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City Of Decatur <br /> Pro�ram Details (Cont.) <br /> "If ERP coverage is desired,then that request must be in writing to the carrier. <br /> Endorsements include, but are not limited to: <br /> . - - • <br /> Common Declarations Page <br /> Signatures <br /> _--.. ---- __— - - -- ._ __. <br /> Protected Self-Insurance Package Policy <br /> _- — -- ---- ------- ----__.._........___-- ------------- <br /> Statutory Requirement Endorsement <br /> _-- ....._- - _---- - -------- ---._..._.....- ---- ----_......-- <br /> Service of Process-IL Endorsement <br /> Endorsement-Contingent Tax Interruption Coverage <br /> _- --_.._.._------ <br /> If you choose to purchase Cap on Losses from Certified Acts of Terrorism , <br /> Exclusions include, but are not limited to: <br /> . - • � <br /> Any negligent acts, errors, or omissions that are dishonest, fraudulent, criminal, or malicious <br /> Terrorism <br /> __......_._....._..... ....._._..---__ <br /> War <br /> -- <br /> � _ ------------- <br /> Nuclear <br /> ---- -_______--- - ---- <br /> —-------- - - <br /> - ------- ____- --------____--------- <br /> Pollution <br /> _ _ <br /> Binding Requirements: <br /> . - - � <br /> Subject to Receipt of A signed and dated Terrorism Disclosure notice must accompany all binding requests <br /> designating an acceptance or rejection of quoted Terrorism coverage. <br /> Subject to Receipt of A signed and dated Application must be submitted to PSI Program Managers, a division of <br /> Risk Placement Services, Inc.within 30 days of binding <br /> Other Significant Terms and Conditions/Restrictions: <br /> • - - • <br /> Total Package TRIA premium includes Surplus Lines Tax Rate of$65.00 and Surplus Lines Stamping Fee Rate of <br /> $4.00 <br /> Note: Quotation is subject to receipt of signed and dated complete application prior to binding. Premium is subject to <br /> change if exposures have increased. This indication is based on Total Insured Value at$207,242,501 (expiring with <br /> 2.5%increase due to inflation), 534 employees, 247 autos, 74,701 population and 163 full-time police. <br /> PSI Program Managers(10.0% Program Management& Underwriting+ 1.5%Claims Management) <br /> Insured's Loss Fund: $350,386 In the Aggregate Annually <br /> The Maximum Limit Of Insurance We Will Pay In Excess Of The Insured's Self Insured Retention For Part I B. - <br /> Clash Coverage Will Be: $750,000 <br /> Arthur J.Gallagher Risk Management Services,Inc. <br /> 25 <br />