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Home My WebLink About20152782.tiff Ullico Casualty Group Inc. 8403 Colesville Rd. 3/31/2015 Silver Spring.MD 20910 888.315.3352 tel 202.962.8853 fax Insured's Name Weld County Retirement Plan A Ullico Inc.Company Address1150 O Street www.ullico.com/casualty Address Greeley, CO 80632 Not all companies are licensed in all states Subject: Change in Policy Terms CA Ullico Insurance Agency Inc Lic#0E16939.NY Ullico Casualty Agency Named Insured: Weld County Retirement Plan Insurer: Alterra America Insurance Company Policy No:AGL001136000 Policy Period:June 16, 2014 to June 16, 2015 Dear Insured, Thank you for your Professional Liability business with Ullico Casualty Group Inc. We are pleased to continue our long term relationship as a managing general agent with our carrier partner. Alterra America Insurance Company,a Markel company, was acquired by Markel Group in 2013. As states accept our filings,our Fiduciary and Union Liability policies will renew with Markel American Insurance Company, headquartered in Richmond, Virginia, which has a rating of A, XIV from A.M. Best Company as of 12/31/2014. Ullico Casualty Group updates policies as exposures in the Union workplace evolve, and we have taken this opportunity to expand coverages to meet the needs of our insureds. We are pleased to offer an even broader policy form this renewal. Please note that we may now offer higher limits on multiemployer Fiduciary Liability policies, up to $25 million. If you have any questions, please contact your broker of record or Ullico Casualty Group at 888.315.3352. Please watch for your renewal packet which your broker will send. Thank you again, and we look forward to providing a renewal quotation on your Professional Liability policy. Tina Fletcher VP, Ullico Casualty Group 8403 Colesville Road Silver Spring, MD 20910 202.682.4976 tfletcher@aullico.com CC: The McLaughlin Company �J Y-19-2'0/5 2015-2782 kV, asuAu www.ullico.com SO1 UTIUNS -�,��,�T+r 11NI1N ti'nl+K ,ct SPECIALTY INSURANCE INVESTMENTS GArthur) Gallagher& Z, Weld County Retirement Plan July 20, 2015 r� , ,►► ►wr. 2015 Fiduciary Liability Proposal fit bl Presented by: Arthur J. Gallagher & Co. 6399 S. Fiddlers Green Circle, Suite 200 Greenwood Village, CO 80111 800.333.3231 www.ajg.com Weld County Retirement Plan G Arthur J Gallagher&Co. Table of Contents Mission Statement 1 Client Service Team 2 Named Insured Schedule, Premium Summary, Premium Finance Options, 3 Conditions to Bind Coverage, Scope of Responsibility Statement Claims Reporting Instructions 4 Fiduciary Liability Coverage Summary 5 Coverage Considerations, Changes and Developments 9 Proposal Disclosures 10 Marketing Summary/ Guide to A.M. Best Ratings 12 Bindable Quotations and Compensation Disclosure Schedule 14 Contingent and Supplemental Commission Disclosure 15 Client Authorization to Bind Coverage 16 Appendix 17 Markel American Insurance Company Specimen Policy and Endorsements Weld County Retirement Plan GArthur J Gallagher& Co. Mangert Mission Statement ARTHUR J. GALLAGHER- DENVER OUR MISSION We are an insurance brokerage, consulting& risk management services company committed to being the best at reducing the cost of risk and protecting the financial integrity of our clients. OUR VISION To be recognized and respected. . . By our clients as unparalleled customer service professionals providing responsive and innovative solutions that address their needs. By our markets as tenacious competitors providing opportunities for growth and operating with the highest degree of integrity and ethical character By our employees as "a winning team"providing a fair, challenging and friendly environment that rewards performance, encourages creativity and supports personal development. B y our community as an organization promoting both individual and collective involvement that"makes a difference". Page 1 Weld County Retirement Plan Arthur J. Gallagher& Co Gallagher Team Members PRIMARY TEAM BACK UP TEAM RISK CONTROL SERVICES Karen Graham Karen Graham Ed Davis Team Leader Team Leader Sr. Loss Control Specialist Area Exec. Vice President Area Exec. Vice President 303.889.2552 303.889.2538 303.889.2538 720.200.5107 (fax) 303.773.9776(fax) 303.773.9776(fax) Ed_Davis@ajg.com a @ jgcom Karen_Graham@ajg.com Karen_Graham@ajg.com Priscilla McCoy James Martinez Kendall Trump Area Senior Vice President Client Service Executive Claims Consultant(Denver) 303.889.2540 303.889.2576 303.889.2570 303.889.2541 (fax) 303.889.2577(fax) 303.889.2571 (fax) Priscilla_McCoy@ajg.com Jimmy_Martinez@ajg.com Kendall_Trump@ajg.com Tracy Paladino Client Services Supervisor 303.889.2614 303.889,2615(fax) Tracy_Paladino@ajg.com Analisa Murphy Client Service Manager 303.889.2590 720.200.5117 (fax) Analisa_Murphy@ajg.com Anita Bruner Sr. Client Service Associate 303.889.2574 303.889.2575 (fax) Anita_Bruner@ajg.com Page 2 Weld County Retirement Plan GArthur J Gallagher& Co Named Insured Schedule Weld County Retirement Plan NOTE: Any entity not named as an insured may not be covered under this policy. This may include Partnerships and Joint Ventures. Premium Summary Limit Deductible 2015-2016 Line of Coverage Annual Premium Fiduciary Liability $1,000,000 Aggregate $0 $10,136 Premium Finance Options Premiums for the policyis due and payable as billed, in full Premiums may be financed, subject to acceptance by an approved finance company. Note: Following acceptance, completion (and signature) of a premium finance agreement with the specified down payment is required. Conditions to Bind Coverage None Scope of Responsibility Statement Gallagher is responsible for the placement of the lines of coverage outlined below: Fiduciary Liability It is understood that any other type of exposure/coverage is either self-insured or placed by another brokerage firm other than Gallagher. If you need help placing other lines of coverage or covering other types of exposures, please contact your Gallagher representative. Page 3 Weld County Retirement Plan GArthur J Gallagher& Co Claims Reporting Instructions Line of Coverage Carrier Policy# Address When to Report Fiduciary Liability Markel TBD Fiduciary Liability Claims As soon as American Management practicable (see Insurance c/o Ullico Casualty Group Policy form Company 1625 Eye Street, NW notification Washington, DC 20006 provisions) Fax: 202.962.8853 E-mail: professionalclaimsullico.com Also Report Claim to: Arthur J Gallagher Risk Management Services, Inc. 6399 South Fiddlers Green Circle, Suite 200 Greenwood Village, CO 80111-4949 Main Claims Email: wr-claims(a�ajq.com Contact: Kendall Trump, Claim Consultant Email : Kendall TrumpRajq.com Phone: 303.889.2570 Fax: 303.773.9776 Page 4 Weld County Retirement Plan GArthur) Gallagher& Co. Fiduciary Liability — Claims Made Form Carrier: Markel American Insurance Company Policy Period: June 16, 2015 to June 16, 2016 Named Plan(s): Weld County Retirement Plan Limits: $1,000,000 Each Claim &Aggregate Self Insured Retention:: $0 Each Claim Defense Provisions: • Defense costs and claims expenses are included in the policy limits and Deductible • Alterra will have the right and duty to defend any Claim covered under the policy • Insured has the right to select defense counsel—must request in writing within thirty days after giving notice to Clam to the Carrier • Consent to Settle Provision applies' • Defense for Failure to Fund Premium Provision Policy Forms& THIS IS A"CLAIMS-MADE" POLICY. Claims-Made but not reported in Endorsements: compliance with the terms and conditions of the policy will not be covered. Claims-Made Coverage Should you elect to change carriers (if a new retro-active date is provided) or Note: non-renew this policy, a supplemental extended reporting endorsement may be available subject to policy terms and conditions. You must request the extended reporting period in writing to the carrier within 30 days of the non- renewal or cancellation date of the policy and pay the additional premium by the due date specified on the premium invoice. The cost of this extended reporting period is 100%of the annual premium and is fully earned. The extended reporting period extends only to those claims that occurred prior to the expiration date and would have been covered by the policy. Claims must be reported to the carrier within 30 days of the end of the policy period. The extended reporting period does not increase the limits of liability and is subject to all policy terms, conditions and exclusions Page 5 Weld County Retirement Plan GArthur J. Gallagher& Co. • Fiduciary Liability — Claims Made Form (Continued) Terms and Conditions: • Pay on Behalf of Form • Consent to Settle Provisions • Estates and Legal Representatives, Spousal Liability Coverage • Severability of Exclusions Provisions Coverage Enhancements: • NCPERS Modification Endorsement including: o Renewal Guarantee o Policy may not be cancelled except for non-payment premium o Wrongful Act Definition amended o Plan Definition Added for Employee Benefit Law • Spouses, Domestic Partners, Estates and Legal Representatives Clause • Waiver of Recourse Provisions • Waiver of Subrogation Provision • Voluntary Compliance Program Expenditures -$200,000 Aggregate Limit • HIPAA and PPACA Fines and Penalties -$1,000,000 Aggregate Limit • Failure to Fund Exclusion exception • • Other Insurance Provision—Excess • Representation and Severability Clause • Texas Amendatory Endorsement Definition of Claim: • A written demand for monetary damages or injunctive relief • A civil proceeding commenced by the service of a complaint or similar pleading • A criminal proceeding commenced by the return of an indictment, or a formal administrative or regulatory investigation or proceeding commenced by the filing of a notice of charges, formal investigative order or similar document against an Insured for a Wrongful Act committed or attempted, or allegedly committed or attempted, by such Insured or by any person for whose Wrongful Acts such Insured is or is alleged to be legally responsible. Claim does not mean or include any internal proceedings of the Insured. Prior and Pending Litigation Date: 06/16/2014 Page 6 Weld County Retirement Plan GArthur J Gallagher& Co x z3 Fiduciary Liability — Claims Made Form (Continued) Extended Reporting If this policy is terminated or not renewed for any reason other than the non- Period: payment of premium, the Insureds will have the right to purchase an extension of the coverage granted by an Extended Reporting Period Endorsement. The Extended Reporting Period, if purchased, will apply only to Claims first made during the Extended Reporting Period, and only if such Claims are for otherwise covered Wrongful Acts committed or attempted, or allegedly committed or attempted, before the Effective Date of such termination or non-renewal. The additional premium for the Extended Reporting Period will be that amount set forth in the Extended Reporting Period Endorsement. This additional premium must be paid within thirty(30) days after the Effective Date of the termination or non-renewal of the policy, and will be deemed to have been fully earned immediately as of the inception of the Extended Reporting Period. The Insurer's Limits of Liability for Loss from Claims first made or deemed made during the Extended Reporting Period will be part of, and not in addition to, the Limits of Liability stated in Item 04(a) of the Policy Certificate, which are applicable to all Loss for which this policy provides coverage. ERP Percentage&Years are as Follows: • 1 Year 100% • 2 Years 150% • 3 Years 200% • 4 Years 225`)/0 • 5 Years 250% • 6 Years 275% Significant Exclusions • Prior and Pending Litigation—Inception date of coverage (Include But are Not • Any Insured having gained any personal profit, remuneration, or other Limited To): advantage that insured was not legally entitled • Liability assumed under contract or agreement except where noted in policy form • Nuclear • Pollution Exposure Basis: Plan Assets, Total Contributions, Number of Participants • Page 7 Weld County Retirement Plan G Arthur J. Gallagher& Co. Fiduciary Liability — Claims Made Form (Continued) Duties in Event of a As outlined in Policy under Section VI.