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Agenda 12/01/2009 Item #16K 6 Agenda Item No. 16K6 December 1, 2009 Page 1 of 83 ,''''''"''' EXECUTIVE SUMMARY Recommendation to approve a Retention Agreement for legal services on an "as needed" basis with the law firm of Grant Fridkin Pearson Athan & Crown, P.A. OBJECTIVE: To obtain approval of a Retention Agreement with Grant Fridkin Pearson Athan & Crown, P,A., to provide outside legal services on an "as needed" basis. CONSIDERATIONS: Attached for the Board's review and approval is a Retention Agreement with the law firm of Grant Fridkin Pearson Athan & Crown, P.A. ("Grant Fridkin"), which is a local Naples law firm currently being used by the County to defend against a pending contract dispute filed in Collier County. This request seeks approval of the Retention Agreement so that the County may retain Grant Fridkin on an as-needed basis to provide representation on other matters where their specialized legal services may be of assistance, .-"'- The attached Retention Agreement does not address any specific project or assignment but rather sets forth the criteria under which payment will be made when services are requested, Although this firm has a wide array of legal expertise, the County generally requests services on an as, needed basis in the area of construction law, contract disputes, employment disputes, and litigation, including related administrative, executive, and judicial hearings, appeals, and negotiations. The rates charged by this firm varies, as with any law finn, depending upon the attorney working on the matter and the other resources that are necessary to provide the County with the services it requests. The proposed agreement also provides for reimbursement of actual out-of-pocket expenses to make clear that lodging and traveling expenses are to be paid in accordance with Section 112.061, Florida Statutes. It is not anticipated, however, that such expenses are likely to be incurred as this law firm is a local Naples firm. [n an attempt to make the outside counsel retention agreements more unifonn, the proposed Retention Agreement is substantially identical to others recently approved by the Board of County Commissioners. FISCAL IMPACT: The approval and execution of the proposed Retention Agreement has no fiscal impact in and of itself, but there will be a fiscal impact in accordance with the temlS and conditions of such contracts, upon the County's request for legal services. GROWTH MANAGEMENT IMPACT: None RECOMMENDATION: That the Board approve and authorize the Chaimlan to execute the attached Retention Agreement with the Jaw firm of Grant Fridkin Pearson Athan & Crown, P,A., for specialized legal services requested on an as-needed basis, Prepared by: Jeffrey A. Klatzkow, County Attorney 04-COA-01158/2844 - - -._--..~._,.., ,_ r, , 0."'..-'"""".'.'1"......."..- "__..-"'_.._~__,, .__.. m .. Agenda Item No. 16K6 December 1, 2009 Page 2 of 83 ,.-. COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS Item Number: Item Summary: 16K6 Recommendation to approve a Retention Agreement for legal services on an as needed basis with the law firm of Grant Fridkin Pearson Athan & Crown, PA 1211120099:00:00 AM Meeting Date: Prepared By Jeff Klatzkow County Attorney Date 11/17/200910:09:12 AM Approved By Scott R. Teach Deputy County Attorney Date County Attorney County Attorney 11/17/200910:25 AM Approved By Jeff Klatzkow County Attorney Date 11/17/20092:30 PM Approved By OMS Coordinator Date County Attorney County Attorney 11/18120099:46 AM Approved By John A. Yonkosky Director. Management and Budget Date Office of Management & Budget Office of Management & Budget 11118/20094:18 PM c___ -..~-,~.- _...._u~~__''''''"_~~.,,.._. _ ,.. ",-----,-_._-'''''' r----.--._n- ..---- Agenda Item No. 16K6 December 1, 2009 Page 3 of 83 RETENTION AGREEMENT WITH GRANT. FRIDKIN. PEARSON. ATHAN & CROWN. P.A. This Retention Agreement is made by and between the Board of COWlty Commissioners of Collier COWlty, Florida (the "COWlty"), and the law firm of Grant, Fridkin, Pearson, Athan & Crown, P.A. of Naples, Florida ("Grant Fridkin"). Whereas, Grant Fridkin has special expertise and resources in a wide range of legal matters, with particular expertise in construction law, contract disputes, employment disputes, and litigation, including related administrative, executive, and judicial hearings, appeals, negotiations; and Whereas, the COWlty from time to time has a requirement and need for legal services which are particularly within the expertise of Grant Fridkin; Now, therefore, in consideration of the premises contained herein, the COWlty hereby hires and retains Grant Fridkin and Grant Fridkin hereby agrees to provide legal services to COWlty. ARTICLE 1 COMPENSATION; METHOD OF PAYMENT \.I Compensation shall be paid to Grant F ridkin in accordance with the terms set forth in Exhibit "A" attached hereto and made a part hereof. Requirements for reimbursable expenses are set forth in Exhibit "8," attached hereto and made a part hereof. Expenses other than automobile expenses must be documented by copies of paid receipts or other evidence of payment. The Certificate contained in Exhibit "e" must be included with every invoice submitted for payment. 1 Agenda Item No. 16K6 December 1, 2009 Page 4 of 83 r" 1.2 The rates set forth in Exhibit "A" shall remain in effect without change for a minimum of two (2) years from the effective date of this Agreement In the subsequent years of the Agreement, upon the request of Grant Fridkin, the County Attorney is authorized to negotiate to increase the hourly rate up to a maximum of ten (10) percent without approval by the Board of County Commissioners. In the negotiation process, Grant Fridkin must substantiate the reason the request is being made (i.e. market conditions, increase in CPI, etc,) 1.3 Multiple Attorney Assignments. The County acknowledges that, from time to time, it may be advisable for Grant Fridkin to assign more than one attorney to a project or case, Nevertheless, in order to ensure that such multiple attorney assignments are efficient and cost-effective for the County, Grant Fridkin agrees to the following procedures and billing limitations for multiple attorney . asSIgnments, 1.3.1 A primary attorney will be identified for such projects or cases and that attorney will be the contact attorney for the County except in the case of an emergency or the County's written pre"approval. In practice, this means that generally only the primary attorney will meet or communicate directly with County personnel or attend meetings, court, arbitrations, mediations or other proceedings on behalf of the County. 1.3.2 Attorneys assigned to a project or case other than the primary attorney will be less senior attorneys with lower billing rates unless the additional attorney(s) haslhave a demonstrated expertise that will demonstrably enhance the value and efficiency of the legal services being provided to the County. 2 -- ,...--.-.. -, - --,._~ -..... .-. ..,-----..-.,--...,.. r------.----. , __"'0"" Agenda Item No. 16K6 December 1. 2009 Page 5 of 83 1.3.3 Grant Fridkin agrees that internal or in-house conferences among multiple attorneys assigned to a project or case shall be kept to the minimum reasonably necessary for the provision of the legal services in question. To the extent internal or in-house conferences among multiple attorneys assigned to a project or case are necessary, each such attorney may bill his or her customary rate for up to thirty (30) minutes for any such conference. To the extent such a conference exceeds thirty (30) minutes in length, Grant Fridkin agrees that it will discount the total billings for all attorneys involved in the conference by forty-five (45) percent. 1.4 Grant Fridkin may submit invoices for hourly work assignments pursuant to Exhibit "An only after the seIVices for which the invoices are submitted have been completed or expenses incurred, An original invoice plus one copy is due within fifteen (15) days of the end of the month, except the final invoice which must be received no later than sixty (60) days after the work is completed or the expiration of this Agreement. 1.5 To be deemed proper, all invoices must comply with the requirements set forth in this Agreement and must be submitted on the fonn and pursuant to the instruction prescribed by County, Payment may be withheld for failure of Grant Fridkin to comply with a tenn, condition, or requirement of this Agreement. 1.6 Payment shall be made to Grant Fridkin at: Grant Fridkin, Pearson, Athan & Crown, P .A. 5551 Ridgewood Drive Suite 50 I Naples, FL 34108 3 -- Agenda Item No. 16K6 December 1, 2009 Page 6 of 83 ,.-,,.,. ARTICLE 2 INSURANCE 2.1 In order to insure the indemnification obligation contained above, Grant Fridkin shall as a minimum, provide, pay for, and maintain in force at all times during the term of this Agreement, professional liability insurance in an amount not less than Three Million Dollars ($3,000,000,00) Per OccUITence, Combined Single Limits. If any liability insurance obtained by Grant Fridkin to comply with the insurance requirements contained herein is issued on a "claims made" fonn as opposed to an "occUITence" form, the retroactive date for coverage shall be no later than the commencement date of the ,- assigned work to which this Agreement applies, and such insurance shall provide, in the event of cancellation or non-renewal, that the discovery period for insurance claims (tail coverage) shall not be less than three years following the completion of the assigned work and acceptance by the County. 2.2 Such policy or policies shall be issued by United States Treasury approved companies authorized to do business in the State of Florida, and having agents upon whom service of process may be made in Collier County, Florida. 2.3 Grant Fridkin shall furnish to the Risk Management Director Certificates of Insurance or endorsements evidencing the insurance coverages specified by this Article prior to beginning performance of work under this Agreement 4 -- ...._- -... ,. 'C~__-=- ., -,_.-.~.._-----"-- , Agenda Item No. 16K6 December 1, 2009 Page 7 of 83 ARTICLE 3 TERM AND TIME OF PERFORMANCE 3.1 The term of this Agreement shall be for a period of two (2) years to begin December 10, 10,2009 and to end on December 9, 2011, unless terminated earlier in accordance with the provisions of this Agreement. Absent notice of intent to terminate, the Agreement may be renewed upon mutual consent of the parties for three (3) additional terms of one (I) year each. In the event the term of this Agreement extends beyond a single fiscal year of County, the continuation of this Agreement beyond the end of any fiscal year shall be subject to the availability of funds from County in accordance with Chapter 129, Florida Statutes. 3.2 Time shall be deemed to be of the essence in performing the duties, obligations and responsibilities by this Agreement. 3.3 Any amendments, alterations, variations, modifications or waivers of provisions of this Agreement shall only be valid when they have been reduced to writing, duly signed by both parties hereto, and attached to the original of this Agreement. ARTICLE 4 TERMINATION 4.1 This Agreement may be terminated by either party for cause upon ten (J 0) days' notice or by either party for convenience upon no less than thirty (30) days' advance written notice in accordance with the "NOTICES" section of this Agreement. 5 Agenda Item No. 16K6 December 1, 2009 Page 8 of 83 --', 4.2 Termination of this Agreement for cause shall include, but not be limited to, failure to suitably perform the work, failure to continuously perform the work in a manner calculated to meet or accomplish the objectives of County as set forth in this Agreement, or multiple breach of the provisions of this Agreement notwithstanding whether any such breach was previously waived or cured, 4.3 In the event this Agreement is terminated for convenience, Grant Fridkin shall be paid for any services performed to the date the Agreement is terminated; however, upon notice by . either party to terminate, Grant Fridkin shall refrain from performing further services or incurring additional expenses under the term of this Agreement. Grant Fridkin acknowledges and agrees that Ten Dollars ($10) of the compensation to be paid by County, the adequacy of which is hereby acknowledged by Grant Fridkin, is given as n_"', specific consideration to Grant Fridkin for County's right to terminate this Agreement for convenience. Grant Fridkin' obligations to the County as provided for hereunder shall cease upon termination, except for participating in an orderly and professional transfer of such responsibilities and files or copies of files to the County or its designee. ARTICLE S RECORD AUDIT AND INSPECTION 5.1 County shall have the right to audit the books and records of Grant Fridkin pertinent to the funding under this Agreement. Grant Fridkin shall preserve and make available, at reasonable times for examination and audit by County, all financial records, supporting documents, and other documents pertinent to this Agreement for a period of three (3) years after termination of this Agreement or, if any audit has been initiated and audit .---~~, 6 -.,-_.~.~ .. "",,-,~~,-~'~".,_..~-...--',- '-- -~_.- ---~,~..... -'- f "----""-"-". -- , --- Agenda Item No. 16K6 December 1, 2009 Page 9 of 83 findings have not been resolved at the end of the three years, the books and records shall be retained until resolution of the audit findings. 5.2 If the Florida Public Records Act (Chapter 119, Fla. Stat.) is determined by County to be applicable to Grant Fridkin' records, Grant Fridkin shall comply with all requirements thereof, however, no confidentiality or non-disclosure requirement of either federal or state law shall be violated by Grant Fridkin. ARTICLE 6 CONFLICT OF INTEREST 6.1 Grant Fridkin states that it is familiar with and will comply with the terms and conditions of Chapter 112, Part III, Florida Statutes (Code of Ethics). 6.2 It is important that Grant Fridkin be independent and impartial in order to properly conduct its services to the County. Grant Fridkin shall not act as counsel in any lawsuit or other adversary proceeding in which County is named as an adversary party or in which Grant Fridkin takes an adverse position to the County. 6.3 Neither Grant Fridkin nor its employees shall have or hold any continuing or frequently recurring employment or contractual relationship that is substantially antagonistic or incompatible with Grant Fridkin' loyal and conscientious exercise of judgment related to its performance under this Agreement. 6.4 In the event Grant Fridkin is permitted to utilize subcontractors, herein, to perform any services required by this Agreement, Grant Fridkin agrees to prohibit such subcontractors, by written contract, from having any conflicts as within the meaning of this section. 6.5 If at any time Grant Fridkin' firm represents a client in matters having to do with the Collier County government, be it before the Board of County Commissioners or any other 7 Agenda Item No. 16K6 December 1, 2009 Page 10 of 83 ,- ( agency or division of Collier County government, Grant Fridkin will contact the County Attorney's Office before undertaking such representation so that it can be determined whether a conflict of interest exists. ARTICLE 7 INDEMNIFICATION 7.1 Grant Fridkin acknowledges and agrees that Ten Dollars ($10.00) of the compensation to be paid by County, the adequacy of which is hereby acknowledged by Grant Fridkin, is given as specific consideration to Grant Fridkin so that Grant Fridkin shall at all times hereafter indemnify, hold harmless and, at County's option, defend or pay for an attorney selected by County to defend County, its officers, agents, servants, and employees against any and all claims, losses, liabilities, and expenditures of any kind, including attorney "._~ fees, court costs, and expenses, caused by negligent act or omission of Grant Fridkin, its employees, agents, servants, or officers, or accruing, resulting from, or related to the subject matter of this Agreement including, without limitation, any and all claims, demands or causes of action of any nature whatsoever resulting from injuries or damages sustained by any person or property. The provisions of this section shall survive the expiration or earlier termination of this Agreement To the extent considered necessary by County, any sums due Grant Fridkin under this Agreement may be retained by County until all of County's claims for indemnification pursuant to this Agreement have been settled or otherwise resolved; and any amount withheld shall not be subject to payment of interest by County, -"_. 8 .'-.-.---,--..."..-.....--,-".-.- ._...... -......----.-......-...... -- _._'"---''' 1--- ---,- Agenda Item No. 16K6 December 1, 2009 Page 11 of 83 ARTICLE 8 OWNERSHIP OF DOCUMENTS 8.1 Any and all reports, photographs, surveys, and other data and documents provided or created in connection with this Agreement are and shall remain the property of County. In the event of termination of this Agreement, any reports, photographs, surveys, and other data and documents prepared by Grant Fridkin, whether finished or unfinished, shall become the property of County and shall be delivered by Grant Fridkin to the County within seven (7) days of termination of this Agreement by either party, Any compensation due to Grant Fridkin shall be withheld until all documents are received as provided herein. ARTICLE 9 INDEPENDENT CONTRACTOR 9.1 Grant Fridkin is an independent contractor under this Agreement. Services provided by Grant Fridkin shall be subject to the supervision of Grant Fridkin, and such services shall not be provided by Grant Fridkin as officers, employees, or agents of the County, The parties expressly acknowledge that it is not their intent to create any rights or obligations in any third person or entity under this Agreement. ARTICLE 10 NONDISCRIMINATION, EQUAL OPPORTUNITY AND AMERICANS WITH DISABILITIES ACT 10.1 Grant Fridkin shall not unlawfully discriminate against any person in its operations and activities in its use or expenditure of the funds or any portion of the funds provided by 9 Agenda Item No, 16K6 December 1, 2009 Page 12 of 83 '~-"" this Agreement and shall affirmatively comply with all applicable provisions of the Americans with Disabilities Act (ADA) in the course of providing any services funded in whole or in part by County, including Titles I and II of the ADA (regarding nondiscrimination on the basis of disability), and all applicable regulations, guidelines, and standards. I 0.2 Grant Fridkin' decisions regarding the delivery of services under this Agreement shall be made without regard to or consideration of race, age, religion, color, gender, sexual orientation national origin, martial status, physical or mental disability, political affiliation, or any other factor which cannot be lawfully or appropriately used as a basis for service delivery, 10.3 Grant Fridkin shall comply with Title I of the Americans with Disabilities Act regarding --'-' nondiscrimination on the basis of disability in employment and further shall not discriminate against any employee or applicant for employment because of race, age, religion, color, gender, sexual orientation, national origin, marital status, political affiliation, or physical or mental disability. In addition, Grant Fridkin shall take affirmative steps to ensure nondiscrimination in employment against disabled persons. Such actions shall include, but not be limited to, the following: employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff, termination, rates of pay, other forms of compensation, terms and conditions of employment, training (including apprenticeship), and accessibility, 10,4 Grant Fridkin shall take affirmative action to ensure that applicants are employed and employees are treated without regard to race, age, religion, color, gender, sexual ._~- orientation, national origin, marital status, political affiliation, or physical or mental 10 - ~,-. . -.-.,,- -._..,-,_...._"'-'''"~.... .~_...=."_.~--....,"..-- r ..- ..--.,,---~,----_...