Loading...
HomeMy WebLinkAboutR-2017-037 Purchase Property and Equipment Insurance Cowell Insurance Group RESOLUTION NO. R- 2017-037 A RESOLUTION AUTHORIZING THE PURCHASE OF PROPERTY AND EQUIPMENT INSURANCE FROM COWELL INSURANCE GROUP INC FOR THE ANNUAL PREMIUM RENEWAL IN AN AMOUNT NOT TO EXCEED $61,582.00 WHEREAS, the City of Riverside has a need for commercial property and equipment floater insurance; and WHEREAS, the City of Riverside in the adoption of its purchasing policy requires all expenditures in excess of$10,000 to be presented to the Board of Aldermen for approval and the City's insurance carrier for commercial property and equipment floater insurance has presented an invoice in the amount of$61,582.00 for annual renewal of such insurance coverage; and WHEREAS, funds for such purpose were budgeted in the Fiscal Year 2016-2017 budget; and WHEREAS, the Board of Aldermen find it is in the best interest of the citizens of the City of Riverside to authorize acquisition and renewal of such insurance coverage and approve the payment to Cowell Insurance Group, Inc. for commercial property and equipment floater insurance coverage for the City of Riverside, in an amount not to exceed $61,582.00. NOW THEREFORE, BE IT RESOLVED BY THE BOARD OF ALDERMEN OF THE CITY OF RIVERSIDE, MISSOURI, AS FOLLOWS: THAT, the acquisition and renewal of such insurance coverage and payment to Cowell Insurance Group, Inc. for commercial property and equipment floater insurance coverage for the City of Riverside, in an amount not to exceed $61,582.00 is hereby authorized and approved; and FURTHER THAT the Mayor, City Administrator, or either of their designees, are hereby authorized to execute all documents necessary or incidental to this transaction and the City Clerk is authorized to attest thereto. PASSED AND ADOPTED by the Board of Aldermen and APPROVED by the Mayor of the City of Riverside, Missouri, the qday of June, 2017. or Kathleen L. Rose s 'A Robjn Kihcaid;,C ity Clerk Cowell James Forge Insurance INVOICE N O . 22988 Page 1 ACCOUNT rvo. CSR DATE 10525 North Ambassador Dr#301 Kansas City,M0 64153 CITYRIV SL 06/16/2017 Phone: 816-471-4245 Fax:816-221-7649 BALANCE DUE ON 07/01/2017 City of Riverside 2950 NW Vivion Rd Riverside,MO 64150 Itm # Trn Type Description Amo" 175754 REN PCKG EMC 17-18 Commercial Prop $38, 300. 00 175755 REN FLTR EMC 17-18 Equipment Coverage $22, 808 . 00 175756 REN CR-S EMC 17-18 Employee Theft/Crime $474 . 00 Invoice Balance: $61, 582 . 00 •""PLEASE RETURN ONE COPY WITH YOUR REMITTANCE`•• /EMC. INSURANCE EMC Insurance Companies PO Box 25470 Overland Park, KS 66225-5470 www.emcins.com CITY OF RIVERSIDE 2950 NW VIVION RD RIVERSIDE, MO 64150-1502 07/01/2017 to 07/01/2016 Prepared on 06/15/2017 Quote Valid Through 07/30/2017 Account Summary Quote Account Number: X654449 Prior Account Number: 1X75526 Commercial Output(B-05) $ 38,300.00 Govt Crime/Fidelity ISO Packagge (F-01) $ 474.00 Commercial Inland Marine (C-05) $ 22.808.00 Total Account Premium Estimate $ 61,582.00 This proposal is offered through EMC Insurance Companies. EMC offers customizable insurance products to meet your unique needs and expert safety resources to help your business prevent claims. As your independent agent, we are here to offer you personalized service. The premium reflects the rates as of the date shown above and assumes the information provided is accurate.* Please review the following pages for coverage details. To discuss the advantages of insuring your business with EMC, contact us at the number listed below or visit www.emcins.com. Thank you, Cowell James Forge Insurance Group, LLC 10525 N Ambassador Dr Ste 301 Kansas City MO 64153-1284 816-471-4145 *This proposal does not guarantee the policy will be accepted or that coverage will be provided in the company selected or at the premium quoted. Due to periodic rete changes, a change to the policy's effective date may result in a different premium. Prepared for: CITY OF RIVERSIDE 006/600 JH 1 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 Q U O T A T I O N - C O M M E R C I A L O U T P U T P R O G R A M QUOTATION IS VALID: FROM 06/12/17 TO 07/27/17 PROPOSED POLICY PERIOD: FROM 07/01/17 TO 07/01/18 P R E P A R E D F 0 R: P R E S E N T E D B Y: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - CITY OF RIVERSIDE COWELL JAMES FORGE INSURANCE 2950 NW VIVION RD GROUP, LLC RIVERSIDE MO 64150-1502 10525 N AMBASSADOR DR STE 301 KANSAS CITY MO 64153-1284 AGENT: AK 7685 AGENCY BILL AGENT PHONE: (816) 471-4245 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INSURED IS: CITY BUSINESS DESC: MUNICIPALITY - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - POLICYWIDE INFORMATION ---------------------- P R E M I U M --------------- NON-REPORTING FORM PREMIUM $ 38,300.00 --------------- PROPERTY PREMIUM $ 38,300.00 TOTAL PROPERTY PREMIUM $ 38,300.00 ------------------------------------------- AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 2 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 CITY OF RIVERSIDE EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P O L I C Y Q U O T E ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION/ADDITIONAL INFORMATION PREMIUM ------------------------------------------------------------------------------ *CL0100 03-99 COMMON POLICY CONDITIONS *CL0167 05-05 GUARANTY FUND COV LIMITATIONS - MO *CL0600 01-15 CERTIFIED TERRORISM LOSS *CL0700 10-06 VIRUS OR BACTERIA EXCLUSION *CO0323 09-13 AMENDATORY ENDORSEMENT MISSOURI *C01000 10-02 COP - PROPERTY COVERAGE PART *CO1080 11-03 LIMITED FUNGUS AND RELATED PERILS BLANKET LIMIT PROPERTY COVERAGE $ 15, 000 *CO1092 07-13 POLLUTANT - AMENDED DEFINITION *CO1227 05-02 SCHEDULED LOCATIONS ENDORSEMENT *CO1238 04-02 PROTECTIVE DEVICES ENDORSEMENT *CO1293 11-03 LIMITED FUNGUS & RELATED PERILS COV *CO7115 03-07 PERISHABLE STOCK EXCLUSION AMENDMENT *CP7011A 05-07 COMMERCL OUTPUT PROGRAM DECLARATIONS *CP7012A 05-07 COP ADDITIONAL/SUPPLEMENTAL COVERAGE *CP7013A 05-07 COMMERCIAL OUTPUT PROGRAM SCHEDULE *IL7004 03-16 MUTUAL POLICY PROVISIONS *IL7131A 04-01 COMM'L POLICY ENDORSEMENT SCHEDULE *IL8383.2A 01-15 DISCL