timing,and Interrelationship of Claims:
(1) As a condition precedent to any right to payment in respect of any Claim, the
Insured must give the Insurer written notice of such Claim,with full details, as
soon as practicable after it is first made and in no event later than seventy-five
(75)days after the expiration date of the Policy Period.
DRWN POL 1000 (10/2006) Page 13 of 17
(2) If, during the Policy Period, the Insured first becomes aware of any Wrongful
Act which may subsequently give rise to a Claim and, as soon as practicable
thereafter but before the expiration or cancellation of this Policy:
(a) gives the Insurer written notice of such Wrongful Act, including a
description of the Wrongful Act in question, the identifies of the
potential claimants, the consequences which have resulted or may result
from such Wrongful Act, the damages which may result from such
Wrongful Act and the circumstances by which the Insured first became
aware of such Wrongful Act; and
(c) requests coverage under this Policy for any subsequently resulting Claim
for such Wrongful Act;
then the Insurer will treat any such subsequently resulting Claim as if it had
been first made during the Policy Period.
(3) All notices under CONDITIONS F(1) and F(2) must be sent in writing to the
address set forth in ITEM 5 of the Declarations.
(4) All Related Claims will be treated as a single Claim made when the earliest of
such Related Claims was first made, or when the earliest of such Related
Claims is treated as having been made in accordance with CONDITION F(2),
whichever is earlier.
G. Cancellation; No Obligation to Renew:
(1) The Insurer may not cancel this Policy except for failure to pay a premium when
due. The Insurer will deliver or mail by first class, registered or certified mail to
the Named Insured at its last known address, written notice of cancellation at
least twenty (20) days before the effective date of cancellation. Such notice shall
state the reason for cancellation. A copy of such notice shall be sent to the agent
of record.
(2) The Named Insured may cancel this Policy by mailing to the Insurer written
notice stating when, not later than the Expiration Date set forth in ITEM 2(b) of
the Declarations, such cancellation will be effective. In such event, return
premium will be computed as 0.90 times the pro rata unearned premium shown
in ITEM 6 of the Declarations and rounded to the nearest whole dollar. Premium
adjustment may be made either at the time that cancellation by the Named
Insured is effective or as soon as practicable thereafter.
(3) The Insurer will not be required to renew this Policy upon its expiration. If the
Insurer elects not to renew this Policy, the Insurer will deliver or mail by first
class, registered or certified mail to the Named Insured at its last known address,
written notice to that effect at least sixty(60) days before the Expiration Date set
forth in ITEM 2(b) of the Declarations. Such notice shall state the specific
reason(s) for non-renewal.
H. Representations:
DRWN POL 1000 (10/2006) Page 14 of 17
The Insured represents that the particulars and statements contained in the Application
are true, accurate and complete, and agrees that this Policy is issued in reliance upon the
truth of that representation, and that such particulars and statements, which are deemed to
be incorporated into and to constitute a part of this Policy,are the basis of this Policy.
Separation of Insureds; Protection of Innocent Insureds:
(1) In the event of any material untruth, misrepresentation or omission in connection
with any of the particulars or statements in the Application, this Policy will be
void:
(a) with respect to any natural person Insured who knew of such untruth,
misrepresentation or omission; and
(b) with respect to the Named Insured, if, and only if, an elected or
appointed official, or the highest ranking member of any board,
commission or unit, of the Named Insured, or any other person in a
functionally equivalent position within the Named Insured, knew of
such untruth,misrepresentation or omission.
(2) No act, error or omission of any Insured will be imputed to any other Insured to
determine the application of any Exclusion set forth in Section III of this Policy.
If it is determined that an Exclusion applies to an Insured in connection with a
Claim, no coverage shall be available under this Policy for such Insured,
however, coverage shall continue in effect under this Policy for any other
Insured, subject to all other terms, conditions, and Exclusions herein.
J. No Action against Insurer:
(1) No action may be taken against the Insurer unless, as conditions precedent
thereto, there has been full compliance with all of the terms of this Policy and the
amount of the Insured's obligation to pay has been finally determined either by
judgment against the Insured after adjudicatory proceedings, or by written
agreement of the Insured, the claimant and the Insurer.