- Agenda Item No. 16K6 December 1, 2009 Page 13 of 83 disability during employment. Such actions shall include, but not be limited to, the following: employment, upgrading, demotion, transfer, recruitment or recruitment advertising, layoff, termination, rates of pay, other forms of compensation, terms and conditions of employment, training (including apprenticeship), and accessibility. 10.5 Grant Fridkin shall not engage in or commit any discriminatory practice in performing the Scope of Services or any part of Scope of Services of this Agreement. ARTICLE 11 NOTICES 11.1 Whenever either party desires to give notice to the other, such notice must be in writing, sent by registered or certified United States Mail, postage prepaid, return receipt requested, or by hand-delivery, addressed to the party for whom it is intended at the place last specified, The place for giving notice shall remain the same as set forth herein until changed in writing in the manner provided in this section. For the present, the parties designate the following: FOR COLLIER COUNTY: Jeffrey A. Klatzkow, County Attorney Government Center 3301 Tamiami Trail East Naples, Florida 34112 FOR GRANT FRIDKIN: Gregory N. Woods Grant Fridkin, P.A, 5551 Ridgewood Drive, Suite 501 Naples, FL 34108 II Agenda Item No. 16K6 December 1, 2009 Page 14 of 83 -~... ARTICLE 12 MISCELLANEOUS 8.1 WAIVER OF BREACH AND MATERIALITY Failure by County to enforce any provision of this Agreement shall not be deemed a waiver of the provision or modification of this Agreement A waiver of any breach of a provision of this Agreement shall not be deemed a waiver of any subsequent breach and shall not be construed to be a modification of the terms of this Agreement. 8.1 COMPLIANCE WITH LAWS Grant Fridkin shall comply with all federal, state, and local laws, codes, ordinances, rules, and regulations in performing its duties, responsibilities, and obligations related to this .. Agreement. 12.3 SEVERANCE In the event a portion of this Agreement is found by a court of competent jurisdiction to be invalid, the remaining provisions shall continue to be effective unless County and Grant Fridkin elect to terminate this Agreement. The election to terminate this Agreement based upon this provision shall be made within seven (7) days after the finding by the court becomes final. 12.4 APPLICABLE LAW AND VENUE This Agreement shall be interpreted and construed in accordance with and governed by the laws of the State of Florida. Venue for litigation concerning this Agreement shall be in Collier County, Florida. . 12 -.."'----..*--.....-...-" ...._--'~ - -~~.~'..-.~-- -.__w.~~'.,"__;".._.._.._ - "--~'"-'- -_....-----,- , Agenda Item No. 16K6 December 1, 2009 Page 15 of 83 12.5 PRIOR AGREEMENTS This document supercedes all prior negotiations, correspondence, conversations, agreements, and understandings applicable to the matters contained herein and the parties agree that there are no commitments, agreements or understandings concerning the subject matter of this Agreement that are not contained in this document. Accordingly, the parties agree that no deviation from the terms hereof shall be predicated upon any prior representations or agreements, whether oral or written. It is further agreed that no modification, amendment or alteration in the terms or conditions contained herein shall be effective unless contained in a written document in accordance with Article 3 above. 12.6 INCORPORATION BY REFERENCE The truth and accuracy of each "Whereas" clause set forth above is acknowledged by the parties. The attached Exhibits "A," "B," and "C" are incorporated into and made a part of this Agreement. DATE: December 10, 2009 BOARD OF COUNTY COMMISSIONERS OF COLLIER COUNTY, FLORIDA A ITEST: DWIGHT E. BROCK, CLERK By: DONNA FIALA, CHAIRMAN to form and . Klatzkow ttorney L3 , Agenda Item No. 16K6 December 1, 2009 Page 16 of 83 ~ GRANT, FRIDKIN, PEARSON, ATHAN & CROWN, P.A. By: Its: S~ STATE OF FLORIDA COUNTY OF COLLIER The foregoing Retention Agreement was acknowledged before me this -'~ ~day of ,2ool by G-n'5ory lDoocb er of Grant Fridkin, P.A., a Florida Professional Association, on behalf of the professional association.@he i~onaljY) (lffio~ to ~or produced as identification. . --,~-. ~YD.8WNIIIClN MY COMMISSION' DO 519153 EXPtRES: Julo 18, 2010 ... .1'RN~I\Mo:UII.,*" Public Kim\Jey[~ D S\AUY1'SOn Name of Notary ubIic typed, printed or My Commission Expires: -" 14 ~'------_.-- .._-.~.,,- .. .,-- , ----.- --" , r ..- -- ---"._~------'--. -" -- .","-._~._,~~'. -"--.'- ,._-~..."." Agenda Item No. 16K6 December 1, 2009 Page 17 of 83 EXHIBIT A For professional services rendered, Grant Fridkin' fee shall be based on the hourly rate as follows: Gregory N. Woods $300.00 per hour All other Partners $300.00 per hour Associates $200,00 per hour Paralegals $100.00 per hour Grant Fridkin's fee shall not exceed $100,000,00 per new matter assigned without the approval of the Board of County Commissioners, Any expenditure beyond the initial $100,000.00 approval by the Board of County Commissioners must have Board approval prior to work being performed, (Where appropriate a "not to exceed" swn shall be agreed to when each assignment is made to Grant F ridkin.) In the event that Grant Fridkin is required or requested to perform any additional or extraordinary services not herein contemplated, Grant Fridkin shall be entitled to apply for additional compensation, the amount of which shall be subject to the approval of County and no such additional compensation in excess of the amount herein stated shall be paid unless specifically authorized in advance by County in its sole discretion. Grant Fridkin shall provide, at no cost to County, the annual response to County's auditors regarding pending or threatened litigation. The auditors typically request information regarding all litigation, claims and assessments considered to be material, The response should include the nature of the litigation, the progress of the case to date, an estimate of the amount or range of potential loss, and any other information considered necessary to explain the case. Grant Fridkin shall provide said response within 30 days of receipt of the request NOTES: . Divisions, or departments within such divisions, shall be responsible and pay for legal counsel services relating to litigation and outside counsel specifically for cases, matters or issues relating to such division or department, as determined by the County Attorney in coordination with the County Manager. 15 Agenda Item No. 16K6 December 1, 2009 Page 18 of 83 .-,,- EXHIBIT B I. In addition to the charges for professional fees set forth in Exhibit "A," and the Schedules attached hereto, County shall reimburse Grant Fridkin for out-of-pocket expenses reasonably incurred in the course of rendering such legal services, including costs of long distance calls, printing, costs of reproduction, and necessary travel expenses incurred in accordance with the requirements of Chapter 112, F .S. Grant Fridkin shall not charge for travel of attorneys between its offices so that it can provide the best available and most appropriate lawyer in any of its office locations for the issues involved. 2. Grant Fridk41 shall submit invoices on a monthly basis for the payment of out-of- pocket expenses. Each invoice shall include a signed certificate listing all costs, expenses, vouchers, invoices and other docwnentary evidence that will describe in reasonable detail the basis for expenditures for which reimbursement is sought as set forth below. 3. REQUIREMENTS ". The following represents Collier County's payment requirements for legal costs >> Your federal employee identification nwnber must be on all invoices submitted. >> The applicable Purchase Order nwnber must be on all invoices submitted. >> No service, interest, or other charge of like nature is to be imposed with regard to any item, invoice, or request. All firms doing business with Collier County must have a current W-9 "Request for Taxpayer Identification Nwnber and Certification" on file, >> Services rendered must be specifically and concisely identified~ >> Names of persons performing services, hourly rates, and dates must be listed. The County agrees to reimburse Grant Fridkin for retention and utilization of sub-consultants, ,.-",,-, 16 "..__~,_",...e'__.___..,,",......_..___.. - _._--'" "'"'''~-~'---''''-"''' -"'-"~ .. -".._..,....-, P' , .. Agenda Item r"o. 16K6 December 1, 2009 Page 19 of 83 ~ Reimbursable expense must be verified by attached receipts or copies thereof. ~ Claims for mileage and meals cannot exceed statutory al10wance as provided for under Chapter 112, F,S. Meals and mileage cannot be charged unless the professional has traveled outside the county of the principal business location. ~ Claims for lodging at single rate (actual cost) must be substantiated by paid bill or charge, with a cap of no more than $150.00 per night. ~ Car rentals required for travel should include compact or standard-size vehicles only. ~ Common carrier travel shall be reimbursable at tourist or coach class fares only. ~ Accounting Division requires original receipts, or copies of receipts which have been individually certified to be true copies of the originals. In addition the Certificate contained in Exhibit C must accompany each invoice. The certifYing person must sign the Certification form and a description provided of the items, which are certified, ~ Faxes shall not be reimbursed ~ Legal Research costs (Lexis-Nexis, Westlaw, etc,) shall not be reimbursed 17 Agenda Item No. 16K6 December 1, 2009 Page 20 of 83 EXHIBIT C CER TIFICA TE IT IS HEREBY CERTIFIED that: I. has been duly designated as special counsel to render legal services or provider of services for or on behalf of Collier County; 2. Each of the documents hereinafter identified and attached is a true and correct copy of the original record; 3. Expenditure(s) enumerated represent costs necessarily incurred during the course of official business for which payment has not been received and for which documentation is not available or reasonably retrievable; 4. Claims are in compliance with the applicable statutes and administrative orders, and with the express provision that all other parties are barred from entitlement to any part of these costs. RE: Invoice No. , Dated " Period Covered: , Amount IN-HOUSE CHARGES: Photocopies: copies @ $0, I 5/each $ Mileage: miles @ Imile $ OTHER (COllies of invoices required): Long Distance Calls $ Other: $ TOTAL: $ FOR THE FIRM Signed: Print Name: Title: Date: ." o.I-C0A..011581282.5 18 " _.'-~-'-'+-' .....,-~--'----,-~-........ .._~~'~'--- "'-"--' I ". "''''.....--. - . Agenda Item No. 16K6 December 1, 2009 Page 21 of 83 Admiral Insurance Company 1255C111lw11Ra1d, ChelTyHil, NJ 01034 Declaration. Page Lawyers Professional Uablllty Insurance CLAIMS MADE WARNING FOR DeCLARATIONS NOllCE: TlIlS POIJCY l'RCMIlElI COWRAGl! 011 A CLAlIII MAIlE AND RIPORTBIIlASllIlUI.IECT TO ITS TERIIS. THIS POUCY APPUElI OIILY TO IoN't "Cl.M1" FlItsT MADE ACIAIISl' THE INSUIIEDI NID RI!PORT1!D TO TIE INIllIIER IlURING TIlE POLICY P!lIlOD, THE AUTOMAllC EXTENII!O 1IEPORl111G P!llIOD, 011 THE l'UIICIlAIllIll!XT!Nllm IlEPCIRTING PIHOD, TIE UlIITS at UABlUTY AYM.ABlE TO PAY IlAllAGI!I 8IIAU. Ill! REDUCED AND IMY IE ElCIIAUIT!D IV AllOUNT. INCUIUIED AI "CI.AlIIS EXPEIIS2" AlII "CUllS EXPBlSE" lIIlAU. BE API'U!D TO THE DEDUCIlIL!. PLEASEIlEAD ANDREVlEWTHE POLICY CAREFULLY AND DISCUSS THE COVERAGEWITH YOUR IIIllURAHCEAGENT 0Il1lROKEll. VIhItIe..r JRllId InflitOllcllr8tonaPoge,1ht lloIdIaoo type """',_ hive !he " ,oe m..nlngsalndicltedillho PliIC)'. PcIcr fGmI: Ll' lI200 (ll5-iB) 1lem1. NonoaIllllAddreoaol NomIdln......: Gtllll, Flidkin. PtIIClr" MIan & ClOWn, P A lNIe 501 PROO~A!lENT: 5551 RIdgel.llOd IlcM MlORE55: - NlIpIoI. FL 34108 .- SUqIIUI IMUI.1:..cc ',j, r . .1..:':' 1'Jt "':1tiU1l1O tt:~ Ack1dl ... rnon~tollKllllwl"~fnrn" 1_...:'....1lW au.p:...!.f:" cr.\Ct" 01 Judy WrigIll 1.,_- ~::.'" . ora Adm_ '-"""' -..,. . AGSIT'8 PDlIcy 1'Iriod: FRlIII.M8y 1, 200Il Qnalpian dIIe) 10 JaJlI)' I, 21110 (upntiondllt) (8.""I.....t12:01 LIII. SflIIItanj TIme It lilt & rr of lilt ....If IIt'll.'IdJ LiJilacllillllily IClrIllt Pallcy PoriocI {Inc:luJM oI......1lld CIIiftI& Expo_I: A. 52.000,000 tICh CIll"" bulln IlCl ~ ""o6ng 8, 52.000,000 i1 tho eggJegIle IClr II Clalllll, A!IPicIbIe Oeduo:tllll: SSO,OOO Pntnlum: $85,5911 11Im 2, 1em3, .... 4. .....5, 11tnl6. 91200 (ll5-98) 83121 (05-89)l Administration Fee: $35.00 Surplus Lines Tax: $4,281.55 Stamping Fee: $85,63 FHCF: $856.31 Service or Suit encIo/IIldl.....,.._ MdII1an 10 SIclIcm IU. K. AddRIan cI rille Ag'" ClwwIgt Item 7. NoIIoo to Iho I...."'.. pIOlIided In IICIioNI VII. A. tnd VII. 8. tnd M'/ I.......... IuJiIhId III .. I....... IXfI'Idod In IIIdian VI. A. ..... be lIOI\lla: _ ~ MInogera, lLC, 0.... 0IpIrtm0n\, Ad,""" 2850 1'0" GoI -. s.m. 800, RIIIr9 MetdclwI. Il eoooe.403'J F.x: (&4'/) ao&-4017 EmIl: 116M:11imOmanitoIIIbiIity._ AI 0110< noticlII reqund 10 be lIMn 10 1he '...Ier uncIIIr IIiI Pelley _ be _ 10: ....i1Dr UeMy 1AIroIII.... 1LC Mchss: 2650 WIlt Gof Rad. SUIte 100, RoGtng M.I .-.. IL ~ Fu: 1M'/) 808G2 These DocInIIonI IIang wifl1he _pltltd and I Fam Illd tho 1I~l'ra' PraIeIIiorel UeIiay 1_ PlliGr. ... canolIlult \llf _ bIIInIn Ile lIamId In.1II1CI Dllt hud: FeIlnIIry 17. 2001 .......dol lJ'lI2D1 em, 0I-0Il) 911_ GIani. FrIcNn. Po._, """"" c.-. PA P.,oI 1 .,,"'._" ,~~. Agenda Item No. 16K6 December 1 , 2009 Page 22 of 83 - SullellOO 28SO WOOl GoIrRood Rollioa _'l60008-IOl9 "'7.106.6S9O f..: 847.a06.6%12 hhp:l1www.monikx1i&bilily.com MONITOR . ... LIAIlIUlY MA/IIACERS.INC. February 17, 2009 Judy Wrigbt Gmt. Fridkin, Pearson, Atbau &: Crown. P.A. Suite 501 5551 Ridgewood Drive N.ples, FL 34108 Dear Judy. '.""~ Thank you for choosing Monitor Liability Managers, Inc. and the W.R. Berkley Corporation for your professiooal liability illSlll'8llCC needs. We know that you bave many cboiCC$ for your inSUI8Jlce and we appreciate your choosing Monitor, Monitor and all its employees are proud of our lradition of providing an exceptional insurance facility and making every effort to assure your satisfaction with our product and service. The people behind the promi8e to pay are critical 10 the value of any iosurance policy. Like most services. you get what you pay for - the premium is only one part of the value of an illS\lllJ\\lt: policy. The most important service we provide and the greatest value you receive docs not come /'rom deli verina the policy _ it comcs from bandling your claims. While we help our policyholders with loss conlToland crisis avoidance, if the day comes when you face a claim, we will be there to help you navigate through the complexities of a professional liability claim. Attached is a narrative from Mr, Jason A. Fogg, Esq., Assistant Vice Pnosident- Claims, outlining claims reportio8 guidelines in the event that a claim does occur, with many yoan of experience handling complelt profcssionallw,i1ity claims - I am confident you will be pleesed to have Monitor on your side. Once again, thank you for choosing Monitor and the W. R. Berkley COIJIOI'Iltion, We hope th8t you will "" the value ia the people behind the promise BOd we hope to be your choice for your professional liability needs for years to come. Please call your profcssionalliahility insurance agent if you have any questions about Monitor, or any comments about our service to you, Your satisfaction is important 10 us. Reprds, Douglas], Powers, CPCU President & CEO .. ,~---- -''"-,-, "~,... ~---. ' '''' --........" -- ,-~. --- ,--- --.--- Agenda Item No. 16K6 December 1, 2009 Page 23 of 83 .. MONIIDR LIAllILIlY MANACERS, INC, Claims Reporting Guidelines for the Insured These guidelines should be followed to help Monitor Liability Managers,lnc, provide efficient claims service. Claim Notices All claim notices shall be sent 10 Monitor Liability ManageR, Inc" Claims Department. The oemces must be reported lIS Bquired by lbe policy to avoid problems regarding timely nemce, The address of the Monitor Claims Department is as follows: Monitor Liability MlINlgers, LLC Oairns Department 2850 West Golf Road . Suite 800 . Rolling Meadows, IL 60008-4039 Mr, JDron A. Fogg, Esq., Ass;slD1II Vier Presid~"1 . CIDims Phone: 847,806.6590 Claims Depl Fax: (847) 806-4017 E-mail: newclaim@monilorliability.com NOIice of c1airn requiring immediate action: If immediate action on lbe nOlice is needed the Insured should express mail the notice to Monitor's Claims Department Situations requiring immediate action may include: I. The Insured being SCI"\Ied with a summons and complaint, 2. The Insured needs 10 provide a response to the claimant immedi8lely. Correspondence from the Insured The claim notice should include a wrinen narrative of the circumstances surrounding the claim or potential claim. The narrative should include, but not be limited to: I. Names oflbe insureds, policy number and effective dates, 2, Names and addresses of the claimant. 3, Details of the underlying claim, including its CUJTCJlt status and the amount in controversy or relief demanded. 4. All pertinent Ieners or documents necessary to properly evaluate the claim. Please provide carbon copies to your profcssionalliability insurance agent of all claim norices and correspondence senllo Monitor Liability MlINlgen,lne, MIOPI2 (06-06) ~-- - Agenda Item No. 16K6 December 1, 2009 Page 24 of 83 Loss Prevention Hotline for Lawyer's Professional Liability Commencement of Service If you encounter circumstances which, in your opinion, expose you to poleJJtialle1l81 malpncticeliabiJily, you may need assistance frOnl MonilOl' Liability MlII\Jlgers. Inc. Lawyers' Malpractiee Prevention Hotline. o Scad a brief, wrilleJJ request for loss prevention advisory services, along with a cum:nt copy of your declarations page. to Hiashaw & Culbenaon by facsimile: 1-877-834-3548 Plcase refrain from providing Hinshaw & Culbertson with substantive information that is confidential and which pertains to your client, untilthc firm caD perform a contlict of interest check. o If you are using the Lawyers' Malpractice Prevention Hotlicc for the fll'St time, Hinshaw & Culbertson will respond to your written request for advice by sending you the following: . Acknowledgement Letter . Loss Prevention Questionnaire Please review !be AcknowledgCDlent Letter carefully, as it sets forth the tcnns and conditions of your allOl'ney-<:lient relationship with Hinshaw & Culbertson as botline counsel. Please execute the Acknowledgement Letter, and complete the Loas Prevention Questionnaire. tJ Return the executed Acknowledgement Letter and Loss PreVCllltion Questionnaire to Hinshaw & Culbertson through the hotline facsimile number. Hinshaw &. Culbertson will notifY you as soon as the firm has complelcd a collflict search of the name(s) provided in the Loss Prevention QuestiOJll\8ire. This will be comple1ed wilhin 4 houn of receipt of your Acknowledgement Letter. Monitor Liability Managers, Inc. is the underwriting manqcr for the Cerolinl Cuullty losunmce Company. Admirallnsurance CoIDJ*lY Lawyers' Professional Liability Inllllrlnce Proe-"ns For addlflona!ll(or_rlon on Monitor Liability MOIIDger., Inc. and our prodtlcu. pI<<tSl vislt O/Ir Web .Ite 01 www.mOllilurliability.com or contoC4)'011r profcniOlUllllablllry broker. MONIlOR'" .,.-.-....-...---... ' LWlIIm MANAGERS.INC- A BBJlKI.BV COIlPANV. MIIflI' (01 01) ",~'-".-"',"".-._~ ...-....,--.- ----- --",-,,-,"'" T-"-'-'-~ ~.~--"- Agenda Item No. 16K6 December 1, 2009 Page 25 of 83 ~l;-::> i~c ~'5]1~ g j~] . 8.g !l!il- ~ ~. : ~ l"~ -6 g ~ 9 ~ .~ b-a::- " ;0: ~ !l 8 g ~.~ 0", . E >. i !' 1;-.. ~ ~- ] -lu~ ~ I"' i 1 QJ c .- ! 0 I! g E 0 ~.g 0 8 i ~.11 ~ ~ ,,::t .. :! ~.. .- = n- z !.w> -5 .. " ~ .R j t.g~ - g :d tt::. ~ ~ '0 0 !ll ~ -'" .- .- ~~ ~ i ~ :'" I~ i ~ S "0. "1> a ~ 9 ~ ! ~ ~ I ~ ~ ~i t ~ ~.2~~ 8 ~ 1 ~.~ ~ tl i ~ ~'5e~ j ~ . .. i:oo!= _.g ~ ~ ~.~ ~ ~ ~~i.@ ... ~ ....l" 'f!? l ~ 8 w - 011 Ii "'.!!l ~~~t ~ ~~ . " Q.!<l .=l . !. i il- ~ r. ::. t ~ < - &0 C:! ~ I~i: ~ "'~ I~i 1 -6 . ~~ <3 ~ .5 - .~ ~ t s-: 'S ~ E .2- " -~8 ~ ~] .!!~ ~ l\i & .~ ~ .JI2 ... .- UJ:~ It-.s.,,, ~!ioll]~ Ig~i lli~ . 8.~.2 .l5 'R ~ tJ lilt _ ; t!.!~ ~~ .. J'6~i ~ .. 8 ~5 ~ " z ! ~ J: >. Il]i: ! & ~ .. " ~~-6 ] o i; Oi.8 !it >" ..U ~. "~:i ~g1! Ij8~ g ~. 1J:~' ~il" 1 ill 'g1>Ie: -~.~ !!~j i ~t ~-8 O!l~ .!! .n~ ~ f II 11]'5<2 l! - ~ ~lfi2jj~:S! ~!~~j g .".1; e ~.. ~= ~.':~I~jJ.Y f ~ .; I ~ . e._ i .i!'~ ~l~~ ~]~~ . D1S."g. i e! I ~. . ~'~~j- i J .