-conditions, B, Insured's duties in the Claim, Reporting event of a Claim, reporting requirements and notice provisions, Page 9 of 13; Requirements and Page 12 of 13, N, Authorization and Notices-A copy is provided in the Notice Provisions Appendix Claims Reporting Fiduciary Liability Claims Management Instructions: c/o Ullico Casualty Group 1625 Eye Street, NW Washington, DC 20006 By Fax: 202.962.8853 By E-mail: professionalciaims(a)ullico.com Page 8 Weld County Retirement Plan GArthur J Gallagher& Co Coverage Considerations Overview Coverages are highlighted here to review available coverages which you should consider. These coverages are included in the coverage section of this proposal only if quoted and highlighted as covered. o Fiduciary Liability • Higher Limits Changes and Developments It is important that we be advised of any changes in your operations that may have a bearing on the validity and/or adequacy of your insurance. The types of changes that concern us include, but are not limited to, those listed below: 1. Changes in any operation such as expansion to another state, new products. 2. Mergers and/or acquisition of new companies. 3. Any newly assumed contractual liability, granting of indemnities, or hold harmless agreements. 4. Circumstances which may require an increased liability insurance limits. 5. Any changes in fire or theft protection, such as the installation of or disconnection of sprinkler systems, burglar alarms, etc. This includes any alterations to same. 6. Immediate advice of any changes to scheduled equipment such as contractors' equipment, electronic data processing, etc. 7. Property, of yours that is in transit, unless we have previously arranged for the insurance. 8. Any changes in existing premises including vacancy, whether temporary or permanent, alterations, demolition, etc. Also, any new premises either purchased, constructed, or occupied. Page 9 Weld County Retirement Plan Arthur) Gallagher& Co Proposal Disclosures The following disclosures are hereby made a part of this proposal. Please review these disclosures prior to signing the proposal acceptance agreement or e-mail confirmation. Proposal Disclaimer: IMPORTANT: The proposal is an outline of certain terms and conditions of the insurance proposed by the insurers, based on the information provided by your company. It does not include all the terms, coverages, exclusions, limitations, conditions of the actual policy contract language. The insurance policies themselves must be read for those details. Policy forms for your reference will be made available upon request. Compensation One of the core values highlighted in The Gallagher Way states, "We are an Open Society," Disclosure: and our open society extends to the compensation Gallagher receives. For more information on Gallagher's compensation arrangements, please visit http://www.ajg.com/compdisclosure. In general, Gallagher may be compensated as follows: 1.Gallagher Companies are primarily compensated from the usual and customary commissions or fees received from the brokerage and servicing of insurance policies, annuity contracts, guarantee contracts and surety bonds(collectively"insurance coverages")handled for a client's account, which such commissions and fees may vary from company to company and insurance coverage to insurance coverage. As permitted by law, Gallagher companies occasionally receive both commissions and fees. In placing, renewing, consulting on or servicing your insurance coverages, Gallagher Companies may participate in contingent commission arrangements with intermediaries and insurance companies that provide for additional contingent compensation if underwriting, profitability, volume or retention goals are achieved. Such goals are typically based on the total amount of certain insurance coverages placed by Gallagher with the insurance company, not on an individual policy basis.As a result, Gallagher may be considered to have an incentive to place your insurance coverages with a particular insurance company. 2.Gallagher Companies may also receive investment income on fiduciary funds temporarily held by them, such as premiums or return premiums. 3.Gallagher Companies may access other facilities, including wholesalers, reinsurance intermediaries, captive managers, underwriting managers and others that act as intermediaries for both Gallagher and other brokers in the insurance marketplace. Gallagher Companies may own some of these facilities, in whole or in part. If such a facility was utilized in the placement of a client's account, the facility may have earned and retained customary brokerage commission or fees for its work. 4.Gallagher assists its customers in procuring premium finance quotes and unless prohibited by law may earn compensation for this value added service. If you have specific questions about the compensation received by Gallagher and its affiliates in relation to your insurance placements, please contact your Gallagher representative for more details. In the event you wish to register a formal complaint regarding compensation Gallagher receives from insurers or third parties, please send an email to Compensation_Complaints@ajg.com or send a letter to: AVC Compliance Officer Arthur J. Gallagher&Co. Two Pierce Place, 20th Floor Itasca, IL 60143 Actuarial Disclaimer: The information contained in this proposal is based on the historical loss experience and exposures that were provided to Arthur J. Gallagher&Co. This proposal is not an actuarial study. Should you wish to have this proposal reviewed by an independent actuary, we will be pleased to provide you with a listing of actuaries for your use. Page 10 Weld County Retirement Plan Arthur J. Gallagher& Co. Proposal Disclosures (Continued) Terrorism Act TRIA/TRIPRA Disclaimer—If this proposal contains options to purchase TRIA/TRIPRA Disclaimer: coverage,the proposed TRIA/TRIPRA program may not cover all terrorism losses. While the most recent legislation eliminated the distinction between foreign and domestic acts of terrorism, a number of lines of coverage excluded under the TRIEA legislation passed in 2005 remain excluded including commercial automobile, burglary and theft insurance; surety insurance, farm owners multiple perils and professional liability(although directors and officers liability is specifically included). If such excluded coverages are required, we recommend that you consider purchasing a separate terrorism policy. Please note that a separate terrorism policy for these excluded coverages may be necessary to satisfy loan covenants or other contractual obligations. The Terrorism Risk Insurance Program Reauthorization Act(TRIPRA) includes a$100 billion cap on insurers' aggregate liability. TRIPRA is set to expire on December 31, 2014. There is no certainty of extension, thus the coverage provided by your insurers may or may not extend beyond December 31, 2014. In the event you have loan covenants or other contractual obligations requiring that TRIA/TRIPRA be maintained throughout the duration of your policy period,we recommend that a separate"Stand Alone"terrorism policy be purchased to satisfy those obligations. Confidentiality Where permitted by law, we consider as confidential any information presented by Arthur J. Statement: Gallagher&Co. in this proposal as well as other verbal and written communications between our organizations. We ask that other brokers not have access to our material and that information presented in this proposal be shared only with those who have a need to know within your company.We make our commitment to you that information already received from you, and any additional information to follow, will be treated with the same high level of respect and confidentiality. Actuarial Loss Arthur J. Gallagher&Co. does not provide actuarial services or actuarial estimates of rate Disclaimer: levels or rate methodology. In the event that Arthur J. Gallagher&Co. provides suggestions regarding the establishment of rates or premiums, that advice is based solely on various insurance industry standards and does not constitute an actuarial evaluation or estimate. It is the recommendation of Arthur J. Gallagher&Co. that you contract with an appropriately certified actuary to provide recommendations for rates and overall rating methodology. We will not be operating in a fiduciary capacity, but only as your broker, obtaining a variety of coverage terms and conditions to protect the risks of your enterprise. We will seek to bind those coverages based upon your authorization; however, we can make no warranties in respect to policy limits or coverage considerations of the carrier. Actual coverage is determined by policy language, so read all policies carefully. Contact us with questions on these or any other issues of concern. Page 11 Weld County Retirement Plan Arthur) Gallagher& Co. 3Nc Fran �ytx'#r ti�^ac ljr .� .H. wfix. ,,v y , Carrier Ratings and Admitted Status Pei . Oar A.M.Best's Rating I an nt Markel American Insurance A, XIV Admitted Company If the above indicates coverage is placed with a non-admitted carrier, the carrier is doing business in the state as a surplus lines or non-admitted carrier. As such, this carrier is not subject to the same regulations which apply to an admitted carrier nor do they participate in any insurance guarantee fund applicable in that state. The above A.M. Best Rating was verified on the date the proposal document was created. Guide to Best Ratings Rating Levels and Categories Level Category Level Category Level Category A++,A+ Superior B,B- Fair D Poor A,A- Excellent C++,C+ Marginal E Under Regulatory Supervision B++,B+ Good C,C- Weak F In Liquidation S Suspended Financial Size Categories (In$000 of Reported Policyholders'Surplus Plus Conditional Reserve Funds) FSC I Up to 1,000 FSC IX 250,000 to 500,000 FSC II 1,000 to 2,000 FSC X 500,000 to 750,000 FSC III 2,000 to 5,000 FSC XI 750,000 to 1,000,000 FSC IV 5,000 to 10,000 FSC XII 1,000,000 to 1,250,000 FSC V 10,000 to 25,000 FSC XIII 1,250,000 to 1,500,000 FSC VI 25,000 to 50,000 FSC XIV 1,500,000 to 2,000,000 FSC VII 50,000 to 100,000 FSC XV 2,000,000 or more FSC VIII 100,000 to 250,000 Best's Insurance Reports,published annually by A.M. Best Company, Inc..presents comprehensive reports on the financial position,history,and transactions of insurance companies operating in the United States and Canada. Companies licensed to do business in the United States are assigned a Best's Rating which attempts to measure the comparative position of the company or association against industry averages. A Best's Financial Strength Rating opinion addresses the relative ability of an insurer to meet its ongoing insurance obligations. It is not a warranty of a company's financial strength and ability to meet its obligations to policyholders. View the A.M.Best Important Notice: Best's Credit Ratings for a disclaimer notice and complete details at http://www.ambest.com/ratings/notice. Best's Credit Ratings are under continuous review and subject to change and/or affirmation. For the latest Best's