PURSUANT TERRSM RISK INS. ACT $ 751 *IL8384A 01-08 TERRORISM NOTICE *IL8720 08-15 POLICYHOLDER NOTICE AS QUOTED ON: 06/12/17 Prepared for:CITY OF RIVERSIDE 008/600 JH 3 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 CITY OF RIVERSIDE EFF DATE: 07/01/17 EXP DATE: 07/01/18 T E R R O R I S M N O T I C E This insurance may include coverage for certified acts of terrorism as defined in the Terrorism Risk Insurance Act, as amended. Attached you will find a disclosure, which identifies the specific charge for certified acts of terrorism. YOU MAY HAVE THE OPTION TO REJECT THIS TERRORISM COVERAGE --------------------------------------------------------- For additional information, please contact your agent AS QUOTED ON: 06/12/17 Prepared for: CITY OF RIVERSIDE 008/800 JH 4 of 34 /EMC IMSURAMCa EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 CITY OF RIVERSIDE EFF DATE: 07/01/17 EXP DATE: 07/01/18 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. D I S C L O S U R E P U R S U A N T T O T E R R O R I S M R I S K I N S U R A N C E A C T ----------------------------------------------------------------------- S C H E D U L E Terrorism Premium (Certified Acts) $751.00 ----------------------------------------------------------------------- A. Disclosure Of Premium: In accordance with the federal Terrorism Risk Insurance Act, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses: The United States Government, Department of the Treasury, will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015, the federal share equals 85% of that portion of the amount of such insured losses that exceeds the applicable insurer retention. Beginning on January 1, 2016, the federal share will decrease by one percentage point per calendar year until equal to 80% of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses: If aggregate insured losses attributable to terrorist acts certified under the 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. The following statement is required to be part of the disclosure notice in MISSOURI: The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions, limitations and exclusions in this policy. You should read the definition in your policy carefully, but generally speaking, "certified" acts of terrorism are acts that exceed $5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. AS QUOTED ON: 06/12/17 Prepared for:CITY OF RIVERSIDE 008/600 JH 5 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 S C H E D U L E O F C O VE R A G E S C O M M E R C I A L O U T P U T P R O G R A M P R O P E R T Y C O V E R A G E P A R T ----------------------------------------------------------------------------- Refer to Scheduled Locations ----------------------------------------------------------------------------- COVERAGE EXTENSIONS L I M I T ------------------- ------------- Consequential Loss See Form Debris Removal, Additional Expense $ 50, 000 Emergency Removal 365 Days Emergency Removal Expense $ 5, 000 Fraud and Deceit $ 5, 000 Damage From Theft See Form Off Premises Utility Service Interruption $ 50, 000 SUPPLEMENTAL COVERAGES ---------------------- Brands or Labels Expense $ 50, 000 Expediting Expenses $ 50, 000 Fire Department Service Charges $ 25, 000 Inventory and Appraisal Expense $ 50, 000 Ordinance or Law (Undamaged Parts of a Building) See Form Ordinance or Law (Increased Cost to Repair/ $ 100, 000 Cost to Demolish and Clear Site) Personal Effects $ 15, 000 Pollutant Cleanup And Removal $ 50,000 Recharge of Fire Extinguishing Equipment $ 50,000 Rewards $ 10,000 Sewer Backup and Water Below the Surface $ 25,000 Trees, Shrubs, and Plants $ 50,000 Underground Pipes, Pilings, Bridges, and Roadways $ 250,000 AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 6 of 34 /EMC M&UBANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 S C H E D U L E O F C O V E R A G E S C O M M E R C I A L O U T P U T P R O G R A M P R O P E R T Y C O V E R A G E P A R T ----------------------------------------------------------------------------- Refer to Scheduled Locations ----------------------------------------------------------------------------- SUPPLEMENTAL MARINE COVERAGES L I M I T ----------------------------- ------------- Accounts Receivable $ 50,000 Electrical or Magnetic Disturbance of Computers See Form Power Supply Disturbance of Computers See Form Virus and Hacking Coverage Limit any one occurrence $ 25, 000 Limit any 12 month period $ 50, 000 Fine Arts $ 100, 000 Off Premises Computers $ 25,000 Property On Exhibition $ 50, 000 Property In Transit $ 50, 000 Sales Representative Samples $ 50, 000 Software Storage $ 50,000 Valuable Papers $ 100,000 ADDITIONAL PROPERTY SUBJECT TO LIMITATIONS ------------------------------------------ Furs (theft) $ 10, 000 Jewelry (theft) $ 10, 000 Stamps, Tickets, Letters of Credit $ 5, 000 SCHEDULED LOCATIONS ------------------- Newly Built or Acquired Buildings $ 500,000 Personal Property - Acquired Locations $ 250, 000 Locations "You" Elect Not To Describe $ 50, 000 AS QUOTED ON: 06/12/17 (BPP) Prepared for: CITY OF RIVERSIDE 008/600 JH 7 of 34 /EMC MOURARCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ LOC: 001 4498 NW HIGH DR DESCRIPTION: 1 STORY NONCOMS BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: COMMUNITY CENTER/BLDG W/ 64150-9578 POOL Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. Covered Property/ Limit Of COIN Specl Optional/Additional Item Coverage Provided Insurance % Intrst Coverages ----------------------------------------------------------------------------- 02 ! PERSONAL PROPERTY OF !$ 167, 000 ! 80% ! !Replacement Cost ! INSUREDS BUSINESS ! ! ! ! ------------------------------------------------------------------------------ LOC: 002 4200 NW RIVERSIDE ST DESCRIPTION: 1 STORY NONCOMS BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: PUBLIC WORKS-OFFICE W/3 64150-9672 BAY GARAGES Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. Covered Property/ Limit Of COIN Specl Optional/Additional Item Coverage Provided Insurance % Intrst Coverages ----------------------------------------------------------------------------- 02 !PERSONAL PROPERTY OF !