& :g,g I B ~.5 ;, l :;p::; - -.I) . _ :CJ:~ i Agenda Item No. 16K6 December 1, 2009 Page 26 of 83 ......- Admiral Insurance Company 1255 Caldwell Road, Cheny HIli, New Jersey 08034 FLORIDA DISCLOSURE NOTICE THIS INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS INSURED BY SURPLUS LINES CARRERS DO NOT HAVE THI! PROTeCTION OF mE FLORIDA INSURANCE GUARANlY ACT TO lME EXTENT OF ANY RIGHT OF RECOVERY FOR THE OBLIGATION OF AN INSOLVENT UNLICENSED INSURER. ,.~. ._.. As of: NOiOlnIM:r ZO.1OOZ .....101'1 .- ..~-~--'_." """","_._'-"'''''.~'~.',,, ~ . ---~._.._-~,.,.. -,.- ------.---..-,..-.-- Admiral Insurance Company 1255 ell"'''' Rood, Chony H18, NJ 08034 Agenda Item No. 16K6 December 1, 2009 Page 27 of 83 Page 1 of , Service of Suit ft is underslood Ind sgfI8d that In lie I'oent 01 the taiIura 01 the 1_ hnon III P"l' II1l' amcunl daImed 10 be dua hamInller, lI1e Insure,. s1l11e request of lI1e Inoand (or R8insur1d), wi! submlt 10 lI1e jurllldiclion oIl11l' CDUIl cI ccmpel8l1ljurilcldllrl w11tlin lI1e lklII8d S1-. cI America or Canada and wII comply wIlh '* rvqu'Iemenls nems"Y to g1~ such CoUIt jurlsdiCliCn and d maltars arising '-nde< wi be cleIarminad in alXXlldBnc:a wIlh the law and practice of such Ccurl. No!hilg in this sndonIem8nl oonsUIuIu or Iho<Id be undersllIOd to conaIIuta I waNer cllI1e lnslllllf'a rigIU 10 commsnoe an action in Iny court of compelant jOOtdiclion in II1e lJnItad SlIIes or Canada, to _ an action to I United StaItI DI8lrlct ColI'l. or 10 SIlk a tranllsr cI an Bdion 10 anoIhar cou~ II pe<mlted by law. It ia further ~ th8l sarvIce of pl~eSl in such sUI may be made upon Daniel A. MacDonakI. SenKlr VIce PrasidanI of Adml'" InsulW1C8 Ccmpeny, 1255 Caldwell Road. P,O. Boa 5725, Ch8ITY iii, New Jsmy 08034-3220. or his ~, lnIlhaI in any suit InalituIed agaInil any 0l'lI 01 ... upon Ihis Clll1IlBd. lI1e Company will abide by Iha Inal decision 01 sucI1 Ccu~ or oIlny AA*lIIIe Court in the ...en! 01 an appaaI. The 81xrJl ....,1Id Is 8Ulhorizad and directed to accepI 88NiC8 01 pnl(MI on behalf 01 the lnaurar In any SUCh IUillndlor upon the request 01 II1e InBUlld (or Ranurad) Ie gi\ll a writ18n undIrtaklng to U1e lnaurwd (or ReInsured) that It or !hey wiI .nlllr a ganoraIlIpllIlIranca upon II1e lnaurw'. IIlIWl in II1e event such I suilllhell be nstItulad. Funt.-, pnuant 1ll1l1l' sl8tu\e 0I1J1Yf 1taIe, tanilory or di6bicl 01 the UnIIad SIaIes of Am8riI:a or provilce of Canada. - makas provision lI1eImr. the In...... hefeby _natBI lI1e SuporirUncI8r(, ConmiBslorlBr, OIrador oIll1lUranee or other officer spdIad lor Ihel pdJXIlI8 in ... 1I8lUIt, or lis SUIX4S1Ol or lua:esa0r5 in olIice, Ie Its IrU8 and ilM1uI aIltmly upon wI1on\ may be ler.ed II1l' IawIuI plOOlS! In any action, suR or poceading In8titIABd by or on behalf 01 the IlIIUfIld (or RainBUrad) or Il1)' benoficlary heIeInIer orising out 0I1h1. oontracI 01 _nee (or I8I11Blnllt8), and ... In....r hereby dBaignsle$ the 8bove-namad II ... person 10 wl10m lI1e said olllc8r is lIUIl10rilad 10 mall such procass or e lnJB copy theraol. - Admiral Insurance Company 1255 CIlcMIIRcId. CherTy HIlI. NJ 08034 Agenda Item No. 16K6 December 1, 2009 Page 28 of 83 Pop 101 1 Addition to Section III, K. Addition of TItle Agent Coverage 11 DDI1IIideIalIon 0I1he pnlIIIlum paid for 111II PIlIicy, I is undontood lIld 8Gl8ed tbal section III. Delnlllons K. 'P"","lonll Strvm' of INs PlIIIcy Is IIlleIlIled by the addillcn ollila foIowIng: III. K.: 'ProIllIBlonal IIBrv.' eIlo ..... a title InsI.nnc8 &g8Ii, pn>vidlId such &eMces ... connedad wilh lIld in<:id8lUI 10 the lnsuNd'a pI8CIic:e 01 law 1M .. pInUlri 10 I MitIen agency svreement with 8 iosnsed tile nUl8I01 compsny; pnMded. ~. the InBlRr 8ll8I not be li8bla to llIIkt any paymanI for Damagea or C1a11llI ElIpIIII8 In caYI8ClIan >Mlh any ClaIm made sgsinsl an InturtcI baSId upon, srillng out 01. direclly or Indirectly IalIIIlg !10m or In coneequence of, or In any 'Wf inwMlg; I. d8IectB In tMle 01 whiell any Inln hid kllO'oOl8llge at Iha d... of issuInC8 of such li1I8 I1SUll11C8 'IlI1elher or not a malI8r of public reconl; b. any IntsnIionII braadI 01 undel'tlritillg aulhorl'/ by any ....urwd functianlng as a tiIIo nurance agent; c. IrI! Iabltty lISumed by III In&uNcI lI1der any contracl or agreement whereby Iha In.urwd bas agllled 10 ~ In Iha payment of a Ion undef I 11111 i1BUr8nce policy, IlcIUling, aItOmeys' f_, c:ou~ costs and expsr_. unless ""ell isblity -*I have atlach8d 10 till Inlurwd even in the absllllOll 01 such agreement. -", WhaI e;er printed In lhls Endonement, 1he baldflCllyps 18rms shall hal'llhB same meanings II indicated In the Pdicy FoITn. AI o1her pIOYiIions of !he Poi ....olIin InlIlnd icy Number Grant, Flldiln. Po_ AtIan & Crown. P A 9876690 Dele of llia I Autt1oI1z8d prasanl8l1ve 0110112009 - - _.,-~-, .. -"".,-~..~..,.-.,--,,,-.~*. " ...."---"',..~-,..-.,., r--'- '. -- -._.~~,,_. --' THIS IS A CLAIMS MADE POLICY. PLEASE READ IT CAREFUUY. Agenda Item No. 16K6 December 1. 200 Page 29 of 8 Lawyers' Professional Liability Insurance POlicy Admiral Insurance Company Agenda Item No. 16K6 December 1, 2009 Page 30 of 83 Admirellnlur.nce Comp8ny ~- CLAIMS IlADE WARNI<<l FOR POUCY NOnCe: TIll POLICY PROVIIlElI CCM!.RAG! ON A ClAIMS IWlE AND REPOR1ED aqs SU8.lI!CT TO rrs TSIIIS. THIS POlICY APPLII!8 ClII. Y TO ANY "CLAIII" AR8T MAD! AClAINllT TllE INSUREDS AND REPORTED TO THE INIIUIl!Il DURING THE POLICY PI!RIOO, 11tI! AUTOMA11C EXT!ND!D f1!PORTING P!IIOD, OR 1HE P\JRCHAllEII EXT!NIlE\l REPORTING PERIOO. THE UMITS OF LIA8IUTY AYAUIILE TO PAY DAMAGES SHALL BE REDUCED AND IlAY BE EXHAUSTED BY AlllOUNTS INCURRED AS "CLAlIIS I!XPI!NIE' AND "CUllS EXPENSI!" 9IW.L BE APPLIED TO THE DEDUCTIILE. Pl.EAlI! READ AND REVEW THE POLICY CAAEI'UlJ. Y AND DISCUSS TH! COVERAOE WITH YOUR INSURANCE AO!NI' OR BROKER. In CIlI18IlerBllon ollhe p8}'llllllll 0I1he premium. and in relilnce gn sI18l8t1mtnts i11he PrapoIaI, and a111llhar infoonatlcll1 pnMIed III Iha 1nI_. and 8Ubjecllel all1he prgyisigns gl1hls Pl1Iicy, the 1_ and lnIIlI'ad(a) auras as fllIlcIw&: I. InlUrI~ ThII PolIcy .... pay 00 bahalf 01 fl. NuIWd all o..nagaa and CIaImI Expantt tIallhe _red rhaII b8cilma IIgalIy dJIigaled III pay, ..g horn Illy Ctllm firsl made IIJ8InsIII1 IMlINId cMing tIIa Palley PerIod and nJIIOI\lld 10 1I1e 1_ n wrililg during IIle PalIey "-Iod or within 60 days thefaafler, fgr any Wrongful Act, pIOlIidad 1hat pri>r III !he inceptitlll dal8 0I1he fiillt Lawyers' ProIassiclnaI UabIly Inaurlll1Cll PclIicy issued by the 1_ to lie Named 1nMnd, which has been ClJIlli1UOUBly ~ed II1d mU1lailad n eIhIcl to the R:eptiClIl of 1Iis Polley PerIod, the lnaured did not know, or coold not "lSOnobly fg...e 1hat eud1 WlOIlglul Act migll raaaonsbIy bs eIlplIC\Ild III bs the t,~ of a CIalaI. ,-~.,- II. ExIIndecI Reporllng Period A. If the Named I1l8UI8d cancela or. the In_ or tie N.dld I1l8UI8d refuses b renew It'js Poi:y, than lhe.....11l8UI8d ehaI hsve the righi, ~pllIl payment III the 8JlllRl1lriate percentage of !he 'TIl11 annual premium', as plO'lid8d i1 sectitlIl II. B., III an IldanIioo 0I1he llOwer.ge granIId by IIill Poi:y with raspoct III any C1a11l first made and I9pClIlad during Iha ~ pericId of IlIClllIhs 8fler the date ~ \WlIch the Polley PerIod ends. bulooly wllh IeBI*I lei any Wrongful Act fully cx:currilg priclr to the end oflha Polk:y PerIod and Clther.1isec:o,ertd by !his l'IlIicy. Such sppIllIlIi8le periodgflllClllths shal bslWfan8d leI.1I1e ExIendad A8prlrting Period. ,. uead harein, 'full annual prtmill11' means II. premium level In effact Imrnadia\ely pri>r to lhe end 01 the Policy PerIod. The ~ c:ontained in lhl8 paragraph shaN tsrminata, 110_, unlells wria&n notice gf eud1111actic1n togethar with lhe addiIlllIlaI premi~m duals I'8CIlIved by the 1_ within 30 days of 1I1a elIactiYa dele gf cancalIIIion or ncn-ren1lWat. B. The pen:enIave gf the 'fuM annusl p",",k.m'1I1d period oIlIlClllths for 1I1e Exlendad Reporting Period allBlI bs: 1. 12 mcmtll5 ExIendad Reporting Period for 100 pergen( oIlha "IuIIMlJ8I premium' of Iha PoIicy,Clf 2. 24 mooths Exlanded Reporting Pariod fgr 150 pergen(oflha 'fuIaMU8lpremium' oI1he Policy, or 3. 36111Cll11h8 Exlarldad Repclting Period fgr 185 percent of the 'U annual premium' 01 the PClIicy. gr 4. 60 IIICll1Ihs Exlarldad Reporting Period fgr 250 pergen( of the 'U 11II1II81 premium' of the Policy. C. The addititlll8J premiln fgr Ihe Extended RapClltnfl Period &1111 be 1~lIy earned aI the iIception of the Elctendad Repgrting Period. The Elltandad Repgrttng Period Is I10l cancelable. O. ,. a condition precedent \g thl riltrt III purehlllll the Extended Repgrti1g Plriod, 1I1e total ~m fgr !his Policy and all DoduGIIbIe obIIgBlions must haw basn paid. E. WIhcut Ill)' addMilnaI premium beng ~, thalli &Il8II bs .. autlm8Iic txtansIon 01 the ooveraga plIad by IhirI Policy Mh I8II*l to Illy ClaIm fila! made lnl repgrtad ciri1g a period 0/60 days siler Iha date ~..tllch tha PoIcly PerIod andI, but ooly wiIh ""*' \g Ilrf Wnlngful Act tuI'{ occurri1g prior III the end 01 tie Polioy Perlod and othafwisa oo.wad by IhiI Policy 8nd only I Ihare is Ill) othaf policy or pgIIcIae thll wguld olherMee provide ilIIIanc:e fgr IIUCII WnIngIuI Act, This 60 day period shall bs ralerrad Ill.... Autlmdc E1CIanded Aeponng Period. F. The AiJ10niIIic Exlandad RepcJI1ing Period gr !he Exlanded Reporting Period &I1B1lllClt bs available wilen Ilrf Ineu_a lilense or riglIlll prsclIca law Is moiled, BUBpelldad, or surrendered. ".'~- LP 9200 (05-99) Page 1 of 7 Thad8ecriDtianl illh. hI.din,. nfthiR Pnir.v ".... lV'MIv fnr(j""nJMi~rU'~ Anti fnrm nn Mrtnftlwl .......,,4,.,..,. r"I'lIV'fMlnn. nI,.".,.,.".. "-~"--'-'-~".~.~,.._.,. .-. , v_..~._~,~...,.,~ " --- i - . , Admiral Insurance Company Agenda Item No. 16K6 .. December 1, 2009 Page 31 of 83 II, DlflnItIons ~ prirtecl n boldIac:e Iype In IhiI Policy, \Illllllowing tallllllll1al hawtha maanilgs idcBlad balow. A. 'Claim' m88lll1 wrlItan demand fer montI8ry or non-monetaly rahf Incildlng, but nollimllad 10, I cMI, crimi1a1, administralive or arbir8lion prooeadlng; prowidad. hclWll'..r. Ihat Clallllllhd nol ilcIudI any proceedilga baIore a stale Icen8lng bOard or IimIar aull1orlty, e_ II othlllWlal pnlYidad In aaction V. SupplIrnantal CoYIrages, oIlhis Poley. A CIalm lIhaIl be desmed III hive been filii made Il!he lime no1i:e oll1e CI*I1s ftIIl r1IC8Md by elVf 1nIInd. B. 'ClaIm ExpeIl8l' II18IIle raasonable and neoeul'Y Ieee, c:oslI Il1d ellp8l1S85 (indud'1llI pramiUlllll lor sny 8IJIIHI band, IIIlactvnent bond or similar bond, but 1riIl1N any abIigalIan to Ipply lor or ~mleh IITt eucI1 bclnd) reeulling solely flom !he iMstigatkIn, adju&manl, dIlenll and appeaJ of a CIaiIII agai1ct!he NunJdI, but excludl'lg salaries, wegas, lMIIhaad or b4I1efIt expenseI ~llacIwith anylnau..... Dr any amount CC'iIf8d byllleciJtytodlllnd Dbigatlan of sny ClIhefinellrar. C. '!larnlIgn" mOIlllll a monetary judgmen~ aW8rd or soltl8menl. pre-judgment int8111Sl and po&l.)udgmanllntarest; pmWled, '-, Dnagss &hd not incklde: 1. texas, cIvtI or criminal fin.., or panalli8I ~ by law, or 2. punlM or exemplary dfmages, or Iny mulqllied demages award in _ of !he amounI so m~, or 3. any mBllaI dHmad unWllllrallle IIldar lIIe law pununllo which lhis Policy IIhsJl be oonstruad, or 4. legel f_. CXlIt8 and alllJ8l_ pUt, Incurred or chargId by lh1 ....., wll8tIer claimed II forfeiture, rBIliluIion of specific funds, ftfllflCielloes, &el-olt or olhelwise, end InjuriB$lhalere a consequanoe of any cI the foregoing, or 5. legal IeM, cosls, liles, pene/lies, sanctions, or other amounts IWlrded ag8i1sl an InaInd or any cIent 01 an Insu.... based upon tie sctull or a11eg1d fding of pl8adings or other pape!S under any fedlraI or &tale lIlMll8, admlniBlratiYe rule, court ruIa or CHa law, incklllng, but r>ollimllld to Rule 11, Federal Ruin 01 CMl P,......dure, any !UCCuw \Ilervto or stale rule coootarparl O. 'SecIron1c lIall' moans !he !18I\s."iSfWl ot rnesaagas and ntormalion 0Y8I1 cIosad, privata network; or a semi1lUbllc MIwork Ihal provides I pIbIic 1CC8101o an on-1I", I8IVice ~r I fee; or Ihe 1_ E. 'lnIInd"means: 1. !he Nsmad 1/IIUIed and any "*- Firm; 2. any ildMdual or profasaional corpor8lion who is or becomas I partner, officer, direclDr, &tllCkho1def, or ar11l1ayee ot \Ila Mo.,.ld lnau...., bill solely while acting within !hi seope oIlheir duIles on bshaW 01 tle Namecll..ured: 3. any ilchidual or proIessional corporatioll wllo _ 0 partner, olficer, drector, SlOCldloIder, or ~ 0I111e NIIIled -..cl or ~ FIrm, but solaIy wille ading wIt1ln 1he ICOIl8 01 thei dllll8ll on behBlf oIl1e NIIned InIured f1I ........ firm; 4. any ildMdual or proIeaional ccrporaIion dasignaled 'l:oI.m1I' or "ot COlft8I' 10 the Naed InauracI, but llOIBly while acting witIIn 1he lICOp8 0I1hei' duties on bah8If of "ll',171~ InaInd lor...,1ch a fee Inured \0 the .....ed InlMnd; S. lilt heirs, _10... edmlni&lralors, and legal re~nlalivos of eB<:h Insulld In 1he ~ of death, inc8pBcIty or bankruptcy, but BOlaly wi1h reepeclto Iheliabilily of each InBlftd 81 oII1erwio. covered by lI1is Poley. F. "Inuw" means ... enli1y lasuing !Ills Policy IS listed on the Declaratione Plge. G. 'NImed InIur'8II' meana \Ile indivIdull. partnel1lhip, pateuionll lI88OClaIion, rmitad labllly psrtnel1lhlp, limited IiabiIy 00lp0fI1I0n, or corporation nlllled in lIP 1, 011he 0ecl8rIlI0ns. H. 'PeIaonaI ~UIY" maans irMIsion 01 prIwcy. 'MOngIuI enay, avi:llon, falBa IIf8llI, taIBa ~ mallcilus pronc:ution, 1IeI, Blander, mental sngui8h, humilatlon, or srnotIonal d1Ilrllt, 0111I or wril\In pulllcetion 01 defsmllory or diopanlging material, or the inadv8rtent disclooure 01 oonfidential or privileged inlormalion communicaled by ae-Io liaR. I. 'P.Iioy Period' means lhe period of tine from the inception date shown in Itam 2. ot the Declarationlllo lhe earlier of !hi elflllralion date shown in Rem 2. oIlhe DecIarat10ns or !hi elfectiYe dale 01 CII1C8Iltion of Ihis Poicy; hoMo..,.., to II. _ thal coverage under !Ills Poley rapIaI;es CO'IlIrage In OIher policias tenni1Bting It noon standard tlmo on 1h8 InoIIp1Ion dII8 of SlICh coverage hel1lllnd&r, II1en such CO'IlIrsge as is pnlYided by this Policy &hill r>ol become eI1ecllve untI eucI1 OCher CO'I8l1Ige has ttnninBtad. LP 9200 (O5-99) Psga 2 ot 1 The de&crIptions il the headilgs oflhiB Poicy are sol81y for convanitllca, and form no part of 1IIe lerme and c:oodiIions ot coverage. ,~.- --,,- ,- Agenda Item No. 16K6 December 1, 2009 Page 32 of 83 AdmlralllUlurance Compllny J. ~ FIrm' IllNI18 III Individual, pIIInerIhlp, proIassional .......lalion, IImIlad liability pamership, fll1lilld \iabIIl\y corponlion, or corporattcn \a whoM flnanclal 8I8IIS and 1iIIbI... tile Named I_red is the majartty 1l.<<IIIor In Intamt. l'nldIcaIIor I'lrm tloe8 !lOt Include an Individual, pWoerahip, poIIaBian81 ~, Imltad liability partn8IIhip, lil1iIad IIblIly corporalion, or corpontlion kI whoaa financial.", nl fl8blllles the NI.....lnIllred bac:omI& the msiDriIY sutOeMOf in irQnJst duli1g lhI PoIIlly PerIotIIIlIe8a "e m-, in lis sola cliacralion, and lIIe NaI8ad InuId 8QIIeS 10 Include &UCIIlndi'lldual, ~ profnsionaI ~, IinlIad IiaIlIIty pemellhip. Iimllad labilly corpor1llon, or corporaIlon u a PnIcIaoMa' Filla. The ~d ..... shaI accapt any premium adjustmenl or COV8fage raoisicnl which lhe 1_/IlIY lIqulre. K. 'PnlMIIonII SIrvioeI" mill. services; 1. I8Ildnd by an Inatnd IDI8Iy U alawyal, medator, 8IllIra1or, or nola.., public tor olher8, or 2. performed by an 1-..1 U III aclmlni&lrstor. conll8Nllor,l8CIIlver. e,..uor, guardan, trusIee, or In any ollar f1duclaty c:apacIty, but only . tile act or omisaion In li8puIe is in lhIlII1deriIg 01 ieMoIS ordInariIJ parto"....:J u . IawyeI and than only to the 8Jdanl of IUCil urvicN. L "PIopoIaI' meanlllla PropoaaI Fonn and any IlIIlaII8I SIlbrnitled lherawltl. M, 'lWaIed WroIlgf\lI W _ Wrongful Acta Mli:h 118 IogicsIIy or caus8ly COI.lICtIld by rtem of Ill\' COIMlOII fact, clrcumlll8nce, siIu8lion, ,ansacllon, casu8lty, IMnt or dacieion. N. 'WnmgtW fd ml8l1l any 8ClU8I or IIaged ac:I, oml8slon, or r.-aJ InJury ariIlng out of ProIeaaIonaI..... randBrad by an Inllnd or by any pIIlIOII tor whoM act or omillsion tile In.red Is legaly responslble.. IV. ExCluliont . The ~ shall not be liable kI rn8Ica any payment for DllII8gII or aa.. expM1II in connection with any CIaIIll made agsiIIIl an IIIIlnd: . A. bBSld upon. ariIlng out of, drecdy or indiractly I8IUIIinV fIlIm or In ~ 01, or In any way InYolYing a di8honast, fraudulent, crimin8l, or malicious act or ornlsllon cornmi1lad by or It"e dlraction of. or rUfied by Iny IlIIlJred; JllOvidId. however, thelnlul'<< ... provide a daIInIe for any &UCII CIaine. wI1houl any IablIIty by lhIl_ 10 pay BUCh IUIl18lhet any I_red shall become Iagdy oblVsted III pay u IlInIJIga.; PNNOCENT INSURED PROVISION; Whenever COYIIIIge under !hie Policy would be excluded, IlUIp8Ilded, Of lost becBuaa of ElIr;Iuslon A., the 1_ IgrelIS I1al &UCIIlnsursnce, as would olherwise be IIIfoIded lIllIer this PolIcy, 11I1811 be applIcabIl with raspacllll an 1Murad, otler thllllhe ~._lIln..red and any PlDea_ Finn, who did not plIIIOfl8Iy participate or peIIDIl8Iy BlXlUleaceln Of ramaln puslve .ftlr having knowledge 01 such conduct] B. by any InIInd; C. II lIIe benali:iBIy or dislritJutee of any trusI or esIate; D. for bocIly Injury, 8leknasa, diN8ra, death, lI8SIulI, or battery 01 any parson, or damage 10. or d8ll1nJdion of Iny tangibl. pmparty, ilcIudilg Ios8 of usa lharaof; E. bued l.P)n, arlilng out 01, diractly or Indiredly _Ililg IIllI11 or In collSequencs 01, or in any way irMlMng any l..-ad'a actMlies or1heir capacity u: 1. an officer, diractor, partnel, truslaa, or 8f1lIlioyeI 011 bu$i11S$ anlarprisa, not named In I1em 1. of lI1e Oeclarallons, e non1l'Ofk olg8llizltion. or I penlion, welfare, proft stilling, mutull or Irw8RnenllTUSt or lund, or 2. I pulllic ofliclaI, employee, or agent 01 a gowmllllll1lal bOdy, 1IIbd1viSlOn, or agency, unIeIIlhB InuId II deemed 10 be a pubic oIlicIaI, employee, or agent 01 sucII sntIty solely by virtue 01 rendering ProInaloIl8l Sarvaellll. or 3. I fkU:Iary lIlder tile EmpIoyIe Reliamant Income Security Ad of 1974 II 8IIl8nded or Ill'( regula1iona JllOIT1ulg8ted lheralI1der or lIlY Binil8r provisione 0I1I'tf sl8II or lederll con llIlOIIlaw or alalute; F. by or in COMBC:tion wIh any bUBil111 enletprise, not named In 11Im 1.0111I1 0ecIaIatiana. In which the InIuNd OMlIlDOf8lhan I 10 percent Intereat, or in which any l_recI is an owoer. psrlnar. or ampIoyee, or which is direClly or indiracUy controIIad, opet8lad, or managed by any Inlllred, other than solsly In a fiduelary ~, but only V the set or omIseIcn In diepuIa Is In \he IlIIldering 0I88rvices onlln8rlly palfo,u oed as I lawyer, and lien only to Iha extent of such seMcee; G. whicII is Insured In whole or In part by anolh8r valid policy, alG:8pl with rlspacllo any elCCeSl beyond Ibe amount or smounl5 01 OQ/I8I'age under IlUCh olher policy whether such olller policy is 8IaI8d 10 be primlry, con\ltbulolY, IXCIII, c:oolingan~ or oIhertIise; LP 9200 (0H9) Page 3 of 7 The daacr1ptions in the headlnllS of this Pollcv 81'1 eoIeIv lor ccnJllliBnce, and 101m no cart ollhl18lmS and condillonS of COWIl8OI. -- ,. ,-...~_.."" I'" .-- - Admlrallnaurance Company H. b8Iad upon, arIsilg out 01, cIracltf or indraelly resulting fl1ll1l or In CCII1!I8qUII1C8 of, or in any way ilvolWlg Illy nuc:1ear reaction, rstialion 01 conlBminsticn, regardlasa of ClOun; I. for actual or IIagId 1IllIlPIQ8, poIutIan or contlnWlllion of any kiId; J. bt-1 ~ nng ouI of, directly or indirecdy resulllng Inlm or in ClCnIquenca of, or in any way invoIWlg lhe Sacurltlas fId. of 1933, the Sec:IriIes ExehIngt Id. of 1934, Me 01 replans promulgBtad 1Ilarllunder or any llimlar ellIl8 lIlatutes, rules, ragulstiona, or common law; It based upon, arisilg oli 01, dil8Cdy or indir8clly resulting fl1ll1l or in coneeqUIDC8 cA, or In Illy way inwlvilg: 1. any Wrongful Act 8IIIgad in eny e1ain which has been raportad, 01 in any circumslance of Yltllch notice nu bien given, prior 10 1hI PoIq- "-locI1J'ld1ll' any oIher policy, or 2. any olh8r WrongU Ad when8Y8r ClCCIIIllng, wtlIch togBIhar with a W/IIIIgfuI Act Voi1Ich has been 1Ila SIiIjacI of eu:h c181m or noIIca, WllUId conetiMe II8IIliId Wrongful Acla; L lor os:rini1l1ion or haJaAIIIlIII bBcaull of race. color, religion, age, sex, diB8bUity, ptelJI8I1CY, nallonal origin, 811II11 orieldll!illl, marlIaI8I8luS, or any olheIlW'18 prohibitad by IBw. Agenda Item No. 16K6 December 1. 