HomeMy WebLinkAbout20252120.tiffResolution
Approve Renewal Application for Public Entity and Employment Practices Liability
Insurance, and Authorize Chair to Sign — Kinsale Insurance Company,
c/o Arther J. Gallagher Risk Management Services, LLC
Whereas, the Board of County Commissioners of Weld County, Colorado, pursuant to
Colorado statute and the Weld County Home Rule Charter, is vested with the authority of
administering the affairs of Weld County, Colorado, and
Whereas, the Board, ex -officio Housing Authority Board, has been presented with a
Renewal Application for Public Entity and Employment Practices Liability Insurance from
the County of Weld, State of Colorado, by and through the Board of County
Commissioners of Weld County, on behalf of the Weld County Housing Authority, to
Kinsale Insurance Company, c/o Arthur J. Gallagher Risk Management Services, LLC,
commencing August 2, 2025, and ending August 1, 2026, with further terms and
conditions being as stated in said renewal application, and
Whereas, after review, the Board deems it advisable to approve said renewal application,
a copy of which is attached hereto and incorporated herein by reference.
Now, therefore, be it resolved by the Board of County Commissioners of Weld County,
Colorado, that the ex -officio Housing Authority Board, has been presented with a Renewal
Application for Public Entity and Employment Practices Liability Insurance from the
County of Weld, State of Colorado, by and through the Board of County Commissioners
of Weld County, on behalf of the Weld County Housing Authority, to Kinsale Insurance
Company, c/o Arthur J. Gallagher Risk Management Services, LLC, be, and hereby is,
approved.
Be it further resolved by the Board that the Chair be, and hereby is, authorized to sign
said renewal application.
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2025-2120
HA0031
PE0037
Renewal Application for Public Entity and Employment Practices Liability Insurance —
Kinsale Insurance Company, c/o Anther J. Gallagher Risk Management Services, LLC
Page 2
The Board of County Commissioners of Weld County, Colorado, approved the above
and foregoing Resolution, on motion duly made and seconded, by the following vote on
the 28th day of July, A.D., 2025:
Perry L. Buck, Chair: Aye
Scott K. James, Pro-Tem: Aye
Jason S. Maxey: Aye
Lynette Peppier: Aye
Kevin D. Ross: Aye
Approved as to Form:
Bruce Barker, County Attorney
Attest:
Esther E. Gesick, Clerk to the Board
2025-2120
HA0031
PE0037
ConMehti*cr109
BOARD OF COUNTY COMMISSIONERS
PASS -AROUND REVIEW
PASS -AROUND TITLE: Housing Authority Insurance Renewal
DEPARTMENT: Human Resources
PERSON REQUESTING: Jill Scott, Kelly Leffler
DATE: 6/26/25
Brief description of the problem/issue:
Attached you will find the Kinsale Housing Authority Liability Renewal application for the 25-26 renewal. It is
recommended by the Broker, AJG, to renew this insurance through Kinsale for the 3r° consecutive year. Once
the application has been submitted, the application will go through underwriting, and we will receive the renewal
premium invoice. Last year's premium was $10,579, and we do not anticipate a high increase.
What options exist for the Board?
Binding with the broker's recommendation or not binding and risking an uninsured loss.
Consequences:
If we do not bind with Kinsale, we risk having an uninsured loss.
Impacts:
Renewing this insurance will assure liability coverage for the Housing Authority.
Costs (Current Fiscal Year / Ongoing or Subsequent Fiscal Years):
The 24-25 renewal was $10,579 and there is not an anticipated increase for 25-26.
Recommendation:
It is recommended that the BOCC approve moving forward with the renewal application through Kinsale for the
Housing Authority Liability coverage.