(2) No person or entity will have any right under this Policy to join the Insurer as a
party to any Claim to determine the liability of any Insured; nor may the
Insurer be impleaded by an Insured or his, her or its legal representative in any
such Claim.
K. Insolvency of Insured:
The Insurer will not be relieved of any of its obligations under this Policy by the
bankruptcy or insolvency of any Insured.
L. Non-Pyramiding of Limits:
If a Claim is made for which coverage is afforded,under this Policy and any other policy
or policies underwritten by Darwin Professional Underwriters, Inc. or any entity to which
DRWN POL 1000 (10/2006) Page 15 of 17
Darwin Professional Underwriters, Inc. has delegated its underwriting authority, to the
Named Insured or to any public entity or political subdivision:
(I) which shares an operational budget with the Named Insured; or
(2) which receives its funding or budget from the same tax base as the Named
Insured; or
(3) operates or has jurisdiction over the Named Insured or which is operated by or
under the jurisdiction of the Named Insured;
then the maximum amount payable in the aggregate under this Policy, and all such other
policies, shall not exceed the single highest Limit of Liability available under all such
policies.
M. Territory:
This Policy applies to Wrongful Acts committed by any Insured, or to any Claim
brought against any Insured, anywhere in the world.
N. Authorization and Notices:
The Insureds agree that the Named Insured will act on their behalf with respect to
receiving any notices and return premiums from the Insurer.
O. Changes:
Notice to or knowledge possessed by any agent or other person acting on behalf of the
Insurer will not effect a waiver or change in any part of this Policy or estop the Insurer
from asserting any right under the terms, conditions and limitations of this Policy. The
terms, conditions and limitations of this Policy can be waived or changed only by written
endorsement.
P. Assignment:
No assignment of interest under this Policy will bind the Insurer without its consent.
Q. Entire Agreement:
The Insured agrees that this Policy, including the Application and any endorsements,
constitutes the entire agreement between them and the Insurer or any of its agents
relating to this insurance.
R. Headings:
The descriptions in the headings and sub-headings of this Policy are solely for
convenience, and form no part of the terms and conditions of coverage.
In witness whereof, the Insurer has caused this Policy to be executed by its authorized officers, but this
Policy will not be valid unless countersigned on the Declarations page by a duly authorized representative
of the Insurer.
DRWN POL 1000 (10/2006) Page 16 of 17
In witness whereof,the Insurer has caused this Policy to be executed on the Declarations Page.
DRWN POL 1000 (10/2006) Page 17 of 17
1
•
ENDORSEMENT NO.
COVERAGE LIMITED TO SPECIFIC WRONGFUL ACTS
This Endorsement, effective at 12:01 a.m. on 02/07/2007 .forms part of
Policy No. 0202-1366
Issued to Weld County Interagency Oversight Group
Issued by Darwin Select Insurance Company
In consideration of the premium charged, it is understood and agreed that:
Coverage under this Policy shall only apply to the Public Officials Wrongful Acts of the Named
Insured, Weld County Interagency Oversight Group, and individuals serving as members thereof but
solely with respect to their activities for the Named Insured; and coverage shall NOT apply to any agency
or entity to which the Named Insured is providing oversight, advice or services.
All other terms, conditions and limitations of this Policy shall remain unchanged.
Authorized Representative
MANU1366 (2007)
ENDORSEMENT NO.
SERVICE OF SUIT
This Endorsement, effective at 12:01AM on 02/07/2007, forms part of
Policy No. 0202-1366
Issued to Weld County Interagency Oversight Group
Issued by Darwin Select Insurance Company
Pursuant to any statute of any state, territory or district of the United States which makes
provision therefore, the Company hereby designates the Superintendent, Commissioner or
Director of Insurance or other officer specified for that purpose in the Statute, or his successors in
office, as our true and lawful attorney upon whom may be served any lawful process in any
action, suit or proceeding instituted by or on behalf of the insured(s)or any beneficiary hereunder
arising out of this contract of insurance, and hereby designate the below named as the person
whom the said officer is authorized to mail process or a true copy thereof.
It is further agreed that service of process in such suit may be made upon Stephen J. Sills,
President of the Company, or his nominee, at 9 Farm Springs Road, Farmington, CT 06032 and
that in any suit instituted against any one of them upon this policy, the Company will abide by the
final decision of such Court or any Appellate Court in the event of an appeal.