2009 Page 33 of 83 V. Uft1s 01 LIIbIIlty and Deductible A. The Limb of L1BbIlty slated in Item 3. of lhe OecI8ralion8 If8 lhe IinIlI of thlllnaln'a liability for aI o.upa and ClBIn I!xpaMI ariIi1g out of II ClaIma IirlIt made against 1Ila ...... durilg 1Ila Policy I'Iriod, 118 AulomaIlc EIllBndad Repo/ting Pariod, and the ExIand8d R8portIng PerKld (K sppIcable). The Linils of Liability for 1ht AuIom8tic EldIInded Reporting Pariod and the Exttnded Aaporting Period shel b8 part of, and not in 8ddIIion 10, the limb 01 LlsblIity for the PolIcy '-loll. FIlrthal, any CIUII made ~ 10 1Ila Policy "-locI. 1111 AUlom81ic Ed8ndad Aaporting Period, or 1Ila ElIlIndad RapDI1Ing Period (I 1jIpIicaIlle) which pursuanllll section VII. B. or VII. C. Is deemed first malle during lhe PoIicy~, 118 Au1om8lic ExIendad RapoIting Period, or 1I1e Exlandad AepoMg Period shall allo b8 subject to 1ht applicable UmiIa of Liabilty II18Itd in IIam 3. of the DecIaIaIiona. In 1I1e aunt 118 LinIls of Ll8biity slated in Item 3. of the OacI8rationa art eld181lSl8d by pa,lollld 0I1laalagaa and/or ClaIma 1!xpaMI, or the Llmill of LiablIty hlVlbeen t8I1derlld 10 or on behd of lhe lnaul8Cl, then any and 811 obIlgaIIonl oIlhe lIl_hIlIlnler shall be dt_,,.,j 10 b8 completely luHiled and exli1guis1led. B. The Ill8Jdmum LIm~ of Uabilty for sII C11l1118 under this Policy shaI not e>U;Bed !he ~1IIlI Limit of Liability statad in IIem 3. B. oflhe Declarations. C. ClaIma I!xpaMI shan first be applied agsN! 1I1e Deductllle and shaI b8 part 01 and no! in addition 10 lha applicable UmiI8 of LI8bIMy slated in Itam 3. of the 0acI8rati0na. Payment of C1IIma ExpanM shaI1 reduce \he lpIllicabla LinIIa of LiabiIly lII8Ied in IlIim 3. of \he 0acIInIi0ns. O. The Deductible III10Uflt 8lIIed I1Itam 4. oIlha OecIarations shill be paid by 1IIe HamId Inalnd and &haIll(lply 10 eacI1 and 8Y8I'/ CIIIm. The Inaurw WI only b8 IlabIe for 1he amount 01 o.&lIIlI sndIor ClaiM ExpeI'lBl arising from I Clailll which 15 In 6....088 of the Deductible amount Ilatad in Itam 4. of the OscIaralion8. SucI1 amo\ITIS Bhal, upon wrIIIan dem8nd by the lna_, be paid by 1I1e NlmetlllllUrlId wilhn 30 dly8. I' the Nanwllnaurlld faJls 10 pay 1he Deductible, then 811 the InaIndI shaI b8 joIn1ly and IlI\I8I'ally obIig8IId to pay tI1a O~. /vrf fI8Ide advanced by tI1a ...... shd IIllIVI to reduce the Linill of UaboTrty. " lie '- brilgs BUit to coIIact tI1a Deducible, 1I1en fha InaInd rasponeibie to pay the 0IduclilIe lIiBo shaI pay 1ht legal 1_. ooIla m expenns i1curred by 1he __ 10 ooIIecI the Deductible. SuppIInItnt8I Cover.. The InauJar will pay: E. up 10 I muimum lI\llll\lgate im~ 01 $7,500 per PolIcy "-Iocf for alllll8lRde for rlIl8Ol1able legal fll8l, costs 8Dd 8llPWM I1Uling Inlm hi iMl8\lgIIion or deIenae of an InMnd in I proceeding before a ."licensing boald 0I11mi18r au1horiIy ..;s;.,g out of any Wrongful Act by BUCh 1nauIad, but only K eucll itglllaa, coats, III expenm are incurred rilr notice ia fiIIl receiYed by Iile InaunId durilg 1he PolIcy Pertod m rwportad to the InMW in writing during lI1e Policy Partod. The 0educIIbIa shll not apply to Ihia ooverage and llI1)' paymen1l made heraund81 shall not reduce the LlmiIB 01 Liabilty Ilalad II Item 3. of !he DecI8ralions. F. up 10 $250 tor sctuaJloss of esmi1ge to each........, tor HCII day or pan 01 e day 01 BUCh In8lll8Cl'a attendance, BIb Ina1nf'I wrIlan raqusst, 1111r181, hAling, or lIIIlilrsIion proceeding illllOlvilg I ClaIm against an Inaurad, up to a rnsxinum wegI1llllmlt of $10,000 per Policy ParIad for alll.-.da. The Deductible ahal not apply lO this ooverage and any pa)lTlllllls mille hereunder shaI not reduce the Limb 01 Liability 81aIed in Item 3. oIlhe DecI8rwtions. LP 9200 (OS-99) Psge 4 of 7 Thedsecrilt/OllS In lhe headinae 0I1IlIs Poicv n solely for OQIMlIIience, and fonn no oart of the._ 1M conclilianB 01_. Agenda Item No. 16K6 December 1. 2009 Page 34 of 83 ,~- Admt.... Inaul'llnce Compllny G. III sddillcnsll0 pen:ent ol the Liml 01 Lilbilky $lated illlem 3. A. oIlhe Dsc:lIraIiona up to a maxIIlMl1lggregal8 imIl of $100,000 per PolIoy I'IriocI for Clan. EIpenaa, bUl only tor I Bi1gill Claim occ:ulTi1g slIar Ihe aggregII& l.i1lIt ofLiBbiity stated in IIem 3. 8. 01 the Dec:larationa lIIaJChaI.8l8d by payment under IhIs Policy. The 0educIibla shall not ~ to 11111I oovnge. VI. DeIenN, Cooperation Ind Settlements A. An IMwed shall not admilliablliy tor, antsr illo any settIemanl ag,"men~ lltipJIBI8 to my judgmn, agree to 1Ib1ntion, or incur aa1mll!xpen" wiIhoul thllnlllrWa prior wrtIIan COIlIeIll, The Inuw'I CCXIIlll11 shaI not be \IlI1NIICil8bIy ~ provldecl llla11he Iaaurw shill be enliIIed to l\dIlnformation and III particulIn l may requBIl il onIar to reach a decision regsrdilg m ClII18IIll Any DIngIa IlIl1Ior ClIimI Explllll ilcumld and IIlItemenlI agreed to prior 10 the InauIW giving lis conssnt wI net be CCMflId hereunder. B. The 1_ 8IIal hlMllhe r~ IIld tha duty to deItnd any ClaIm to which tlis irIIurancs applias. _ I my aIIagaligns of 118 ClshII ara glllUl1deu, faIlse, or ftauclJlenl Th, In..rW. right and duly to ~ any Clllm shall and whIn fl, lnMlNr'. appIcabIa Limit of Liablily has belli 8lChal.Blad by paymant 01 Dam.... an~ Claims Ex~_ II, or hu beIlI1andarad to, or an behIll 01, "'1nIIIM, or 10 a ClClUI\ 01 ctlII1pItenI junadlc1ion. C. Each ..... shill coopIlf8te will the 1_ in Ihe cIIIInG8 and 8IllIemenl of any ClaIm, and in IIIlIoIcing any light of conlrilu1ion or indemrily agIi1It my peraan or organization 1hat may be ll8blllD hllnalncI, .1 no COIl to III lnau... Upon hi raque&I 01 the lnaurar, Ihe lneurad shd 8UbIlIiIto suminatJon and iltall1lg8lion, undllr oaIlI raquifad by a ~ 01111 1_, IIld aliBI attend heamgs, daposllians and 1risIB, 8IIi8l1n eIIIcting 88IIIemIr1l. lIICurlng and g1vilg 1I'Iidence, abIUlilO!he aIendanc:. of ~ as WIll u giving wriIIen SlIIllm4ll1t(S) to \lie 1naI.-^ representalivas, and mHlIng with IUCl1 ~ lor pIIIllO>.1I 01 irMlItlgIItbn or d.fense, all wWlOUt ch8lgt 10 the 1_. D. The 1_ BhaII not setIIe my ClaIm wiIhlM \he "",,_d lnaurad'a wrilIlIn con&8Ill. K, however, Ihe NaIMd InIlnd BhaII reIusa to c;orlNI1llo any settIament .ac:g",m.ndad by the InlUler, which Is acc:apIable 1Cl\he dBi'nan~ and 8haB eleet to IlGn1aSlIhe ClaIm, or c:an1i1ue any 1agaI, adminislralive, or IrtJitralion prClC8adin1lS in connectian willi &IICl\ Claim, than ...lnau....liBbiliIy lor Ih. ClaIm shaN not .XCl8ad tha BmClunt for wlIlch Ihe ClaIm ClOUId hlYl been setlIad, Including CWn Experll iolned up to Ihe date ofllUCh ratusaI. Such Il1IOUnlS are lubjsc:t to ft, pro'IiIlons at secIion V. --'^ W. NoIIce of Clllm and Multlpit CIUnI A. As s condition precedent to thai' rights under 11111I Policy, an lnauracl sl1aIl give the Ineurer wriIIen notice 01 any ClaIm IS lIOOI188 prsc:tIcabl8 . B. n lbing the PoUcr PlrIod an 11l8UlWll bec:omss IWI/& 01 any fac:l, c:iR:umslanCl or siluaIlon which may IN8OI\Ibly be elqleCt8d to give r8e III I ClaIm being made agsilst any IltIUlWd and shall gMI wrtttan notic:e to the I/SIW, u IllOII . practlcable (but prior to !he .xpiation of or cancellation of the PoIicyl, of: . 1. \he spac:iIic tact, c:ircImBlanc:e or Bilu8lion, with UI delais 88 to dlllls, persons. and enliti881nvo1ved; and 2. \he I~ or dim.. which may mullbatellom; and 3. ... citcurn&1Bnc88 by vdlich the II-.d fins! bec:ama _re"ereo!; \hen any ClaIm sull6equanl1y made arisilg out at sucl1 tact, QltUrnstalloe or sltualion 811811 be deemed to have been made when notice was finst ~ to 1I1a!nNw. C. All ClaIme based upon or arising out of 111. I8lI1t WnIngIul Act or any ReI8I8d Wronglul Acta, or one or more 88I1ae of any slmllar,l8plI8lad or continuous WnIngIuI Act or ReIeted WnIfttIuI Acta, IIhaII be considered a 8iIglI Claim. Each ClaIm lhal be dIImed to be list mId8 .11. earIie8t ollie following lines: 1. whIxllhe earliesl CIaiIII arising out of sucl1 Wranglul Act 0I11alalMl WnlngIvI Acta is Iiral made. or 2. when notice pulSU8Ill to seofion VII. B. of Ifact, ciItUmetanca or BltuaIion glmg rile to IUch CIaIIII III givan. O. In adcItion to fumishilg the notice es provldsd in sections VII. A. 100 VII. B., the 1__ shal give \he lnaurw such InformaIion sod COOplIrItion 88 t may m....abIy require and shaI~ IS soon 81 praeticBble, fumiBh the lneurar wiIh c:opi8s oll9pOr\S, iMIsIigaIiDns, pleadings and other papBfI in connection lherawlth. "^ LP 9200 (05-99) Paga 5 017 The ~ in ",lIeadlnlll 011115 PoIIc:v Ira solett lor _Ianoe. and form no oart of the _ snd tIlIldiI..... at I....""M _n_.~,___.. ".".".~---_.~_. ,,",'" .- --,""--~._-_.~~,.--- I" Adm...."nsunlRC8 Company Agenda Item No. 16K6 December 1, 2009 Page 35 of 83 VIII. GInIrII Condltiona A. Termination or Policy and Non-Renewal 1. This Pelley slIaI1elmina1a Illhe ea1iesl oI1he lolowing tin .ell: I. upon the racaipt by !he lnIulW of writlen nolIc:t 01 CIIlCIllIllon from the .......1Mund; b. IJpoIl expiration of the Policy PIriod IS salforth in him 2. ollhe Dedefllllons; c. at such 0Iher lima IS may be &geed between 1he HI ad Inaured end lh.lnavrw; or d. 20 dayI alia! racaipt by 1he Nsmad 1-.1 of1he '-'a Millen nolice 01 cancellBtion tol ~ of pnIIIlill11. 2. The I1lIum may not cancel this Pclicy aapt lor ngn.peymen! of any premium when We. 3. H lhis Policy Is CIIIlC8Iad by Iha Namad Ineurad, Ile 1_ &haR ....lIlh. cuaIomIlry Ihorl rale prllpOI1ion of the premium herein. Plymenl or l8nder of any uneIfnad pemium by Iha InsulW aha. not be a condIlion precadenlto the e~ 01 canoeIaIian, but such paymlnt 8haII be made IS 6OOIl1I practicallle. 4. H!he InIurw decIcl88 riot to renew 1I1is Policy, the __ shall provide wrIIan noIice 10 !he ,....lnellllld atlllllll eo dayI prior 10 lha end 01 the Policy PerlocI. The noIIca 8haI ncklde the 18810II tor" such 1l0Ilo/an_. 5. Arrf notic:ee 10 be giYen tD the Namad 1-.1 under Ihis section shBB b, pnMdad 10 the NIIIIad NIl_ BIlle Isst i<nowll pI1ncipBl addms Ind to Its ilsurance sgsnl or broker. The maiing by certlliad mall of u:h notice sh811 be s~ B. PropoaaI The Propolal is the bloMi of !his Policy and is ilcorporsted in and conslittllBS a perl 0I1his Policy. A copy of !he Proposal Form is anachad heralD. Arrf matllri8Is lIliImlltad with 1he Proposal Form shll be mUlt8inad 00 fie wiIh 1I1e 1_ end shll be deemed to be e1laChad hemn, IS " ~ atl8Ct18d. h is agreed by 1111 InIUNd 11111 '"~ slIl8manl$ il th. p,gpo.J ant 1h8lr ~, 1haI1hBy art material and that this Policy is Issutd n reIiInca upon 1ha trulh of such IIprM<<llltions. C. Action Against the Insurer No don sIl8lI is against tlllnelnr unlass, IS I Cllnditioo precadert thntD, there all.. have been full ~ with aU ollhe Ion". of 1hla Policy, nor untI the amount ollle 1ntutIda' obIlgstian 10 pay ahall have been finBlly dalermi1ad ei1har by ~ agail8t 1ha InIlnda after IctuaJ trial or by wriIIan Igllament ollhe lnIInda, the cIIllmllnl end 1he 1_. Arrf perICIIl or OI9I"izaIIon oc the Iagal raprwenlelivelhmof who hall aacurad such judgment or writtaII agraemanl with lie In_ ahan 1hele8I1er be enItIIad to recover undellllis Policy 10 the 8ldant of the insurance eflordad by tlis Policy. No pllIOl1 or organiza1ion shal have any r91l undel this Policy 10 join Ihe 1_.. as party 10 any action agsinIt 1ha InMlradllO determine !he 1nIurad&' 1iaIliily, nor shallle Inturw be impleaded by !he Inlllleda oc lheir IIgaI rBpf888IltIliwa BankruplCy or ilIloIvenCY of the tnaenda Dr of 1halr eel8lIIlhll not raIiM 1I1e 1_ oj sny ot Its obllg8lion8 hIrelInder. D. Firm Changes W M1g 111I "*' I'Iriod '*' Is I 50 pel OIld or gre&I8r chsngt ilthe Named 1__', tDlallswyer populalioo, I/Ien !he NIIIIId InIUIWd Bh8Il ~ the IIlIuIW wriItan nolic8 of such c:h8nQlllll. U 100I\ IS practicable, bul il no 8'IllI1I1a1e! "'an eo days liter !he eftedive dale of such ch5lga; provided, hOwever, lh81 this pIO)'..., shift not sppIy W the Namad ....... had lass "'.. 6 Iawyars who met IhI dafinlliln of IIIIIINd It Ille Policy i1c8pIion d8ll. ThllnMlNd sMI accept sny premium adjumlen1 or eoverage revisions which the I_".y f9QIIire. E. SUbrogation In the IYIIIt of sny poyment undBr this Policy, !he In_ shal be sublllOllad 10 Ille axlInt of such payment 10 sll1l1e 1ntuNds' rtghts of IIClMlry 1hll8ol, and 1ha 11IIUrad& thai eX"clltll allJIII8lll raqulrad IlIld shall do IVIrylhlng that may be nac;1 ~ "''Y to lICUl'e such rights i1clucing Iha 8X8CUl1on 01 such doaJmenlenecml'Y 10 an8llle 1I1e In_ to effectively bringsu~ ilthe neme 01 Iha InBInd8. LP 9200 (05-99J Page 6 of 7 The dascrilIions illha heacflllOl of tlls Pokv ant solelY tor oonveniencI. end form no D8Jl of the terms IlIld COIIIlIIiIlnf 01 COV8lBQll. Agenda Item No. 16K6 December 1, 2009 Page 36 of 83 AdmIr. Insurance Company .-0<- F. Anlgnment llis Policy end IIIIY and III rillI* htrIlIldar BrI not asa9aIile witloullha written ~ cllhetn_. G. Entire Agl'lllMllt By accaplance of tie Policy, the .... and the InIurar agree that..is Poicy (lnc:IlIdilg lI1e PnIpaIaI) end any wrIIIen endor1amen1S 8Ilachad hereto conalItute the entirt IIGratmen1 be\WWI the parties. H. Repmenlltion by Named IlIIurtd his If'Id that the NMIad IllIlnd shall w::t 011 behaI of dlnauradl with I8Ip8Cl to the giving at any no\icae under sadiana VII. A. and VII. B., or giq ..d receiq lIlY noli;as L81der saction VIII. A., the payment 01 premiuma and fla receiving oIl111Y return pl8lIliume 1hat mey becCme due IIldar lhiII Polley, the rlCllpl end aocepI8nc8 of any sndorsemBnIs illIuad WI fonn a pili oIl11is PoIcv 8IllI the ex8ICisilg or declillng lo aUK'1I 8I1Y 1911108l'l ExI8nded Reporting ParIod. I. Cover. Territory llis Policy triy eppIiee WI a Wlonglul AAt l8ldng place anytofleft in ... WOl1d, but 0Il1y 1118 ClaIm is made end au. is brought sgainBllha tnaunocl withil!he Unilad Slalae of Amtri:a, Is leIrIorIeI or JlO5MSIio'lI. In wltna&8 whenIoI. fla 1_ has caused flie Policy to be signed by ill President and Chief Ell_live Officel end Secretary, bullhis Policy.' not be vaId unlaea counlall9*! CIIlhe Daclar810ns Page by I duly .u1horized ~tM1 of 1lI~. s. '---.. ~.J/#~~ s-.y ~.'donl and CIIioI EUClJ/IVe 0fIicIr ,.'- --"~'- LP 9200 (OS-99) Page 7 017 The dascriIlIions in !he ha8dinaa of l1is PoIIcv 118 aoI8W!os _ienoa. and 1Mn M nor! nf 1M _..ntl MnriIlinn. nt.. .",ro'" - -.-....,....----. --- -, -" .~,~----,--~._._. -- , -,.~-~,.. -,_.,,'-' .t . \112112008 '5:54 I.lItgert InIl.nnCt (FAX)Z3I2ll2S3BO .L\genda Item No. 16K6 p!tmfO'tJ!r 1 , 2009 'Hpage 37 of 83 . ' . ,. ". . , Admiral Insurance Company -.a Fonn ,2IICIIdwIlRlled.Ch8nlHI.NJ 080S4 n....- LllW}'ers' Professional Uability Insurance C~ MADE WARNING FOR APPUCATlON THIS PROPOSAL FORM IS FORA ClAIIIlS MADE AND REPORTED pOUCY. RElATIIG TO CLAlIIS lADE AGMtST THE INSUREDS DURING THE POLICY PERIOD. THE AUTOMATIC EXTeNDED REPORTIIG PERIOD OR THE W-pklld~IU~==:==:::=Pokt. 1NIPlqIUF~. III b8 ~.... NIpso\ to the.......,.1 Fltm. -"~fm~~It~~t. CrOWl\.]>.Il. ,... ""'~I 11 i.l......'Y'l"'O Dv, I50t ' . I 01\" ~ ZlpClldl ~ ~~ , The .-__ ~;;';:'~ ~ Am Ind d 11._ 10 ...... any sncl 811lO11ll811ram .. -- err _1IllharlIod rsp~ Q(FQ~~ J~_~'~ . . GenerallnfO!lT1lltlon I. CMckIhe ballIl8t doocdb8B Iht"""" AppIcInl firm. lJ.liIiIId ~ ColJKllIlIan lJ ~ u.LII, M_.nIp i:J Po. olOllhlp lJ PrOlNIlao" ~""'sliDn Ill'llllenlansl CcrparalIoI\ i:J lIllIo ~ r ,... 118 I .... JItlPIIeIlIr, pruvIde Ih8 .... of lhe ..:..~s) """ ...., bl rapanllblo for yaw otIaIrI W you ... __I:lf.. -.led pMIod 0I11m1 ~.I. 'I8CIII\ln, linn., oll:). Nome: __ (CIy, SIBte, ZIp): lolopl1ant NulnbBr: ;m 2. 08It CO"oII,.",.ed ~ 3. Liltllle lUll'" oIIIPledtW'lO' Flrme 1D,*,-IHI\III1dIlllDiMIhBAppbnIfi1n IllhernsjrriylllGlMllfln lldudtlht llIIo ... PndR...... FInnI...............d IhB - 01 . Nu..' Pl'IlIIc.'" Flm llIte EIIaIlbbed of B...... 0IIIce IIr8ndl 0lIIc0 0fIc0 tkIlICIlOlficll 1011I_011 P arlllWdodlI OIh..dIIiIIII oIIIf . :3 CllrnpIM the ~"InIurecI8lJpPIeIn8II1II FomIILPL 1leOO}. 5. llooo any I...,... In 1110 AflI*Iri FIInI_ u a_I, oftIcor. In 1", , orpll1n" of, err -- any IidutIwy codnlI _, any,...- oIhIr Ih8n the ~I:snt Fml7 . "Yes'. IhB ~.. [J No f'IrCInIBGI of TIllII FInn ~ Orglnizltion _.n....,.,. NlmaolOlglnlallon FD'_'" Noo-Prorll7 PII;e 1 '" 5 LPLI605 (IIY. 05-04) 111211200I 15:55 \.lIt9Irt IrIIUrII'a (FAlQ239ZI253eO Agenda Item No. 16K6 rp~i!r 1,2009 Page 38 of 83 , . . /_. . . . . . . . AdrnInIlnsunmce compan~ Mature of PrMrt!ce . .-. a. ~1IIt,,1rIClImIl1or1llt8lllllealllafllC""V- ,""--_......blBdlDcI8II1Ilor..... .........lll ftyaolf AppIIc:IntAmddB prlmdr. OllIlIIg8IICYlBI ([l"'. ,....._...,UBI ,...-.l: . AdUllIorIl'8lDlCllleJ*lrayer. UC1 fU5...6tt.,(....~- !.E'-f!l'l4.h. 7. rdC8I8lhe.....a1~_IIIor.. pill.... ,.rdll!l\<Od"", ..1alIaW4i..- a1p18Cb: ~ ~ ~ I.~ .1. ~lM.Geneni " ...",,,...Cowra8I ... ~ .. I_DolBnIILIII. '10 A/IDInIIf/TndeRsgullb '10 IrtemIIIICIn8IlM '10 ~n .. 18bcrRslIllianB.L8bDr 'rt 8IIlIlrUi*Jt % Lobar RslIIIonI .lolIInIlg8IllInl " ~ and u... " IJlIv8Ilon (ClVIJ " ClIt ~ 8llCI ~ 'Yo l.lIcII Go\iImI1lIIlI La' - wIIlllU IIandt " _ _,., MIIgIrII8lII AcqIMIon8 \10 _ _" OlIlldGII '10 _" "...1IIIl~BInBtb - 'Yo " p"......IrfnY... NoglIg8nOI~"" DoIInBa --" " PI.......1rfnY and NsgIlg8nOl UIIgIIIan. pWaII( " . _ _" PWIc c:annoll8lW " _ _" Pu'ilicUlllin " _. . _" Re8I f'RlP8IlY' CoIliBJ.... - -" '10 Re8I Prup.ty. ~ '10 " IW PnlpIIIy.11Ia e....IIn..... " " SaaIr\lIIIIAw - iIdIIding IIUIIcIpIII \lllIld5 .. . _" TU8lilllI.OfrilnI " . _ _" T8IIIIan . PrIpaIian '1\ _ " \'IaIUlt' ComplIlIIIIGn \JlIgIlIon - PIIIInlII " " WoIUII' C/Jn1IllIlIIlkl UIIgIIon . De/InII .. .. 0f18r (llIIl: 'II " " . . . TarA\. ,..., 111Ofo 01. l IrdI:Ul!lI~Dl..AflllIcIIlllilm'lplai1l.hml........lcll.n..Ub. J,...o/ "- GllIIlral Polk;y and proceduree 9. IJocIlat end CaIandIr i'nlC8lIInI: (I] lloIlt III /fllIcIIIl Film onsinlIIn I pl8nnsd daclleI CllllII1II tyaIOm and prllCI- """ II ioIIt 2 nlopsndInI- llClIlllOII? (b) ,.. III docllIl arid IJII8a(Ilftllllt pracotluro ~ a..u/ltldlllaw ClIrnI\IIdIIlUgIIIan - D8I8IIR ~1"""d.alLlglllon" P1IrnUIf ~(FCCl ~Law ~...... Caqa8ID CdlrinlllIW _ .... .....,. MsnagIllIIIlI -lllIIIIli Maner.......,.m EI\llIIQmlIII\ILM EalIII, TIUSl"'1'!llb8I8 FI/IItyLaw Goll8lll~ He8lIlCIn l8mIgnIIIIln lIld NaJnIl,IlIcxI 10. Bu*III PI"" _na: ID'valJ HI> l!1 V.IJ No 'v.ONe 11I'1. [] No g"V.CNa o IC\- ovaiii'Na leIIn? _. (8) Doll.... Afllbnl firm" I'll lloIlt \lIB AppIIaant FInn msInlIln a ,,*",1lI1Ml1d c:antIdB or...-.a (e) III11CX11111* 1YIl8m~ \Il) How II*'Y _lor caIBc:liclI "'... h8't'I ,-"by" "..... Am ~ Ole past ~ )-a'I (8) How Il\lIl)' IaWjn oIllt1 ffIIIIl:8I'Il RIm h8't'I paltldpsIIIIln IaIInIII oanlidn918g11Da1on flIOP"I. af al Ie8It 1 houri, cWlllllll8ll yIlI'l . (l) 011II11I AppIcInl FIrm III.. aflIo8 .....11II*_, ,. ", ar leI8IIIad"'" oIIIIf IndIWIuII. 01 ClIUlIIII. ~, 11Im, ar OfVIIIiZIIlklII7 n"felt, provide, III .......1It8ChmIlIl.1h.!IIIM DIllie tnIIy(1a). LP\. 91105 (m.lH4l Pa;e 2 of 5 . . -"..- .._.".,,,,~..~-~~,,,, --,- _..~~-'"--"-- r' . . Agenda Item No. 16K6 December 1, 2009 P~390f83 12101II2OO8 08:45 Lutgen IISnIICe (FAX)2382825!80 , . . A_1m IMUI1Ince CCII1Ip8Iny Prior Insurance Inform.uDn 11. IIIv.CIlD , 12, HsI...~Fimarllll'~ In bWIilIDMrjandlond. 'EllIIIIGIdRep8fnal'lllall" cr'lJlow,<<Y PIIIcd' IIndBr I plcr""" wIIidI aIIIllI8cl'" dltlllIlplIlIllQ pII\lld It Il1e paIoy ................. III' -- t_"~.n U .,.', pnw*I8lu1 cI8lltL lJ V. Ii 110 13. UIlIhe "ldll8llonlnllbllly ~ pun:IllIHd lit... AppIcII1I Ftm fer.-:ll 01"''' S)'I '.. ..... LbnI d U8IlIIly 00cMdIII !'IImI.m Fmm . " II " " " , .' ,. .' , . . , !il'v.CNc I ,. 14. Ill8Ib AppIcBnt FmI'a"!'.sv1 "';~.J!'*'lIY sxpnd pcioJ c:aMIn" ...- dalI'I . ""I'...,lndIcaI8lhed*~ (Ma/DI)IY~ ~alion and Claim Information 15. Has.., 1aWyIr~ till AppIiI:llItRm__ rIMed admIIIIcn Ill~........., arupond8dllom ",...IilI, rapmw.dlld.1IIIlIcnId. arcllldplk1ld lit lIlY CCIIII ar sdIrin'IlIIIioI rqIIIII:(I I 'Vas', JII'C'ldOlllIldel* CV.ti'No IiIv.ONe . 11. DurIng blBll S,..., Ml8ny prcIaIIIan8llllbllycll*n 11I'.... madlagsNt'" ApjII. ,.~ FInn, ar 11I7 pIId8C88IClfln...., 11I'11I7 pat or pI.lnt...,..1n III ~Fim? ""'as', pIIIldIlIId8lIIIIllIIlIeCllim' IncidI1t~ faml (I.P\. 9&10~ 11. 11118 AppIlaInlAm 0111I7"""" In ... ""","","t Fim I_d..y faCt.__. or........ thal nP1ll....1n IIIlYpldoIIIanallllill'c:lllmcrault~!..ur.~F1ml,orlll7~lnm.-.arl8lYl8larlA. ,~ I ilJ V 8110 ...1n......,......Fim? (fl~t\. ct.fI..,,,,,,~ ~~~w- · . 