Credit Ratings and Best Credit Reports(which include Best Ratings),visit the A.M. Best website at http://www.ambest.com. See Guide to Best's Credit Ratings for explanation of use and charges. Copies of the Best's Insurance Reports for carriers listed above are also available upon request of your Gallagher representative. Best's Credit Ratings reproduced herein appear under license from A M Best and do not constitute,either expressly or impliedly,an endorsement of(Licensee's publication or service)or its recommendations,formulas,criteria or comparisons to any other ratings, rating scales or rating organizations which are published or referenced herein. A.M.Best is not responsible for transcription errors made in presenting Best's Credit Ratings. Best's Credit Ratings are proprietary and may not be reproduced or distributed without the express written permission of A.M.Best Company. Gallagher companies use A.M.Best Company's rating services to evaluate the financial condition of insurers whose policies we propose to deliver. Gallagher companies make no representations and warranties concerning the solvency of any carrier,nor does it make any representation or warranty concerning the rating of the carrier which may change. Page 12 Weld County Retirement Plan Arthur J Gallagher& Co Carrier Ratings and Admitted Status (Continued) GUIDE TO BEST'S FINANCIAL STRENGTH RATINGS A Best's Financial Strength Rating is an independent opinion of an insurer's financial strength and ability to meet its ongoing insurance policy and contract obligations.The rating is based on a comprehensive Quantitative and Qualitative evaluation of a company's balance sheet strength, operating performance and business profile Financial Strength Ratings-Insurer Rating Descriptor Definition A++,A+ Superior Assigned to companies that have,in our opinion,a superior ability to meet their 1, ongoing insurance obligations 3 A,A- Excellent Assigned to companies that have, in our opinion,an excellent ability to meet their rn ongoing insurance obligations B++, B+ Good Assigned to companies that have,in our opinion,a good ability to meet their ongoing insurance obligations B, B- Fair Assigned to companies that have,in our opinion,a fair ability to meet their ongoing insurance obligations. Financial strength is vulnerable to adverse changes in underwriting and economic conditions. C++,C+ Marginal Assigned to companies that have, in our opinion,a marginal ability to meet their ongoing insurance obligations. Financial strength is vulnerable to adverse changes in underwriting and economic conditions C,C- Weak Assigned to companies that have,in our opinion,a weak ability to meet their ongoing insurance obligations. Financial strength is very vulnerable to adverse changes in cis underwriting and economic conditions c D Poor Assigned to companies that have,in our opinion,a poor ability to meet their ongoing insurance obligations. Financial strength is very vulnerable to adverse changes in underwriting and economic conditions E Under Regulatory Assigned to companies(and possibly their subsidiaries/affiliates)placed under a Supervision significant form of regulatory supervision,control or restraint-including cease and desist orders,conservatorship or rehabilitation,but not liquidation-that prevents conduct or normal,ongoing insurance operations. F In Liquidation Assigned to companies placed in liquidation by a court of law or by a forced liquidation S Suspended Assigned to rated companies when sudden and significant events affect their balance sheet strength or operating performance and rating implications cannot be evaluated due to a lack of timely or adequate information Rating Modifiers Modifier Descriptor Definition u Under Review Indicates the rating may change in the near term,typically within six months.Generally is event driven,with positive,negative or developing implications pd Public Data Indicates rating assigned to insurer that chose not to participate in AM.Best's interactive rating process.(Discontinued in 2010) s Syndicate Indicates rating assigned to a Lloyd's syndicate Outlooks Indicates potential direction of a Financial Strength Rating over an intermediate term,generally defined as 12 to 36 months. Positive Indicates possible rating upgrade due to favorable financial/market trends relative to the current rating level Negative Indicates possible rating downgrade due to unfavorable financial/market trends relative to the current rating level Stable Indicates low likelihood of a rating change due to stable financial/market trends Not Rated Designation NR:Assigned to companies that are not rated by A.M.Best. Rating Disclosure A Best's Financial Strength Rating opinion addresses the relative ability of an insurer to meet its ongoing insurance obligations.The ratings are not assigned to specific insurance policies or contracts and do not address any other risk,including,but not limited to,an insurer's claims-payment policies or procedures;the ability of the insurer to dispute or deny claims payment on grounds of misrepresentation or fraud;or any specific liability contractually borne by the policy or contract holder.A Best's Financial Strength Rating is not a recommendation to purchase,hold or terminate any insurance policy,contract or any other financial obligation issued by an insurer,nor does it address the suitability of any particular policy or contract for a specific purpose or purchaser.In arriving at a rating decision,A.M.Best relies on third-party audited financial data and/or other information provided to it.While this information is believed to be reliable,A.M Best does not independently verify the accuracy or reliability of the information. For additional details,see A.M Best's Terms of Use at www.ambest.com. Best's Financial Strength Ratings are distributed via press release and/or the A.M.Best Web site at wwwambest.comn and are published in the Credit Rating Actions section of BestWeek". Best's Financial Strength Ratings are proprietary and may not be reproduced without permission. Copyright©2013 by A.M Best Company;Inc. Version 021712 Page 13 Weld County Retirement Plan Arthur J Gallagher& Co. 2.0�k. .��.s Bindable Quotation and Compensation Disclosure Schedule Wholesaler, Wholesaler, Estimated AJG MGA or MGA or Wholesaler,MGA Annual Commission% Intermediary Intermediary% or Intermediary Premium or Fee Name or Fee AJG-Owned? Carrier Name Coverage 1 2 3 4 Yes or No Markel Fiduciary $10,136 15% N/A N/A N/A American Liability- Insurance $1,000,000 Company Limit Some carriers pay Gallagher supplemental or contingent commissions in addition to the policy commission. Contingent commissions are typically contingent upon performance factors such as growth, profit, volume or retention, while supplemental commissions are not. These supplemental or contingent commissions may range from less than 1% up to 10 % of the policy premium. Please refer to the Contingent and Supplemental Commission Disclosure or contact your Gallagher representative for additional information. 1. The commission rate is a percentage of annual premium excluding taxes &fees. 2. We were able to obtain more advantageous terms and conditions for you through an intermediary/ wholesaler. 3. *The non-Gallagher intermediary/wholesaler did not provide their compensation information for this proposal. The usual and customary compensation to a wholesaler/intermediary ranges from 5%to 12%, but we cannot verify that range is applicable in connection with this proposal. Page 14 Weld County Retirement Plan GArthur J Gallagher& Co Contingent and Supplemental Commission Disclosure Effective October 1, 2009, Arthur J. Gallagher& Co., and its subsidiaries operating as insurance agents/brokers under the corporate holding company known as Arthur J. Gallagher Brokerage & Risk Management Services, LLC, resumed participating in contingent commission arrangements which are routinely offered by insurance companies and intermediaries to agents and brokers, after voluntarily foregoing the benefit of this type of compensation since January 1, 2005. Contingent commission arrangements provide for additional compensation if certain underwriting, profitability, volume or retention goals are achieved. Such goals are typically based on the total amount of certain insurance coverages placed by Gallagher with the insurance company and/or through the intermediary, not on an individual policy basis. As a result, Gallagher may be considered to have an incentive to place your insurance coverages with a particular insurance company. During the time Gallagher's retail operations did not accept contingent commissions, some insurance markets and intermediaries, including Gallagher owned intermediaries, modified their commission schedule with Gallagher, resulting in an increase in some commission rates. The additional commissions, commonly referred to as "supplemental commissions", are known at the effective date of the policy, but some intermediaries and insurance companies are paying the commission increase apart and later from when the commission is normally paid at policy issuance. Unlike contingent commissions, supplemental commission payments are determined without regard to any performance factors which are contingent on future growth, retention, profitability, etc. Contingent and supplemental commission ranges from less than 1% up to 10% of written or earned premium on eligible lines of business (not all lines of business qualify). NOTE: Upon request, your Gallagher representative can provide more specific market information regarding contingent and supplemental commission related to your insurance coverage. Page 15 Weld County Retirement Plan GArthur J. Gallagher& Co. Client Authorization to Bind Coverage After careful consideration of your proposal dated July 20, 2015,we accept your insurance program subject to the following exceptions/changes: Policy Options: YES NO OPTION DESCRIPTION Bind All Policies As Shown Herein as shown below: Fiduciary Liability—Markel American Insurance Company,$1,000,000 Limit, $0 SIR, $10,136 Bind TRIA Terrorism Coverage As Quoted Except For the Following Policies X Included Provide Quotations or Additional Information on the following Coverage Considerations It is understood this proposal provides only a summary of the details;the policies will contain the actual coverages. We confirm the values, schedules, and other data contained in the proposal are from our records and acknowledge it is our responsibility to see that they are maintained accurately. We agree that your liability to us arising from your negligent acts or omissions,whether related to the insurance placed pursuant to these binding instructions or not, shall not exceed$20 million, in the aggregate. Further,without limiting the foregoing,we agree that in the event you breach your obligations, you shall only be liable for actual damages we incur and that you shall not be liable for any indirect, consequential or punitive damages. tent Si nature �p 20 t Dated Page 16 Weld County Retirement Plan GArthur J Gallagher& Co Appendix • Markel American Insurance Company Specimen Policies and Endorsements including NCPERS Endorsement Page 17 MARKEL® Markel American Insurance Company 4521 Highwoods Parkway Glen Allen, VA 23060 Governmental Fiduciary Liability Claims-Made Policy IMPORTANT NOTICE: This is a Claims-Made Governmental Fiduciary Liability Policy 1. This policy does not become effective unless a Policy Certificate is issued to form a part of it. 2. This is a claims-made Governmental Fiduciary Liability Insurance Policy. The coverage afforded by this policy is limited to liability for only those Claims first made during the Policy Period specified on the Policy Certificate resulting from Wrongful Acts and which are subsequently reported to the Insurer as soon as practicable. 