$ 135, 000 ! 80% ! !Replacement Cost ! INSUREDS BUSINESS ! ! ! ! 05 !BUSINESS PERSONAL !$ 73, 000! 80% ! !Replacement Cost !PROPERTY OF INSUREDS ! ! ! ! !BUSINESS-SHED ITEM 03 ! ! ! 06!BUSINESS PERSONAL !$ 23, 000! 80% ! !Replacement Cost ! PROPERTY OF INSUREDS ! ! ! ! !BUSINESS-SHED ITEM 04 ! ! ! ! 09!BUSINESS PERSONAL !$ 80, 000! 80% ! !Replacement Cost !PROPERTY OF salt stock ! ! ! ! ------------------------------------------------------------------------------ AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 8 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ LOC: 003 1001 ARGOSY PKWY DESCRIPTION: 1 STORY NONCOMB BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: AMPHITHEATER BUILDING 64168 LOC DESCRIPTION: E.H YOUNG PARK Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. Covered Property/ Limit Of COIN Specl Optional/Additional Item Coverage Provided Insurance % Intrst Coverages ----------------------------------------------------------------------------- 03 !BUSINESS PERSONAL ! $ 3, 000! 80$ ! !Replacement Cost ! PROPERTY OF INSUREDS ! ! ! ! !BUSINESS ! ! ! ! 07 !BUSINESS PERSONAL !$ 4, 000! 80% ! !Replacement Cost ! PROPERTY OF SHELTER ! ! ! ! !HOUSE ! ! ! ! 08 !BUSINESS PERSONAL !$ 4, 000! 80$ ! !Replacement Cost !PROPERTY OF SHELTER ! ! ! ! !HOUSE ! ! ! ! ------------------------------------------------------------------------------ LOC: 004 2950-2990 NW VIVION RD DESCRIPTION: 1 STORY FRAME BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: CITY HALL 64150-1502 Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. Covered Property/ Limit Of COIN Specl Optional/Additional Item Coverage Provided Insurance % Intrst Coverages ----------------------------------------------------------------------------- 02 ! PERSONAL PROPERTY OF ! $ 1, 481, 000 ! 80% ! !Replacement Cost ! INSURED'S BUSINESS ! ! ! ! 03!BUSINESS PERSONAL !$ 40, 000! 80% ! !Replacement Cost ! PROPERTY OF gym equipment! ! ! ! 04 !BUSINESS PERSONAL !$ 50, 000! 80$ ! !Replacement Cost ! PROPERTY OF training ! ! ! ! !room equipment ! ! ! ! ------------------------------------------------------------------------------ AS QUOTED ON: 06/12/17 (BPP) Prepared for.CITY OF RIVERSIDE 008/800 JH 9 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R 0 G R A M S C H E D U L E COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ LOC: 007 4100-4102 NW RIVERSIDE DR DESCRIPTION: 1 STORY NONCOMS BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: OFFICE/STORAGE 64150 LOC DESCRIPTION: KITTERMAN BUILDING Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. Covered Property/ Limit Of COIN Specl Optional/Additional Item Coverage Provided Insurance 8 Intrst Coverages ----------------------------------------------------------------------------- 02 !BUSINESS PERSONAL !$ 100, 000 ! 808 ! !Replacement Cost !PROPERTY OF INSURED'S ! ! ! ! !BUSINESS ! ! ! ! ------------------------------------------------------------------------------ LOC: 008 4500 NW HIGH DR DESCRIPTION: 1 STORY MAS NONCOM BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: MUNICIPAL BUILDING 3 BAY 64150-9534 GARAGE STORAGE PROTECTIVE DEVICES: P-1 AUTOMATIC SPRINKLER SYSTEM, SEE FORM C01238 Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. Covered Property/ Limit Of COIN Specl Optional/Additional Item Coverage Provided Insurance 8 Intrst Coverages ----------------------------------------------------------------------------- 02 !BUSINESS PERSONAL !$ 250, 000! 808 ! !Replacement Cost ! PROPERTY OF INSURED'S ! ! ! ! !BUSINESS ! ! ! ! ------------------------------------------------------------------------------ AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 10 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E B L A N K E T COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ BLKT: 01 Blanket Buildings at Locs: 001-015. Limit Of Insurance: $ 24, 135,052 Coinsurance: 80% LOC: 001 4498 NW HIGH DR DESCRIPTION: 1 STORY NONCOMS BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: COMMUNITY CENTER/BLDG W/ 64150-9578 POOL Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST ------------------------------------------------------------------------------ LOC: 002 4200 NW RIVERSIDE ST DESCRIPTION: 1 STORY NONCOMB BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: PUBLIC WORKS-OFFICE W/3 64150-9672 BAY GARAGES Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST 03 !BUILDING ! 01 ! !REPLACEMENT COST !MACHINE SHED ! ! ! 04!BUILDING ! 01 ! !REPLACEMENT COST !MACHINE SHED ! ! ! 07 !BUILDING ! 01 ! !REPLACEMENT COST !STORAGE CANOPY ! ! ! 08 !BUILDING ! 01 ! !REPLACEMENT COST !STORAGE CANOPY ! ! ! ------------------------------------ ------------ AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 11 of 34 /EMC IMOURAROa EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E B L A N K E T COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ LOC: 003 1001 ARGOSY PKWY DESCRIPTION: 1 STORY NONCOMS BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: AMPHITHEATER BUILDING 64168 LOC DESCRIPTION: E.H YOUNG PARK Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST 02 !BUILDING ! 01 ! !REPLACEMENT COST !RESTROOM BUILDING ! ! ! 04!BUILDING ! 01 ! !REPLACEMENT COST !SHELTER HOUSE ! ! 05!BUILDING ! 01 ! !REPLACEMENT COST ! SHELTER HOUSE ! ! ! 06!BUILDING ! 01 ! !REPLACEMENT COST !ROCK BELL TOWER ! ! ! 09!BUILDING ! 01 ! !REPLACEMENT COST !MESA SHELTER HOUSE ! ! ! 10!BUILDING ! 01 ! !REPLACEMENT COST !SHELTER HOUSE ! ! ! ll!BUILDING ! 01 ! !REPLACEMENT COST ! PLAYGROUND EQUIPMENT ! ! ------------------------------------------------------------------------------ LOC: 004 2950-2990 NW VIVION RD DESCRIPTION: 1 STORY FRAME BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: CITY HALL 64150-1502 Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST 05!BUILDING ! 