'Ya", pnw*I8 fill dIItIII on lie CIIIm IInddInl ~ Form (I.PL 9810~ a;. . IT IS UNDeRSTOOD AND AGREED THAT THE INSURER St\AU. NOT Be LIABLE TO MAKE AHV p ENT FOR DAMAGES OR CLAIMS EXPENSE IN CONNECTION WITH AMY CLAIIlIlADE AGAIICST NfY INSURED BASED UPON, ARISING em 01', DIRECTly OR \tlDlRECTLY RESULnNG FROM OR IN CONSElJJENCE OF, OR II AJl( WAY INVOLVING AH'i PI\OFEISIOMAL LIABlUTY CLAIM OR SUIT. FACT, CIRCUMSTANCE,'OR sntJAmN SET FORTH IN RESPONSE TO QUESTIONS 16. OR 17. . f'IOISd5 LPL 9505\.... 05-(4) ,\dmIPIlntlurenll8 CompIlny PIe... Reltd ClIlllfully 1lle UIlIIBnIgnBd _Ill blMII a1111e ~ FIrm II1d .. peIIllI_ pcpol" ill ua h\U8llCllIIIdslw tlBllIIe .......... .. - hemI PI tnllllIIlI.....ci IWlIlIlllt I1llIllUIlb 8IIal8 hM beBn 1lIIda.. oIiI*lllltlld8nlln/llnnllOlllD .......... "'" pI1IIIII snd .. ....... ~ err.. PIqICInI Fam. The II\dIIIIgIIId Bgl88I1hIIlIII pII'IIWlI snd ItIIIrMnlIIlOIlllM8lIIa Iht PnIpaIII """" IIllI snr nosI8Ital ~ 1100"'" .. ... ........ 8IlII tilt 118J.. ...... .. .. b8IlI GlIht ~ _",...:I. lllI ~ fuItMr ..,1tIl1IIa PnIpo88I FalIn IIhIII 118 ocn*lnd 8II8CIl8d 10. a pall III the 1'IlIcy, My m8llltll 1UbITillad" lilt PlqIaIII faIIIl8h8ll be ............ CXl "will" -- IIIlI .. bII....,...d to b118II8Ched MIlllIl. ~ phpIC8IIJ 8lI8lNd. . I" ""* 8IJIIIIllllt . I.., ~ dlqt In lll8 0IlId1IDn "'... sppIcInllo ......_....-1IIe dill ",...1'RltIl8 Farm IIld the _1ncIpICXld*. ... ""*' "'* INs PI\:IpcIIIl farm ~ l/IIncOmP1BII,IUllco d" cIIqt will be..,rlld IIIll11t1nQ to lIII....lmmIdlsIBlr. . snr PaIoy, III_oed, wi be In ,......pan.........oudl ~ . IhII Prapa8II Farm Ia..... 0IIIIIl'IBIId .18IpsdI..... ~F1nB; . . III nI1I r:l ua Prapa8II Form _ oatl*WllIIe und8lIlpd lD purcllM" ........ _ .' lIllI: ... ,,'i--'lt PIInlNnl lliI...... InUI8ICI CamI*'I' PmpaI8l "-0 IncUcIng lIlY ".obIItIl sutmIlId hoo..~Ih, ..... be ha'd 111811t1l181l ClIIIIIIBnCL ~ POLICY CANNOT BE ISSueD UNLESS THE PROPOSAL FORM IS PRQPE1tL Y SIGNED AND DATED. !'.-11Ibml \hII PnIpaSII Fofm ~ spplllllIlal8 daCUIllInI8DDR tI: Inc., 28lill WIsI ~Acad, U. BOO, M8aIIoWI.IL llOllOI-COlII ,..',,< 0Illld: . <FAX)Z3IIZ625380 11/Z1t2008 15:56 I.Utgert nurance , - , . . " , ~ \)_'1I.0-01r - s ui::eNllE NJIlBEI\ .- LPL 1505 pv. 0H4) _..,.^~ .- -~'-~.'_,--~',-, "_.'w_ . -'-..-..- Agenda Item No. 16K6 December 1 , 2009 P.oo!1QCJ3 40 of 83 - Pllge4 01 5 r ..' ,~,----,~._,..._.-_...-., 1112112008 15:57 I.ut9II't Irsnncl Agenda Item No. 16K6 December 1, 2009 P.ooil&'l~ 41 of 83 . .' ., " . , Adrnlralll1llurence Company . IT III1NLAWFUL TOKIIOWlIlGLY PROVIDEfALll!, ~OIl-.EAlllll8 'AC'lIOIl . iiii'OlIIA'IIlN TO AIlIIl8UlWlCl! COIIPANY FOR TIE PIlRl'OIIl! r:1IllI!F1WIIIlNlI OIl ATTElI'TllG TO IIMlAIID 'IlII ~Nrt. I'IJW.TlES IIAY INCLUDE 1II'IIlIONIlINT, 1'1II11, D!IItAL Of INIURAIICI. AIID CML IWUlIlR NIf IN&UIIC!! CllllPNIf OR AGENT r:1I AN INIURANCE COKl'NIf WHO 1OICIWIIIIIl.Y PROVIlEI FU!,INCOIIPLETE. 0It.1UiADIllI fMlTl OIl 1II'OIlItA1lON TO A PClUCY HCIl.llER 0It CUIMAIIT ,OIt lIlE PIlRPOII! 01' IlIFlIAUlllIIG OR Am;JIfTIIllI TO IlIFRAUD 'I1l!! I"QUCY HaLDIK OR CLMIAH1' WITH IlElJARD TO A I!rTLIM!NT OIl AWARD PAYABI.E FaIlllIN8lJlWjc:e l'llOCI!!lIIlIlAI.L Ie RIPORTEIl TO TIlE COLClIlADO lllYIIlON Cl' IIBIIWICE _THIN THE Il&PARTNI!IIT Of R1!8ULA1OIlY MErlCIEI, . NlY PIII80II WHO llIIllMNOLY AND WITI1 MElll'TO DEPlWIIl Nf'( INIUIIAIlCE COMPNlY OR lInER PIIlIOIlI'US All APPUCAT101lPOlt IIlIUlWICE OR STATElEIIT OF Cl.AII CCllITAIIIING AtrlllAtalW.Y fALllE 1/lflllUIA11ClII, 01 COIlCIALI FOR TIE PUIlPOIE Of IIIILEADllIO. UI'OltIIATION CONC8IIIIlG NIf F~ 1IA'lIIIIAL THBErO, CC*mI A fIIAI,IlIW!NT IN8UlIANCE ~, WIIClIIll A CIIIII1!. AIID IlIALL ALIO . UJIlCT TO A ClYL PBIAI. TV NOT TO I!XCl!I!D PIYE THQUIAIlD IIOl.1.AIII AND 'I'IIE STAlID VALUE OF TH! Cl.AII FOR EAQlIUCH WlLATlOII. . NlY PIllION WHO KIKlWIIlGLY AND wmt IIIT8IT TO DIPlIAUD ANY 1N811RA1lCE COMPANY OR OTHER I'EIt8OllI'US All APPlICATION FOR INIlIlANCE OIl &fATalEIll' Cl' CLAIII COlITAlllIIG ANY IIAlEIlIALL Y 'ALllIIII'OIIIIAT\CIII OR COlICEAl.8 FOR 1IlE PURPOII Of' 118L!AllIIG, 1NFORIIA11OII COIICI!RIING AllY FIICT 1IA'IIIlAl. l18ETO COIIIIIl'I A I'llAllIlULEHT Il8URANCE ACT, WIIIC1lIS A CMlI! AND IUIlJI!CTI 8llCII PI!RIClN TO CIIIIIIIAI. AIID CIVL PEIlALTI!I. A1f'( PER8CIII WHO KNOWIfl(lL Y. AND WlTlIIIIreNT TO IIUlRI!.IllI1IAUllS OR IlECEMJl ANY __ OR 0TlER PER8CII FLEI All APPUCATK* f'OIllllSUlWlCl! OR STA~ OF CLAII FOR TIll PIlllCEEDS OP All IN8UIWIC! POLICY COHTAIIlIIlI AllY ,AlA IICOlI'\SE, OR MIILEADIIlIINFOUATIOII OR COIICI!Al.8 FOR TIE PIJRI'OSE OF MI8I.!ADIlG III'ORMATION C~ A!rf FIICT IIATBlIAL TISlETO, IS GW.1Y OF A ~ AND 18 8l&KT TO CllIIHAl. AND eM. PENALT1E8. . AHY PI!RSClN WlIO IQIOWINlILY, AND wmt IIlTEIIl' TO INJURe, DEFlIAUIlS OR DllCIIV!I AJf'( INUEll OR OTHER PElISON fLEI AN APl'UCATIOII POll IN8UIIAIlC! OR srATMJlT OF CLAI1I FOR TItlll'tlOCElllS r:1I N1IIl8URAHCE POUCY COlITAINlIIlI ANY FALSE, INCClII'\.ETE. OR IIIILEAlIItG 1lI'ClllIM1lON OR COIICIAl.S FOR TH! PUllPOII! Of' Ill8LEADUIG RFOIUIA'I1ON CONCI!RHlIlG Nf'( F~ IIAT&RIAl. THERE1O,I8 8lM.TVOF A Fl!l.ONY AND" 8U8.I!CTTO CRlIlIIIAL AIID CML PEIlALTIES. . rr IS A C_ TO JCIDoWIGLY PROVIIIE fAl.8E, INCOIIPLETE OR IIUADlHG INFOIlIIATION TO AIlIl8I1RA1lCE COIIPNIf FOR THE P\JIIIIOII or llEI'\WIDIIG ntI CClIII'ANY.1'EIIAl. TElINCLlIlE \IIPRI8ONIIEtIT, FINES AND DENIAl. OF IIl8URANCE IENI!fIT8. .' , If 18 A CllIIIE TO IOIOWIlGL Y PROWll! 'ALS!, INCOIIf'LE11! OR IIISI.I!AIIINlIIIIFORIIATION TO All 1IlIUlWIC! COIIPNf'( FORTfE PIJRPOS! OF DEfRAUlllNG 11\E COIIPNIf. PeHALnEllINCLWE IIIPR1$Cll111EtfT, I'INES OR PENIAl. OF IN8lIRA/lCf 1lENEl'1T8. Pags5of5 LP\. 8605 (18V. 05-04) 11/211ZOO8 15:58 LUt,er' lnIU'IIICe (fAlC)23l262S3l1O Agenda Item No. 16K6 DE!,<;!i'1lI<!ilr 1, 2009 P.uul'l!lg~ 42 of 83 . , ,.'" .' . . . . , IndlYldulllMU1'ld supplemintel Form Admiral Insurance Company 12&5 ~ RollI, awry HI. NJ OIOM Lawyers' Professional Liabil~ Insurance CLAIMS MADE WARNIlQ FClRAPPLlCATION THIS PRoPOSAL FORM 1& FOR A CLAIMS MADE AND REPORTED POLICY, RELATING TO CLAIIIIlADE AGAINST nIE IlSUREDS DURING THE POLICY PERIOD, TIE AUTOIIATIC EXTENDED REPOR11HG PERIOD OR THE pU~ EXTEIIDl!D REf'ClR'I1MQ PERIOD, IF A~ Nam8 CII .-..' Arm IWEALLOIIINEIl'I.l'/IKllI ~.,~~; A DN:1CRI.IloClOtCIlJII!REll'LQl'Elll.NlDiiI'LC7t&IllAlVRoATTM:HMI _ ~~IIIlElIUl'f'lJ!lEl!!''-'JlClllMIP1lE'''-~'' . - D88IIJIIIGnF. 'V' ~, Dlo.w~ ar SI-ooNhaldsll 01,.. AppIIo:8N Arm lIIlO ...... 1 d IoWjln ,.. ~ofl~ "ll" 5oIePl\lpllltlll "E' Emf*l'fId l8WjlIII (111IIII be smpape of o\IlIIIC8l1l ~l "c' "Of Cc\InW' attorn..,. fer """"" CllVII8IIIIIIIoIRd 'If! AnaCIsIB lorwhom..ovnge II daIirId ~ , IIIIIlllnUlld tI1aI'" ~ IIlIlInII8d tMnkl tIeCllIlleS I r-l of '" AIil'CII\t flmf1l.8wyll11' PIofealanII UlilIIIlY flnlpoSlII Fum IIIlCIIs III'" ..... .Irld~ DoIIIgn- ~ 1 O,P,s,e,c AdmII8d III YlI8ISil i1lIIviCMIl __ ~ Goad SIlIldInll dill NIIne or" BlrMoNr PrIdiClI 1IIr~1 1. t 3. . 4. 0 5. e. 7. . . l- I. 10. 11. \2- 13. 14. 1&. 11. 11. 11. 19. 20. -,.,'..-- of Pemor 0wMl'. Olbr'" )l..&.,...~~ Print- l1Is: .,. ~ - ,........:s- ll8Iod: ~ - '-0- 0, Plon..-1hiI PnlpoIIl Foml ildUlllng IPJlRllld8le ~ Ill: 1II,lnc. mo W8II GolfRlld. &111I eao. R\lIn9 ~ L eol)08.ol83ll DatacI: iluInIIlod AG&HT'S ill;fNSE N\JMlIf.R PIge 1012 ,-'. AGENTS !WE ~ P$l\ Nam8 Hare! LPI. seoo ("",.1I5-Bi) ---'0- , ..........,,- r ... lllZ1l2Oll8 1&:58 \.ut98rt inuRe (FAX)Z3826Z5ll8O ,t;genda Item No. 16K6 9>eZii.~ 1, 2009 ~430f83 . . , . . . . . Adm....II..u.ranc:e CompanY . _ , IT IS UllLAWFII. TO 1Ol0000000Y PIUMDl! FALl&, lNCOIRm.OR IIIUAIIIIG FACl1 OR III'OIUIATION TO A111l18U1lA11Cl! COIII'AIIY 'OR THE .URPOII OF IlEI'\tAIlIIIIG OR AT1BI'l1lG TO lJEFllAIIlllE tolII'MlY. I'IlIIALTElIlAY IIlCI.UIIE 1II'IlIlIOllIII, I'lIlD. DBML 01' INI\lRNlCI, NIl ClVL DMIAlIE& AllY IIIllUIWICE COlI'AII'I OR NJl!Nf ClI' All_RANCE Cf1IIIm<< WIlO KIlOWIMGLY PRDVIDS 'AI.IE, INCC*l'LE1I. OR ~ ,ACrI OR NQIIIIA110Il TO A I'QIJCY HlIDIR OR cLAIIIAICT PllR 1llI1'UIII'OII OF IlEFIIAIllIIlG OR A~D TO \lIPItAllD 1llI1'ClLICY IlllUll!R llIt CINUllT WITH IlE8AIUI TO A &mUIIEICT llIt AWARD .AYHlLl FlIIlIINIURANCI PROCl!EIIIlIHALL · ~ TO THE COLOIIAIlO IlN*lIl 01' INS\JIWlCI! WI11IN THE IIEPMTMENT OF IlUUlAlllIlY ABaCa AII'I PERIOII WIIO lCIIClMIQLY AlII WITH unINT TO IlEFlWID 1<<'I1IlSIIWICl! Cf1III'Nf'I OIl OMIt PIIl8CJI PUll All Al'PLlCATIOIl FOR IIIS\IIWlCE 01l STA'IIIl&llf OF C\.AIM COIITAIHlNG AllY IIA1ElULLY FAI.IE ~t1ON, OII.COMCEALS 1'01I nil I'UlI'OIE OF 1M8lJ!ADIIIG, 1NPOIIIIA'llDII COlICEIUIIIG AII'I FMf 1lA1IIIIAI. 1lIEIEY0, COIIIITI A f1IAUDlJlB(\' INIUIlAIlCI Mf. WH1C111S A CRIl!, AIlD IIW.~ A\.IO.1lII.lICT TO A ClYL JlllW.TY NOfTO EXc:&ED FIYE 1tlOIJ8MtD DOUARll AIID TIll STATEDYALlIE OF THE cL.Mlf'QII. EM:lIIUCMVlClLAl1OIL . Nf'I P!RIlOlI WHO lCIlOIIlIIllL Y AND WI1lIIIITEIlT TO IlEI'1IAUD AllY INB\llWlCE COIII'ANY OR OTHER PEMON FILII All APl'UCATION f'QII. 1IlIURAIlCE OR STATlIIIIlT OF CLAIII CCNrAlNllll AllY IlAT1!IIW.LY maE IIII'ClRIlATIONOR COIlCEAL8 FOR THE PIJIlI'OSE Of aEADIH\I, lIIFtllIMtIDH COIICl!IIMCI AMY FAC\' IlATERAL TlI!IIETO CCIWI1I11 A FllAl/DUL!IIl' \IIIUIIAIlCE N:I, WHICllIS A CIlIIII NIl SUBJ!C1II11C11 PI!IIIOII TO CRIIIIlAI. AIID CIVIL f'ElW.llES. . , AII'I1'EltIOII WHO KNCM'lIlGLY, AIID WlTllIIri!Nf TO ...... DIfRA\IIlS lilt DECBVES AllY __ OR OTHER PEIlIIOIl FI.ElI All AJ'I'UCATIOIl FOR INIUIlANCE OR STAtiENT OF CI.AIIII fOR TIll I'IlllCeDS OF All INS\IlWICE POLJCY COlll'AIIIING ANY FAI.Il!, INCDlII'I.ETE, OR IIIILl!AIl1IIG INFOIlMAt'lON 011 CONCeALS I'CR TIE PIlItI'OIIE OF 1ISLEAIIlNll1ll'ClRllATION CONCalIlIN3 ANY FACT IIATSlIAl ntERE'fO, 11 ClUIlTY OF A CIlIlE AJlD 1S.IJIJECTTOC\lIIIIIIALANll CIYL PI!IlALns . AllY I'\!RIlON WIlO K/IOWINlIl. Y, AIlD WI1lIINTIIlT TO INJUIlE, DEFRAlJDI OR DEC!NII AllY lIIS\l1lEIlllR OTHER .1!llION FlLEI All APl'lJCA'I1ON FOR IIlIUIWlCI OR ITAlBEIlr OF CLAIM fOR TIll! PROCEEDI Of AtlIIISUIWlC! I'OLICY COIIl'AINIIll AllY ,ALSE, INCQIII'I.STE, llR IIlSl.I!AI*G IIlFOIIIIAl1OIlllR COIIl:EAl.I FOR TIlE PIIII'OIE OF Ml8l.EADINCIIN,OIlUillClN c;oNcl!IUIIIG AllY FAC\' 1IA'IlIUAL THERETO, IS Gl&.'lYOI' A J'I\.llNY ANDIS IUllJECTTO CRIIINAI. AND CML PEIlALTlEll. . rr IS A CIlIlE TO KJIDWIN8LY PIIlMDE FALSE, IIICOIIPIEIE OR IIISlEAIllNG 1NF0lUlA1IOIl TO AN tllBUllANCE CQlPAIIY FOR TIlE PUIIFOIE 01' llEfltAllIlIIlG 1M! COIII'AIIY. PENALTU INCLUDE II'RISONIIlENT, FlNEI AND DeMAL OF INS\RWICE BENEFITS. , IT 18 A CRllE TO KJl(lMNCl\. Y PRCMOE FAI.8E, IllC011'LETE OR IIILEADlIlG IlFORIIATIOIl TO AN INIlJRAHCE COIIt'ANY fOR 'hiE pURPOIE 01' DEfRAIIIIING THE COM.ANY. PEIlALTIEI1IlCLUDE 1IIPlUIIOIlIlIi, FINES OR DENIAL OF 1NIllRAIlCl8l!lEFlT8. . f'I9l 2 012 IJ'Ueoo (.... QS.98) 1112112008 1S:Sll LUtgertl/lUll'lC8 (FAX)Z382lIZ&38lI Agenda Item No. 16K6 December 1. 2009 P.oo~ 44 of 83 . . /..--, . . Firm Name: Gl'IIIIt, Il'r1dkla, Peano., A1baa" en.-. P.A. AppUcattoD Dale: NtIVIlIDbcr ZO, :ZOOS . AddUld_ to JulmlraIID.....DCC COlDpili)' L.,..,.en' Pnfeuloul Liability W1Il'IDee AppIlcldioD . QtleatiOll 5: Attorneys who IICI'W u a dilectoJ. officer, cmpIoyee, or otbar mllD1l&1lIIICDt capacity for I past or pn:aent c:licnt .,- r... or % N_ rInD =- ~ .. Nome PnIf\I CTIIDI'I Po8IdaII HsId I. EdIJClllon Jloa4Illon of Colliclr NP No I. BMRIMombor NlA ~w<.ty . 1. Dru&"" Colllor NP No 2. BoBnI Member II: BuOcI See 8llOCbed lilt. ClOWll I. SIIIdn Hsrbnlohtlo_ThdI I'P VOl I. Tnuleo NlA 2. a.,. Mer..,... _ TlUII FP VOl 2. Trustee 3. DaD DIae 1D--I-"'.e 'J'rUI* FP Yes 3. Trustee ,ridkin I. NaplclII1f1a Cl10mber of NI' No I. ,.....lIIl1...putdl8lr NlA . C-OC"m..-oc 2. LcsdInhip Colllor ,cuadstion NP N. 2. CIIIir Bleel . 3. l'GCU l'oandalIoo NP No J. ChalnDIIl EmoriaII 4. FOCU PiDlDciq Corp. NP . No 4. 5'_1"" . . 5. Loo ~~ly Port Aulhorlly 8poeiol NP No 5. Memb.. ~CoIIIDI. G1a1 I. JlcaIom~ Drlelopooonl ~~ or NP No I. Bl81I MIIIIbIr NlA Colllor Coomty,lac. . 2. So4llIIwwl FloridB LIIld NP No 2. BoBnI Momber 1\ I otion ..... . Pesnoa 1. Ell of Leo D' Andrei NlA All.. 1. Cur8\Dr NlA 2. Ell ofMorjoiic Lan. lIrm 2. PmoonoI Rep . 3. Leroy It He'" Appollmv Thdl clieals J.~ daIIcI 7(131'17 4. Leroy L, Appall; Holm L. Appol 4. TnIslOe !my TrultAII forth. bonoIit of Ioalc8 Leo Cohill daIIcIlll3OI9I S. l"""l' L. Appol It H.... L. Appel S. Tnuleo hTov Tr1IIl Agt for lho _lit of Nolhatl peUx Cob.., d8Illd 9128/99 . 6. Lon)' A.. 'IboIIIaIlmv TnIsl All 6. TnlsIOC . daIIcIlOI26'OO . 7. Sco1l A. 1los. mav Trust All cJotocI 7. T...... 4ll7/99 SlnIuU I. Bat I; Trual of J.... ,enol< N/A I. V.. I. Co-Plllt Co- T\'UIlIO NIA 2. Ell of Jamoa WIUiomIlltI N/A 2. V.. 2. TIUl ProleclOr 3. 1lII of Iuao 'ODoI< NlA 3. VOl 3. Co-Pr II: Co- 'flott, 4. !!at of lolT)' Vorplsnk NlA 4. V.. 4. Co-PIl s. BsI1<. TnutofPbyIlil!C1)' Hardy NlA S. V.. s. c:o-Flduolslr . 6. BIt I<. TnIIl 00. Guy Hoavor NlA 6. V.. 6. Co-I'iduclory . 7. Incllana SocIoly ofSoulllwOll fL Nt' 7. No 7. Board Mombot 8. Mc\!IdIllrD F~ (I privati B. No .. Board MiIlllbor flomIlv f\>w:ldaticn --.., ~..._,-".~_.~,." -.__._-~---~-_.", ., , .. ~me of Organlzdon PIQIlt Slalus Clltlnt? PoallIon Held "" Held 11/21/2001I 18:00 Lul9Wt ~ Agenda Item No. 16K6 December 1, 2009 P.Ol~ 45 of 83 . . . Erro~ .. Oml.lona: David G. Budd Norlll America Invtlllmen Inc. Far-Profit Assl SecAI$ 0 FIllhAYtlIlUII DIN Ino. For-Profit Aaal~ 0'110 IMDO .dbaV in. For-PlQftt .. O'l'o Gu N Inc. For-ProlIt .. =- PresidoInt 0% GuW Horizon IIWII8Ime Inc. For-Profit VIoII....~ 0% GuIfIun I~ 7i01 For-Profit VPISeale 0% me RllVOClIbJe TIUat UlI 12117 1 For-Proftl r ru.... 0% MOlhW SIl LLC For-PrOllt MIIn 0% KWP L1.C For-Proflt AMI. 0% MlArlInda P . LlC Far.pRlfll 0% r . T LlC For-Profit .j;ea ADt Men D% Wesl~nc. For-Proflt VPlSecreta 0" III UblIam Inc. or-Profit .. VP 0'lC0 ~~n~lnc. For-PlQfit .. Vf' 0% PIul8 Pro nc. or-PlQfit H ~ 0% EvIdcn Inc. Far-Prollt V '" D% A~C For-PlQfit .. Aaat. Ma r 0% Hal UC For-Profit Asst. Mana 0'lC0 Snvwll'" C,_l!Ik Rench Lie For-Profit ... ADI. D% LowTlcle Doc~L1.C Far-Profit v. Asal Man er 0% ~Co.!l!:. Fa'-Prcfit ea . VPtsecrelB 0"" Sea. . For-Profit as VP 0% ~Co. Far-Profi\ /'.set Etlka Ine. For-Profit Il& VPI cretarv 0% 8S&T Inc.- For-PIafit -\l!!. As8l See O'l'o ~er Broth... Ine. For-Profit Aaat 0% a T .. B"""- Florida, Inc. For-Prolit AlaI. 88__ 0% ~nc. . For-Profit . a 1nN81 Dlr8ctor D'llo e' Inc. For:rrrollt I Inllilll Director 0% DaIcollI BMla, L1.C For-Profit .....l Se 0% Pul Moon Inc. . For-PRlflI - VPllia ere . 0% KMw Moon lno. For-Profit VPI 0% JobcIX UC For-Prcfit 8S ARt. MIl "r 0% Sheiltllr LLC For-Prafit at r 0% Dabudd L1.C For- t es As8l Me er ~ LLC Far-Profit ... As8l MIl R m&r["C Fal-Profit B8 ABel Mal er 0% Ie L1.C For-Pmfit as Assl Mane .., 0% ~a, loloC For Ass!. MIl 0 For-Profrt ea Alltt Mana 0% JewakI LLC Kumrln LLC For-Pro t tIS Aslt r 0% Kumalf. LLC For-Profit Aut Men 0% W. croea & AJaoQl8Ias$ FOI-Profit Aaat. Seere 0% ~tian LLC~ For-Protlt ~~ 0% I Rlok Man LLC For-ProfIt . 0% . (fAX)Z3IZCIZ5!IIO Agenda Item No. 16K6 ~.6,i'~r 1, 2009 l"I'ltfe 46 of 83 1t1Z112OO8 16;00 LUt9Il't I/IIlI'IllC4I . . QuestiOll 7: AJQI ofPractiee , Pleue be advised that we do not IIIIlntaia our bi1liD& aud lIl:001llltillg Iystems in . I"DnN!I' that permits us to Preclao1y break our b1Uinp cIoWII in the II\IllID8l thai you teqIIIM. Our defiDitions or pnetice areas also do DOt exactly match yours. SOIllt:l of the .... OD your fu.rn - uaclafiDed or DOl'included in your deflnItloas. We have tDBde subjective judJlllCllla in . way !hat is ~ tg COIIfona to your criteria II much IS possible Biven tbeIe 1Imlts. . . Our practice ereas as defined by our billiDSll)'B\lm1 are ICIl out below. Area ofPraclice Bum"" Trat1IlICtioDa - Coramezcial Law l!atatc P1aDnin I Estate ACIm.iDiattation I Trust / Probate I GelIeraI Petcent 4.5 32 6 40 15 2.5 100 Real Estate - 0e0claI1 TI9"~OSI8! Real &tate - L08l\I TOTAL .,..~ QUestiolllli: ClailDl or suits arisiD& out of the rendition oflcga1 servicea made apm.:t attomey(l) cluriDs the past 5 )-,: W"111iam Peanon - Sposit/EI1me of Shirley Pein;Oo WUlilJI\ P......oa - McNeiI/KautiDan Jacqueline J. Buyze - Bevan va. (DOt legal malpractice) O. Helen Atban - SmDlIwood v. A.thtm Richerif Onnt - Sigllatun: Cnmmllnitics, IDe. Ricblrd Omnt - Emergency Physicians ofNaplea See atIBcbed I\IDlIllIII'Y of enon audOJDiuioa iasues. We will provide a lUUIe tletailod expIimmon of these malters during the week of November 24,2008. Question 17: Fact. cimunat/"V""s, or situations that might te8UIt In 8DY professioaalliablIity clal"l or suit ap;not the Film, or BOy pred~ssor in business, or 8DY peat or p.4S(.nllawyar&: Richard C. 0raDI. - Basil Street Partners, LLC . Jeffrey D. FridJdn - Jacqueline Bus'nn;.... ~erome M. SttauIS . Trust of Phyllis Kay Hardy (not legal malpractice) ."'- '^.....,,_.._..... '0-- -_.._~,~^"- .. I 11/21l2OO8 18:01 LL/t9Irtm&nlce (FAX)238ZllZ5380 Agenda Item No. 16K6 Dece..'llP.W 1, 2009 P.o1~i 47 of 83 . . . . . l'InD N....e: Gnat, Frldkla, Pe.noa, Adln " CtoWI'D, P.A. Applle11l0D Date: Non.mber 2008 Adalnlllllgp-ee Company LawyCft' ProfaalolUll L1UUIty IDIal'llllca Applicladoa Individual wand hppJeaeoUll Jlorm 2008 List of Attorneys ..l~"~ D...,. _to "'...... La, ,--...'.INI."f.... ~1,1 .. . ..-.-. ..... .....1 "'-lit ... ttI"AIIOC~ ~.w.... r .. ... 21.1 1"'_ r n 1'l.....l1l.111 AllIn. 0.111' 11 0 11m .. ....11.... L8w. "" I '. Fl.......... _.,..0. . c ..... .1 c-..,....1' , 1'l.,0H,- Cl_,.I~.IIRI\. 0 11", n F' . "~nv fI.._ flsIrll\~""lfI.,D. 0 .., n . . .. Lf4IP"', CNI TMI F'L.,MO........ __c. 0 .... .. ..... ....U!. Cot "- I'l.,...... . " 114.&.,QIIyIL" 0 ........ I .....----,0... 1 PL._ 1_' lW/,Aa-~L1S. .. ..,. , '''Ot.''" fI.._ "__1Dl,,1I1"'q ..... 0 I_ I' WIII.'T~&.".. PL.1X,_ 8'Al!1r "'0.. M. C - III VWII. TN.., r..,1 - FL."I""" . T, - ... a_' IT. .. - I 1:1...._ twl~I_..~~I.DllII PL.- W4 _ll'~~ D.lCllllb 0 III' 11 ~.4.ll PL._ "*'-14'.0"..... I 1011I' II 11..-.6 Tu p' ~. PL.1X . "'V. I." CJNoorV N. 0 - .. ~.. .oW t __ .. -, ,... 'IX ~ - . . '" """""",-",~"._,.,,".. "'",,, ,- ._-- . AUacbcd is . IIUlI1mory of pe:ading mstmrs that haw been or will be reported 10 0Ul' eurrmt ~ Zuricb. Insunmce Ccro1pIlJY. It rDa'/ be ptOViclcd to other pci1l::ntW c:uriars to evaJuaIe oW' fum.. It be, bl) n prepared in IIIOStly gCllllrie bIllS to preserve llOllfidelltiality. It sbould be trealIld as conficlcotial. . 11/21/2001 16:01 Lutgert nannce (FAX)23926ZS!80 Agenda Item No. 16K6 December 1. 2009 P .o13lll3!7e 48 of 83 . . r - .- . (~fPA(~ ATTDaMITI AT 1.4. . . .. .' _....__.~ ~ .. .._.,...~~l.~~!..~.L~nIAN&.OID~!.~A. ml....-Dmo._SOl N....I'\addI3410W71P Tol23P.514.IDOO '"" 23UI4.ll377 RIClWlDC. GRANT Bod ClrtllltllRalIlslllOAllomoy :I:lp.514.1DOOIld. 2lm ......oPl*..... -_....~ November 3, 2008 Huat1cy A. Hombeek, Pzcaidellt Lutprt Jasuno"OC 139S PaIl=Lanc, SuI1B 100 NspIes, FL 34109 Ra: Grant, Frldldn, I'Rn;lIII, AtlAIn & ClOWn, P.A. P.......lo.... Llebluty '...uraAC;' Doer Bad: . . . Let me or JclJ FridldD know if you IIcctl _ lnfurmaliOD or if questiODS exist Yffr'J truly )'OlIfI, "-.-... - lUc:MJd C, 0raDt RC~w Eaelosure 00: Jeffrey D. Fridkia, Esq. . . ,.,_. - ,....~-,-,-", -.. ...- "....~._~._~..- ... r .- - - ......_"._n'W..'."'.__.__....,, . Agenda Item No. 16K6 December 1. 