3. This is a policy with Claims Expenses included in the Limits of Liability. Claims Expenses shall reduce the Limits of Liability up to 100%. This could result in the exhaustion of the Limits of Liability by the payment of Claims Expenses, and the Insurer shall not be liable for any Loss after the exhaustion of the Limits of Liability. 4. Please review this policy carefully and discuss the coverage with your lawyer, insurance advisor, agent or broker. Gov-1000(1 1/2014) Page I of 14 illMarkel American Insurance Company 4521 Highwoods Parkway Glen Allen, VA 23060 Governmental Fiduciary Liability Claims-Made Policy Whenever the term Insured is used in this policy, it refers to any person or organization qualifying as such in Section IX. Definition M. Whenever the terms "we,""us,""our"or"the Insurer"are used in this policy, they refer to Markel American Insurance Company. Other defined terms are used throughout this policy. These terms appear in boldface type and are defined in Section IX. Definitions. In consideration of payment of premium and subject to the Policy Certificate, exclusions, limitations, conditions, provisions and other terms of this policy,the Insurer agrees as follows: Section I. Insuring Agreement A. The Insurer shall pay on behalf of the Insured all Loss which the Insured becomes legally obligated to pay resulting from any Claim first made against the Insured during the Policy Period,the Automatic Reporting Period or the Extended Reporting Period(whichever is applicable)for a Wrongful Act. B. The Insurer will pay on behalf of the Insureds those Voluntary Compliance Program Expenditures incurred by the Insureds as a result of their participation in any Voluntary Compliance Program if such participation commences during the Policy Period, the Automatic Reporting Period or the Extended Reporting Period(whichever is applicable). Section II. Defense and Settlement A. If there exists any applicable statute, ordinance, regulation or agreement which provides for the defense of any Claim to which this insurance applies at no specific additional cost to the Insureds or to the Insurer, then the Insurer will not be obligated to assume the defense of the Insured, or of the investigation, defense and/or settlement of any Claim, but the Insurer will have the right and shall be given the opportunity to associate itself, at its own expense, in the investigation, defense and/or settlement of any such Claim which, in the Insurer's opinion, may give rise to liability on the part of the Insurer under this Policy. B. In the absence of any statute,ordinance, regulation or agreement wh'g which provides for the defense of any Claim as described in paragraph II.A above: I. The Insurer will have the right and duty to defend any Claim covered by this policy, even if the allegations in such Claim are groundless, false or fraudulent. Upon the exhaustion of the Limit of Liability applicable to any Claim, the Insurer's duty to defend such Claim will cease and, upon the exhaustion of the Insurer's maximum Aggregate Limit of Liability under this policy as set forth in Item 04(a) of the Policy Certificate, the Insurer will thereafter have no duty or obligation to defend or to continue to defend any Claim. 2. Subject to Section II.B.I above, the Insureds will have the right to select defense counsel to defend Claims against them, subject to the Insurer's approval, such approval not to be unreasonably withheld, and subject to such selected counsel's compliance with applicable Litigation Management Guidelines. The Insureds must, however, exercise this right in writing within thirty (30) days after first giving the Insurer notice of the Claim with respect to which such counsel is to be retained. If the Insureds do not inform the Insurer in writing of their intent to retain their own defense counsel within thirty(30)days after providing notice Gov-1000(I I/2014) Page 2 of 14 of a Claim, the Insurer will have the right to appoint defense counsel to represent the Insureds in connection with such Claim and to conduct the defense thereof. C. Claim Expenses incurred by counsel retained by the Insureds pursuant to Section I1.B.2 above, or by the Insurer if the Insureds do not exercise their right to retain their own defense counsel, are part of and not in addition to the applicable Limit of Liability as set forth in Item 04(a)of the Policy Certificate,and the payment by the Insurer of such Claim Expenses will reduce,and may exhaust,the applicable Limit of Liability under this policy. D. The Insureds agree to provide the Insurer with all information,assistance and cooperation, which the Insurer reasonably requests,and the Insureds further agree that, in the event of a Claim,they will do nothing that may prejudice the Insurer's position or actual or potential rights of recovery. At the Insurer's request, the Insureds will assist in the conduct of 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 assist in making settlements. E. The Insureds agree not to settle any Claim, incur any Claim Expenses or otherwise assume any contractual obligation or admit any liability with respect to any Claim without the Insurer's written consent, which consent will not be unreasonably withheld. The Insurer will not be liable for any settlement, Claim Expenses, assumed obligation or admission to which it has not consented in writing. F. The Insurer may, with the written consent of the Insured, propose or make any settlement offer or compromise offer of a Claim we deem appropriate. If the Insured withholds consent to the Insurer's proposed offer or compromise of any Claim for any reason or unreasonably delays considering or acting on such proposed offer or compromise, the Insurer's liability for all Loss with respect to that Claim shall not exceed the amount of the offer which the Insurer proposed to settle or compromise any Claim, plus Claims Expenses accrued as of the date the Insured refused to consent to the proposed offer of settlement or compromise of such Claim,subject to the applicable Limits of Liability stated in Item 04(a)of the Policy Certificate. G. If both Loss covered by this policy and Loss not covered by this policy are incurred, either because a Claim against an Insured includes both covered and uncovered matters or because a Claim is made against both an Insured and others, the Insurer shall allocate such amount between covered Loss and uncovered Loss based upon relative legal exposures of such parties to such matters. Any amounts so reimbursed shall not apply to or create any presumption of a fair and proper allocation of other amounts between covered Loss and non-covered amounts. Section III. Estates, Legal Representatives,and Spousal Liability Subject to the Limit of Liability and the Policy Certificate,exclusions,conditions, limitations,provisions and other terms of this policy,the coverage provided by this policy will extend to Claims made against: A. The estate, heirs, legal representatives or assigns of any natural person Insured if such natural person Insured is deceased, or the legal representatives or assigns of any natural person Insured if such natural person Insured is incompetent, insolvent or bankrupt;and B. The lawful spouse or domestic partner of a natural person Insured solely by reason of such spouse or domestic partner's status as such or such spouse or domestic partner's ownership interest in property, which the claimant seeks as recovery for liability of such natural person Insured. All exclusions, conditions, limitations, provisions and other terms of this policy applicable to Claims against and Loss incurred by any natural person Insured will also be applicable to Claims against and Loss incurred by their estates, heirs, legal representatives, assigns, spouses and domestic partners. No coverage will be available under this Section III., however, for any Loss, including Claims Expenses, Gov-1 000111/2014) Page3of14 arising from any act, error or omission committed or attempted, or allegedly committed or attempted, by a natural person Insured's estate, heir, legal representative,assign,spouse or domestic partner. Section IV. Exclusions A. The Insurer will not be liable for any Loss on account of any Claim against any Insured based upon,arising from, in consequence of,or in any way related to: 1. Any fact, circumstance or situation, which may reasonably be expected to result in a Claim, known by any Insured, at any time prior to the Prior & Pending Litigation Date shown in Item 06 of the Policy Certificate page. This exclusion shall not apply if the Prior and Pending Litigation Date is six or more years prior to the Effective Date of this policy. 2. Any Claim or Loss, against an Insured, if written notice of such has been given to any Insured,or previous carrier under any policy of a previous carrier,prior to the Effective Date of this policy. 3. Any deliberately dishonest, fraudulent or criminal act or omission or any intentional or willful violation of any statute or regulation by the Insured; provided,however,that this exclusion shall not apply to such Claim,or to the Insurer's obligation to pay Claim Expenses regarding such Claim, until an admission, plea agreement,judgment(including exhaustion of all appeals taken),or other final adjudication adverse to the Insured shall establish such act, omission or violation. 4. Any actual or alleged Bodily Injury, Property Damage or Personal Injury. 5. Any liability of others assumed by the Insured under any contract or agreement,either oral or written, except to the extent that the Insured would have been liable in the absence of a contract or agreement or unless the liability was assumed in accordance with or under the Agreement of Declaration of Trust pursuant to which the Plan was established. 6. Any actual or alleged failure of the Insured to comply with any law governing workers' compensation, unemployment, social security or disability benefits or any similar federal, state or local law,except for an Employee Benefit Law. 7. Any Insured having gained any profit, remuneration, or other advantage to which such Insured was not legally entitled, if an admission, plea agreement, judgment (including exhaustion of all appeals taken),or other final adjudication adverse to the Insured establishes the gaining of such a profit,remuneration or advantage. 