01 ! !REPLACEMENT COST !SCBA FILL STATION AND ! ! ! !COMPRESSOR ! ! ! ------------------------------------------------------------------------------ ------------------------------------------------------------------------------ AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 12 of 34 /EMC. INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/16 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E B L A N K E T COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ LOC: 005 2901 NW VIVION RD DESCRIPTION: 1 STORY FRAME BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: SHELTER HOUSE AND 64150 RESTROOM LOC DESCRIPTION: RENNER BRENNER PARK Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST !SHELTER HOUSE ! ! ! 02 !BUILDING ! 01 ! !REPLACEMENT COST !RESTROOM ! ! ! 03!BUILDING ! 01 ! !REPLACEMENT COST ! PICNIC SHELTER CANOPY ! ! ! !RENNER BRENNER PARK ! ! ! 04 !BUILDING ! 01 ! !REPLACEMENT COST !PLAYGROUND EQUIPMENT ! ! ! !RENNER BRENNER PARK ! ! ! LOC: 006 4500 NW GATEWAY AVE DESCRIPTION: 1 STORY JSTD MAS BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: CLOCK TOWER 64150-9721 Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01 !BUILDING ! 01 ! !REPLACEMENT COST AS QUOTED ON: 06/12/17 (BPP) Prepared for: CITY OF RIVERSIDE 008/600 JH 13 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E B L A N K E T COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ LOC: 007 4100-4102 NW RIVERSIDE DR DESCRIPTION: 1 STORY NONCOMB BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: OFFICE/STORAGE 64150 LOC DESCRIPTION: KITTERMAN BUILDING Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC . OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST LOC: 008 4500 NW HIGH DR DESCRIPTION: 1 STORY MAS NONCOM BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: MUNICIPAL BUILDING 3 BAY 64150-9534 GARAGE STORAGE PROTECTIVE DEVICES: P-1 AUTOMATIC SPRINKLER SYSTEM, SEE FORM C01238 Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST ---------------- LOC: 009 4900 NW GATEWAY AVE DESCRIPTION: 1 STORY NONCOMB BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: UNITED STATES POST OFFICE 64150-3640 Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST -------------- AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 0081600 JH 14 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E B L A N K E T COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ----------------------------------------------------------------------=------- LOC: 010 RIVERWAY BLVD AT NW PLATTE DR DESCRIPTION: 1 STORY FRAME BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: TRAFFIC SIGNALS/SIGNAL 64150 SYSTEM Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST ------------------------------------------------------------------------------ LOC: 011 INTERSECTION OF VIVION RD DESCRIPTION: 1 STORY FRAME BLDG AND NW GATEWAY AVE NW IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: TRAFFIC SIGNALS/SIGNAL 64150 SYSTEM Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST --------------- --------------- LOC: 012 HOMESTEAD PARK AT CORNER OF DESCRIPTION: 1 STORY FRAME BLDG HOMESTEAD ROAD& HOMESTEAD TERR IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: PLAYGROUND EQUIPMENT 64150 Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST AS QUOTED ON: 06/12/17 (BPP) Prepared for: CITY OF RIVERSIDE 008/600 JH 16 of 34 /EMC MOURANCF EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 . RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L O U T P U T P R O G R A M S C H E D U L E B L A N K E T COVERAGE PROVIDED APPLIES ONLY AS INDICATED BY AN ENTRY BELOW: ------------------------------------------------------------------------------ LOC: 013 5025 NW CANAL ST DESCRIPTION: 1 STORY FRAME BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: OBELISK STRUCTURE AND 64150-7201 SIGNS Deductible Per Occurrence On All Covered Causes of Loss $ 2, 500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST LOC: 014 NORTH WOODLAND AND LINEAR DESCRIPTION: 1 STORY FRAME BLDG TRAIL IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: CROSSWALK SIGNALS 64150 Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST LOC: 015 ARGOSY PARKWAY AT SNOWDEN DESCRIPTION: 1 STORY FRAME BLDG IN PROTECTION CLASS 03 RIVERSIDE, MO OCCUPANCY: CROSSWALK SIGNAL 64150 Deductible Per Occurrence On All Covered Causes of Loss $ 2,500. COVERED PROPERTY/ SPEC OPTIONAL/ADDITIONAL ITM COVERAGE PROVIDED BLKT INT* COVERAGES ------------------------------------------------------------------------------ 01!BUILDING ! 01 ! !REPLACEMENT COST ------------------------------------------------------------------------------ AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/800 JH 16 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 S T A T E M E N T O F V A L U E S ----------------------------------------------------------------------------- VALUE ITEM CONSTRUCTION/OCCUPANCY COVERAGE 100% VALUES TYPE ----------------------------------------------------------------------------- LOC NO: 001 4498 NW HIGH DR RIVERSIDE, MO 64150-9578 01 ! 1 STORY NONCOMB BLDG ! BUILDING !$ 2, 817, 612 ! RC ! IN PROTECTION CLASS 03 ! ! ! ! COMMUNITY CENTER/BLDG W/ ! ! ! ! POOL ! ! ! ----------------------------------------------------------------------------- LOC NO: 002 4200 NW RIVERSIDE ST RIVERSIDE, MO 64150-9672 01 ! 1 STORY NONCOMB BLDG ! BUILDING ! $ 647, 040! RC ! IN PROTECTION CLASS 03 ! ! ! ! PUBLIC WORKS-OFFICE W/3 ! ! ! ! BAY GARAGES ! ! ! 03 ! - ! BUILDING !$ 185, 950! RC ! ! MACHINE SHED ! ! 04 ! ! BUILDING !$ 68,789! RC ! ! MACHINE SHED ! ! 07 ! ! BUILDING !$ 51, 809 ! RC ! ! STORAGE CANOPY ! ! 08 ! ! BUILDING !$ 75, 217 ! RC ! ! STORAGE CANOPY ! ! ----------------------------------------------------------------------------- LOC NO: 003 1001 ARGOSY PKWY RIVERSIDE, MO 64168 LOC DESCRIPTION: E.H YOUNG PARK 01 ! 1 STORY NONCOMS BLDG ! BUILDING !$ 211, 171! RC ! IN PROTECTION CLASS 03 ! ! ! ! AMPHITHEATER BUILDING ! ! ! 02 ! ! BUILDING !$ 204, 867! RC ! ! RESTROOM BUILDING ! ! 04 ! ! BUILDING ! $ 97,706! RC ! ! SHELTER HOUSE ! ! 05 ! ! BUILDING !$ 95,790! RC ! ! SHELTER HOUSE ! ! 06 ! ! BUILDING !$ 172, 010! RC ! ! ROCK BELL TOWER ! ! 09 ! ! BUILDING !$ 27, 030! RC ! ! MESA SHELTER HOUSE ! ! 10 ! ! BUILDING !$ 26,265 ! RC ! ! SHELTER HOUSE ! ! 11 ! ! BUILDING !