2009 P.01.wW 49 of 83 1112112(Q1 16:02 Lutgert InIlnnCe (FAlQ23826253llO . . . . . Graat, FridldD, P-a, Atb.a .. CrowD, P.A. - ElTOn .ad Omlasloa 1.._ Thia ~ and expJab1a the claim fqlOl1S we have IlIlIde to our 08 OlIlller, Zurich lDsuI:ance, tbat lUll DOW pendinlllllld other matters that oould be the basis for future c:I,lm.. This 8UIJllI1C)' explains the bBCkgrouad and the status of all the matters Iavolved. Theso IIIIllten are quite untypical. They have ~ifdt8bly occuu.,J in a sbort period of Ii...... The matters involve three of our shareboldera: Ridwd C. Otant, Jefliey D. Fridkin, aad a. Helen Alban. They are explained below. Smallwood LudacapiDs. IDe. Smallwood 1.Imdsc8ping, Inc. and its sole shareholder, JOfnne ~m~llwood, w= elients of our film aItbDu8h nor for gcnersl corpcnate matters CJIliOing. RatMr we bad periodically provided colUllCI to Iuir on disputed matten. bl 2006 Ms. Smallwood foUDd a buyer for tho lIIICtI of !be company. Heletl Athaa in our firm was cogaged t\l review, advise, and negotillte a letter of intent, 1lSSCl88le Btllcc/'uOIlt aad handle the closing. Ms. SJD8l)wood claims that Ms. AtbaII failed to lIlIcc steps to protClCt her from these losses and to guard agoolnot !be bvF clOlmll clown the bll,;n~fS thus llepriviDg her of tbelc bellefits. She bas JUcd our fino. and Ms. AtbIIII. . Shortly after the sale WIllI c\oaefl Ms. Smallwood bwalllG embroiled in a diapute with the buyer of tho. bllS!ness over her own performance and cllllms that she had mi&reln-..a...1Ilcd material matters. .AJi a result the buyer ... ..,;lUItcd her continued ServiCCll and Iiquidatecl the bu,p,.,-o thus deprivizig her of future compeosation and an eamoUt payment for the business. That dispute resulted in litigation betweeII Ms. Smallwood and hlS\' lni~r. It was 5Cltied betwceu tbcm a Ww months ago. Ms. Smallwood contends that Ms. Alban failed to take steps to protect her from this. We dispute this. It is our belief tbet her lD!lses primarily resuItcd Loa! her OWD fallme of pcdo.....nce UDdcr continuing Ijpu.."""ts she had with her buyer anell or miSlepRSClltations me made to her buyer. Ie out cise a ODD biadiDg court ordered arllittation was held in JUDC 200g. This is standard procedure. Tbe PfOCClCdicgs w= c1isorPQi~ and thc arbitrator appcers to have becomc COJlfused.'Tbe attorney IlI8igucd by Zurich to tepmeDl us in this matm' bad not c:xpeetcd to have tho arllitration occur lit this time as be had filed a motiOl\ asking !be court to defer it. The court denied the motion. AJ!. a ClllISeqUeIICC ourlltlOmey was not as we1I prepared for the arbitration as he 'could or should have been. Ms. Smallwood's attomcy presc:ntcd an expert witneas who bad ZDviowcd tho files and who testi5ed in somc detail why it was his opinion that Ms. Athan bad failed to propcrly ~t MI. Smallwood. Our lIltl>mey did not rcfutetbil as well as it could have been. The arbitrator rulad against us aod cctercd an awud of over S 1,000,000 against our finn and Ms. Alban. We have dctermincd to proeecd to a full trial. We and our COlmee1 belWve that it can be shown that thc bvF's action was taken, and was petbaps justified, by our clieD.t's OWD action and the miSlqlrot(llltatioas sbe mMe. Wc also believe it C8lI be shown tbet our cUent had adequate leaal recourse to II\COVCf mytbiag to which she wQ entitled b~,..-d on the doCUll1Cl11S cxocuted lit the closing other than the ~covery of lID ~Jlll\out pl)"""nt .i",.-e there was DO later pe:formancc on which to base it. Curiously the I ,,-- , Agenda Item No. 16K6 December 1, 2009 P.01~1, 50 of 83 1112112008 18:03 LUtgert n.nnce (FAX)23II2IZ" . . . . mbib1ltor n1Ied that WI! weN not liable for the loss of the eamout, but '..e.e liable for the loss of aa1cy as CEO. Wo may have'some llXpOSW'e to the claim tbst we should have takeo 81llps to insure paytllCDt of the unpaid IICCOunt payables, but those are in the S 1 SO,OOO nage. EmplayJDeat CoIllnct DIspute Tbil olietlt is a profelsioaal pmctice group. In 2007 It entered iDlo IICIOtiatiOlll with 1hreo owner-lllIIIlIbeIa 10 witbhaw from the gtV1Ip. Rit:bard C. Grant acIl::d . ill COIIIIIei in drattiD& and ccgo1iating the ........ of the documentation. Thm Is a problem with the way in which a clause in Olle of the documentsla drIlfted that has resulted in our c1lel1t baing sued . a ~t. It did Dot 8lIOIIr&tcly state wbat was intellCled. The c1ieDt repnICII1atiVCll bad IlIDple opportllDity to Ieviaw- it and note the problem before it was axecatcd. The cI1ent BCkaowledp that it sJwes responsibility for the probletn. A suit filed by ODO of the withdrawing members has .~ently n:sultlld in a judtpIlatlt apinst our cUm!. The hasis for the judll',-'ot is the claase in C(IICItion. We have reacbed 1/9~.ent with the cUm! to sl:uIre notlOO.<l than fifty percent of any loss it sustains. . Two other fonner members catered into similar contracts SOOll after the fint ODe. The client handled tbDse itself; but \~ the 58IlIe set of dOCUlllClIIlI. It evllO ",ade some nlVisiODl to the clause in question. We continue to represent this client and have its confidence. CoDdoDlIDlum WIlTIIDly C.e This client owned a resideDtiaI coDdominium unit which she had purchased from a developer. She lllICOIIIItmed a serious blown inaulatiOll jnfestalioD that was as a -wt of COIIItIuction dcfem and mpged Jaffrcy Fridkin la our firm to sue the developer for dlmages ""...... on the provisions of 1bc Florida Condomlaiwn Act which mandate tbst IIlI colldomiaiUDIllllits sold include certIlin statutoiy warranties that I developer and the contractor are de>""''lCi to provide. The appli4'&ble Ilat\ltO dOes Dot provide for the recovery of attorney fees by the preval1in& parties. The developer defellded the suit aggressively. ID its pleadings it (lemandad ~ feClIlf it wen: the prmdlinll party. We did DOt move to strike this delf\smd, but we did file In mswcr that dclIied CDlitlelllllllt to attomey feels. The purchase con1r8Ct for the unit conq,ined a provision that the prevailing party in ID)' action "arisinll UDder" the contract wou1c1 be entitled to recover attorne)'I' feels. The contract expressly dilc1aimed any wan;anties except those arising UIIder statute. The lawsuit we filed expressly claimed to be brougbt solely UJlder the Klatllte, and did ootlllention or rely UPOD the CODtra~ M the auit progressed the court ordered non bindillg mmdalory arbitration. The arbitrator Nled 8&"inst our client. As a result the client detllrtnined not to proceed with the cue and to dismip it. Eb...t\ Oft the theory of the case. and the abseIIce of lIllllUtory attorney fees to the prevailing party, Mr. Fridldn advised tho client that sbe would not be liable for the ck:vdoper's lIttomcys' fees. We df.....isRd the 5lIit as deaired by the clicat, with hor decision to do 10 beillg in reliance OD our lIdvlce that she would DOt bear tho burdoD of the developer's legal fees. _. 2 -.-.-_---,, _._,._~.... -.......,,~.,. "---,,.,-'-'''''' r _H __ '.. ..,~.__~..._._ _ ._u. 11/2112008 11:03 Lutgert....MCI (FAX)23I2IZDIO Agenda Item No. 16K6 December 1, 2009 p.ofilb1751 of 83 . . . . . . The 4eve1oper thea 61cd a motion to recover ilS IIIll the contractor'l sttomeya fi:cs. Bath argued that because the conlDct by which the client purchaacd the condominimn uilit foUlU it confirmed the exi....ee I1f the stalutorily mandated warranties and provided for recovery of attomDy feel In the eveat of a coatractuBl diapute, tbal the dispute aroIO Ullder the COIIlmCt, IIOl just bucd 011 a SlIItutOl'y WBmIl1ty, and that U I resull both were entitled to recover attorney r-. Mr. Frldkin bas bc;(11 told tbat the lIttomeys' fees being sought total about $250,000. Ho~er at this time no besrlna IIu bot..... SIll to establbb 811 awud of fees. The developer has filed for baDIaup1cy, and Its 8ItOmeyS bave indlClllcd that it is UDSI\ftl if 11 will proc=d wlIb iu cl_im for fees. We believe the colZrt erred in ita ruling 8Dd that subllantial aUlbority 8IId the tbeory of the e-o- will support a revenal on appeal. W'rth Zurich's conCllba."ll!, M have Informed the c1ieut that a boad will be posted pending appeal,. at no cost to the client, ill the event a j\lda>,......t for attomeys' feel is enllftd In the c..... We are defending our clillllt apmst the fee cI_im at DO cost to the ~Ii;ot. No fonnal claim by the clieut bas been made. Developer l8IlIelI ad Claims Our firm bas a subItmtiaI. practice involvina the provision of legal services to real estate developers. ID the put two yeara, U the -' estste IDIIrket has deterionrted, buyers of property under COl\$lnICtion have iucreuingly looked for ways to avoid clollng em coatraCts and ways in which .to recover earnest money deposita. GeneraIly this invol yes trying III fiDd fiwJt with ~ coatent, jbrm, or subslmce of a Jea! eslate pun:Jwe 11&0' ',lel]\ or with the pwceas by which the deveIopec has engaged in selling its product. A common method of finding relief cxista if the developer bufailed to comply with the Interstate uwi Sales Pull Ol8cloo... e Act (ILSA). If applicable ILSA requires either fcderaI reglslmtion or satisfying the requimnoltlJ of ODe of many exemptious. Failure to comply with ILSA mlden aD coDtnlCtll voidable. We Iutve ODe cliCllt who has sustaiIIcd some deposit ]OI5C8 becauae of ILSA iuues that exist with the doo.,..,""tB ... we dnd\ed and! or adviOCl we gave. . We have another c1ieot who has OllCOUlIlcrcd some legal issues wlth S\lIIle 1cgal documeDIS that we prepared for a mixed use coodominium project inoludlng ~cIcDtial. IIIIIIiDa and hold condominium unitl that oouId be a baeis for a loss. The Issues teIIIIt because of the lnclullioa of provislODl in tho cIocumeIIls that erroneously dCllClibe the size of certain cClllllollllnlum UDi1B aud that provide for !lmJtatlona on tho use of certain Ullils by their ownen. The UDit IIi%e ~, bear on the value of the Ullita. Th~ use limitatiODl bear on wbetber the cliont can be wd to have imPosed SDcII restrictions OD its own or wblltber the reslrIctions can be said to be ll\CRlly lmpllllMllting me<:banlsms to ;nmlO compliance wi1h exis1hllllO"",..nlental use restJict:lOII9. If found to.be the fonner it can be argued that the sale oftbc hotel Wl!U Is not in compIilllCO with existing guldeli...... for the aa1e of hotel coadominium units and might be fout1d to be a sccurlty thai would have required rcaistnD.on. We believe that we ~ly advised lbo c1leot on the l1O<{Uircd content. There iI an issue over our responsibilily to lnswe tbat the clieot pmvldecl the lDformatlon. proper . 3 ...., ,.'-" ....- . Agenda Item No. 16K6 December 1, 2009 P .ol7lot752 of 83 11/2112008 18:04 lUtgert l'IIlI1nc:' (F AlO238282531O . 6o.. . . - . Tho _Ii for our firm it whether wiU focus on tba reuonablt. J'n of our reliRIlI'.e on iDformation provided to us by the clieat md its other professlollllll!bat was lDc1udcd in tlIo t1Ol:11Il-nl8 that We drafted These: devc:loper IIl8lter8 involw poteatiaIly substantial dollar rnm~. Rlebard C. Ormt is primarily respcmslble for our servi_ tp these cliaats. S__ry . . As cen.be seen the Smallwood IIllIlH:r IIlIlI !be developer is8ues have the poatlaI to be large 0ICp0IIIRS. Tho convergence of aIllbese IIIIIlten at oaec: Is UlIfortunato, but not iDdiclllive of lID 1IIIllerlyina Wiure or aystclllatic problem with our 11lW firm ClOmpeteatIy plllcticiDa illw. Cot1BiDly the dove1opcr IIIIItterI would DOt likdy have IlriseII but for tile delmiomtcd rc:aI estm market aa4 the problema of the tiDaDciallllUke1s. But tbst is DOt relevaot. NonetbaIeaa we do DOl believe 8I1Y ofthcae matters, or 1he couverpmoe oftb""', is 8lI indicBtion that our law firm Is a bed lpsurance risk. We IIlIiDtIin 8Dd lD8lIIge a good practice. We do it carefuUy. , The lb._lawyers involved in these matters have practiced respectively for 35, 25. aa4 20 ~~. . None bas mlI: bad a malprllCtice claim prior to 1bese matters. AJl tb= enjoy A V DtiDgs 1>om Martindale Hubbell md haw been reco~ by pcc:l1I by iacl118ion in Best Lawyers of America. Mr, Fridldn IIlIlI Mr. Orsnt have been listed as Super Lawyers ami Mr. Gnmt bas beeD Iistcd among the Florida LcpI Elite:. Mr. Onmt was reoeotly IIdviacd that be: bas b..cll selected as thl singuJar best lawyer real estm lawyer orlbe year for 2009 in !be Ft. Myers- Naplea area. We: have bcQ.1 insured by Zurich since our incoptiOll on Jill.....,. I, 1995. Zurich baa _er beell .rc:d to pBY any cIaifTl or expetISC on our behalf U1Itil we exceeded our fifty tbo1'pnrl dollar ($50,000) dedueb"ole for 200& on tba Smallwood matter in the I1lDIIII<< of 2008. We pnIlllice law in a collaborative ami teRm llppIlIlICh. Most advice, COUIIIICl, and decision makiDg CODCeiDins the Iwt_ of legal matters is dollO collabonllively involving more tbaD one lawyer III guani apiDst oversilhts or "'. or. The: issues Jd-nt.c:tI by each of tbase lIIIIltc:r8 lIJ'e cIiftereDt. tbc:y ~t isolated IituatiollB. They are not repetitlw, nor indicative that they .eo likely to be repeated. Our firm eqjoys a very good reputation for tauIts, quality legal war1c, md cliCllt service. That 1qIUllIli0ll bas b....:n eamed IIIIli Is c1eserwd as Is inclic.tcd by the aecolecles described &bow. It sbDuld alto "" noted tbIt, except for Ms. SmaIlwood, all clillllts iIIvolved ill these matters COIIIinuc: to ~ collfideace ill aDd use our law finn. . Gnmt, Fridkin, PeltSOD, Athaa & Crown, P.A. Novcmbet 3. 200g . 4 ,..-..-- -, ...,---...., ~..,_.._. r .-..-.... - -_.-.~-_._..._--_.., -. ..-..-..-.....-.... --..-..--..... - .-._.......<~>_.., .---.-,,-.... 12117/2001 10'.37 Lutllrt mnnct (FAll)23Il2ll25311O Agenda Item No. 16K6 December 1, 2009 P~1753 of 83 . . . Age:tlCY Mllfketing Services DClC:lelIIber 16, 2008 Page 2 . other slIltUlory requlremenlll simply require that we belteI' sc:t1IliDi= dOcwnetlQ thaI we draft and pay blllter attentiOll to !he sppIication of 1Ip]l6cable IIWS that bear OD those documonts and oonttacts, AU Itt~ys involved 'in the finD Bnl painJWly 8W8le of 1be problem8 thl1 exist in not doing so. I believe adequate JI'ooodw-es and steps exiSllO guard apjast dlis oceunina in tho future. Lawyers ill our fum work with other lawyers In oar finn on most mattcn, consult reaularlY, BOd ask each other to review !be (llber', WOJt wberc there are s1galfle-nt isIucs and concenis,. We use this precess to guard apinst elTon and oversig1rts. . With respect to the tD8llt:r in which our firm. i$ involved iD litigation with .. fe"...a client, a goof deal of what has resulted ftom It could have bIlelIawided by having preparocJ BO eaaaaement letter with that client, b~g better docuIIIented advice thai was g1vet1 to that client, and COIIfirming in writing infomIIltiOll that the client gave 1D and risles that the client ~tcd and of which the nllent was aware. I do IIOt believe something like this will reoccur. . If you hlrve further quest!OI1ll or need mon: informatiDll pieR"" let me kDow. Yor)' Iruly yours, - ~-... - Ricbatd C. Qrant For the Firm RCOljw Bnclo8U1l:1 . . 1Z/17lZOO1 10'A4 \.Ut98rt....Rt (FAlQ2382I2li3llO Agenda Item No. 16K6 Def.li~I.,1, 2009 "fl6~o4 of 83 -- , , Lawyen Professional UabWty lnIaraace Polley DIdInlIDI8II 'l1Ila II. Cola NIdo 8lllI___1'oIlo)I. PIo_ rm_h PoIloJoaoIidIy. n. poIiar IlI1mi1od III IIBbiIily Illr GIlly IbaN C1si11111balllllillllllldo ..... tIoo 11...... ...s repodllCIlo till: CoaIpuIf cIurIac lbo '*1ratod. .. ZURICH ,.,NuDer. "Pro 3.17....-13 Ra.1llle!NIaIIIw: x.n. 1nUIG.U ilia I. ll-....,..8lDCt.......,...... 88d~ OIUodIllec.pu, IJIIaIGalI ~ . ~'r'I.Xft ~..._..-cII oOCIIIPUX' _2. Noo-lL-.d.IIllIWolIIaaAdcbac I&UII' , 1'aJD&D, ......, _._...11. ISll......-..~ IJa%ft ~ 101 . -- Pro ~noa ~ ",....cr __...c.s. DIC' . rr. .,0. _ 1721. n. ..c. ....", ... J).,,.-7111 , COlJl~ r-3. l'GIIIf Pwtod: J\ -, 01...,..-100. 'hi 01-07.-20" 12:01 _ll1OIIIId 'I1nl1t tIoo..... ortlle NAMSD lN8UIU!D ........ sboYe. -,-""~" _ 4. J.lIIIh ofLlobllit7 I!aI:b CI8\m ~ ilia 50 J)edIIGIIbII ilia" J>aemlum aoo. na -.acr ....,. Ftt--II-Alle:WatlK'-. S I.OO'.OOD . I 1.000.000 S 10,000 I .....,.00 1.041.14 - ZOO. PIllA IIlII'IlII&' 'H.Of 1.110..4 lEa ATI'ACIIBD SCII!!DtJLB 01' JIORMlI AND .--. CaDIO~.ClolIII 1-800-987-3373 . Iil)' ___lllI'lblo poIIor'" r ............IIIst!be _.....110 fa bo cIooIoaoIioaa _ tile ""lioa"lIllI rIff'- .....~ lID lbo 1111._.... DIIllI ~ 88d Chu lIda po/Io1...c1i...U"," . IIlCIIliof We tIoo.....nd IIllI tho ~"rlfforllo ~ IClIliII& tollda _.... .. .eo.n-IpIlI at: SlpOlI~ K...t',., .~- ~~_.w'-I;~a :u/ll/.7 ""acD.. IlallI~ Ill. _ ..&CIl. PL --'" lH'lANn'O\ CW l'Ml ..... ot~ . - '--'.,,- -.--... -- ,- ~-_.' I' --....-..--- ---...._- ._"~"."-- /I :';I'"...rl~ It-,.-.,m "'-I...... ~ cy~ December 1, 2009 Page 55 of 83 FLORlDA-EXCESS LIABILITY POLICY DeCLARATIONS Landmark American Inlunnca Company (All C*~"""1IIi SD:t Co.) (lwli_...... .... Canpony') EXECUTIVE OFFICES: 945 East Paces Ferry ROIld, Su~e 1800, A1lanta, GA 30326-1160 PoIIc7 Number: LHZ720235 RENEWAL OF: NEW Named In.urad ""cI Melling AcIc1...I: Producer Nam.: GRANT FRIDKIN PEARSON ATHAN AND CROWN PI'. 555t RIDGEWOOD DRIVE SUITE 501 NAPlES, Fl34108 PDlll:yPeIlocl: From: 01101/09 To: 01101110 .Ut:D1A.M...'.donlTlmo.................odtI_....- dl__1o. IN CONSIDERATION OF TIE PAYMENT OF THE PREMIUM, IN RELIANCE UPON THE STATEMENTS HEREIN OR A"ACHED HERETO, AND SUBJECT TO All TERMS OF THIS POLICY, THE COMPANY AGREES WITH THE NAMED INSURED AS FOLLOWS: 1. PROFESSIONAL SERVICES: Law Firm 2. PRIMARY INSURANCE: Admiral Insurance Company LPL 16746llO-12 0110112009.0110112010 3. DESCRIPTION OF PRlIIARY INSURANCE: $2,000,000 per claim and aggregate TBD Lawyers ProIee8Ional Liability . 4. DESCRIPTION OF EXCESS INSURANCE: a Exc_ Profeaalanal Liability Coverage Form Claims Made Basis $ 3,000,000.00 $ 3,000,000.00 5. PREMIUM: $ 45,000.00 EllCh Claim Aggregate Limit 01101/1995 Not SubjeC1 to AudR Filing Fee: $35.00 Surplus Lines Tax: $2,251.75 Stamping Fee: $45.04 FHCF: $450.35 A Hun1cane CAT Fund Emergency Assessment eque/to 1% of the Florida premium is applicable. FORII(S) AND ENDORSEMENT(S) MADE A PART OF THIS PClLICY AT TIME OF ISSUE: sea attached fcrmllisl. THESE DECLARATIONS TOGETHER WITH A SIGNED COPY OF THE NAMED INSURED'S APPLICATION FOR THIS POLICY, COVERAGE FORM(S), FORMS AND ENDORSEIIENTS, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABQYJ; NUIIBE~ POl-ICY. Del. RSG 50016 0607 Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE ccfrlF"ANf of 83 ~", SCHEDULE OF POI"ICY ATTACH,gNTS AN!) FOBMl!. RSG510261103 Excess Professional Liability Coverage Form Claims Made Basis - RSG 51026 1103 Employment Prectices Liability Exclusion - ROO 56027 0903 Florida - State Freud Statement - RSG 99022 0908 Florida Changes - Cancellation and Nonrenewal - RSG 53007 0106 Florida Important No1ice to Policyholders - RSG 99003 0603 Florida Surplus Lines Disclosure Notice - RSG 99064 0106 Infringement Exclusion Endorsement - ROO 56041 0903 Lateral Hire Exclusion - Excess - RSG 56045 0903 Minimum Retained Premium - RSG 54025 0405 Nuclear Energy Liability Exclusion - RSG 56056 0903 Prior and Pending litigation Exclusion - RSG 56069 0104 Prior Knowledge Endorsement - RSG 56070 0903 R.I.C.O. Exclusion - RSG 56074 0903 Service Of Su~ - RSG 94022 0407 ENDT-01 ENDT-02 ENDT-03 ENDT-04 ENDT-05 ENDT-06 ENDT -07 ENDT-06 ENDT-09 ENDT-10 ENDT-l1 ENDT-12 ENDT-13 -. Policy Number: LHZ720235 RSG 14054 0903 ,,,~",,""""_-~.,.'""--' - _._-~~--,. r' ....-.---.-.-.----....,." Agenda Item No. 16K6 December 1, 2009 Page 57 of 83 LANOMARK AMERICAN INSURANCE COMPANY This Form Provides C/aims.Made Coverage. Please Read The Entire Form Completely. EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS The word .Company. refers to the Company providing the insurance shown on the Declarations. Throughout this document, words and phrases that appear in bold have special meaning. Refer to Pari II. DefInitions. I. Coverage. Insuring Agl1lements A. Covered Services Pay on behalf of the Insured all sums that the Insured becomes legally obligated to pay as Damagea and associated Claims and Claims Expen..... lor loss In excess of Underlying Insurance as described in the Declarations provided that the: 1. Claim is first made against the Insured during the Policy Period. and reported to the Company no later than thirty (30) days after the end of the Poley Period; 2. Negligant act, error or omission took place after the Retroactive Date shown in the Declarations. B. Following Form Policy This excess insurance policy shall follow the insuring agreements, exclusions, definitions, conditions, warranties, representatklns, and endorsement of the controlling Underlying Insurance policy except for: 1. the limits of liability under this policy; 2. the Policy Period; 3. any provisions which are inconsistent with this policy; 4. the Retroactive Date; 5. any provisions of eny Extended Reporting Period option of any Underlying Insurance; 6. premium; 7. any renewal agreemen~ 8. any loss settlement by any underlying insurer or by any Insured without the Company's prior written consen~ 9. the cancellation provisions. C. Policy Limits Regardless of the number of Claims, persons or entilies Insured or included in the definition of Insured, or the number of claimants or Clalma made against the Insured: 1. The maximum liability of the Company for Damag.. and Claims Expense from each Claim made against the Insured during the PDllcy PerlDd and the Extended Reporting Period option, if purchased, shall not exceed the amount as shown in the Declarations as each Claim. 2. The maximum liability of the Company lor all Damages and Claims Expense as a result of all Claims first made against the Insured during the Policy Period and the Extended Reporting Period option. if purchased, shall not exceed the amount shown in the Declarations as Aggregate. Page 1 of5 RSG510261103 .-. ,_.~-,'- - Agenda Item No. 16K6 December 1 , 2009 Page 58 of 83 -,.-. ..