Backup Documents 03/25/2014 Item #16E1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 E 1 ,
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Routed by Purchasing Department to Office `: Initials Date
the Following Addressee(s) (In routing order)
1. Risk Management Risk
2. County Attorney Office County Attorney Office
31114'
3. BCC Office Board of County
Commissioners vVAS 31(
2'b\\A
4. Minutes and Records Clerk of Court's Office 0/,� 1o.
5. Return to Purchasing Department Purchasing ��
Contact: Diana DeLeon
PRIMARY CONTACT INFORMATION
Name of Primary Diana DeLeon for Rhonda Cummings Phone Number 252-8375
Purchasing Staff March 25,2014
Contact and Date
Agenda Date Item was March 25,2014 Agenda Item Number 16.E.1 1/
Approved by the BCC
Type of Document Amendment Number of Original 2
Attached Documents Attached
PO number or account N/A Solicitation/Contract 11-5689 IRMS
number if document is NumberNendor Name
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? DD
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the N/A
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DD
signature and initials are required.
7. In most cases(some contracts are an exception),an electronic copy of the document and DD
this routing slip should be provided to the County Attorney's Office before the item is
input into SIRE.
8. The document was approved by the BCC on the date above and all changes made DD
during the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready f• the (� -
Chairman's signature. Gv'
16E1
MEMORANDUM
Date: March 28, 2014
To: Diana De Leon, Contracts Technician
Purchasing Department
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Amendment #1 to Contract #11-5689 "Brokerage and Insurance
Coverage"
Contractor: Insurance and Risk Management Services, Inc.
Attached is an original copy of the contract referenced above, (Item #16E1)
approved by the Board of County Commissioners on March 25, 2014.
The second original will be held on file in the Minutes and Records Department for
the Board's Official Record.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
16E1
EXHIBIT A-1 Contract Amendment#1 to Contract#11-5689
"Brokerage and Insurance Coverage"
This amendment, dated 14tv.c.vA 25,2014 to the referenced agreement shall be by and between the
parties to the original Agreement, Insurance and Risk Management Services, Inc. (to be referred to as
"Consultant")and Collier County, Florida, (to be referred to as"County").
Statement of Understanding
RE: Contract# 11-5689 "Brokerage and Insurance Coverage"
In order to continue the services provided for in the original Contract document referenced above, the
Consultant agrees to amend the Contract by replacing in its entirety "Exhibit A Payment Schedule
01/01/2012 to 12/31/2014"with Exhibit Al-A attached hereto and is hereby made an integral part of this
Amendment.
All other terms and conditions of the agreement shall remain in force.
IN WITNESS WHEREOF,the parties have each, respectively,by an authorized person or agent,have
executed this Amendment on the date(s) indicated below.
Accepted: f 11 ct,,-e k a 3- ,2014
OWNER:
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNT/, FLORIDA
Uwig t E.Brock, rk
ftest•a lo Chairman's Tom Henning, Chai �n
srgnattire only.
Consult )t W. ess CONSULTANT:
Z„--/
INSURANCE AND RISK MANAGEMENT
SERVICES, INC. �.
By: _ 7
ti /Die-44— By: � .,G Cl/
Print Name
Print Name and Title
Consultant Secon Witness
By: e
r [4-4,in ( .�6)
Print Name
Approved as to form and legality: I �I
511 -mss
L.10,
} 3 q
ssistant Cou Attoniey
ka.'d
D.-1!iy 131 K
1 ..w s.+.0 r ew s. •
EXHIBIT Al-A 16 E 1
EXHIBIT A
PAYMENT SCHEDULE
Effective January 1, 2014
Agreement No. 11-5689
"Property Casualty Insurance Broker"
Month Amount
January $7,531.46
February $7,531.46
March $7,531.46
April $7,531.46
May $7,531.46
June $7,531.46
July $7,531.46
August $7,531.46
September $7,531.46
October $7,531.46
November $7,531.46
December $6,531.40
Total $89,377.46
Builders Risk Policies - the cost to handle this line of coverage is included.
