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+ . • -9- <br /> , <br /> SCHEDULE V <br /> SERVICES AND EEES <br /> Client: City of Decatur, illinois <br /> Service Period: From 10/1/05 to 10/1/06 GB Client#: 000322 <br /> SERVICES PROVIDED: j� SERVICES PROVIDED: jp� <br /> A. Claims Administration C. Loss Funding <br /> Auto Liability-Bodity Injury(AB) X SIMMS X i <br /> Auto Liability-Property Damage(AD) X Voucher <br /> Auto Physical Damage(APD) X Ciient Owned Banking II <br /> General Liability-Bodily Injury(GB) X D. Supplemental ' <br /> General Liability-Property Damage(GD) X Loss Notice Program Rpt.Level$10,000 X <br /> Products Liability <br /> Detail Status Rpts.Rpt.Level$50,000 X <br /> Professional Liability X Meetings X <br /> Property X Settlement Authority$10,000 X <br /> Workers'Compensation(WC) Index Bureau X <br /> Medical Only X <br /> Coordination X <br /> Indemnity X <br /> Audits X <br /> Other Electronic Incidents X <br /> AssumpUon Manual Report by Branch X <br /> B. Information Services Copying Correspondence X <br />' RISX-FACSO Risk Inspections <br /> Standard Package X GBlGCR Mgd.Care(Paid Off File) X <br /> Non-Standard Reports E. Risk Control Consulting <br /> risxfacs.com X Loss Control - Hours <br /> Terminals&Printers Risx-ConVol Consulting- Hours <br /> Data Transfer X <br /> Other TOTAL $ 104,388 <br /> ADDITIONAL SERVICE TERMS AND CONDITIONS: <br /> Client will be billed$441 per claim for each Auto/General Liability,Auto Physical Damage, Professional Liability or Property claim <br /> reported against the initial deposit of$52,920 and$406 per claim for each Workers'Compensation claim reported against the initial <br /> deposit of$36,540. <br /> Electronic Incidents will be billed at the rate of$16 per incident against the initial deposit of$160. <br /> All parties to this agreement fulty agree that should the client terminate this program for convenience or through default prior to <br /> 10/1/06,the Client shall pay GB an early termination surcharge based on an additional 2%of the annualized service fees for the then <br /> current period of the overall program. Such surcharge to be due and payable by the Client immediately upon receipt of invoice from <br /> GB. <br /> BILLtNG AND PAYMENT TERMS: <br /> Fee is payable in 12 monthly installments beginning 10/1/05. Fees are payable upon receipt of invoice. GB reserves the right <br /> to charge 1% per month,or the maximum legal rate, on balances unpaid after 30 days. <br /> 06\cql�Decatur,IL,Cityof-OOQ322.doc <br />