~'" ~ the Limits of Liebillty as shown In the Declarations are on an excess of loss basis, the limns of the Company's liability shall ba the amount of all Damages or Claims Expen..a to which this policy applies which is in excess of Underlying Insurance up to the limits stated in the Declarations. If the aggregate Limn of Liability of the Underlying InaufBnce should be reduced or exhausted by reason of payment of Dameges or Claims Expenses, then: a. in the event of reduction, the Lim~s of Liability applies in excess of the applicable reduced Underlying Insurance aggregate Limit of Liability; or b. in the event of exhaustion, the Limits of Liability continue in force as the applicable Underlying Insuranca subject to all the terms and condnlons of the Underlying Insurance and the terms and conditions of this policy. The Company shall not be obligated to pay any Claim or judgment or defend any suit after the applicable Limn of Liability has been exhausted by payment of judgments, settlements, or Clalma Expenses or any combinetion thereof. Clalma Expens8a shall be part of and not in addnion to the applicable Limits of Liability. Payment of Clalma Expenses by the Company shall reduce and exhaust the applicable Limits of Liabilny, D. Extended Reporting Period If the policy is not renewed for any reason, or is cancelled for any reason other than for non payment of premium or deductible (whether cancelled by the Compeny or by the Named Insured), the Named Insured as shown on the Declarations, has lhe right to purchase, wilhin thirty (30) days of policy termination, an extension of the coverage granted by this policy, This reporting period extension shall remain in force for a period of twelve (12) months after the policy terminates, but only for Claims resulling from negligent acts, errors or omissions committed before the effective date of the cancellation or non renewal, and otherwise covered by this policy. Increased premiums or deductlbles or modifications of coverage terms or condnions upon renewal do not constitute cancellation or non renewal. The premium for this Extended Reporting Period will not exceed two hundred percent (200%) of the full annual pramium set forth in the Declarations and any attached endorsements, and must be elected and paid wnhin thirty (30) days after the effective date of tha policy's termination, Such additional premium is daamed fully earned immediately upon the inception of the Extended Reporting Period. The Extended Reporting Period is added by endorsement and, once endorsed, cannot ba cancelled. The Extended Reporting Period does not reinstate or increase the Limns of liability. The Company's Limns of Liability during the Extended Reporting Period are a part of, and not in addition to, the Company's Limits of Liability stated in the Declarations. II. Definitions A. Claim means a written or verbal demand received by the Insured for money or services, Including service of suit or institution of arMratlon proceeding against the Insured. B. Claim Expense means expenses incurred by the Company or the Insured with the Company's Consent in the investlgaijon, adjustment, negotistion, arbitraijon, mediation and defense of covered Claims, whether paid by the Company or the Insured with the Company's consent, including: 1. Expenses the Company incurs including such as but not limned to independent adjusting I invesijgative expenses: 2. Attorney's fees; 3. Costs taxed against the Insured in any suit defended by the Company; 4. Interest on the full amount of any judgment that accrues after entry of the judgment and before the Company has paid, offered to payor deposited in court the part of the judgment that is wi1hin the applicable Limit of Liability; 5. The cost of appeal bonds or bonds to release attachments, but only for bond amounts within the available applicable policy limn and only if said Claims are covered by the policy: 6. Reasonable expenses incurred by the Insured at the Company's request other than: RSG 510261103 Page 2 of 5 _ _,..".w~.____,^,_. """"O~__";_~' . ." ~_._~,"-,-- r . Agenda Item No. 16K6 December 1 , 2009 Page 59 of 83 a. loss of earnings; and b. Salaries or other compensation paid to the Insured or any employee of the Insured. C. Primary Insurance meens the underlying policy as shown in the Declarations and includes any addrtional exclusions, endorsements or limitations contained wrthin the Primary Insurance and any other policies in excess of the Primary Insurance and underiying this poiicy. D. Damages mean monetary judgmen~ award or setUement, except those for which insurance is prohibited by law. Damages does not include punitive or exemplary Damages, fines, penaKies, sanctions, taxes, ewards or Damagea that are multiples of any covered Damagas, disputes over fees, deposits. commissions or charges for goods or services. E. Policy Period means the period of time stated in the Declarations or any shorter period resulting from policy cancellation or amendment to the policy. F. Retroactive Date means the dale staled in the Deciarations on or after which any alleged or ectual negligent act, error or omission must have first taken place in order to be considered for coverage under this policy. G. Undarlylng Insuranca means the Primary Insuranca policy and any other pnmary or excass insurance policies contributing to the limrt of liabilrty as shown in the Declarations, including any deductible amount, the insured's participation or self-insurance ratention of any policy. III. General Conditions A. Maintenance of Underlying Insurance The Underlying Insurance shall be maintained in full effect during the period of this policy except lor reduction of the Underlying Inaurance limits or exhaustion of such limits due solely because of Claims mada during the Policy Perlod or any Extended Reporting Period Option, if any. n the Underlying insurance is not maintained in full force and effect, the Insured will become san insured for the amount staled in the Declarations and will assume all the obligations of the underlying insurer. The Company's obligation under this policy shall not be increased, expanded or otherwise changed as a result of: a. any position taken by the underlying insurer with respect to coverage; b. the Insured's failure to comply with any condrtion of any such policy; or c. the receivership, insolvency, or the Inabilrty or refusal to pay of any underlying insurer or the cancellation of the Underlying Insurance. B. Nollee of Claim The Insured must notify the Company as soon as practicable of an inciden~ occurrence or offense which may reasonably be expected to resuK in a Claim. The Insured must immediately send copies of any demands, notices, summonses or legal papers received in connection with any Claim or suit and provida authorization to the Company to obtain records and other inlormation. Notice to any underlying insurer shall not constitute notice to the Company under this policy. Please send all claim Informalion to: Attention: Claims Dept. RSUI Group, inc. 945 East Peces Ferry Road, Suite 1800 Atlanta, Georgia 30326-1160 C. Prohibition of Voluntary paymenta and Settlementa The Insured shall not, wrth respect to any Claim covered under this policy, except at the Insured's cost, make any payment, admit liabilny, settle Claims, assume any obligation, agree to arbitration or any other means of resolution of any dispute, waive any rights or incur Claim Expen..a without prior written Company approval. RSG510261103 Page 3 of 5 Agenda Item No. 16K6 December 1, 2009 Page 60 of 83 "..... -" / , D. Cooperation The Insured shall cooperate with the Company and, upon the Company's request, subm~ to examination and interrogation by Company representative. under oath if required, and shall attend hearings and trials and assist in effecting settlements, seOJring and giving evidence, Obtaining tha attendance of witnesses and in the conduct of suits. E, Notice of Cancellation and Non Renewal The Named Insured may cancel this policy by mailing or delivering to the Company written notice of cancellation. For other then non payment of premium, the Company will provide the Named Insured sixty (60) days written notice prior to cancellation or non renewal of this policy by mailing or delivering the notice to the first Named Insured's last known mailing address, ~ the Company cancels the policy because the Named Insured failed to pay a premium or deductble amounts when due, this policy may be cancelled by the Company by giving not less then 10 days written notice of cancellation. The cancellation will state the effective date of the cancellation and the Polley Period will end on lhal date. If cancelled by the Company, the earned premium shall be computed pro-rata. If cancelled by the Insured, the earned premium shall be computed short rate, . F. Premium and Audit Premiums for this coverage are computed in accordance with the Company's rules and rates. Any premium shown as advanca premium may be a deposit premium only. If the premium is a depos~ premium, at the close of each aud~ period, the Company will compute tha earned premium for that period. Aud~ premiums are due and payable upon notice, The Company may examine and audit the Insured's books and records at any time during the Policy Period and within three years after the final termination of the policy, as far as they relate to the subject matter of this policy. The first Named Insured as shown in the Declarations must keep records of information the Company will need for premium computation and, upon request must send the Company copies olthe information. G. Authorization The first person or entity named in the Declarations agrees to act as the Named Insured with respect to the giving and receiving of all notices, the exercising of Extended Reporting Period option, the cancellation of the policy, the payment of premiums and dedudibles and receiving of any return premiums that may become due. H. Change This policy contains all of the agreement concerning the insurance provided. The first Named Insured as shown in the Declarations is authorized to make changes in the terms of this policy with the Company's consent. The policy terms can be amended or waived only by endorsement issued by the Company and made a part of this policy. I. Subrogation In the event of any Claim under this policy, the Company shall be subrogated to all Insured's rights of recovery against any person or organization and the Insured shall axecute and deliver instruments and papers and do whatever else is necessary to secure such righls. The insured shall do nothing after the loss to prejudice such rights. J. other Insurance This policy shall be excess over, and shall not contribute with. any other existing Insurance unless such other insurance is specifically written to be excess of this policy. -~.~" RSG 510261103 Page 4 of5 -_.- ,~...~-~,",..,._".....- ""-"--- ~_.."._- 1------- ------.--.' Agenda Item No. 16K6 December 1, 2009 Page 61 of 83 II it is determined that both this insurance and other insurance or se~ insurance apply to any Claim on the same basis, whether primary, excess or contingent, the Company shall not be liable under this policy for a greater proportion 01 the Damag.. or Claim Expen... than the applicable Limit of Liability under the policy for such Damag.. bellS to the total applicable Limij 01 liability 01 all valid insurance whether or not collectibie against such Claim.. K. Action. Againat the In.urar No aelion shall lie against the Company unless as a condition preceden~ there shall have been full compliance with all of the terml of this policy, and until the amount 01 the insured's obligations to pay shall have been finally determined either by judgment against the Insured after aeluai trial or by written agreement 01 the Insured, the claimant and the Company. L Non-Transferability The insured's rights end duties under this policy mey not be transferred without the written consent 01 the Company, M. Cov....age In Bankruptcy Bankruptcy or insolvency 01 the Insured or of the Insured's es1ata shall not relieve the Company of their obligetions under this policy. N. False or Fraudulent Claim. II an Insured makes any Claim that is lalse or lraudulen~ this insurance shall become void and entijlement Ie coverage lor all Claim. hereunder shall be forfeited. O. Application The Insured egrees that the statements in the epplication are personal representations, that they shall be deemed material and that this policy is issued in reliance upon the truth of such representations and that this poiicy embodies all agreements existing between the Insured and the Company, or any 01 its agents, reieting to this insurance. RSG 51026 1103 Page 5 of 5 ~ Agenda Item No. 16K6 December 1 , 2009 LANDMARK AMERICAN INSURANCE COMPm62 of 83 .....,,, This Endorsement Changes The Policy. Please Read It Carefully. EMPLOYMENT PRACTICES LIABILITY EXCLUSION This endorsement modifies insurance provided under the following: EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS In consideration 01 the premium charged, it is agreed that no coverage shall apply to any Clalma arising out of or in anyway related to: 1. Refusal to employ; 2. Termination 01 employment; 3. Coercion, demotion, pelformance evaluation, reassignment, discipline, defamation, harassment, humiliation, discrimination or other employment related practices. procedures, policies, acts or omissions: or 4. Consequential Bodily Injury or Pel1lonallnjury as a resu~ of (1) through (3) above. This exclusion applies whether the Insured mey be held liable as an employer or in any other capacity and to any obligation to share Damages with or to repay someone else who must pay Damag.. because of the injury. It is further agreed that no coverage shall apply under this policy to any Claim brought by or against any spouse, child, parent, brother or sister 01 the Insured or any other person. The Company shall not have a duty to defend any Claim, sui~ arb~ration or any other form 01 a trial court proceeding. All other terms and conditions of this policy remain unchanged. This endorsement effective 01/01/2009 Forms part of Policy Number LHZ720235 Issued to GRANT FRIDKlN PEARSON ATHAN AND CROWN PA by Landmark American Insurance Company Endorsement No.: 01 RSG 56027 0903 - ~---"---,-~ - ._".__._~_......._- -,~.~-,--_. r --- .....-.-.<..-.-......, ._.,,-'..."- Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE COMPA~ of 83 State Fraud Statements Fraud Statements - Signature Required for New York Only ARKANSAS, LOUISIANA, RHODE ISlAND, TEXAS AND WEST VIRGINIA FRAUD STATEMENT Any person who knowingly presents a false or fraudulent claim for payment of e loss or benefit or knowingly presents false information In an application for insurance is guiijy of e crime and may be subject to fines and confinement in prison. ALASKA FRAUD STATEMENT A person who knowingly end w~h intent to injure, defraud. or deceive en insurance company files e daim containing false, incomplete. or misleading information may be prosecuted under stete law. ~ONAFRAUDSTATEMENT For your protection Arizona law requires the following statement to eppear on this form, Any person who knowingly presents a false or fraudulent claim for payment of a loss is subject to criminal and civil penalties. CALIFORNIA FRAUD STATEMENT For your protedion, California law requires that you be made aware of the following: Any person who knowingly presents false or fraudulent claim for the payment of a loss is gui~y of a crime and may be subject to fines and confinement in state prison. COLORADO FRAUD STATEMENT ~ is unlawful to knowingly provide felse, Incomplete, or misleading facts or information to an insurance company for the purpose of defrauding or attempting to defraud the company. Penalties may include imprisonment, fines, denial of insurance, and civil damages. Any insurance company or agent of an insurance company who knowingly provides false, incomplete, or misleading facts or information to a policyhoider or claimant for the purpose of defrauding or attempting to defraud the policyholder or claimant w~h regard to a settlement or award payable from insurance proceeds shall be reported to the Colorado division of insurence w~hin the department of regulatory agencies. DISTRICT OF COLUMBIA FRAUD STATEMENT WARNING: It is a crime to provide faise, or misleading information to an insurer for the purpose of defrauding1he insurer or any other person. Penalties indude imprisonment and/or fines. In addition, an insurer may deny insurance benefits if false information materially related to a claim was provided by the applicant. FLORIDA FRAUD STATEMENT Any person who knowingly and w~h intent to injure, defraud or deceive any insurer, files a statement of claim or an application containing any false, incomplete, or misleading information is guiity of a felony of the third degree. HAWAII FRAUD STATEMENT For your protection, Hewaii law requires you to be informed that any person who presents a fraudulent claim for peyment of a loss or benefit is gui~y of a crime punishable by fInes or imprisonment. or both. IDAHO FRAUD STATEMENT Any person who knowingly. and with intent to defraud or deceive any insurance company. files a statement of claim containing any false, incomplete or misleading information is guilty ot a felony. INDIANA FRAUD STATEMENT Any person who knowingly and with intent to defraud en insurer files a statement of claim containing any false, incomplete, or misleading information commits a felony. RSG 99022 0908 ~ INlT'bet 01 Aleghlt!1'i tnlllJf8l1ca Hraldlnga LlC KENTUCKY FRAUD STATEMENT Agenda Item No. 16K6 December 1, 2009 Page 64 of 83 r' Any person who knowingly and with intent to defraud any Insurance company or other person files an application for insurance containing any meterially false information or conceals, for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime. MAINE FRAUD STATEMENT K is a crime to knowingly provide false, incomplete or misleading information to an insurance rompany for the purpose of defrauding the company. Penalties may include Imprisonment, fines or e denial of insurence benefits. MARYLAND FRAUD STATEMENT Any person who knowingly and willfully presents a false or frauduient claim for payment of a loss or benefrt or who knowingly and willfully presents faise information in an application for insurance is guilty of a crime and may be subject to fines and confinement in prison. MINNESOTA FRAUD STATEMENT lv1y person who files a claim with intent to defraud or helps comm~ a fraud against an insurer is guiKy of a crime, NEW HAMPSHIRE FRAUD STATEMENT lv1y person who, with a purpose to injure, defraud or deceive any insurance company, files a statement of claim rontaining any fal.se, incomplete or misleading information is subject to prosecution and punishment for insurance fraud, as provided in RSA 638:20. NEW JERSEY FRAUD STATEMENT Any person who includes any false or misleading information on an application for an insurance policy is subject to criminal and civil penalties. NEW MEXICO FRAUD STATEMENT ;,.- Any person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents false information in an application for insurance is guilty of a crime and may be subject to civil fines and criminai penaKies. OHIO FRAUD STATEMENT lv1y person who, w~h intent to defraud or knowing that he is facilitating a fraud against an insurer, submits an application or files a claim containing a false or deceptive statement is guilty of insurance fraud. OKLAHOMA FRAUD STATEMENT WARNING: Any person who knowingly and with intent to injure, defraud, or deceive any insurer, makes any claim for the proceeds of an insurance policy containing any false, incomplete or mislaading information is guiKy of a felony. OREGON FRAUD STATEMENT lv1y person who knowingly presents a false or fraudulent claim for payment of a loss or benefit or knowingly presents materially false information in an application for insurance may be guiKy of a crime and may be subject to fines and confinement in prison, PENNSYLVANIA FRAUD STATEMENT Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information, or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insuranca ect, which is a crime and subjects such person to criminal and civil penalties. >"> TENNESSEE, VIRGINIA, AND WASHINGTON FRAUD STATEMENT K is a crime to knowingly provide false, incomplete or misleading information to an insurance company for the purpose of defrauding the company. Penalties include imprisonment, fines and denial of insurance benefits. RSG 99022 0908 AlTIllntlerof~lI'Iyll'llUranQllHoldlnllaU.C '--.