$ 125, 000 ! RC ! ! PLAYGROUND EQUIPMENT ! ! ----------------------------------------------------------------------------- LOC NO: 004 2950-2990 NW VIVION RD AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 0081600 JH 17 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 S T A T E M E N T O F V A L U E S ----------------------------------------------------------------------------- RIVERSIDE, MO 64150-1502 O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 12,203, 026! RC ! IN PROTECTION CLASS 03 ! ! ! ! CITY HALL ! ! ! 05 ! ! BUILDING !$ 50, 000! RC ! ! SCBA FILL STATION AND ! ! ! ! COMPRESSOR ! ! ----------------------------------------------------------------------------- LOC NO: 005 2901 NW VIVION RD RIVERSIDE, MO 64150 LOC DESCRIPTION: RENNER BRENNER PARK O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 29,580! RC ! IN PROTECTION CLASS 03 ! SHELTER HOUSE ! ! ! SHELTER HOUSE AND ! ! ! ! RESTROOM ! ! ! 02 ! ! BUILDING !$ 43,000! RC ! ! RESTROOM ! ! 03 ! ! BUILDING !$ 25, 000! RC ! ! PICNIC SHELTER CANOPY ! ! ! ! RENNER BRENNER PARK ! ! 04 ! ! BUILDING ! $ 125, 000 ! RC ! ! PLAYGROUND EQUIPMENT ! ! ! ! RENNER BRENNER PARK ! ! ----------------------------------------------------------------------------- LOC NO: 006 4500 NW GATEWAY AVE RIVERSIDE, MO 64150-9721 O1 ! 1 STORY JSTD MAS BLDG ! BUILDING !$ 1, 386,792 ! RC ! IN PROTECTION CLASS 03 ! ! ! ! CLOCK TOWER ! ! ! ----------------------------------------------------------------------------- LOC NO: 007 4100-4102 NW RIVERSIDE DR RIVERSIDE, MO 64150 LOC DESCRIPTION: KITTERMAN BUILDING O1 ! 1 STORY NONCOMB BLDG ! BUILDING ! $ 803,709! RC ! IN PROTECTION CLASS 03 ! ! ! ! OFFICE/STORAGE ! ! ! ----------------------------------------------------------------------------- LOC NO: 008 4500 NW HIGH DR RIVERSIDE, MO 64150-9534 O1 ! 1 STORY MAS NONCOM BLDG ! BUILDING !$ 803, 709! RC ! IN PROTECTION CLASS 03 ! ! ! ! MUNICIPAL BUILDING 3 BAY ! ! ! ! GARAGE STORAGE ! ! ! ----------------------------------------------------------------------------- AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/800 JH 18 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 S T A T E M E N T O F V A L U E S ----------------------------------------------------------------------------- LOC NO: 009 4900 NW GATEWAY AVE RIVERSIDE, MO 64150-3640 O1 ! 1 STORY NONCOMS BLDG ! BUILDING !$ 3, 000, 000 ! RC ! IN PROTECTION CLASS 03 ! ! ! ! UNITED STATES POST OFFICE ! ! ! ----------------------------------------------------------------------------- LOC NO: 010 RIVERWAY BLVD AT NW PLATTE DR RIVERSIDE, MO 64150 O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 212, 180 ! RC ! IN PROTECTION CLASS 03 ! ! ! ! TRAFFIC SIdNALS/SIGNAL ! ! ! ! SYSTEM ! ! ! ----------------------------------------------------------------------------- LOC NO: 011 INTERSECTION OF VIVION RD AND NW GATEWAY AVE NW RIVERSIDE, MO 64150 O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 265, 740! RC ! IN PROTECTION CLASS 03 ! ! ! ! TRAFFIC SIGNALS/SIGNAL ! ! ! ! SYSTEM ! ! ! ----------------------------------------------------------------------------- LOC NO: 012 HOMESTEAD PARK AT CORNER OF HOMESTEAD ROAD& HOMESTEAD TERR RIVERSIDE, MO 64150 O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 70, 000! RC ! IN PROTECTION CLASS 03 ! ! ! ! PLAYGROUND EQUIPMENT ! ! ! ----------------------------------------------------------------------------- LOC NO: 013 5025 NW CANAL ST RIVERSIDE, MO 64150-7201 O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 236, 900 ! RC ! IN PROTECTION CLASS 03 ! ! ! ! OBELISK STRUCTURE AND ! ! ! ! SIGNS ! ! ! ----------------------------------------------------------------------------- LOC NO: 014 NORTH WOODLAND AND LINEAR TRAIL RIVERSIDE, MO 64150 O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 37, 080! RC ! IN PROTECTION CLASS 03 ! ! ! ! CROSSWALK SIGNALS ! ! ----------------------------------------------------------------------------- LOC NO: 015 ARGOSY PARKWAY AT SNOWDEN RIVERSIDE, MO 64150 O1 ! 1 STORY FRAME BLDG ! BUILDING !$ 37, 080 ! RC ! IN PROTECTION CLASS 03 ! ! ! CROSSWALK SIGNAL ! ! ! AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 19 of 34 /EMC INeURANC[ EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: B654449-05 RIVERSIDE CITY OF EEE DATE: 07/01/17 EXP DATE: 07/01/18 S T A T E M E N T O F V A L U E S ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- Total Building $ 24, 135,052 RC -------------- Combined Total $ 24, 135,052 1. Values shown must be 100% Actual Cash Value or Replacement Cost and should reflect coverage basis for each item of Buildings, Personal Property or Both. 2. Value shall be submitted to insurance company, subject to its acceptance. 3. Nothing contained in these instructions shall be construed as changing in any manner the conditions of this policy. 4. The company may require this Statement of Values to be signed by the insured or in the case of firms, by a partner or an officer. ALL VALUES SUBMITTED ARE CORRECT TO THE BEST OF MY KNOWLEDGE AND BELIEF. SIGNED: -------------------------------------------------------- TITLE: DATE: -------------------------------- ----------------- AS QUOTED ON: 06/12/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/800 JH 20 of 34 /EMC /MSURAMCf EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: F654449-01 GOVERNMENT CRIME QUOTATION QUOTATION IS VALID: FROM 06/15/17 TO 07/30/17 PROPOSED POLICY PERIOD: FROM 07/01/17 TO 07/01/18 P R E P A R E D F 0 R : P R E S E N T E D B Y - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - CITY OF RIVERSIDE COWELL JAMES FORGE INSURANCE 2950 NW VIVION RD GROUP, LLC RIVERSIDE MO 64150-1502 10525 N AMBASSADOR DR STE 301 KANSAS CITY MO 64153-1284 AGENT: AK 7685 AGENT PHONE: (816) 471-4245 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INSURED IS: CITY BUSINESS DESC: MUNICIPALITY - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - COVERAGE IS WRITTEN: PRIMARY SEE ATTACHED SCHEDULE FOR DESCRIPTION OF LOCATIONS, LIMITS, AND DEDUCTIBLES. C O V E R A G E S P R O V I D E D P R E M I U M -------------------------------------------------- -------------- EMPLOYEE THEFT - BLANKET (PER LOSS) $ 474. 