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City Of Decatur .�=� Gallagher <br /> f+C{aRE�60 <br /> Binding Requirements: <br /> r . <br /> ', Subject to Receipt and Acceptable Underwriter Review of the Latest Dam Inspection Report <br /> ', Subject to Signed TRIA Selection Form and Signed Application are Required at Binding(Acord 60 US(2015/01) <br /> Other Significant Terms and Conditions/Restrictions: <br /> R • <br /> Optional TRIA Premium does not Include Additional Tax of$75 <br /> 11.5% PSI Program Managers(10.0% Program Management&Underwriting+ 1.5%Claims Management) <br /> Loss Fund is fully earned at Inception <br /> PART I B.-CLASH COVERAGE <br /> Subject to the policy limitations,terms and conditions,the following applies in the event of a covered loss involving more <br /> ' than one COVERAGE SECTION under PART I A.-SPECIFIC INSURANCE: <br /> A.We will indemnify the NAMED INSURED for all of those sums of SELF INSURED RETENTIONS described in the <br /> SCHEDULE OF SELF INSURED RETENTIONS for which the INSURED is responsibie for all of the <br /> COVERAGE <br /> SECTIONS involved in a covered loss, less the amount of the INSURED'S SELF INSURED RETENTION for PART I <br /> B.-CLASH COVERAGE described in Paragraph C.below. <br /> B.The maximum LIMIT OF INSURANCE we will pay in excess of the INSURED'S SELF INSURED RETENTION for <br /> PART I B.-CLASH COVERAGE will be: $750,000. ' <br /> C.The amount of the INSURED'S SELF INSURED RETENTION for PART I B.-CLASH COVERAGE that the <br /> INSURED is responsible for will be calculated by us as follows: <br /> 1. For each applicable COVERAGE SECTION involved in the covered loss(including all applicable coverage <br /> options under such COVERAGE SECTION), identify the applicable SELF INSURED RETENTION and payments ' <br /> for the covered loss made by the INSURED; ' <br /> 2. From the amounts identified in 1.above,for each COVERAGE SECTION identify the amount that is the lesser of <br /> the applicable SELF INSURED RETENTION or the payments for the covered loss made by the INSURED; ' <br /> 3.Add together all amounts identified in 2.above; <br /> 4.The INSURED'S SELF INSURED RETENTION for PART I B.-CLASH COVERAGE will be the lesser of: <br /> a.The total sum identified in 3.above;or <br /> ' b.The largest SELF INSURED <br /> -. _ <br /> Premium $259,757.00 <br /> Taxes <br /> Surplus Lines Tax $9,091.00 <br /> Stamping Office Fee $195.00 <br /> Fire Marshal Tax $1,039.00 <br /> Total Taxes $10,325.00 <br /> ESTIMATED PROGRAM COST $272,025.00 <br /> Minimum And Deposit Premium-Combined for Package Lines $259,757.00 <br /> TRIA/TRIPRA PREMIUM $1,868.00 included above <br /> �+Additional Surcharges,Taxes and Fees as applicable) <br /> Subject to Audit: NIA <br /> ,a,:=:�� <br /> �.�� v�='�: <br /> �.. <br /> :Y�p��,;�-M*: <br /> 15 ��t $ �r�,..> <br /> ��� �;-:.:�; <br /> � _��r:. <br /> -�:~:. <br /> ��- ` �;�, �i. <br /> k::. <br /> S o „[, <br /> _..».-s . :.."..'�': <br />