Perry L. Buck
Scott K. James
Jason S. Maxey
Lynette Peppier
Kevin D. Ross
Support Recommendation Schedule
Place on BOCC Agenda Work Session Other/Comments:
out ota,
2025-2120
-7/ZW/Z5
ARUO�1
A KINSALE®
Kinsale Insurance Company
P. O. Box 17008
Richmond, VA 23226
(804) 289-1300
www.kinsaleins.com
PUBLIC ENTITY AND EMPLOYMENT PRACTICES LIABILITY RENEWAL APPLICATION
APPLICANT'S INFORMATION
1. Current Kinsale Policy Number: EKI3439109
2. Legal name of the Public Entity who is the primary applicant and will be the first named insured listed on the policy:
Weld County Housing Authority
3. Please list all other entities / organizations that you are requesting to be a named insured on the policy (a request does
not guarantee that all such entities will be quoted / covered):
NA
4. Principal Address: 1150 "O" Street
City: Greeley
Public Entity's Website: www. www.weld.clov
State: CO Zip: 80631
5. Do you have a Full Time Risk Manager? ® Yes ❑ No
If "yes" — how many years has the Risk Manager been in this position? 2 years
Name of Risk Manager: Kelly Leffler Phone Number: (970-400-4220
6. Type of Public Entity: ❑ Town ❑ City ® County ❑ State
X Special District or Commission (Please Indicate):
❑ Airport ❑ Parks Department ❑ Transit Authority
❑ Development/Finance Authority ❑ Port Authority ❑ Utility (Gas/Electric/Cable)
Housing Authority ❑ Sports/Convention Center ❑ Water/Sewer
❑ Other:
7. Populations Trends: Please provide Population information:
CURRENT YEAR
Population of Municipality: 359,442
Seasonal increase in population? ❑ Yes % ® No
8. Are the Public Entity's board, council or commission members appointed or elected? ® Appointed ❑ Elected
a. If APPOINTED, bywhom? Board of County Commissioners
b. If ELECTED, are they elected via: ❑ Single Member District ❑ At Large ❑ Combination of Both
Page 1 of 8
GENERAL INFORMATION
Please provide the following information. If "Yes" to any question below, or if the applicant has budget deficits in the post
three years, please explain on a separate attachment. NA
1. a) Indicate fiscal year end date: 2023
b) Please provide a budget figure for the most recent fiscal year.
CURRENT YEAR
Revenues $ $4,118,609.00
Expenditures $ $4,023,431.00
Surplus/Deficit o 0 $
Outstanding Bond Issues
Budget Surplus (Deficit)
c) Has any State or Federal funding (aid) been eliminated in the past year?
d) Does the Public Entity anticipate any special project which will result in a
substantial budget increase or decrease in the next 3 years?
e) Has the Public Entity been in default on principal or interest on any bond?
❑ Yes IN No
❑ Yes ® No
❑ Yes ® No
If you selected "yes" to either C, D, or E, please provide a narrative explanation including dates and amounts involved.
2. Latest bond rating (Standard & Poor's or Moody's): NA
Previous Rating: NA
3. Please attach a copy of your most recent comprehensive annual financial report.
OPERATIONS
Please respond to the following inquiries and use a separate attachment for details requiring further explanation.
1. Does the public entity administer any of the following operations?
Authorities
❑ Airport Authority
Housing Authority
❑ Port Authority
❑ Transit Authority
Utilities
❑ Electric Utility
❑ Gas Utility
❑ Water / Sewer Utility
Zonine/Safety
❑ Building Inspection
❑ License Issuance
❑ Permit Issuance
❑ Police Department
❑ Tax Assessment / Collection
❑ Zoning
Other
❑ Daycare
❑ Hospital / Nursing Home
❑ Landfill
❑ Other Not Listed
2. If "yes" to question 1 above, were any of these services/operations new during the past 12 months, or will be
introduced during the next 12 months? ❑ Yes ® No
By attachment to this application, please explain any "yes" response including which services/operations are new, the
associated budget and staff count, and risk management controls in place.
EMPLOYEES
1. Number of Employees - Full Time: 17
2. Number of Volunteers: 0
Part Time: 0
How many hours per week do volunteers work on average?
Page 2 of 8
A
3. Please describe the services performed by Volunteers for, or on behalf of, your Entity:
4. Salary Ranges
(including bonuses, dividends, and commissions) Number of Full Time Employees Number of Part Time Employees
$50,000 or less: 3 0
$50,001 to $100,000: 13 0
$100,001 and over: 1
TOTAL: 0
0
0
Number of employees in each category:
2 Accountants 0 Engineers 0 Police
0 Architects 0 Fire/Rescue 0 Road / Utilities
0 Attorneys 9 General Office 6 Other: Inspectors, Maintenance
5. Did any of the following take place in the past 12 months?
a) Strike, slowdown, or other staffing disruption?
b) Disputes involving integration, segregation, discrimination, or violations of civil
rights (with staff or with students)?
c) Has any employee been suspended, dismissed, demoted, transferred, or had a
tenure contract non -renewed?
Please explain all "yes" answers to 5 A -C:
❑ Yes ® No
❑ Yes ® No
❑ Yes I No
6. Does the Applicant use seasonal or temporary employees? ❑ Yes ® No
If "yes" - when and how many?
7. Does the Applicant use leased workers? ❑ Yes No
If "yes" — how many have been retained by the Applicant in the past 12 months?