2 (CAg
16E1
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AGREEMENT#11-5689
for
Brokerage and Insurance Coverage
THIS AGREEMENT,made and entered into on this rb44^day of t)orp 6.2A— 2011,
by and between Insurance and Risk Management Services,Inc., authorized to do business in
the State of Florida, whose business address is 8950 Fontana Del Sol Way,Suite 200, Naples,
Florida 34109, hereinafter called the "Consultant" and Collier County, a political subdivision
of the State of Florida,Collier County,Naples,hereinafter called the"County":
WITNESSETH:
1.. COMMENCEMENT. The Consultant shall commence the work on January 1,2012.
The contract shall be for a three (3) year period, commencing on January 1, 2012, and
terminating on December 31,2014.
The County may, at its discretion and with the consent of the Consultant, renew the
Agreement under all of the terms and conditions contained in this Agreement for two
(2) additional one (1) year periods.The County shall give the Consultant written notice
of the County's intention to extend the Agreement term not less than ten(10) days prior
to the end of the Agreement term then in effect.
2. STATEMENT OF WORK. The Consultant shall provide insurance brokerage services
in accordance with the Scope of Work, and terms and conditions of RFP #I1-5689 and
the Consultant's proposal referred to herein and made an integral part of, this
agreement. This Agreement contains the entire understanding between the parties and
any modifications to this Agreement shall be mutually agreed upon in writing by the
Consultant and the County Project or Contract Manager in compliance with the County
Purchasing Policy and Administrative Procedures in effect at the time such services are
authorized.
3. COMPENSATION: The County shall pay the Consultant for the performance of this
Agreement pursuant to the fees as set forth in Exhibit"A", included in this agreement,
together with the Travel and Reimbursable Expenses as defined in this agreement.
Payments shall be made to the Consultant not more frequently than once per month,
pursuant to Exhibit"A" and at actual costs for Travel Expenses. Payment will be made
upon receipt of a proper invoice and in compliance with Chapter 218 Fla. Stats., .
otherwise known as the"Local Government Prompt Payment Act".
3.1 Payments will be made for services furnished, delivered, and accepted, upon
receipt and approval of invoices submitted on the date of services or within six (6)
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months after completion of contract. Any untimely submission of invoices beyond
the specified deadline period is subject to non-payment under the legal doctrine of
"laches" as untimely submitted. Time shall be deemed of the essence with respect to
the timely submission of invoices under this agreement.
TRAVEL AND REIMBURSABLE EXFENSES 0
Travel and Reimbursable Expenses shall be reimbursed as per Section 112.061 Fla.Stats.
Reimbursements shall be at the following rates:
Mileage $0445 per mile
Breakfast $6.00
•
'Lunch $11.00
Dinner $19.00
Airfare Actual ticket cost limited to tourist or
coach class fare
Rental car Actual rental cost limited to compact or
standard-size vehicles
Lodging Actual cost of lodging at single
occupancy rate with a cap of no more
than$150.00 per night
Parking Actual cost of parking
Taxi or Airport Actual cost of either taxi or airport
Limousine limousine
Reimbursable items other than travel expenses shall be limited to the following:
telephone long-distance charges, fax charges, photocopying charges and postage.
Reimbursable items will be paid only after Consultant has provided all receipts.
Consultant shall be responsible for all other costs and expenses associated with activities
and solicitations undertaken pursuant to this Agreement.
4. SALES TAX. Consultant shall pay all sales, consumer, use and other similar taxes
associated with the Work or portions thereof, which are applicable during the
performance of the Work.
5. NOTICES. All notices from the County to the Consultant shall be deemed duly served
if mailed or faxed to the Consultant at the following Address:
Insurance and Risk Management Services,Inc.