NOTHING HEREIN SHALL VARY, ALTER, WAIVE, OR EXTEND ANY OF THE TERMS,
PROVISIONS, REPRESENTATIONS, CONDITIONS OR AGREEMENTS OF THE POLICY
OTHER THAN AS STATED ABOVE.
Authorized Representative
s1006 DSI (4/2005)
Professional Governmental Underwriters, Inc.
CLAIM REPORTING REFERENCE FORM
IN CASE OF CLAIM-FOLLOW THESE INSTRUCTIONS
For your:
• Law Enforcement Liability Insurance
• Public Officials Legal Liability—Errors and Omissions Insurance
• School Board Legal Liability Insurance
YOUR INSURANCE COMPANY FOR THE ABOVE IS:
• Platte River Insurance Company
• Capitol Specialty Insurance Corporation
• Darwin National Assurance Corporation
• Darwin Select Insurance Company
IF NOTICE OF SUIT OR INCIDENT IS RECEIVED:
• Do NOT assume or admit responsibility.
• Do NOT reveal your policy's limits of liability.
• Document your file with records of all employees/officials involved.
• Make NO statement to anyone except your legal counsel or insurance company
representative.
IMMEDIATELY REPORT ALL SUMMONS AND CLAIMS TO THE
FOLLOWING LOCATION:
Darwin Professional Underwriters, Inc. Phone: 860-284-1300
Attention: Claims Department Fax: 860-284-1307
9 Farm Springs Road Email: noticeofloss@darwinpro.com
Farmington, CT 06032
BE PREPARED TO INCLUDE WITH YOUR REPORT:
• Your policy number.
• Insured name.
• Insured address.
• Name of department involved.
• Name and phone number of official to be contacted.
• The official summons and notice of claim.
MANAGING UNDERWRITER ISSUING THIS POLICY
Professional Governmental Underwriters, Inc.
P.O. Box 35471
Richmond, VA 23235
KEEP THIS FORM WITH YOUR POLICY
•
Professional Governmental Underwriters, Inc.
Announces New Service through Darwin
Workplace HELPLINE Services
Your purchase or renewal of insurance coverage with Professional Governmental Underwriters, Inc.
(PGU)and Darwin includes access to Workplace HELPLINE Services at no cost. You are already
registered to begin using these services once you activate your account per the instructions below.
Overview of Services
• Toll-free Employer HELPLINE
Policyholders receive personalized attention to specific human resources and employment law
questions like hiring and termination,drug and alcohol testing, FMLA,ADA, exempt/non-
exempt, harassment, and discrimination.
• Online Resource Web Site
The site, www.darwinhelpline.com, includes access to current human resources information,
sample policies, and additional valuable content to support policyholder risk management efforts.
• Monthly HR Express Updates and HR Alerts
These resources keep policyholders informed of continuously changing state and federal
workplace regulations.
• Unlimited Access
Policyholders have seamless access to experienced employment attorneys and may contact these
experts via phone or e-mail for guidance as often as they like throughout the policy period.
Activate Your Account
It is the practice of Workplace HELPLINE Services to contact you within 60 days of the start of
your policy. We encourage you to take advantage of these services sooner by:
• Contacting Helpline Relationship Mangers toll-free at 1-877-568-6655 to schedule a call.
OR
• Faxing this page, with the information box below completed,to 1-877-705-3678 to schedule a
call.
When are you available? Organization Name:
Date:
Time: Policy Number:
•
(Indicate EST,CST,etc.)
Phone: Fax:
Professional Governmental l.nderwriters,Inc.
9020 Stony Point Parkway,Suite 455
Richmond,VA 23235
V 800-586-6502
F 804-272-7852
www.pgui.com
Darwin refers to Darwin Group,Inc.,which consists of Darwin National Assurance Company,Darwin Select Insurance Company,and
Darwin Professional Underwriters, Inc. Darwin also places coverage on Platte River Insurance Company and the insurance
subsidiaries of Capitol Transamerica(Capitol Indemnity Corporation and Capitol Specialty Insurance Corporation).
2006 Darwin Group, Inc.All Rights Reserved. PGU FS Binding(1/06)
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