8. The actual or alleged or threatened discharge, release, seepage, escape or disposal of any hazardous or toxic waste, Pollutants, Environmental Agents, emissions or substances, including but not limited to pollution or contamination of any kind, and including but not limited to any directions, requests or orders that an Insured report,test for, monitor,clean up, remove, recycle,contain,treat, detoxify or neutralize any hazardous or toxic waste,emissions or substances, or the payment of any carbon offsets, or any voluntary decision to do so; or nuclear radiation in any form no matter how emitted. B. The Insurer will not be liable for any Loss,other than Claim Expenses: 1. Based upon, arising from, in consequence of, or in any way related to any actual or alleged failure to fund a Plan in accordance with any applicable Employee Benefit Law or the Plan instrument, or for failure to collect contributions owed to a Plan; provided,that this exclusion will not apply to that portion of Loss payable solely as the personal obligation of a natural person Insured. Gov-1000(11/2014) Page 4of14 2. Vb'hich constitutes the return to any employer, public entities or governmental authorities of any contributions if such amounts are or could be chargeable to a Plan. 3. Which constitutes benefits due or to become due under the terms of any Plan,or which would be due if the Plan complied with all applicable Employee Benefit Laws. However, this Exclusion B.3 shall not apply to Loss to the extent that: a. The Insured liable for such Loss is a natural person who has been adjudicated to be personally liable,and b. Such Loss is based upon a covered Wrongful Act. 4. Which constitutes amounts attributable to a loss of the Plan or loss in the actual accounts of participants in a Plan because of an actual or alleged act, error, omission or breach of duty resulting in a change in value of investments held by that Plan. Section V. Severability of Exclusions With respect to the Exclusions in Section IV. of this policy, no act or omission of one Insured shall be imputed to any other Insured for the purpose of determining the applicability of any exclusion, and the coverage otherwise afforded under this policy shall continue to apply to all Insureds who did not commit, direct,approve, ratify or have knowledge of such act or omission. Section VI. Limits of Liability A. Number of Claims All Claims arising out of the same Wrongful Act or any Related Wrongful Acts shall be deemed one Claim,and such Claim shall be deemed to have been first made at the earliest time a Claim was first made or is deemed to have been first made against any Insured alleging such Wrongful Act or any Related Wrongful Acts. B. Self-Insured Retention and Limits of Liability The Self-Insured Retention shown in Item 05 of the Policy Certificate shall be deducted from all amounts, including Claims Expenses,paid by the Insurer for each Claim,and the Insurer shall be liable only for sums in excess of such retention amount up to the Limit of Liability stated in Item 04(a)of the Policy Certificate.The Insurer may elect to pay all or part of the retention amount to effect settlement of a Claim and,upon notice of the action taken by the Insurer,the Insured shall promptly reimburse such part of the retention amount as has been paid by the Insurer.The Self- Insured Retention amount is not included within,and will not reduce,the Limit of Liability. Section VII.Conditions A. Insured's duties in the event of a Claim, reporting requirements and notice provisions 1. The Insureds shall, as a condition precedent to the application of all insurance afforded by this policy,give the Insurer written notice as soon as practicable of any Claim made against any Insured for a Wrongful Act. 2. If during the Policy Period, the Automatic Reporting Period or the Extended Reporting Period (if applicable) an Insured becomes aware of any Wrongful Act which may subsequently give rise to a Claim and gives written notice thereof as set forth herein to the Insurer, then any Claim subsequently made against the Insured with regard to such Gov-1000(1 1/2014) Page 5 O1 14 Wrongful Act shall be deemed to have been made during the Policy Period, the Automatic Reporting Period or the Extended Reporting Period in which Wrongful Act was first reported to us. 3. The required written notices as stated above shall contain particulars sufficient to identify the Insured, any Claimant or potential Claimant and full information with respect to the time, place and circumstances of the Wrongful Act which led to the Claim, or which may subsequently give rise to a Claim, including the names and addresses of persons or entities which may have or which allege to have suffered loss,and of available witnesses. 4. The Insureds shall, as a condition precedent to the application of all insurance afforded by this policy, give the Insurer such information and cooperation as it may reasonably request. The Insureds shall, upon request, assist in making settlements and in defense of Claims and in enforcing rights of contribution or indemnity against any person or entity which may be liable to the Insured because of an act or omission covered under this policy, shall attend hearings and trials and assist in securing and giving evidence and obtaining the attendance of witnesses. The Insureds shall not prejudice the Insurer's position or its potential or actual rights of recovery. 5. Notice to the Insurer under this condition shall be given to the Claims Department in writing by one of the following methods: a. By Mail: Professional Liability Claims Department C/O Ullico Casualty Group, Inc. 8403 Colesville Road, 13th Floor Silver Spring, MD 20910-6331 b. By Fax to: 202.962.8853 c. By E-Mail to: professionalclaims@ullico.com Notice shall be deemed given only when received by the Insurer at the physical address, e- mail address or fax number stated above. B. Automatic Reporting Period If this policy is cancelled or non-renewed by either the Insured or the Insurer, an Automatic Reporting Period will be afforded. The Automatic Reporting Period provides coverage on account of any Claim first made against the Insured during the sixty (60) day period beginning with the non-renewal or cancellation of this policy, but only for Wrongful Acts occurring wholly prior to such non-renewal or cancellation date, and which are subsequently reported as soon as practicable but in no event after the end of the Automatic Reporting Period. Any Claim made during the Automatic Reporting Period shall be deemed to have been made during the immediately preceding Policy Period. Therefore, the Automatic Reporting Period shall not provide a new, additional or renewed Limit of Liability beyond that stated in Item 04(a) of the Policy Certificate. The Automatic Reporting Period may not be canceled. The Automatic Reporting Period, however,shall not apply to any Claim if other insurance the Insured obtains covers the Claim or would cover the Claim if its Limits of Liability had not been exhausted. C. Subrogation and Waiver of Recourse In the event of payment under this policy,the Insurer will be subrogated to,and will be entitled to an assignment of,all of the Insureds' rights of recovery. The Insureds will execute all papers and GOV-1000(1 1/2014) Page 6 of 14 do everything necessary to secure such rights, including the execution of any documents necessary to enable the Insurer to effectively pursue and enforce such rights and to bring suit in the name of the Insureds. If any premium for this policy is paid out of the assets of a Plan,the Insurer will have no right of recourse against any Insured. D. Authorization By acceptance of this policy, the Producer agrees to act on behalf of all Insureds with respect to the giving and receiving of notice of cancellation or non-renewal, the payment of premiums and the receiving of any return premiums that may become due under this policy, and the negotiation, agreement to and acceptance of Endorsements. All Insureds agree that the Producer shall act on their behalf; provided, however, that nothing herein shall relieve the Insureds, and each of them,from giving any notice to the Insurer that is required under Condition A above. E. No Action Against the Insurer No action may be taken against the Insurer unless, as a condition precedent thereto, there shall have been full compliance with all of the terms of this policy, and the amount of the Insured's obligation to pay shall have been finally determined either by judgment against the Insureds after actual trial, summary judgment, or settlement between the Insureds, the Claimant and the Insurer.No person or entity will have any right under this policy to join the Insurer as a party to any dispute to determine the liability of any Insured; nor may the Insurer be impleaded by an Insured or the Insured's legal representative in any such dispute. F. Bankruptcy or Insolvency of Insured The Insurer will not be relieved of any of its obligations under the policy by the bankruptcy or insolvency of any of the Insureds or their estates. G. Representations and Severability The Insureds represent that the Policy Certificate and statements contained in the written application for this policy are true, accurate and complete, and agree that this policy is issued in reliance on the truth of that representation,and that such Policy Certificate and statements, which are deemed to be incorporated into and to constitute a part of this policy, are the basis of this policy. Such written application for coverage will be considered as a separate application for coverage by each Insured and, with respect to the Policy Certificate and statements contained in such written application for coverage,no declaration or statement in the application or knowledge possessed by any Insured will be imputed to any other Insured for the purpose of determining whether coverage is available. H. Assignment and Transfers This policy shall be void if assigned or transferred without the Insurer's prior written consent by Endorsement to this policy. I. Changes Notice to or knowledge possessed by any agent or other person acting on behalf of the Insurer shall not effect a waiver or a change of any part of this policy or stop us from asserting any right under the terms of this policy, nor shall the terms of this policy be waived or changed, except by Endorsement. Gov-1000(I I/2014) Page 7ofI4 J. Premium All premiums for this policy shall be computed in accordance with the Insurer's rules, rates, premiums and minimum premiums applicable to the insurance afforded herein. K. Cancellation I. If the Insured cancels: To cancel this policy, the Insured must surrender the policy to the Insurer or mail a written notice stating when thereafter it wishes the cancellation to take effect. If the Insured cancels prior to the Expiration Date of the current Policy Period,the Insured shall be refunded any unearned premium on a pro-rata basis. 2. This policy may not be cancelled by the Insurer except for non-payment of premium. L. Non-Renewal The Insured or the Insurer may non-renew this policy at the end of the Policy Period. 1. If the Insured non-renews: If the Insured does not pay the renewal premium, or sends us written notice stating the intent not to renew the policy for the next Policy Period,the Insured has non-renewed the policy. 2. If the Insurer non-renews: If the Insurer non-renews the policy at the end of the Policy Period, a written notice will be sent out a minimum of sixty (60) days in advance to the address shown on the Policy Certificate or to the most current address the Insured has provided in writing. M. Other Insurance All Loss payable under this policy will be specifically excess of and will not contribute with any other valid and collectible insurance, whether such other insurance is stated to be primary, contributing, excess (except insurance specifically in excess of this policy), contingent or otherwise. N. Coverage Territory The insurance afforded by this policy applies anywhere the world, provided the Claim is made and brought in the United States of America, its territories or possessions. O. Valuation and Foreign Currency All premiums, limits, retentions, Loss and other amounts under this policy are expressed and payable in the currency of the United States of America. If judgment is rendered, settlement is denominated or any element of Loss under this policy is stated in a currency other than United States dollars, payment under this policy will be made in United States dollars at the rate of PY exchange published in the Wall Street Journal on the date such final judgment is reached, the amount of such settlement is agreed upon or such element of Loss is due, respectively. P. Changes in Exposure GOV-1000 11/2014 1 ) Page I. If, during the Policy Period, a Plan merges into or consolidates with another Plan not enumerated in Item 02 of the Policy Certificate, or any entity, regulatory agency or governmental agency, body or subdivision (or group of entities, regulatory agencies or governmental agencies, bodies or subdivisions acting in concert) assumes administrative, organization or supervisory control over any Plan, written notice thereof must be provided to the Insurer as soon as practicable. Coverage under this policy will continue in full force and effect with respect to Claims for Wrongful Acts committed or attempted, or allegedly committed or attempted,before such event by such Plan,by any natural person Insureds with respect to any Plan or by any person for whose Wrongful Acts any such Insured is legally responsible. However, coverage under this policy will cease with respect to Claims for Wrongful Acts committed or attempted, or allegedly committed or attempted, after such event by any such Insured or by any person for whose Wrongful Acts any such Insured is legally responsible. 