8. Does the Applicant use independent contractors? ® Yes ❑ No
If "yes" — how many work solely for the Applicant? 0
9. For which of the following services does the Public Entity use subcontractors (check all that apply)
❑ Administrative / Secretarial ❑ Custodial ❑ Medical ❑ Transportation
❑ Accounting / Financial ❑ Food ❑ Specialized Education ® Other
Please explain in detail:
10. Do you require all subcontractors or independent contractors to provide evidence of ® Yes ❑ No
carrying liability insurance?
If "yes" - are you added as an additional insured to these policies? ® Yes ❑ No
11. How many employees are covered by collective bargaining or other union agreements?
12. In the past 12 months, how many employees have left your employ? 10
Of the above, how many were terminated involuntarily? 8
Page 3 of 8
A
0
EMPLOYMENT PRACTICES & HUMAN RESOURCES
1. Has the Applicant established or changed any written policies/procedures governing teachers & other personnel
in the past 12 months? If "yes" to any response, please attach a narrative explanation detailing the changes.
Background checks LI Yes ® No
Demotion ❑ Yes ® No
Dismissal ❑ Yes No
Drug Testing ❑ Yes ® No
Hiring ❑ Yes ® No
Promotion ❑ Yes ® No
Sexual Harassment ❑ Yes ® No
Suspension ❑ Yes ® No
Transfer ❑ Yes ® No
2. Do you conduct background checks on all:
Applicants? ® Yes ❑ No
New Hires? Yes ❑ No
Volunteers? Yes ❑ No
3. Please check the appropriate areas for the type of checks performed:
Type
Academic Credentials
Credit
Criminal Checks — All States
Criminal Checks — Federal
Criminal Checks — Home State
Driving Record
Licenses
Personal References
Prior Employers
Random Drug Tests (post hire)
Other:
Employees Volunteers
❑ ❑
❑ ❑
® ❑
❑
❑
❑ ❑
❑ ❑
® ❑
® ❑
❑ ❑
❑ ❑
4. Have the Applicant's supervising personnel or other employees attended training and ® Yes ❑ No
education programs/seminars on sexual harassment and other types of discrimination
within the last 12 months?
If "yes" —who has attended? All Employees
If "yes" — who conducts the sessions? Unknown
5. Does the Applicant have its employment policies/procedures reviewed by labor or ® Yes ❑ No
employment counsel?
If "yes" — identify the firm and date of last review: unknown / / 01/01/2018
6. Does the Applicant have a Human Resources or Personnel Department? ❑ Yes ® No
If "no" — who handles this function? Vincent Ornelas
7. Does the Applicant have an employee handbook? ® Yes ❑ No
Page 4 of 8
If "yes" — does the Applicant distribute to all employees? ® Yes ❑ No
If "yes" — do all employees sign for its receipt? ❑ Yes ® No
If "yes" — does it expressly state that it is not a contract and that employment is "at will"? ® Yes ❑ No
8. Does the Applicant have written procedures for handling employee complaints of ® Yes ❑ No
discrimination and/or sexual harassment?
9. Does the Applicant require all terminations to be reviewed by:
The person in charge of human resources?
Outside Counsel?
10. Does the Applicant maintain a personnel file for each employee?
El Yes ®No
❑Yes ®No
®Yes ❑ No
OTHER MATERIAL INFORMATION
1. After inquiry with each person as appropriate, does anyone have any other Material ❑ Yes ® No
Facts to disclose? (If "yes" — please provide such Material Facts on a separate sheet.)
A Material Fact is one likely to influence assessment of this risk, the premium charged or the terms and
conditions imposed by Underwriters. If you are in any doubt as to whether a fact would be considered material,
you should disclose it. All of the information requested in this proposal is material.
INSURANCE AND LOSS HISTORY
1. Does the Applicant currently carry General Liability Insurance?
❑ Yes ® No
2. Other than routine visits, has the entity had any on -site monitoring visits by a State or ❑ Yes ® No
Federal Agency within the last 12 months?
If "yes" — please explain:
3. Is the Applicant operating under any court orders?
If "yes" — please explain:
❑ Yes ® No
4. After inquiry with each person as appropriate, in the last 12 months, have any Public ❑ Yes ® No
Entity Liability claims, or any wrongful termination discrimination, sexual harassment
claims, or any other wrongful employment practices liability claim or suit (including third -
party claims) ever been made against the Entity, or any predecessor Entity, or any current
or former member of the Entity, or predecessor Entity (whether insured or uninsured)?
If "yes" — how many?