8950 Fontana Del Sol Way,Suite 200
Naples,Florida 34109
Attention: William H. Kuhlman,Executive Vice President
Telephone: 239-649-1421
Facsimile: 239-649-7933
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All.Notices from the Consultant to the County shall be deemed duly served if mailed or
faxed to the County to:
Collier County Government Center
Purchasing Department
.3327 Tanvami Trail,East
Naples,Florida 34112
Attention:Steve Carnell,Purchasing/GS Director
Telephone: 239-252-8371
Facsimile: 239-252-6584
The Consultant and the County may change the above mailing address and/or contact
information at any time upon giving the other party written notification. All notices
under this Agreement must be in writing.
6. NO PARTNERSHIP. Nothing herein contained shall create or be construed as creating
a partnership between the County and the Consultant or to constitute the Consultant as
an agent of the County.
7. PERMITS: LICENSES: TAXES. In compliance with Section 218.80, F.S., all permits
necessary for the prosecution of the Work.shall be obtained by the Consultant. Payment
for all such permits issued by the County shall be processed internally by the County.
All non-County permits necessary for the prosecution of the Work shall be procured
and paid for by the Consultant The Consultant shall also be solely responsible for
payment-Of any and all taxes levied on the Consultant. In addition, the Consultant shall
comply with all rules, regulations and laws of Collier County,the State of Florida,or the
U: S. Government now in force or hereafter adopted. The Consultant agrees to comply
with all laws governing the responsibility of an employer with respect to persons
employed by the Consultant.
8. NO IMPROPER USE. The Consultant will not use, nor suffer or permit any person to
use in any manner whatsoever,County facilities for any improper,immoral or offensive
purpose, or for any purpose in violation of any federal, state, county or municipal
ordinance, rule, order or regulation, or of any governmental rule or regulation now in
effect or hereafter enacted or adopted. In the event of such violation by the Consultant
or if the County or its authorized representative shall deem any conduct on the part of
the Consultant to be objectionable or improper, the County shall have the right to
suspend the contract of the Consultant. Should the Consultant fail to correct any such
violation,conduct, or practice to the satisfaction of the County within twenty-four(24)
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16E
hours after receiving notice of such violation, conduct, or practice, such suspension to
continue until the violation is cured. The Consultant further agrees not to commence
operation during the suspension period until the violation has been corrected to the
satisfaction of the County.
9. TERMINATION. Should the Consultant be found to have failed to perform his
services in a manner satisfactory to the County as per this Agreement, the County may
terminate said agreement for cause; further the County may terminate this Agreement
for convenience with a thirty(30) day written notice. The County shall be sole judge of
non-performance.
10. NO DISCRIMINATION. The Consultant agrees that there shall be no discrimination
as to race, sex,color,creed or national origin.
11. INSURANCE. The Consultant shall provide insurance as follows:
A. Commercial General Liability: Coverage shall have minimum limits of $1,000,000
Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property
Damage Liability. This shall include Premises and Operations; Independent
Consultants; Products and Completed Operations and Contractual Liability.
B. Business Auto Liability: Coverage shall have minimum limits of $1,000,000 Per
Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage
Liability. This shall include: Owned Vehicles, Hired and Non-Owned Vehicles and
Employee Non-Ownership.
C. Workers' Compensation: Insurance covering all employees meeting Statutory
Limits in compliance with the applicable state and federal laws.
D. Professional Liability: Coverage shall have minimum limits of $1,000,000 Per
Occurrence.
Special Requirements: Collier County Government shall be listed as the Certificate
Holder and included as an Additional Insured on the Comprehensive General Liability
Policy. •
Current, valid insurance policies meeting the requirement herein identified shall be .
maintained by Consultant during the duration of this Agreement. Renewal certificates
shall be sent to the County ten(10) days prior to any expiration date. There shall be a
thirty (30) day notification to the County in the event of cancellation or modification of
any stipulated insurance coverage.
Consultant shall insure that all subConsultants comply with the same insurance
requirements that he is required to meet. The same Consultant shall provide County
with certificates of insurance meeting the required insurance provisions.