2. If, during the Policy Period, the responsibility for the administration of a Plan is fully assumed by another person, entity or group of persons or entities, written notice thereof must be provided to the Insurer as soon as practicable. Coverage under this policy will continue in full force and effect with respect to Claims for Wrongful Acts committed or attempted, or allegedly committed or attempted, before such event by any natural person Insureds with respect to such Plan prior to such transfer of responsibilities or by any person for whose Wrongful Acts any such Insured is legally responsible. However,coverage under this policy will cease with respect to Claims for Wrongful Acts committed or attempted, or allegedly committed or attempted, after such event by any such natural person Insured or by any person for whose Wrongful Acts any such Insured is legally responsible. 3. If any Plan is terminated, whether before or during the Policy Period, written notice thereof must be provided to the Insurer as soon as practicable. Coverage under this policy will continue to apply to Claims for Wrongful Acts committed or attempted, or allegedly committed or attempted,before such event by such Plan, by any natural person Insureds with respect to such Plan or by any person for whose Wrongful Acts any such Insured is legally responsible. No coverage will be available under this policy, however, with respect to Claims for Wrongful Acts committed or attempted, or allegedly committed or attempted, after such event by any such Insured or by any person for whose Wrongful Acts any such Insured is legally responsible. Q. Terms of Policy Conform to Statute Terms of this policy that conflict with applicable statutes of the state where the Insured is domiciled are hereby amended to conform to such statutes. R. Authorized Representative of the Insurer The authorized representative, Ullico Casualty Group, Inc., shall act on behalf of the Insurer with respect to receiving notices as required under this policy, any other correspondence from the Insureds or Producer, and receipt of any premiums that may be due under this policy. Except as required in Condition A.above,all notices shall be given in writing to: Ullico Casualty Group, Inc. 8403 Colesville Road, 13th Floor Silver Spring, MD 20910-6331 S. Entire Agreement GOV-IOU()(I 1/2014) Page 9 of 14 The Insureds agree 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. Should any provision of this policy be declared or be determined by any court of competent jurisdiction to be illegal, invalid, void or unenforceable, the legality, validity and enforceability of the remaining parts,terms or provisions of the policy shall not be affected thereby. Section VIII. Extended Reporting Period If this policy is non-renewed or is canceled by either the Insured or the Insurer,the Insured shall have the right to purchase an Extended Reporting Period Endorsement provided that the Insured is in compliance with all terms and conditions of the policy and all billed premiums have been paid. The Extended Reporting Period Endorsement provides coverage on account of any Claim first made against the Insured during the Extended Reporting Period, but only for Wrongful Acts occurring wholly prior to the non-renewal or cancellation date of this policy, and which are subsequently reported as soon as practicable but in no event more than thirty (30) days after the end of the Extended Reporting Period specified in the Extended Reporting Period Endorsement. Any Claim made during the Extended Reporting Period shall be deemed to have been made during the immediately preceding Policy Period. Therefore, the Extended Reporting Period Endorsement shall not provide a new, additional or renewed Limit of Liability. This right to purchase this optional Endorsement shall lapse unless the Insurer receives the following: A. A written notice requesting an Extended Reporting Period Endorsement within thirty (30) days following the non-renewal or cancellation date of this policy,and B. The payment of the additional premium for such coverage by the due date specified on the premium invoice. The term of the Extended Reporting Period is twelve(12) months. The Insurer reserves the right to approve a request for an Extended Reporting Period exceeding twelve (12) months, but under no circumstances shall the Extended Reporting Period exceed seventy-two (72) months. The additional premium for the Extended Reporting Period Endorsement will be computed in accordance with the rules, rates and premiums in effect on the date of non-renewal or cancellation. Upon payment of such additional premium, which shall be deemed fully earned and non-refundable, the Extended Reporting Period Endorsement will be issued. The Extended Reporting Period Endorsement is not cancelable. Section IX. Definitions The following terms,when set forth in this policy in boldface type, will have the meanings set forth below: A. Administration means: a. Giving advice to participants and beneficiaries with respect to a Trust or Plan; b. Interpreting a Trust or Plan; c. Handling the records,effecting enrollment,and termination or cancellation of participants under a Trust or Plan; d. Choosing, changing, terminating, or eliminating provisions of a Trust or Plan, including amending benefits, requiring employee contributions, or changing the level of employee contributions; exclusively in a fiduciary or settlor capacity. Gov-1000(11/2014) Page 10ot14 B. Aggregate means the Limit of Liability shown in item 04(a)of the Policy Certificate and is the total sum of the Insurer will pay for all Claims, regardless of the number of Claims or the number of Insureds involved in such Claims, first made or deemed to have been first made during a single Policy Period. C. Automatic Reporting Period means a sixty (60) day period beginning with the non-renewal or cancellation date of this policy. D. Bodily Injury means any actual or alleged physical injury, sickness, disease, disability, pain and suffering, mental anguish, emotional distress, loss of consortium, or death of any person, or for damage to or destruction of any tangible property including loss of use or diminution in value thereof. E. Claim means a: 1. Written demand for monetary damages or injunctive relief, 2. Civil proceeding commenced by the service of a complaint or similar pleading, 3. Criminal proceeding commenced by the return of an indictment,or 4. Formal administrative or regulatory proceeding commenced by the filing of a notice of charges, formal investigative order or similar document; against an Insured for a Wrongful Act, including any appeal therefrom. Claim does not mean or include any internal proceedings of the Insured. F. Claim Expenses means that part of Loss consisting of reasonable and necessary costs, charges, fees (including but not limited to attorneys' and experts' fees) and expenses incurred by or on behalf of the Insureds in the investigation, adjustment, defense or appeal of a Claim, including the premium for an appeal, attachment or similar bond pertaining to an appeal. Claim Expenses will not include any regular or overtime wages, salaries, fees or benefits of, or overhead expenses associated with or attributable to any Insured,or any director, officer,Trustee or employee of any Insured. G. Effective Date means the day this coverage begins at 12.01 a.m. Local Time in this Policy Period.This date is shown in Item 03 of the Policy Certificate. H. Employee Benefit Law means any applicable statute, including any rules or regulations promulgated thereunder, and any pursuant amendments to the foregoing, of the United States of America or any state, territory or other political subdivision thereof setting forth the obligations, responsibilities or duties imposed upon fiduciaries of Plans and to which the Plan is subject, including but not limited to the: I. Consolidated Omnibus Budget and Reconciliation Act(COBRA)of 1985, 2. Federal Employees' Retirement System Act(FERS)of 1986, 3. Health Insurance Portability and Accountability Act(HIPAA)of 1996, 4. Health Information Technology for Economic and Clinical Health Act(HITECH Act), 5. Newborns' and Mothers' Health Protection Act of 1996, 6. Women's Health and Cancer Rights Act(WHCRA)of 1998, Gov-I 000(11/20141 Page 11of14 7. Patient Protection and Affordable Care Act(PPACA). I. Endorsement means a document that modifies the coverage provisions set forth in the policy. If the terms of any Endorsement are inconsistent with the terms of this policy, the terms of the Endorsement supersede the policy. J. Environmental Agents means any: I. Bacteria 2. Mildew, mold,or other fungi 3. Other micro-organisms 4. Mycotoxins,spores,or other by-products of 1,2,or 3 above; 5. Viruses or other pathogens(whether or not a micro-organism);or 6. Colony or group of any of the foregoing. K. Expiration Date means the day this coverage ends at 12:01 a.m. Local Time in this Policy Period.This date is shown in Item 03 of the Policy Certificate. L. Extended Reporting Period means the period of time indicated in the Extended Reporting Period Endorsement. All dates are 12:01 a.m. Local Time. M. Extended Reporting Period Endorsement is an Endorsement which provides coverage on account of any Claim first made against the Insured, but only for Wrongful Acts occurring wholly prior to the non-renewal or cancellation date of this policy, and which are subsequently reported as soon as practicable but in no event more than thirty (30) days after the end of the Extended Reporting Period shown on this Endorsement. N. Insured or Insureds means any: 1. Plan; 2. Natural person serving as past,present or future Trustee of a Trust or Plan; 3. Natural person serving aspast, present or future employee of a Trust or Plan, while acting in his or her capacity as such;and 4. Other natural person or organization designated as an additional Insured by Endorsement to this policy. O. Limit of Liability means the amount(s)indicated in Item 04(a)of the Policy Certificate P. Loss means Claims Expenses and monetary damages, judgments (including pre- and post- judgment interest, if any)or settlements which an Insured is legally obligated to pay as a result of a Claim; provided, Loss will not include the multiple portion of any multiplied damage award or any fines,taxes or penalties other than: Civil fines and penalties imposed pursuant to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Health Information Technology for Economic and Clinical Health Act(HITECH Act)or the Patient Protection and Affordable Care Act of 2010 ("PPACA"). Gov-[000(I I/2014) Page 12 