Please complete a separate Supplemental Claim Form for each claim or suit and include
a currently valued loss run for each claim.
5. In the last 12 months, have any of the following taken place:
a. Grand Jury investigations into activities of any entity or employee?
If "yes" — please provide details
Pages 5 of 8
A
❑ Yes ® No
b. Indictment of any entity or employee? ❑ Yes ® No
If "yes" — please provide details
6. After inquiry with each person as appropriate, do you, or any of your board members, ❑ Yes ® No
trustees, or employees know of any circumstances, acts, errors, omissions, or any
allegations or contentions of any incident that could result in a Public Entity Liability claim,
or any employment related claim, including third party claims (whether insured or
uninsured)?
If "yes" — how many?
Please complete a separate Supplemental Claim Form for each potential claim and
provide as much detail as possible.
7. Of the total number of EEOC/State agency charges filed against any Applicant over the last 12 months, indicate
the number of primary allegations as follows:
8. With respect to litigated cases (including wrongful termination suits under state law other than anti-
discrimination law) and EEOC/State agency charges over the last 12 months for which settlement was or may be
paid, please provide the following information, which must be currently valued:
FRAUD WARNING
NOTICE TO ALABAMA, ALASKA, ARIZONA, ARKANSAS, CALIFORNIA, CONNECTICUT, DELAWARE, GEORGIA, IDAHO, ILUNOIS, INDIANA, IOWA, KANSAS,
MARYLAND, MASSACHUSETTS, MICHIGAN, MINNESOTA, MISSISSIPPI, MISSOURI, MONTANA, NEBRASKA, NEVADA, NEW HAMPSHIRE, NORTH CAROLINA,
NORTH DAKOTA, OREGON, RHODE ISLAND, SOUTH CAROLINA, SOUTH DAKOTA, TEXAS, UTAH, VERMONT, WASHINGTON, WEST VIRGINIA, WISCONSIN,
AND WYOMING APPLICANTS: In some states, any person who knowingly, and with intent to defraud any insurance company or other person, files an
application for insurance or statement of claim containing any materially false information, or, for the purpose of misleading, conceals information
concerning any fact material thereto, may commit a fraudulent insurance act which is a crime in many states.
NOTICE TO COLORADO APPLICANTS: It is unlawful to knowingly provide false, incomplete or misleading facts or information to an insurance company for
the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance and civil damages. Any
insurance company or agent of an insurance company who knowingly provides false, incomplete or misleading facts or information to a policy holder or
claimant for the purpose of defrauding or attempting to defraud the policyholder or claiming with regard to a settlement or award payable for insurance
proceeds shall be reported to the Colorado Division of Insurance within the Department of Regulatory Agencies.
Page 6 of 8
NOTICE TO DISTRICT OF COLUMBIA APPLCANTS: WARNING: It is a crime to provide false or misleading information to an insurer for the purpose of
defrauding the insurer or any other person. Penalties include imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false
information materially related to a claim was provided by the applicant.
NOTICE TO FLORIDA APPLICANTS: My person who knowingly and with intent to injure, defraud or deceive any insurance company files a statement of
claim containing any false, incomplete or misleading information is guilty of a felony of the third degree.
NOTICE TO HAWAII APPLICANTS: For your protection, Hawaii law requires you to be informed that presenting a fraudulent claim for payment of a loss or
benefit is a crime punishable by fines or imprisonment, or both.
NOTICE TO KENTUCKY APPLICANTS: Any person who knowingly and with intent to defraud any insurance company or other person files an application for
insurance containing any materially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits
a fraudulent insurance act, which is a crime.
NOTICE TO LOUISIANA APPLICANTS: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents
false information in an application for insurance is guilty of a crime and maybe subject to fines and confinement in prison.
NOTICE TO MAINE APPLICANTS: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of
defrauding the company. Penalties may include imprisonment, fines, or denial of insurance benefits.
NOTICE TO NEW JERSEY APPLICANTS: Any person who includes any false or misleading information on an application for an insurance policy is subject to
criminal and civil penalties.
NOTICE TO NEW MEXICO APPLICANTS: Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents
false information in an application far insurance is guilty of a crime and may be subject to civil fines and criminal penalties.
NOTICE TO NEW YORK APPLICANTS: Any person who knowingly and with intent to defraud an insurance company or other person files an application for
insurance or statement of claim containing any materially false information, or conceals, for the purpose of misleading, information contenting any fact
material thereto, commits a fraudulent insurance act. which is a crime and shall also be subject to a civil penalty not to exceed $5,000 and the stated value
of the claim for each such violation.