00 --------------------------------------------------------------------------- TOTAL POLICY PREMIUM $ 474.00 ------------------------------------- AS QUOTED ON: 06/15/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 21 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: F654449-01 CITY OF RIVERSIDE EFF DATE: 07/01/17 EXP DATE: 07/01/18 G O V E R N M E N T C R I M E P 0 L I C Y Q U 0 T E ------------------------------------------------------------------------------ ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION/ADDITIONAL INFORMATION PREMIUM ------------------------------------------------------------------------------ *CR0024 11-15 GOVT. CRIME COV. FORM - DISCOVERY *CR0127 08-07 MISSOURI CHANGES *CR0750 08-08 AMENDMENT-DELETE PROV REGARD TERROR *CR7002. 6 11-15 GOVT CRIME QUICK REF (DISCOVERY) *CR7010A 11-15 GOVERNMENT CRIME DECLARATIONS *CR7011A 11-15 GOVERNMENT CRIME SCHEDULE *IL0274 02-13 MO CHANGES - CANCELLATION/NONRENEWAL *IL7131A 04-01 COMM'L POLICY ENDORSEMENT SCHEDULE *IL7306 08-98 EXC. OF CERT. COMPUTER LOSSES AS QUOTED ON: 06/15/17 Prepared for: CITY OF RIVERSIDE 008/600 JH 22 of 34 /EMC, INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: F654449-01 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 G O V E R N M E N T C R I M E S C H E D U L E --------------------------------------------------------------- --------------------------------------------------------------- ----------------------------------------------------------------------------- D E D L I M I T D E S C R I P T I O N (PER OCCURRENCE) (PER OCCURRENCE) ----------------------------------------------------------------------------- EMPLOYEE THEFT — BLANKET (PER LOSS) $ 11000 $ 100, 000 ----------------------------------- ----------------------------------------------------------------------------- AS QUOTED ON: 06/15/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 23 of 34 /EMC INBUNANCa EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: C654449-05 Q U O T A T I O N - C O M M E R C I A L I N L A N D M A R I N E QUOTATION IS VALID: FROM 06/15/17 TO 07/30/17 PROPOSED POLICY PERIOD: FROM 07/01/17 TO 07/01/18 P R E P A R E D F O R P R E S E N T E D B Y - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - CITY OF RIVERSIDE COWELL JAMES FORGE INSURANCE 2950 NW VIVION RD GROUP, LLC RIVERSIDE MO 64150-1502 10525 N AMBASSADOR DR STE 301 KANSAS CITY MO 64153-1284 AGENT: AK 7685 AGENCY BILL AGENT PHONE: (816) 471-4245 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - INSURED IS: CITY BUSINESS DESC: MUNICIPALITY - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - SEE ATTACHED SCHEDULE FOR LIMITS AND DESCRIPTION OF COVERAGES ------------------------------------------------------------- C O V E R A G E S H E A D I N G S P R E M I U M ----------------------------------------------- -------------- CONTRACTORS EQUIPMENT $ 17,484.00 ELECTRONIC DATA PROCESSING $ 5,224 .00 #WATERCRAFT COVERAGE $ 100.00 --------------------------------------------------------------------------- TOTAL INLAND MARINE PREMIUM $ 22, 808 .00 -------------------------------------------- A DEDUCTIBLE MAY APPLY FOR THE COVERAGE PROVIDED. IN THE EVENT A LOSS (OTHER THAN EARTHQUAKE) INVOLVES COVERED PROPERTY AT MORE THAN ONE LOCATION OR IN MORE THAN ONE CLASS, ONLY ONE DEDUCTIBLE, THE LARGEST DEDUCTIBLE SHOWN ON THE SCHEDULE FOR THE LOCATION OR CLASSES INVOLVED IN THE LOSS, WILL APPLY PER OCCURRENCE. AS QUOTED ON: 06/15/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/800 JH 24 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: C654449-05 CITY OF RIVERSIDE EFF DATE: 07/01/17 EXP DATE: 07/01/18 C 0 M M L I N L A N D M A R I N E P O L I C Y Q U O T E ------------------------------------------------- ------------- - -- - - ENDORSEMENT SCHEDULE EDITION FORM DATE DESCRIPTION/ADDITIONAL INFORMATION PREMIUM ------------------------------------------------------------------------------ *CLO100 03-99 COMMON POLICY CONDITIONS *CL0167 05-05 GUARANTY FUND COV LIMITATIONS - MO *CL0170 09-13 AMENDATORY ENDORSEMENT MISSOURI *CL0600 01-15 CERTIFIED TERRORISM LOSS *CL0700 10-06 VIRUS OR BACTERIA EXCLUSION *CM0001 09-04 COMM. INLAND MARINE CONDITIONS *CM0118 11-13 MISSOURI CHANGES *CM7001A 09-97 COMMERCIAL INLAND MARINE SCHEDULE *CM7002 09-00 QUICK REFERENCE *CM7004 09-06 QUICK REFERENCE *CM7021 11-01 LOSS PAYABLE ENDORSEMENT *CM7481 06-97 WATERCRAFT COVERAGE FORM *CM7482 06-97 WATERCRAFT LAYUP ENDORSEMENT *CM7497 10-08 AMENDATORY ENDORSEMENT - MISSOURI *IL0274 02-13 MO CHANGES - CANCELLATION/NONRENEWAL *IL0952 01-15 CAP/LOSSES/CERTIFD ACTS OF TERRORISM *IL7131A 04-01 COMM'L POLICY ENDORSEMENT SCHEDULE *IL7306 08-98 EXCLUSION OF CERTAIN COMPUTER LOSSES *IL8383.2A 01-15 DISCL PURSUANT TERRSM RISK INS. ACT WAIVED *IM2051 09-13 AMENDATORY ENDORSEMENT - MISSOURI *IM2250 07-13 POLLUTANT - AMENDED DEFINITION *IM7000 04-04 CONTRACTOR'S EQUIPMENT COVERAGE *IM7200 10-02 EDP EQUIPMENT COVERAGE - SCHEDULED *IM7227 01-12 REPRODUCTION EQUIPMENT *IM7228 01-12 TELECOMMUNICATIONS EQUIPMENT *IM7238 10-02 EARTHQUAKE, FLOOD AND SEWER BACKUP AS QUOTED ON: 06/15/17 Prepared for:CITY OF RIVERSIDE 008/600 JH 26 of 34 IEMC INounANCa EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NUMBER: C654449-05 CITY OF RIVERSIDE EFF DATE: 07/01/17 EXP DATE: 07/01/18 THIS DISCLOSURE IS ATTACHED TO YOUR POLICY IN RESPONSE TO THE DISCLOSURE REQUIREMENTS OF THE TERRORISM RISK INSURANCE ACT. THIS DISLOSURE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. D I S C L O S U R E P U R S U A N T T O T E R R O R I S M R I S K I N S U R A N C E A C T ----------------------------------------------------------------------- S C H E D U L E Terrorism Premium (Certified Acts) Waived ----------------------------------------------------------------------- A. Disclosure Of Premium: In accordance with the federal Terrorism Risk Insurance Act, we are required to provide you with a notice disclosing the portion of your premium, if any, attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Schedule of this disclosure or in the policy Declarations. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses: The United States Government, Department of the Treasury, will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015, the federal share equals 858 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. Beginning on January 1, 2016, the federal share will decrease by one percentage point per calendar year until equal to 808 of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses attributable to terrorist acts certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses: If aggregate insured losses attributable to terrorist acts certified under the 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. The following statement is required to be part of the disclosure notice in MISSOURI: The premium above is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions, limitations and exclusions in this policy. You should read the definition in your policy carefully, but generally speaking, "certified" acts of terrorism are acts that exceed $5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. AS QUOTED ON: 06/15/17 Prepared for: CITY OF RIVERSIDE 008/600 JH 26 of 34 /EMC, INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NO: C654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L I N L A N D M A R I N E S C H E D U L E ------------------------------------------------------------------------------- P 0 L I C Y W I D E C O V E R A G E S ----------------------------------------------------------------------------- CLASS/ITEM DESCRIPTION *SPEC INTEREST LIMITS ----------------------------------------------------------------------------- CONTRACTORS EQUIPMENT 801 CONTRACTORS EQUIPMENT $ 1000 DEDUCTIBLE APPLIES PER OCCURRENCE TO THE FOLLOWING ITEMS 100% COINSURANCE $ 3, 967, 543 CATASTROPHE LIMIT - THE MOST "WE" PAY FOR LOSS IN ANY ONE OCCURRENCE COVERAGE EXTENSIONS ADDITIONAL DEBRIS REMOVAL EXPENSES $ 5, 000 SUPPLEMENTAL COVERAGES EMPLOYEE TOOLS (ACTUAL CASH VALUE) $ 5, 000 NEWLY PURCHASED EQUIPMENT PERCENTAGE OF CATASTROPHE LIMIT 30% POLLUTANT CLEANUP AND REMOVAL $ 25, 000 RENTAL REIMBURSEMENT LIMIT $ 5, 000 WAITING PERIOD 72 HRS SPARE PARTS AND FUEL $ 5, 000 ACTUAL CASH VALUE 001 FIRE FIGHTING EQUIPMENT ON TRUCKS (4) $ 500, 000 ACTUAL CASH VALUE 002 STANDBY GENERATOR $ 17, 665 ACTUAL CASH VALUE 003 MOBILE RADIO EQUIPMENT $ 540, 000 ACTUAL CASH VALUE 004 PARK CAMERA SYSTEM, , MOTOROLA $ 300, 000 ACTUAL CASH VALUE 005 ACCESS CONTROL & VIDEO SYSTEM, GOVT $ 310, 000 COMPLEX ACTUAL CASH VALUE 006 IN CAR VIDEO SYSTEM $ 125, 000 ACTUAL CASH VALUE 007 NEW HOLLAND TRACTOR $ 27, 000 ACTUAL CASH VALUE AS QUOTED ON: 06/15/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 27 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NO: C654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L I N L A N D M A R I N E S C H E D U L E ------------------------------------------------------------------------------- 008 STANDBY GENERATOR $ 17, 665 ACTUAL CASH VALUE 009 PLAYGROUND EQUIPMENT $ 5,500 ACTUAL CASH VALUE 010 MONUMENT (RENNER VILLAGE SITE) $ 4,500 ACTUAL CASH VALUE 011 2010 BOBCAT UTV 4-SEATER 3400 XL $ 17, 015 SN AJNV11095 ACTUAL CASH VALUE 012 MISCELLANEOUS UNSCHEDULED POLICE $ 250, 000 DEPARTMENT EQUIPMENT ACTUAL CASH VALUE 013 MISCELLANEOUS UNSCHEDULED FIRE $ 310,500 DEPARTMENT EQUIPMENT ACTUAL CASH VALUE 014 MISCELLANEOUS UNSCHEDULED PUBLIC WORKS $ 1, 174, 000 EQUIPMENT ACTUAL CASH VALUE 015 2 SPEED TRAILERS MDL KUSTOM SIGNAL-PS $ 24, 000 @ $12, 000 EACH ACTUAL CASH VALUE 016 BC E-35, A91 ANGLE BLADE, RAIDO 02 $ 46,371 SN AR 1K11364 DB 24 SD BUCKET, SN 1093807 ACTUAL CASH VALUE 017 CASE/IH MAXXOM 125 $ 83, 461 SN ZFEE02896 ACTUAL CASH VALUE 018 2016 BOBCAT S650 SKID STEER W/ 74INCH 03 $ 46, 343 TOOTH BUCKET & 74 INCH SMOOTH BUCKET SN ALJ818965 ACTUAL CASH VALUE 019 2016 BOBCAT E-35 EXCAVATOR W/ 24 INCH 03 $ 51, 123 BUCKET SN AR1K12100 ACTUAL CASH VALUE 020 . POLICE ROBOT $ 17, 000 AS QUOTED ON: 06/15/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/600 JH 28 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NO: C654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L I N L A N D M A R I N E S C H E D U L E ------------------------------------------------------------------------------- ACTUAL CASH VALUE 021 POLICE NIGHT VISION MONOCULAR $ 10, 000 ACTUAL CASH VALUE 022 POLICE WEAPONS (MISC) $ 15, 000 ACTUAL CASH VALUE 023 GATOR UTV $ 15, 000 SN-MOHP4GX017321 ACTUAL CASH VALUE 024 GRASS FIRE SKID UNIT $ 2, 000 ACTUAL CASH VALUE 025 KOHLER 15K MOBILE GENERATOR $ 20, 000 ACTUAL CASH VALUE 026 BUSCH WHACKER FLEXWING $ 14, 000 SN-ST18016050505 ACTUAL CASH VALUE 027 PUBLIC WORKS 1997 ALTEC CHIPPER/TRAILER $ 6, 000 SN-4HAEB1L06VC000215 ACTUAL CASH VALUE 028 2007 4X4 HPX JOHN DEERE GATOR $ 15, 000 SN-MOHP4GXC017321 ACTUAL CASH VALUE 029 SURETRAC TRAILER $ 3, 400 PREMIUM $ 16, 984 840 CONTR. EQUIP. - LEASED OR RENTED FROM OTHERS LIMITS OF INSURANCE THE MOST "WE" PAY FOR LOSS TO ANY ONE ITEM $ 100, 000 THE MOST "WE" PAY FOR LOSS IN ANY ONE $ 100, 000 OCCURRENCE ACTUAL CASH VALUE DEDUCTIBLE $ 1000 NON-REPORTING FORM PREMIUM $ 500 LOSS PAYEE (S) APPLY TO THIS COVERAGE: COLEMAN EQUIPMENT, INC. AS QUOTED ON: 06/15/17 (BPP) Prepared for:CITY OF RIVERSIDE 008/800 JH 29 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NO: C654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L I N L A N D M A R I N E S C H E D U L E ------------------------------------------------------------------------------- - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - LOCATION: 001 2950 NW VIVION RD RIVERSIDE, MO 64150-1502 SPECIAL* CLASS DESCRIPTION INTEREST LIMITS ----------------------------------------------------------------------------- ----------------------------------------------------------------------------- DATA PROCESSING: $ 1, 000 DEDUCTIBLE APPLIES TO ALL COVERED PERILS UNLESS A DIFFERENT DEDUCTIBLE IS INDICATED BELOW $ 5, 000 DEDUCTIBLE - EARTHQUAKE AND VOLCANIC ERUPTION NOT COVERED DEDUCTIBLE - "FLOOD" $ 1,000 DEDUCTIBLE - "MECHANICAL BREAKDOWN", "ELECTRICAL DISTURBANCE" AND "POWER SUPPLY DISTURBANCE" 100% COINSURANCE $ 995, 000 EARTHQUAKE "AGGREGATE" LIMIT $ 995,000 EARTHQUAKE "OCCURRENCE" LIMIT $ 995,000 EARTHQUAKE "CATASTROPHE" LIMIT NOT COVERED FLOOD "AGGREGATE" LIMIT NOT COVERED FLOOD "OCCURRENCE" LIMIT NOT COVERED FLOOD "CATASTROPHE" LIMIT $ 