of 14 Loss will not, however, include any matter uninsurable under the law pursuant to which this policy is construed. Q. Personal Injury means injury arising out of one or more of the following offenses: I. False arrest,detention or imprisonment,or malicious prosecution; 2. Abuse of process; • 3. The publication or utterance of libel or slander or of other defamatory or disparaging material, or a publication or an utterance in violation of an individual's right to privacy; 4. Wrongful entry or eviction,or other invasion of the right to private occupancy;or 5. Harassment, misconduct or discrimination of any nature arising out of any cause whatsoever, including, but not limited to, age, race, creed, color, sex, national origin, religion, disability, marital status or sexual orientation. R. Plan means each Plan, system or Trust enumerated in Item 02 of the Policy Certificate of this policy. S. Policy Certificate means the document that validates the coverage available under this policy. The Policy Certificate shows the Trust or Plan, the certificate number, the Policy Period, the Limits of Liability purchased, the Self-Insured Retention Amount, the premium and the Producer. This policy is not in effect unless a Policy Certificate signed by an authorized representative of the Insurer has been issued. T. Policy Period means the period of time between the Effective Date and Expiration Date shown in Item 03 of the Policy Certificate. If the policy is canceled prior to the Expiration Date, the Policy Period is the period of time between the Effective Date and the cancellation date of this policy. U. Pollutants means any substance located anywhere in the world exhibiting any hazardous properties as defined by, or identified on a list of hazardous substances issued by, the United States Environmental Protection Agency or any counterpart thereof in any state, county, municipality or locality. Such substances will include, without limitation, solid, liquid, gaseous or thermal irritants, contaminants, smoke, vapors, soot, fumes, acids, alkalis, chemicals and waste materials, including substances which are intended to be or have been recycled, reconditioned or reclaimed. Pollutants also means any other air emission, odor, waste water, oil or oil products, infectious or medical waste,asbestos,asbestos products and noise. V. Prior & Pending Litigation Date means the date and hours listed in Item 06 of the Policy Certificate. W. Producer means the person or organization authorized to represent the Insureds and designated as such in Item 01 of the Policy Certificate of this policy. X. Property Damage means physical injury to,or destruction of,tangible property, including loss of use thereof. Y. Related Wrongful Act means all Wrongful Acts which are based upon, directly or indirectly arising or resulting from, in consequence of, or in any way related to the same fact, circumstance, situation, transaction or event, or to a series of continuous or related facts, circumstances, situations, transactions or events, regardless of the number of persons or entities bringing Claims and regardless of the number of persons or entities who are Insureds. Gov-1000 1 1 1/20 14) Page 13of14 Z. Self-Insured Retention is the amount listed under Item 05 of the Policy Certificate. AA.Trust means those trusts shown in Item 02 of the Policy Certificate. BB.Voluntary Compliance Program means any voluntary compliance resolution program or similar voluntary settlement program administered by the U.S. Internal Revenue Service or any other state or governmental regulatory authority. CC.Voluntary Compliance Program Expenditure means: I. Reasonable costs, charges and expenses of attorneys, accountants and/or other professionals that are incurred solely in investigating and evaluating a Plan's actual or alleged noncompliance with a statute, rule or regulation and effecting a resolution thereof pursuant to a Voluntary Compliance Program;and 2. Any fees, fines, penalties or sanctions paid by an Insured to a governmental or regulatory authority pursuant to a Voluntary Compliance Program as a result of a Plan's actual or alleged inadvertent noncompliance with a statute, rule or regulation and, subject to the Insurer's approval, costs to correct a Plan's actual or alleged inadvertent noncompliance with any statute, rule or regulation that are incurred by the Plan in connection with its participation in a Voluntary Compliance Program. DD.Wrongful Act means any actual or alleged: I. Breach of the responsibilities, obligations or duties imposed upon Insureds by an Employee Benefit Law; or 2. Negligent act,error or omission by any Insured in the Administration of any Plan. Gov- 000(11/2014) Page 14 of 14 Fiduciary Liability MARKED Markel American Insurance Company FIDUCIARY LIABILITY CLAIMS MADE POLICY ADVISORY NOTICE TO POLICYHOLDERS This is a summary of the major changes in your policy as a result of revisions to the Fiduciary Liability policy. No coverage is provided by this summary nor can it be construed to replace any provision of your policy. You should read your policy for complete information on the coverages you are provided. If there is any conflict between the policy and this summary, THE PROVISIONS OF THE POLICY SHALL PREVAIL. Only the changes that broaden or restrict coverage have been identified in this notice. This notice does not reference most changes made to the policy that are for clarification, consistency or editorial only, unless noted below. FIDUCIARY LIABILITY—CLAIMS MADE FID-1000 (11/2014) A. BROADENING OF COVERAGE 1. The "HIPAA" and "PPACA"coverages found under the definition of Loss no longer have a sub-limit on the Policy Certificate. Full limits are provided within the Aggregate Limit of Liability. 2. Section IX. Definitions, A. Administration has been modified as follows to include terminating provisions of a Trust or Plan, merging or consolidation with another trust or plan, and funding decisions made by an Insured. Clarification was also provided that the definition applies in a fiduciary or settlor capacity. Administration means: 1. Giving advice to participants and beneficiaries with respect to a Trust or Plan; 2. Interpreting a Trust or Plan; 3. Handling the records, effecting enrollment, and termination or cancellation of participants under a Trust or Plan; 4. Choosing, changing, terminating, or eliminating provisions of a Trust or Plan, including amending benefits, requiring employee contributions, or changing the level of employee contributions; 5. Merging or consolidating with another trust or plan; 6. Funding decisions made by an Insured; exclusively in a fiduciary or settlor capacity. 3. Section IX. Definitions, E. Claim has been modified to include non-monetary relief. 4. Section IX. Definitions, H. Employee Benefit Law has been modified to include: Health Information Technology for Economic and Clinical Health Act(HITECH Act) 5. Section IX. Definitions, N. Insured has been modified to remove the reference "while acting in a fiduciary capacity" in N.2. to clarify that Trustees are Insureds whether acting in a fiduciary or non-fiduciary capacity for covered Claims. The definition was also broadened to include committee members of a Trust or Plan. 6. Section IX. Definitions, P. Loss has been modified as follows to include the HITECH Act, Section 4975 and 4976 Penalties, Section 203 of the Bipartisan Budget Act of 2013, and punitive, exemplary, and multiplied damages where insurable by law. Loss means money, including, but not limited to, damages, equitable relief(including but not limited to surcharge or constructive trust)judgments, settlements, costs, prejudgment and post-judgment interest, which any Insured shall become legally obligated to pay as a result of a Claim. Loss also means Claims Expenses incurred in the investigation, defense, settlement and appeal of a Claim. Loss does not include matters uninsurable under the law pursuant to which this policy is construed or any fines, taxes or penalties other than: MPGL 1008 01 14 Page 1 of 2 a. Civil penalties or excise tax imposed pursuant to Section 502(c) of the Employee Retirement Income Security Act of 1974 ("ERISA") or pursuant to any other provision of ERISA or the Code that was amended by the multiemployer plan provisions of the Pension Protection Act of 2006 ("PPA") and any pursuant amendments to the foregoing; b. Civil penalties of up to five percent (5%) imposed pursuant to Section 502(i) of ERISA; c. Civil penalties of up to twenty percent (20%) of any settlement or judgment imposed pursuant to 502(1) of ERISA for breach of fiduciary duty; d. Civil fines and penalties imposed pursuant to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"), Health Information Technology for Economic and Clinical Health Act (HITECH Act) or the Patient Protection and Affordable Care Act of 2010 ("PPACA"); e. Excise tax penalties up to fifteen percent (15%) imposed pursuant to Section 4975 and 4976 of the Internal Revenue Code, with respect to covered judgments; or f. Section 203 of the Bipartisan Budget Act of 2013 (H.J. Res 59) (the "Act"). Where permitted by law, Loss shall include punitive, exemplary or multiplied damages imposed upon any Insured, subject to this policy's terms, conditions, and limitations, including, but not limited to, Section IV.A.3 B. MODIFICATION IN POLICY LANGUAGE 1. Section II. Defense and Settlement part G. has been modified to clarify how a claim is handled when both covered and uncovered matters exist. 2. Section VII. Conditions part A.5. has been modified to show the new mailing address for reporting claims. 3. Section VII. Conditions part E. No Action Against the Insurer was modified to remove the mandatory Arbitration language. 4. Section VII. Conditions part P. Changes in Exposure was modified to clarify how the policy will respond for mergers, acquisitions, and terminations. 5. The following definitions were added to Section IX. Definitions for clarification purposes and to align with other terms of the policy: a. Aggregate b. Limit of Liability c. Self-Insured Retention 6. Section IX. Definitions, CC. Voluntary Compliance Program was modified to clarify the intent that this definition also include Employee Plans Compliance Resolution System. Voluntary Compliance Program means any voluntary compliance resolution program or similar voluntary settlement program, including the Employee Plans Compliance Resolution System, the Delinquent Filer Voluntary Compliance Program, and the Voluntary Fiduciary Correction Program, administered by the U.S. Internal Revenue Service, U.S. Department of Labor or any other federal, state or local governmental regulatory authority. C. REDUCTIONS IN COVERAGE 1. Section IV. Exclusions has been modified to add an exclusion for Prior Claims if notice was given to a prior carrier—Item A.2.. MPGL10080114 Page 2of2 ML® Markel American Insurance Company p Y 4521 Highwoods Parkway Glen Allen, VA 23060 TRIA Issue Date: Policy Number: Endorsement Number: Endorsement Effective Date: (12:01 a.m. Local Time) Cap on Losses From Certified Acts of Terrorism It is agreed that the above numbered policy is amended as follows: A. If aggregate insured losses attributable to terrorist acts certified under the federal Terrorism Risk Insurance Act exceed$100 billion in a calendar year and we have met our Insurer deductible under the Terrorism Risk Insurance Act, we shall not be liable for the payment of any portion of the amount of such losses that exceeds $100 billion,and in such case insured losses up to that amount are subject to pro rata allocation in accordance with procedures established by the Secretary of the