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12. INDEMNIFICATION. To the maximum extent permitted by Florida law, the
Consultant shall indemnify and hold harmless Collier County, its officers and
employees from any and all liabilities, damages, losses and costs, including, but not
limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the
negligence,recklessness, or intentionally wrongful conduct of the Consultant or anyone
employed or utilized by the Consultant in the performance of this Agreement. This
indemnification obligation shall not be construed to negate, abridge or reduce any other
rights or remedies which otherwise may be available to an indemnified party or person
described in this paragraph.
This section does not pertain to any incident arising from the sole negligence of Collier
County.
13. CONTRACT ADMINISTRATION. This Agreement shall be administered on behalf of
the.County by the Risk Management Department.
14. CONFLICT OF INTEREST: Consultant represents that it presently has no interest and
shall acquire no interest, either direct or indirect, which would conflict in any manner
with the performance of services required hereunder. Consultant further represents
that no persons having any such interest shall be employed to perform those services.
15. COMPONENT PARTS OF THIS CONTRACT. This Contract consists of the attached
component parts, all of which are as fully a part of the contract as if herein set out
verbatim: Consultant's Proposal, Insurance Certificate, RFP #11-5689
Specifications/Scope of Services and Addenda.
16. SUBJECT TO APPROPRIATION. It is further understood and agreed by and between
the parties herein that this agreement is subject to appropriation by the Board of County
Commissioners.
17. PROHIBITION OF GIFTS TO COUNTY EMPLOYEES. No organization or
individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee,
service or other item of value to any County employee,as set forth in Chapter 112,Part
III, Florida Statutes, Collier County Ethics Ordinance No. 2004-05, and County
Administrative Procedure 5311. Violation of this provision may result in one or more of
the following consequences: a. Prohibition by the individual, firm, and/or any
employee of the firm from contact with County staff for a specified period of time; b.
Prohibition by the individual and/or firm from doing business with the County for a
'specified period of time, including but not limited to: submitting bids, RFP, and/or
quotes; and, c. immediate termination of any contract held by the individual and/or
firm for cause.
18. _IMMIGRATION LAW COMPLIANCE. By executing and entering into this agreement,
the Consultant is formally acknowledging without exception or stipulation that it is
fully responsible for complying with the provisions of the Immigration Reform and
Control Act of 1986 as located at 8 U.S.C. 1324,et seq. and regulations relating thereto,
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as either may be amended. Failure by the Consultant to comply with the laws
referenced herein shall constitute a breach of this agreement and the County shall have
the discretion to unilaterally terminate this agreement immediately.
19. OFFER EXTENDED TO OTHER GOVERNMENTAL ENTITIES. Collier County
encourages and.agrees to the successful proposer extending the pricing, terms and
conditions of this solicitation or resultant contract to other governmental entities at the
discretion of the successful proposer.
20. AGREEMENT TERMS. If any portion of this Agreement is held to be void,invalid, or
otherwise unenforceable, in whole or in part, the remaining portion of this Agreement
shall remain in effect.
21. ADDITIONAL ITEMS/SERVICES. Additional items and/or services may be added to
this contract upon satisfactory negotiation of price by the Project or Contract Manager
and Consultant.
22 DISPUTE RESOLUTION. Prior to the initiation of any action or proceeding permitted
by this Agreement to resolve disputes between the parties,the parties shall make a good
faith effort to resolve any such disputes by negotiation. The negotiation shall be
attended by representatives of Consultant with full decision-making authority and by
County's staff person who would make the presentation of any settlement reached
during negotiations to County for approval. Failing resolution, and prior to the
commencement of depositions in any litigation between the parties arising out of this
Agreement,the parties shall attempt to resolve the dispute through Mediation before art
agreed-upon Circuit Court Mediator certified by the State of Florida. The mediation
shall be attended by representatives of Consultant with full decision-making authority
and by County's staff person who would make the presentation of any settlement
reached at mediation to County's board for approval. Should either party fail to submit
to mediation as required hereunder, the other party may obtain a court order requiring
mediation under section44.102,Fla.Stat.