995, 000 SEWER BACKUP "AGGREGATE" LIMIT $ 995, 000 SEWER BACKUP "OCCURRENCE" LIMIT $ 995, 000 SEWER BACKUP "CATASTROPHE" LIMIT 848 ELECTRONIC DATA PROCESSING - SCHEDULED LIMITS COVERAGE LIMITS $ 979,750 "HARDWARE" $ 15,250 SOFTWARE INCLUDED "MEDIA" INCLUDED "PROGRAMS AND APPLICATIONS" INCLUDED "DATA RECORDS" INCLUDED "PROPRIETARY PROGRAMS" NOT COVERED Income Coverage AS QUOTED ON: 06/15/17 (BPP) Prepared for: CITY OF RIVERSIDE 008/600 JH 30 of 34 /EMC INSURANCE EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NO: C654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L I N L A N D M A R I N E S C H E D U L E ------------------------------------------------------------------------------- EQUIPMENT COVERAGE EXTENSIONS Additional Debris Removal Expenses $ 10, 000 ELECTRICAL AND POWER SUPPLY DISTURBANCE COVERED Emergency Removal (Number of DAYS) 365 Emergency Removal Expenses $ 2, 500 Fraud and Deceit $ 2,500 MECHANICAL BREAKDOWN COVERAGE COVERED EQUIPMENT SUPPLEMENTAL COVERAGES Acquired Locations $ 500, 000 Earthquake Coverage COVERED Flood Coverage NOT COVERED NEWLY PURCHASED OR LEASED HARDWARE $ 500, 000 Off-Site Computers $ 5, 000 Pollutant Cleanup and Removal $ 10, 000 Property in Transit $ 10, 000 Protection and Control Systems $ 10, 000 RECHARGE OF FIRE EXTINGUISHING EQUIPMENT $ 15, 000 Reproduction Equipment $ 10, 000 Sewer Backup COVERED REWARDS $ 2,500 Software Storage $ 50, 000 Telecommunications Equipment $ 10, 000 Virus and Hacking Limit any one occurrence $ 25, 000 Limit each separate 12 month period $ 75, 000 FOREIGN TRANSIT AND LOCATION LIMIT NOT COVERED PREMIUM $ 5, 224 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - WATERCRAFT COVERAGE 182 INBOARD, INBOARD/OUTBOARD, PERSONAL WATERCRAFT 001 LENGTH: 14 FT. HORSEPOWER: 20 2012 SATURN RUBBER BOAT SD-430 WITH $ 4, 600 2012 MERCURY 20HP OUTBOARD MOTOR , MDL 1F20301HK SN OR469619 NAV. PERIOD: FROM 01/01 TO 12/31 (INLAND WATERS) DEDUCTIBLE: $ 500 AS QUOTED ON: 06/15/17 (BPP) Prepared for: CITY OF RIVERSIDE 008/600 JH 31 of 34 /EMC 'NounANc EMPLOYERS MUTUAL CASUALTY COMPANY QUOTE NO: C654449-05 RIVERSIDE CITY OF EFF DATE: 07/01/17 EXP DATE: 07/01/18 C O M M E R C I A L I N L A N D M A R I N E S C H E D U L E ------------------------------------------------------------------------------- PREMIUM $ 100 - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - ----------------------------------------------------------------- *SPECIAL INTERESTS SPEC.* INT. NO. LOSS PAYEE - LOSS PAYABLE 01 LOSS, IF ANY, WILL BE ADJUSTED WITH THE NAMED INSURED AND COLEMAN EQUIPMENT INC. RE: LEASED/RENTED EQUIPT. PO BOX 456 BONNER SPRINGS, KS 66012-0456 SPEC.* INT. NO. LOSS PAYEE - LOSS PAYABLE 02 LOSS, IF ANY, WILL BE ADJUSTED WITH THE NAMED INSURED AND KANSAS STATE BANK PO BOX 69 MANHATTAN, KS 66505-0069 SPEC.* INT. NO. LOSS PAYEE - LOSS PAYABLE 03 LOSS, IF ANY, WILL BE ADJUSTED WITH THE NAMED INSURED AND KS STATE BANK AND/OR ITS ASSIGNS PO BOX 69 MANHATTAN, KS 66505-0069 AS QUOTED ON: 06/15/17 (BPP) Prepared for: CITY OF RIVERSIDE 008/600 JH 32 of 34 /EMC. INSURANCE Disclosure Pursuant to Terrorism Risk Insurance Act This disclosure is attached to and made part of your Quote Proposal in response to the disclosure requirements of the Terrorism Risk Insurance Act. This disclosure does not grant any coverage or change the terms and conditions of any coverage under the policy. A. Disclosure Of Premium: In accordance with the federal Terrorism Risk Insurance Act, we are required to provide you with a notice disclosing the portion of yourpremium, if any, attributable to coverage for terrorism acts certified under the Terrorism Risk Insurance Act. The portion of your premium attributable to such coverage is shown in the Quote Proposal. B. Disclosure Of Federal Participation In Payment Of Terrorism Losses: The United States Government, Department of the Treasury, will pay a share of terrorism losses insured under the federal program. For losses occurring in 2015, the federal share equals 85%of that portion of the amount of such insured losses that exceeds the applicable insurer retention. Beginning on January 1, 2016, the federal share will decrease by one percentage point per calendar year until equal to 80% of that portion of the amount of such insured losses that exceeds the applicable insurer retention. However, if aggregate insured losses attributable to terrorist acs certified under the Terrorism Risk Insurance Act exceed $100 billion in a calendar year, the Treasury shall not make any payment for any portion of the amount of such losses that exceeds $100 billion. C. Cap On Insurer Participation In Payment Of Terrorism Losses: If aggregate insured losses attributable to terrorist acts certified under the 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. The following statement is required to be part of the disclosure notice in MISSOURI: The premium shown on the Quote Proposal is for certain losses resulting from certified acts of terrorism as covered pursuant to coverage provisions, limitations and exclusions in the policy that may be issued based on this quote. You should read the definition inyour policy carefully, but generally speaking, 'certified"acts of terrorism are acts that exceed $5 million in aggregate losses to the insurance industry and which are subsequently declared by the U.S. Secretary of the Treasury as a certified terrorist act under the Terrorism Risk Insurance Act. Some losses resulting from certified acts of terrorism are not covered. Read your policy and endorsements carefully. Thank you for the opportunity to present this proposal to you. We hope you will allow us the privilege to serve your insurance needs. Cowell James Forge Insurance Group, LLC Prepared for:CITY OF RIVERSIDE 008/600 JH 33 of 34 /EMC INSURANCE Terrorism Risk Insurance Act Schedule For the following sections,coverage for Certified Acts of Terrorism Is accepted: Commercial Output(B-05) $ 751.00 For the following sections,coverage for Certified Acts of Terrorism is not applicable: Govt Crime/Fidelity ISO Package(F-01) Commercial Inland Marine(C-05) Prepared for:CITY OF RIVERSIDE 008/800 JH 34 of 34