NOTICE TO OHIO APPLICANTS: Any person who, with intent to defraud or knowing that he/she is facilitating a fraud against an insurer, submits an application
or files a claim containing a false or deceptive statement is guilty of insurance fraud.
NOTICE TO OKLAHOMA APPLICANTS: WARNING: Any person who knowingly, and with intent to injure, defraud or deceive any insurer, makes a any claim
for the proceeds of an insurance policy containing any false, incomplete or misleading information is guilty of a felony.
NOTICE TO PENNSYLVANIA APPLICANTS: Any person who knowingly and with intent to defraud any insurance company, or other person, files an application
for insurance or statement of a claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact
material thereto commits a fraudulent insurance act, which is a crime and subjects the person to criminal and civil penalties.
NOTICE TO TENNESSEE APPLICANTS: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose
of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.
NOTICE TO VIRGINIA APPLICANTS: It is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose
of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits.
The Applicant acknowledges that the answers provided herein are based on a reasonable Inquiry and/or investlgation. The Applicant warrants that the
above statements and particulars together with any attached or appended documents are true and complete and do not misrepresent, misstate ar omit
any material facts.
The Applicant agrees to notify us of any material changes in the answers to the questions on this questionnaire which may arise prior to the effective
date of any policy issued pursuant to this questionnaire and the Applicant understands that any outstanding quotations maybe modified or withdrawn
based upon such changes at our sole discretion.
Page 7 of 8
t empletlon of this form does not bind coverage. Applicant's acceptance of the company's quotation is required prior to binding coverage and policy
issuance.
All written statements and materials furnished to the company in conjunction with this application are hereby incorporated by reference Into this
appl.tion and made a part of this application.
I declare that the information submitted herein is true to the best of my knowledge and becomes a part of my
Professional Liability Application. I understand that an incorrect or incomplete statement could void my
protection.
Applicant Name (Print) Perry L. Buck
Applicant's Signature
Attest: 7"
Esth E Gesi k, Clerk to the Board
By:
Deputy Clerk to the Board
Agent/Broker Name: Gallagher
(ignayo y for 4ppticant Entity)
Page 8 of 8
Title: Chair, Board of Weld County Commissioners
Contract Form
Entity Information
Entity Name* Entity ID*
ARTHUR J GALLAGHER RISK @00000344
MANAGEMENT SERVICES, INC
Contract Name *
HOUSING AUTHORITY INSURANCE RENEWAL
Contract Status
CTB REVIEW
O New Entity?
Contract ID
9709
Contract Lead *
BPETERSON
Contract Lead Email
bpeterson@weld.gov
Contract Description *
RENEWAL APPLICATION FOR KINSALE INSURANCE HOUSING AUTHORITY FOR 25-26.
Parent Contract ID
Requires Board Approval
YES
Department Project #
Contract Description 2
THE 24-25 RENEWAL WAS $10,579 AND THERE IS NOT AN ANTICIPATED INCREASE FOR 25-26.
Contract Type*
APPLICATION
Amount*
$10,579.00
Renewable*
YES
Automatic Renewal
Grant
IGA
Department
HUMAN RESOURCES
Department Email
CM-
HumanResources@weld.g
ov
Department Head Email
CM-HumanResources-
DeptHead@weld.gov
County Attorney
GENERAL COUNTY
ATTORNEY EMAIL
County Attorney Email
CM-
COUNTYATTORNEY@WEL
D.GOV
If this is a renewal enter previous Contract ID
If this is part of a MSA enter MSA Contract ID
Requested BOCC Agenda
Date *
07/07/2025
Due Date
07/03/2025
Will a work session with BOCC be required?*
NO
Does Contract require Purchasing Dept. to be
included?
Note: the Previous Contract Number and Master Services Agreement Number should be left blank if those contracts
are not in OnBase
Contract Dates
Effective Date
Termination Notice Period
Contact Information
Contact Info
Review Date *
06/01/2026
Renewal Date *
07/07/2026
Committed Delivery Date Expiration Date
Contact Name Contact Type Contact Email Contact Phone 1 Contact Phone 2
Purchasing
Purchasing Approver Purchasing Approved Date
Approval Process
Department Head
JILL SCOTT
DH Approved Date
07/07/2025
Final Approval
BOCC Approved
BOCC Signed Date
BOCC Agenda Date
07/28/2025
Finance Approver
CHERYL PATTELLI
Legal Counsel
BYRON HOWELL
Finance Approved Date Legal Counsel Approved Date
07/08/2025 07/08/2025
Tyler Ref*
AG 072825
Originator
BPETERSON
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