Treasury. "Certified act of terrorism"means an act that is certified by the Secretary of the Treasury in accordance with the provisions of the federal Terrorism Risk Insurance Act,to be an act of terrorism pursuant to such Act.The criteria contained in the Terrorism Risk Insurance Act for a"certified act of terrorism" include the following: 1. The act resulted in insured losses in excess of$5 million in the aggregate,attributable to all types of insurance subject to the Terrorism Risk Insurance Act;and 2. The act is a violent act or an act that is dangerous to human life,property or infrastructure and is committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. B. The terms and limitations of any terrorism exclusion,or the inapplicability or omission of a terrorism exclusion, do not serve to create coverage for any Loss that is otherwise excluded under this policy. Nothing contained herein shall vary, alter or extend the terms, conditions and limitations of the policy except as stated above. This Endorsement is part of the above numbered policy and is effective as of the Endorsement Effective Date shown above. MARKEL AMERICAN INSURANCE COMPANY ?I‘jamPgw" Authorized Representative TRIA(11/2014) Page 1 of 1 MARKEL® Markel American Insurance Company p Y 4521 Highwoods Parkway Glen Allen, VA 23060 TRIA-DN Issue Date: Policy Number: Endorsement Number: Endorsement Effective Date: (12:01 a.m. Local Time) DISCLOSURE NOTICE OF TERRORISM INSURANCE COVERAGE You are hereby notified that, under the Terrorism Risk Insurance Act as amended, we are making available to you insurance coverage for losses resulting from acts of terrorism as defined in Section 102(1) of the Act. The policy you are purchasing already includes insurance for such acts. The term "act of terrorism" means any act or acts that are certified by the Secretary of the Treasury in consultation with the Secretary of Homeland Security and the Attorney General of the United States—to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of an air carrier or vessel or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. YOU SHOULD KNOW THAT UNDER THE INSURANCE PROVIDED BY YOUR POLICY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM, SUCH LOSSES MAY BE PARTIALLY REIMBURSED BY THE UNITED STATES GOVERNMENT UNDER A FORMULA ESTABLISHED BY FEDERAL LAW. HOWEVER, YOUR POLICY MAY CONTAIN OTHER EXCLUSIONS WHICH MIGHT AFFECT YOUR COVERAGE, SUCH AS EXCLUSION FOR NUCLEAR EVENTS. UNDER THIS FORMULA, THE UNITED STATES GOVERNMENT GENERALLY REIMBURSES 85% THROUGH 2015; 84% BEGINNING ON JANUARY 1, 2016; 83% BEGINNING ON JANUARY 1, 2017; 82% BEGINNING ON JANUARY 1, 2018; 81% BEGINNING ON JANUARY 1, 2019 AND 80% BEGINNING ON JANUARY 1, 2020, OF COVERED TERRORISM LOSSES EXCEEDING THE STATUTORILY ESTABLISHED TRIA-DN (I/2015) Page 1 of2 DEDUCTIBLE PAID BY THE INSURANCE COMPANY PROVIDING THE COVERAGE. THE PORTION OF THE OFFERED POLICY'S ANNUAL PREMIUM THAT IS ATTRIBUTABLE TO INSURANCE FOR ACTS OF TERRORISM IS: $0.00 AND DOES NOT INCLUDE ANY CHARGES FOR THE PORTION OF LOSS THAT MAY BE COVERED BY THE FEDERAL GOVERNMENT UNDER THE ACT. YOU SHOULD ALSO KNOW THAT THE TERRORISM RISK INSURANCE ACT,AS AMENDED, CONTAINS A $100 BILLION CAP THAT LIMITS U.S. GOVERNMENT REIMBURSEMENT AS WELL AS INSURERS' LIABILITY FOR LOSSES RESULTING FROM CERTIFIED ACTS OF TERRORISM WHEN THE AMOUNT OF SUCH LOSSES IN ANY ONE CALENDAR YEAR EXCEEDS $100 BILLION. IF THE AGGREGATE INSURED LOSSES FOR ALL INSURERS EXCEED$100 BILLION,YOUR COVERAGE MAY BE REDUCED. If you have any questions about this notice,please contact your agent or broker. TRIA-DN (1/2015) Page 2 of2 MARKEL® Markel American Insurance Company p Y 4521 Highwoods Parkway Glen Allen, VA 23060 GOV-049 Issue Date Policy Number: Endorsement Number: Endorsement Effective Date: (12:01 a.m. Local Time) National Conference on Public Employment Retirement Systems Endorsement 1. It is agreed that Section VII.Conditions is amended by the addition of the following language: Renewal Guarantee a. Upon expiration of the Policy Period,the Insurer shall renew this policy unless: 1. There has occurred a change in the law(including insurance regulations)or insurance regulatory action that prevents the Insurer from issuing a renewal policy at the same terms and conditions as this policy; 2. All premium amounts owed are not paid in full; 3. One or more Claims is made during the Policy Period; 4. The Plans merges with another Plan during the Policy Period; b. A renewal of this policy pursuant to this Endorsement shall be at the same terms and conditions as this policy for one year except: 1. Inception and Expiration Dates of the Policy Period and Claim Period;and 2. There will be no requirements that this Endorsement be attached to and form part of the renewal policy. c. The premium for any renewal policy pursuant to the Endorsement shall be 100%of expiring premium. 2. It is also agreed that Section IX. Definitions is amended by the following: Definition H, Employee Benefit Law is deleted in its entirety and is replaced by the following: Employee Benefit Law means any applicable statute, including any rules or regulations promulgated thereunder,of the United States of America or any state,territory or other political subdivision thereof setting forth the obligations, responsibilities or duties imposed upon fiduciaries of Plans sponsored by public entities or governmental authorities and to which a Plan is subject, including but not limited to: a. The Consolidated Omnibus Budget and Reconciliation Act of 1985; b. The Federal Employees' Retirement System Act of 1986; c. Health Insurance Portability and Accountability Act(HIPAA)of 1996 GOV-049(11/2014) Page 1 of 2 d. Health Information Technology for Economic and Clinical Health Act(HITECH Act); e. The Newborns' and Mothers' Health Protection Act of 1996; f. The Women's Health and Cancer Rights Act of 1998); g. Workers Compensation; Unemployment,Social Security; Disability Benefits; Retiree Life, Dental, Vision,and Health Care Insurance;and Deferred Compensation Plans as promulgated or imposed on Insureds by governing federal, state,or other governmental regulatory authority;or g. Patient Protection and Affordable Care Act(PPACA). 3. It is also agreed that Section II. Defense and Settlement is amended by the following: Item F is deleted in its entirety and is replaced with the following: F. The Insurer may make any investigation it deems necessary and,with the written consent of the Insureds, make any settlement of a Claim it deems expedient. If the Insureds withhold consent to such settlement,the Insurer's liability for all Loss on account of such Claim will be 80%of the amount in excess of the amount for which the Insurer could have settled such Claim. Nothing contained herein shall vary, alter or extend the terms, conditions and limitations of the policy except as stated above. This Endorsement is part of the above numbered policy and is effective as of the Endorsement Effective Date shown above. MARKEL AMERICAN INSURANCE COMPANY Authorized Representative GOV-049(11/2014) Page 2 of 2 COLORADO DEPARTMENT OF LABOR AND EMPLOYMENT DIVISION OF WORKERS' COMPENSATION WC112 Self-insured Surcharge Form Confirmation Number 404mmh1 Filing Period: January-June 2015 Filing Type: WC112 Company Name: Weld County FEIN: 84-6000813 Block Number: Street Address: 1150 O Street Suite: City: Greeley State: CO Zip Code: 80631 Address changed since last filing'' No President or Chief Officer; Weld County Commissioner Barbara Kirkmeyer Secretary or Chief Agent: Esther Gesick Other Contact Person: Michelle Raimer Contact Phone: 970-336-7220 Contact Email: mraimer@weldgov.com Total Of Payroll Premium Equivalents S 752,336.51 Premium Equivalent less Deductible is the Subject Premium S 606,383.22 Subject Premium times NCCI Experience Mod=Modified Premium 1.04 S 630,638.55 Modified Premium times Rating discount =Standard Premium S 586,493.85 Surcharge Premium: Standard premium minus the discount is the Surcharge Premium S 520,220.05 Surcharge Premium times rate=surcharge due S 5,722.42 We, the undersigned President and Secretary (or other chief officers or agents) of the corporation for which this return is made, being severally duly sworn, each for himself/herself, deposes and says that this return has been examined by him/her and is to the best of his/her knowledge, information and belief, a true, correct and complete return made pursuant to provisions of The Colorado Workers' Compensation Act, Colorado Revised Statutes, Sections 8-44-112, 8-46-102 and 8-46-202. RAFAELA A_ICIA MARTINEZ Weld County Commissioner Barbara Kirkmeyer Notary SeaNOTARY PUBILIZrporate S 1 President or Chief Officer STATE O COLORADO NOTARY ID 20144002878 MY COMMISSION EXPIRES JANUARY 22,2018 Esther Gesick Secretary or Chief Agent Subscribed and sworn to before me this 027th Michelle Raimer 970-336-7220 Name of Contact Person (print) Phone Number day of oiH p26t5- C4 , et.62—GLIL) Ajdj-i Nota 0ublic My commission expires�,�QU I J A� 10�6C`6 Division of Workers' Compensation P.O. Box 628 Denver, CO 80201-0628 (303) 318-8771 FAX (303) 318-8778 Michelle Raimer From: Analisa Murphy <Analisa_Murphy@ajg.com> Sent: Monday, July 20, 2015 3:04 PM To: Michelle Raimer Subject: Weld County Retirement Plan - Fiduciary Liability Renewal Proposal eff. 6/16/15 Attachments: 15-16_Weld Cty Retirement Plan_NCPERS_Alterra Fiduciary Proposal.pdf; 15-16 _WCRP_Renewal Letter.pdf Importance: High Hi Michelle, Please find attached our 2015 Fiduciary Liability renewal proposal for Weld County Retirement Plan for your review. The renewal premium is$10,136 which is a slight increase of$33 over the expiring premium. Please note that the major change in the renewal is the name of the insurer from Alterra America Insurance Company to Markel American Insurance Company. Please see attached letter for reference. To bind coverage, please refer to page 18 (Client Authorization to Bind Coverage) of the proposal . We'll need this page signed and dated. Also, please be sure to mark an "X" under the "Yes" column next to the Fiduciary Liability description. Please return the signed & dated Client Authorization page to my attention by Wednesday, 7/22/15. Please let me know if you have any questions. Thank you, Analisa Murphy, CIC Client Service Manager Public Sector I Higher Education Arthur J. Gallagher& Co. 6399 S. Fiddler's Green Cir., Suite 200 I Greenwood Village, CO 80111 P: 303-889-2590 1800.333.3231 Ext 2590 I F: 720-200-5117 www.aiq.com Arthur J.Gallagher Risk Management Services, Inc. tri A,0tat.n S MO`',' c ETHICAL N COMPANIES This email and any files transmitted with it are intended only for the person or entity to which it is addressed and may contain confidential material and/or material that is protected by law Any retransmission or use of this information may be a violation of that law If you received this in error,please contact the sender and delete the material from any computer. Legal Disclaimer: I would like to emphasize that the discussion set forth above is only an insurance/risk management perspective and is NOT legal advice. We do not provide legal advice as we are not qualified to do so. l highly recommend that you seek the advice of legal counsel in order to become fully apprised of the legal implications related to these issues. Claim Disclaimer:Communications concerning this matter, including this email and any attachments, are provided for purposes of insurance/risk management consulting Opinions and advice provided by Arthur J, Gallagher& Co. is not intended to he, and should not be construed to be. legal advice Please direct any request for legal advice to your attorney 1 Hello