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Excess Liability — Insurance Co. of
the State of Pennsylvania
(Claims Made Form)
Carrier: Insurance Company of the State of Pennsylvania
Policy Number: 6907962
Policy Period: January 1, 2010 to January 1, 2011
Limits:
Amounts Coverages
$ 10,000,000 Auto Liability, Each Occurrence
$ 10,000 Auto Medical Payments. Each Person
$ 10,000,000 Personal Injury, Property Damage(Includes Law Enforcement and
EMTs)
$ 10,000 Premises Medial Payments, Each Person
$ 1,000,000 Sewer Backup
$ 10,000,000 Public Officials Errors and Omissions
$ 10,000,000 Employee Benefit Liability
Aggregate Limits of Coverage(Apply Separately to CAPP and for each Participating Member
County(PMC)) :
Amounts Coverages
$ 10,000,000 In any One Policy Year, Personal Injury, Property Damage
$ 10,000,000 In any One Policy Year, Products/Completed Operations
$ 10,000,000 In any One Policy Year, Public Officials Liability Errors and
Omissions
$ 10,000,000 In any One Policy Year, Employee Benefit Liability
Self Insured Amounts Coverages
Retention (SIR):
$ 250,000 Each Occurrence or Wrongful Act(includes Defense Costs)
$ 6,000,000 In any One Policy Year. This aggregate does not include any
amounts payable by a PMC for any Occurrence or Wrongful Act as
outlined in such County's Agreement for Partially Self-Funded
Program issued by CAPP as follows:
• SIR is not eroded by the first$75,000 of loss and loss expense
for Summit County
• SIR is not eroded by the first$125,000 of loss and loss
expense for Eagle, Pueblo, and Weld Counties
• SIR aggregate is also not eroded by the loss and loss expense
for$10,000 ETR deductible loses
7 QQQ.G79
2010 CAPP Excess Liability Summary-Page 1
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