Any suit or action brought by either party to this Agreement against the other party relating to
or arising out of this Agreement must be brought in the appropriate federal or state courts in
Collier County,Florida,which courts have sole and exdusive jurisdiction on all such matters.
23. KEY PERSONNE!JPROIECT STAFFING: The Consultant's personnel and
management to be utilized for this project shall be knowledgeable in their areas of
expertise. The County reserves the right to perform investigations as may be deemed
necessary to insure that competent persons will be utilized in the performance of the
contract. The Consultant shall assign as many people as necessary to complete the
project on a timely basis, and each person assigned shall be available for an amount of
time adequate to meet the dates set forth in the Project Schedule. The Consultant shall
not change Key Personnel unless the following conditions are met (1) Proposed
replacements have substantially the same or better qualifications and/or experience. (2)
that the County is notified in writing as far in advance as possible.The Consultant shall
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make commercially reasonable efforts to notify Collier County within seven (7) days of
the change. The County retains.final approval of proposed replacement personnel.
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IN WITNESS WHEREOF, the Consultant and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date and year first
above written.
BOARD OF COUNTY COMMISSIONERS •
.�' -3`'x'0 COLLIER COUNTY,FLORIDA
ATTFS� .-
Dwai- ;'f E ie c, ei erlc of Courts � n
------7:',:" , , a . `i ce. Co-t3„,k .
,y x I 114,Y sel.,. e _ By'
Dated -X - Fred W.Coyle, Chairman
Attest::;.tt, i-0i`it i
ignaturt M*.j :
Insurance and Risk Management Services,Inc.
/ Consultant
it itness Signature
1
Gary Eakin
tType/ witness namet
, ` 5 A n.
„ William Kuhlma , Jr.
Second Witness Typed signature and title
Diana Turner
1'Type/print witness name T
Approved as to form and
legal sufficiency:
clii.i/<1 i-----
959
A to *County Attorney
(.5 Go# /2 ."4-A-A-L._
Print Name
Page 8 of 9
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• EXHIBIT A
PAYMENT SCHEDULE
01/01/2012 to 12/31/2014
Agreement No.11-5689
"Property Casualty Insurance Broker"
Month 01/01/2012 to 12/31/2014
January $10,500
February $10,500
March $10,500
April $10,500
May S10,500
June $10,500
July $10,300
August $10,500
September $10,500
October $10,500
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November $10,500
December $9,500
Totals $125,000
In accordance with Florida Statutes 626.572, the Consultant shall be permitted to accept a reduced
commission to be no greater than eight and one-half percent (8.5%) on all National Flood Insurance
policies placed on behalf of the County and the acceptance of .these commissions shall not be
considered a violation of this agreement. This shall include all National Flood Insurance policies with
the commencement dates prior to and subsequent to the effective date of this agreement.
Builders Risk Policies-the cost to handle this line of coverage is included.
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, • may, dOP.ID:DO
ahcElMYfoDtYwY1
;pact RIO: ` CERTIFICATE OF LIABILITY INSURANCE ;, 1,tt
—
THIS CERTIFICATE IS:ISSUED:AS A'MATTER OF INFORMATION ONLY AND CONFERS NO.RIGHTS UPON THE CERTIFICATE HOLDER.THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,.EXTEND OR:ALTER THE COVERAGE'AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES'NOT-CONSTITUTE A CONTRACT'BETWEEN THE ISSUING INSURER(SI,AUTHORIZED
REPRESENTATIVE OR-PR000CER,AND THE CERTIFICATE HOLDER.
IMPORTANT: If the certificate holder.is an.ADDITIONAL INSURED,the,poftcy(ies)must be endorsed. If SUBROGATION IS WAIVED,subject to
the terms and conditions'Of the policy,certain policies may require an endorsement A statement on'thla certificate does not confer rights•tto the
certificate holder in lieu of such endorsements).
