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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 N e 5 4.. 21 I y ` l 4I l- httt 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 0 M:\Client doc\Weld County\2007 Binders,Policies,Endorsements\Weld County 1OQ07_Weld County IOG_D&O-EPLICSI 072807 ch.doc WELD COUNTY INTERAGENCY OVERSIGHT GROUP EXPOSURE 8t PREMIUM SUMMARY M:\Client.doc\Weld County\200TBindery Policies,Endorsements\Weld County IOG\07 Weld County IOG_D&O'EPLI_CSI 072807 ch.doc Page 1 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. M:\Clienldoc\Weld County@007\Binders,Policies,Endorsements\Weld County IOG\0J Weld County IOC_D&O-EPLI CSI 072807 ch.doc Page 2 WELD COUNTY INTERAGENCY OVERSIGHT GROUP rl/ COVERAGE SUMMARY M;Client.doc\Weld County@007\Binders,Policies,Endorsements\Weld County IOC\W_Weld County IOC_O&O{PLI CSI 072807 ch.doc Page 3 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 M:\Client.doc\Weld County\2007\Binders,Policies,Endorsements\Weld County IOG\07_Weld County IOG_D8O-EPII_CSI 012807 ch.doc Page 4 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. M:\Cllent.dodWeld Count5A2007\Binders,Policies,Endorsements Weld County IOO07_Weld County IOC_D&O-EPLI CSI 072807 ch.doc Page 5 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 M:\Client.doc\Weld County@00Y\Binders,Policies,Endorsements\Weld County IOC,07 Weld County IOG_D&O-EPLI_CSI 072807 ch.doc Page 6 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 M:\Clienl.dac\Weld County\2007\Binders,Policies,Endorsements\Weld County IOG\07 Weld Coumy IOG_D&O-EPLI_CSI 072807 ch.doc Page 7 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) Hello