- _4 CONTACT —
PRODUCER .. . ..23944941 iii NAME: FAx ----
Services,and Risk Management 239449.7933 IM N;.r,m; • I•AM.Not:
Services,Inc.. ......... f .__. _.._.____�• eaMAiL ..
8950 Fontana Del 90l Way 1X200 • ADDR ••• •••••--•----
Naples,FL.34t09.4374 FROtlU t ---
Samuel R.Neidigti,ARM,AAE NSi F. ...._
INSURES AFFORDING ODVERAGe NNG A
F
MIMED Insurance and Rlsk•Managerement INSUt Ca A;raiate.I Vuetinau,enee Ca 120141•
Services,Inc. t •aauaeR s:Foci Inswanu cameos. --- 10178
I 8960 Fontana Del Sol Way,;#200 IUSORe•c:Wedpcdinswanosaoriicmtion 134207
Naples,FL 349:09 INBNREx.D;_ _ ____— — ..._
• DIStCR91 E: ....___...* •----
INSURER•F: •
COVERAGES CERTIFICA.TE'NUMBER: ___ R£VISION.NUMBER:
THIS IS TO:CERTIFY THAT'TWE'POLIO1ES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED'•NAMED ABOVE.FOR TI•IE.POLICY•PERIOD
INDICATED. NOTWITHSTAT;DING ANY REQUirtEMENT.TERN OR CONDITION.OF ANY COt RACT OR OTHER.DOCUMENT WITH.RESPECT TO WHICH THIS
CFRTFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES'DESCRIBED HFRf1N IS SUBJECT TO ALL THE TERMS.
EXCLUSIONS AND CONDITIONS CF SUCH POLICIES.LIMITS SI+OWN MAY HAVE BEEN'REDUCER.BY PAID CLAIMS:
MEV ' _—^`_.....-._Tl%o-uePTer.._.p5[ItY-G wleRa __ •
LTR; TYPE OF WE/RANCE ,1 1 NURSER LisiNo0.MYtry1.It ntro rrer) _
I i GENERAL L1ABR.ITY r 1 EACii OCCURRENCE $ 1.10_00,00,
, 7".146E.T REIrEts5.._.... 10_0,00/
A !X COMt1ERCaAL.GENERAL LIABILITY X L04094803 I It/1501 ttfl3ltZ PREMISES(Eeoc�ulrmtcll •.
w.__ 600
i C1.:F.154 ASS i X j occult 'met Facp tAr�,i Drat,pawn) —S
• 1,000;01g
•
41�FRSONAt;a•FRA/wJUR'C s
.--I GENERALAGGREC)ATE S
GEHLAGGREOA-eE LEAD' PRODUCTS.O.OMPRIPAGG_:s IncIttd_:.
i - rs Exclude
Po cc..r PRO- : I Lac inp Ben:•
i ;AUTOMOMELIABILITY =MIF RINGtELIMIT. $, 1,600,0.''
i
B — ( tEs aecaenll
ANY AUTO • �A441•4746 T 1
i .
MI:MYINi/0Y____m+I :N
i-•--. AL.O CDgtrrt:; i i DOOCY'INJURY IPrsc l S .._....___..._
I SCHEDULED AU7'CJS ft(ROPERTY DAMAGE
i A - CPreWslent1. $
!X F� AU as s—
I X 1 NON-OWNED _....... -.:i._ i
i-•--1 1 L
I
I X i UM aRELL UAe ••I.X. OCCUR I — - EACI;OOOURR2t ._-_ s__ 5;000.000'
C �ExCEsSUAa AGGREGATE •S 5,000,000'
I _ _ I C;LgIMS4RADEr ennmuscoss sce 11/1$/11 71116112 ,—•^"'"'-''
`±`DEDUCTIBLE I __ :$ I
1 X I RErENTDN s. 10,000 _� —. LvGSfATkI I 0_x• t i
WORKERS COMPENSATION _-._ x!TORY UNITS;_—iEli--
1 AND EMPLOYERS'IJAaILITT Y/N -- 50o,6DD1
:B i ANY PROPRIETORAARTNE7t/EIECJrWE?". pOlWO1UtAT9SO 06/01111 06/01/1:2 `E_FAC7f ACQOENT :S•
OFFICS,R/FAEMBEREXCLUDED?. N1A. ..-- '500,0_60:
t andamry In NH) S. DISEASE...EA EMPLOYEE'S—_
I,yes:derdbe under SL a__.-..PO.---- tr i s Stltl,00fli
DESCRIPTION OF OPERATIONS below --,-, -
I
_ _•
.DESCRIPTION.OF.OPERATONS/LOCATIONS/VENICLES fANaah'ACORD in AddIeaul Nxmatts Schein.,It mom speev ae m,Wlred)
In reference to Contract#41869"Property&Casualty Insurance Broker".
Corker County is:listed as an additional Insured with respects.to'Generai
Liability
CERTIFICATE:HOLDER CANCELLATION
COLLCO2
SHOULD.ANY OF THE ABOVE'OESCRIBED.POUCIES'BE CANCELLED BEFORE
Co111ef�0URt BOafti.Of CCSIIn ms EXPIRATION. DATE THEREOF., NOTICE 'WILL BE DELIVERED IN
y ty AC,RORDANCE WITH.TIE POLICY pleCtriSioNs.
Co TnmISsloners
.3301 EaSt 12 i Trail AUTNOR REPReaENTATIVE
341 •
Naples,FL 344'12 -s
'1@ 198 •2009ACORD CORPORATION. Alt rights reserved.
•ACORD 26(2009/09) The.ACORD name and logo are registered marks of ACORD
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WESTPORT INSURANCE CORPORATION
CERTIFICATE•OF'INSU RAN CE
([maims First Made}
Issue Date; 11./TS/.2 01.1
Certificate Holder:
COLLIER COUNTY GOVERNMENT
BOARD OF COUNTY COMMISSIONERS
3301 TAMIAMI TRAIL E BLDG G
NAPLES, FL 3 .112
This is to certify that the named insured is covered by the insurance policy described below issued by Westport lnsuranec
Corporation of Overland Park,Kansas.Coverage afl'ordcd the named insured is subject to•all terms,.exclusions;limitations and
conditions of such policy, Limits shown may have been reduced by paid claims: This certificate of insurance does not
affirmatively or negati ely amend,extend,or alter the coverage afforded by the.insurance policy.
TYPE OF INSURANCE: Insurance Agents Errors& Omissions Liability
POLICY NU MBER:WED4F1,005847806
NAMED INSURED: INSURANCE AND RISK MANAGEMENT SERVICES,INC
OTHER.INSUREDS AS DEFINED€N.POLICY: •
Policy Aggregate Limit of:L:iability for ails "coverage.units":510;000,000
IT CLAIMS EXPENSES ARE IN ADDITION TO THE LIIET OF LIABILITY FOR THE COVERAGES
PROVIDED BY THE ABOVE:POLICY NUMBER
El CLAIMS EXPENSES ARE:INCLUDED"WITHIN THE LIMIT OF LIABILITY FOR THE
COVERAGES PROVIDED BY THE ABOVE POLICY NUMBER
Limits of Liability: $10,.000,000 Per Claim
.SI0,000,000 • Aggregate for'thc Policy Period
Suhlimit olLiability for BREACH OF PERSONAL DATA; NO COVERAGE Per Claim
NO.COV ERAGE Aggregate for the Policy Period
Deductible: $ 25,000 'Pei Claim
$ 75,000 hggrcgntc:For the Policy Period
Retroactive Date: Full Prior Acts
EFFECTIVE DATE: FROM: November€5,201I TO: November:i5;2012
By the issuance of this Certificate, Westport Insurance Corporation assumes no obligation to provide notice of
change in or cancellation of the policy.
WESTPORT INSU RANCE CORPORATION
Authorized Representative
SP 000 260 0610
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