-"-' '--.,"..,-., ,-",,---,.-.~,_.. I" Agenda Item No. 16K6 December 1, 2009 Page 65 of 83 SIGNATURE REQUIRED NEW YORK FRAUD STATEMENT MY person who knowingly and with intent to defraud any insurence company or other person files an application for insurance or statement of claim containing eny materially false information, or conceals for the purpose of misleading, informetion concerning eny fact material thereto. commits a fraudulent insurance act, which is a crime, and shall also be subject to a civil penalty not to exceed five thousand dollars and the stated value of the daim for each such violation, InsuredlApplicanVClaimant By (Authorized Representative) Tiije Date RSG 99022 0908 ~ ITBrrDIor ol' Nlegnany I,*,IWI~ HoId11'Q1: lLC - Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE CO~ of 83 This Endorsement Changes The Policy. Please Read It Carefully. FLORIDA CHANGES-CANCELLATION AND NONRENEWAL This endorsement modifies insurance provided under the following: EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS The Notice of Cancellation and Nonrenewal section of this coverage form is replaced by the following: A. NotlCII of Cancellation 1. The first Named Insured shown in the Declarations may cancel this policy by mailing or delivering to us advance written notice of cancellation. 2. Cancallation of Policies in Effect 90 Days or Less If this policy has been in effect for 90 days or less, we may cancel this policy by mailing or delivering to the first Named Insured written notice of cancellation, accompanied by the reasons for cancellation, at least a. 10 days before the affective date of cancellation, ~ we cancel for nonpayment of premium; or b. 20 days before the effactive date of cancellation, ~ we cancel for any other reason, except we may cancel immediately if there has been: (1) A material misstatement or misrepresentation: or (2) A failure to comply with underwriting requirements established by the insurer, 3. We will mail or deliver our notice to the first Named Insured's last mailing address known to us, 4. Notice of cancellation will state the effective date of cancellation. The policy period will end on that date. S. If this policy is cancelled, we will send tha first Named Insured any premium refund due. If we cancel, the refund will be pro rata. If the first Named Insured cancels, the refund may be less than pro rata. If the return premium is not refunded with the notice of cancellation or when this policy is returned to us, we will mail the refund within 15 working days efter the date cancellation takes effect, unless this is an audit policy. If this is an audit policy, then, subject to your full cooperation with us or our agent in securing the necessary data for audit, we will return any premium refund due within 90 days of the date cancellation takes effect. If our audit is not completed within this time limitation, then we shall accept your own audit, and any premium refund due shall be mailed within 10 working days of receipt of your audit. The cancellation will be effective even if we have not made or offered a refund. 6. If notice is mailed, proof of mailing will be sufficient proof of notice. 7. Cancellation of Policies in Effect for More Than 90 Days a. if this policy has been in effect for more than gO days. we may cancel this policy only for one or more of the following reasons: (1) Nonpayment of premium; (2) The policy was obtained by a material misstatement; (31 Failure to comply with underwriting requirements within 90 days of the effective date of This endorsemant effective 01/01/2009 Fonns pert of Policy Number LHZ720235 -- Issued to GRANT FRIDKIN PEARSON A THAN AND CROWN PA by landmark American Insurance Company ,." Endorsement No.: 03 RSG 53007 0108 Indudes copyrighted materiel of Insurance Services Office, Inc.. wilh Its pennlsslon. Page 1 of 2 <llISO Properties Inc., 2006 '-^.,----,~,.~.~..."." '. "'-'--"'''-'''' ... ,- Agenda Item No. 16K6 December 1, 2009 "d~d G7 of 83 coverage; (4) A substential change in the risk covered by the policy; or (5) The cancellation is for all insureds under such policies for a given ciass of insureds. b. If we cancel this policy for any of these reasons, we will mail or deliver to the first Named Insured written notice of cancellation, accompanied by the reasons for cancellation, at least: (1) 10 days before the effective date of cancellelion if cancellation is for nonpayment of premium; or (2) 45 days before the effective date of cancellation if cancellation is for one or more of the reasons stated in 7.a.(2) through 7.e.{S) above. B. Nonrenewel 1. If we decide not 10 renew this poiicy, we will mall or deliver to the first Named Insured written notice of nonrenewat, accompanied by the reason for non renewal, at least: a. 10 days prior to the expiration of this policy, if we non renew for nonpayment of premium; or b. 45 days prior to the expiration of this policy, if we nonrenew for any other reason. 2. Any notice of nonrenewal will ba mailed or delivered 10 the first Named Insured's last mailing address known to us. If notice is mailed, proof of mailing will be sufficient proof of notice. All other terms and conditions of this policy remain unchanged. RSG 53007 0108 Includes copyrighted material of Insurance Service. OffICe. Inc., with i1:5 pennission. Page 2 of 2 <!:> ISO Properties Ine., 2006 Agenda Item No. 16K6 December 1, 2009 Page 68 of 83 LANDMARK AMERICAN INSURANCE COMPANY r IMPORTANT NOTICE IMPORTANT INFORMATION TO FLORIDA POLICYHOLDERS KEEP THIS NOTICE WITH YOUR INSURANCE PAPERS QUESTIONS ABOUT YOUR INSURANCE? . If you have any inquiries, need to obtain coverage information or nead assistanca In resolving complaints, please do not hesitate to contact your Insurance company or agent. FOR COMMERCIAL INSURANCE CONTACT: RSUI Group, Inc. 945 East Paces Ferry Road Su~e 1800 Atlanta, GA 30326 Cail Collect (404) 231-2366 -". , ~, RSG 99003 0803 --.---+_. .,. -_.' .,.~ -_.-'" '-'~.'._-'--' -- , , . - Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE COM~jl.m-69 of 83 IMPORT ANT NOTICE FLORIDA SURPLUS LINES DISCLOSURE NOTICE THIS INSURANCE IS ISSUED PURSUANT TO THE FLORIDA SURPLUS LINES LAW. PERSONS INSURED BY SURPLUS LINES CARRERS DO NOT HAVE THE PROTECTION OF THE FLORIDA INSURANCE GUARANTY ACT TO THE EXTENT OF ANY RIGHT OF RECOVERY FOR THE OBUGATlON OF AN INSOLVENT UNLICENSED INSURER. RSG 99064 0106 - Agenda Item No. 16K6 December 1. 2009 LANDMARK AMERICAN INSURANCE COM~O of 83 /"'. This Endorsement Changes The Policy. Please Read It Carefully. INFRINGEMENT EXCLUSION ENDORSEMENT This endorsement modifles insurance provided under the following; EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS In consideration of the premium charged. ~ is understood thalthis policy does not apply to Iny Claim or Claim Expen.... based upon or arising out of infringement of copyright, patent, trademark, trade name, trade dress, service mark, mle or slogan, All other terms and cond~ionl of thiS policy remain unchanged. ,~'-'" This endorsement effective 01/01/2009 Forms part of Policy Number LHZ720235 Issued to GRANT FRIDKIN PEARSON ATHAN AND CROWN PA by Landmark American Insurance Company Endorsement No.: 06 RSG 56041 0903 - ..,~_..",--~--_.._-, - '"""'-""~'----~-' '.-_.._,'-~''''~'''"- Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE COMP-J6iIV1 of 83 This Endorsement Changes The Policy. Please Read It Carefully. LATERAL HIRE EXCLUSION (EXCESS) This endorsement modifies insurance provided under the following: EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS In consideration of lhe premium charged, ~ is understood and agreed thai tha following Exclusion is added to the policy: This policy does not apply to any Claim or Claim Expenses based upon or arising out of: Any Claim resulting from any act, error, omission. or Personal Injury which occurred prior to tha date when an Insured became an employee, partner, member, of counsel, or shareholder, of the Named Insured Law Firm. All other terms and cond~ions of this policy remain unchanged. This endorsemant affective 01/0112009 Fonns part of Policy Number LHZ720235 Issued to GRANT FRIOKIN PEARSON A THAN AND CROWN PA by Landmark American Insurance Company Endorsement No.: 07 RSG 56045 0903 - Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE co.fP'A'NY72 of 83 r This Endorsement Changes The Policy. Please Read It Carefully. MINIMUM RETAINED PREMIUM This endorsement modifies insurance provided under the following: EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS In the event of cancellation of this poliCy by the Insured, return premium shall be computed at .90 of the pro rata unearned policy premium. subject however to a retention by the company of not less than $11,250.00. Nothing in this endorsement is deemed to affect the Company's cancellation rights which remain as indicated in the coverage form. It is further agreed that return premium may be allowed on a pro rata basis if cancelled for non payment of premium or deductibie, subject however to retention by the company of the minimum retained premium as shown above. All other terms and conditions of this policy remain unchanged. This endorsement effective 01/0112009 Forms pert of Policy Number LHZ720235 Issued to GRANT FRIDKIN PEARSON ATHAN AND CROWN PA by Landmark American Insurance Company Endorsement No.: 08 RSG 54025 0405 -----._--- '-,-.,.-- ""_'.,^_."._"_.,,,~,. ,,,..._...~..._._.. - [' Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE COMmv73 of 83 This Endorsement Changes The Policy. Please Read It Carefully, NUCLEAR ENERGY LIABIUTY EXCLUSION This endorBemenl modifies insurance provided under the following; EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS This policy does not apply; a. Under any LIability Coverage, to bodily injury or property damage; (1) with respect to which an Insured under the policy is also an Insured under a nuclear energy liabilRy policy issued by Nuclear Energy Liabll~y Insurance Association, Mutual Atomic Energy Liability Underwriters, or Nuclear Insurance Associates of Canada, or would be an Insured under any such policy but for its termination upon exhaustion 01 its Iimij of Iiabllijy; or (2) resuRing from the hazardous properties of nuclear material end with respect to which (a) any person or organization is required to maintain financial protection pursuant to the Atomic Energy Act of 1954, or any law emendatory thereof, or (b) the Insured is, or had this policy not been issued would be, entitled 10 indemnity from the United States of America, or any agency thereof, under any agreement entered into by the UnRed Stales of America, or any agency thereof, wrth any person or organization; b. Under any Medical Payments Coverage or any Supplemental Payments provision relating to first aid, to expenses incurred with respect to bodily injury resulting from the hazardous properties of nuclear material end arising out of the operation of a nuciear facilijy by any person or organization; c. Under any Liablllly Coverage to bodily injury or property damage resulting from the hazardous properties of nuclear material, it. (1) the nuclear material (a) is at any nuclear facility owned by, or operated by or on beha~ of, an insured, or (b) has been discharged or dispersed therefrom; (2) tha nuclear material is contained in spent fuel or waste at any time possessed, handled, used, processed. stored, transported or disposed of by or on behalf of an insured; or (3) the bodily injury or property damage arises out of the fumishing by an Insured of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any nuclear facility but ij such facility is located within the United Stales of America, its territories or possessions, or Canada. this exclusion (3) applies only to property damage to such nuclear facility and any property theraat; d. As used In this Endorsement: (1) "Hazardous properties" include radioactive, toxic, or explosive properties; (2) "Nuclear material" means source material, special nuclear material or byproduct material; (3) "Source material", "special nuclear material", and "byproduct material" have the meanings given them in the Atomic Energy Act of 1954 or in any law amendatory thereof; (4) "Spent fuel" means any fuel element or fuel component, solid or liqUid, which has been used or exposed to radiation in a nuclear reactor, (5) "Waste" means any waste material (a) containing byproduct material and (b) resuijing from the operation by any person or organization of any nuclear facility included within the definRion of nuclear facilily under paragraph (6), (a) or (b) thereof; This endorsement effective 0110112009 Fonns part of Policy Number LHZ720235 Issued 10 GRANT FRIOKIN PEARSON A THAN ANO CROWN PA by Landmark American Insurance Company Endorsement No.: 09 RSG 56058 0903 Page 1 of2 Agenda Item No. 16K6 December 1. 2009 i"d;;~Y40f83 ,-",- (6) "Nuclear facility' means: (a) any nuclear reactor, (b) any equipment or device designed or used for (i) separating the isotopas of uranium or plu1onium, (Ii) processing or utilizing spant fuel, or (iii) handling, processing, or packaging waste; (c) any equipment or device used for the processing, fabricating or allo~ng of special nuclear material if at any time the total amount of such material in the custody of the Insured at the premises where such equipment or devioa is located conslsta of or contains more than 25 grams of plu10nium or uranium 233 or any combinstion thereof, or more than 250 grams of uranium 235: (d) any structure, basin, excavation, premises Of place prepared or used tor the storage or disposal of waste; and includes the s~e on which any of the foregoing is located, all operations conducted on such sita, and all premises used for such operations; (7) "Nuclear reactor" means any apparatus designed or used to sustain nuclear fission in a seif-supporting chain reaction or to contain a critical mass of fissionable material; (8) "Proparty damage" includes all forms of radioactive contamination of property, All other tarms and conditions of this policy remain unchanged. ,_., RSG 56058 0903 Page2of2 - "-'_.__.~.--."" , -""...-..---,".'.-"... , . Agenda Item No. 16K6 December 1, 2009 lANDMARKAMERlCAH INSURANCE COAmA:N'll of 83 This Endorsement Changes The Policy. Please Read It Carefully. PRIOR AND PENDING LITIGATION EXCLUSION ENDORSEMENT This endorsement modifies Insurance provided under the following: EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS In consideration of the premium charged. it is agreed that this policy does not apply to any Clalm(s' arising from: 1. eny Claim or l~i98tion against any Insured occurring prior to. or pending as of January 01,2009 including (but not limited to) Claims, demands. causes of actions, legal or quasi-legal proceedings, decrees, or judgments; 2. any subsequent litigation or Claims arising from, or based on substantially the same matters as alleged in the pleadings of such prior or pending litigation; 3. any act, error, omission, Personallnlury or Advertising Liab~lty of any insured(s) which gave rise to such prior or pending I~igation or Claim.. All other terms and conditions of this policy remain unchanged. . - This endorsement effective 01/01/2009 Forms part of Policy Number LHZ720235 Issued to GRANT FRIDKIN PEARSON ATHAN AND CROWN PA by Landmark American Insurance Company Endorsement No.: 10 RSG 56069 0104 Agenda Item No. 16K6 December 1. 2009 LANDMARK AMERICAN INSURANCE coi~Y6 of 83 This Endorsement Changes The Policy. Please Read It Carefully. PRIOR KNOWLEDGE ENDORSEMENT This endorsement modifies insurance provided under the following: EXCESS PROFESSIONAL lIABILITY COVERAGE FORM CLAIMS MADE BASIS In consideration of the premium charged, K is agreed that the fcllowlng exclusion is added to the policy: Any alleged act, error, omission, or circumstance likely to give rise 10 I Claim that an Insured had knowledge of prior to the etfedive date of this policy. This exdusion includes, but is not limKed to any prior Claim or possible Claim referenced in the Insured's application. All other terms and conditions of this policy remain unchanged. .^-- -~,- This endorsement effective 0110112009 Forms part of Policy Number lHZ720235 Issued 10 GRANT FRIDKIN PEARSON A THAN AND CROWN PA by landmark American Insurance Company Endorsement No.: 11 RSG 56070 0903 -..._-_.~-~---, r' Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE C~ of 83 This Endorsement Changes The Policy. Please Read It Careful/y. R.I.C.O EXCLUSION This endo~ment modifies insurance provided under the following: EXCESS PROFESSIONAL LIABILITY COVERAGE FORM CLAIMS MADE BASIS The following addnional Exclusion is added to the policy, "This policy does not apply to any Claim or Claim Expenses based upon, arising out ot in any way connected with any adual or alleged violation ot the Racketeer influenced and Corruption Organimon Act, 18 USC Sections 1961 et seq., and any and all amendments thereto, and any rule, regulation, or order issued pursuant thereto,. All other terms and condnions ot this policy remain unchanged. This endorsement effective 0110112009 Forms pert of Policy Number LHZ720235 Issued to GRANT FRIDKIN PEARSON A THAN AND CROWN PA by Landmark American Insurance Company Endorsement No.: 12 RSG 56074 0903 Agenda Item No. 16K6 December 1, 2009 LANDMARK AMERICAN INSURANCE coliipAAy8 of 83 -' This Endorsement Changes The Policy. Please Read It Carefully. SERVICE OF SUIT This endorsement modifles insurance provided under the following; ALL COVERAGE PARTS ~ In the event of our failure to pay any amount claimed to be due, we, at your raquest, will subm~ to the jurisdiction of any court of competent Jurisdiction within the United Slates of America. Nothing in this cond~ion const~utes or should ba undenotood to consmute a waiver of our rights to commence an action in any Court of competent jurisdiction in the Un~ed States, to remove an action to a Un~ed States District Court or seek a trensfer of a case to another Court as pennitled by the laws of the Un~ed States or of any state in the Un~ed States, moreOVllf, this endorsement is not an agreement that the law of a partiOJlar jurisdiction applies to any dispute under the poiicy. Service of process in such suit may be made upon the Senior Claims Officer of RSUI Group, Inc. 945 East Paces Ferry Road, Suite 1800, Atlanta. GA 30326-1160, or his designee. In any suit instituted against any one of them upon this contract, we will abide by the final decision of such Court or of any Appellate Court in the event of an appeal. . The above nemed is euthorized end directed to accept service of process on our behalf in any such suit and/or upon your request to give a wrnten undertaking to you that we will enter a generai appearance upon our beheW in the event such a suit shall be instituted, Further, pursuant to any statute of any state, terr~ory or district of the United States of America, which makes provision therefore, we hereby designate the Superintendent, Commissioner or Director of Insurance or other officer specified for the purpose in the statute, or his successor or successors in offica, as our true and lawful attorney upon whom may be served any lawful process in any action, suit or proceeding instituted by you or on your behalf or any beneficiary hereunder arising out of this contract of insurance, and we hereby designate the above named as the person to whom the said officer is authorized to mall such process or a true copy thereof. All other terms and cond~ions of the policy remain unchanged ,........ This endorsement effective 01/0112009 Fonns part of Policy Number LHZ720235 Issued to GRANT FRIDKIN PEARSON ATHAN AND CROWN PA by Landmark American Insurance Company Endorsement No.; 13 RSG 94022 0407 --'-~""'~""~"'." "~"-'''''' -, I' -, -'-~",""',>'---""'-" Agenda Item No. 16K6 December 1, 2009 Page 79 of 83 Lawyers Professional Liability Insurance Application @ ZURICH AMERICAN GUARANTEE AND UABlUTY INSURANCE COMPANY THIS APPlICAnON IS FOR A CLAIMS-MADE AND REPORTED POUCV. IF ISSUED, PLEASE READ YOUR POLICY CAREFULL V. Plaa.. typo or prln' c1..rly 'n Ink. Ana_r.n questions. II ."aca Is Insufflcl.nt 10 ..swar IllY qu_llon 'ully, oItach I ..par." ""eel- Completa.n roqulrod .upplom.n,.. GENERALINFORMAll0N Appllclnrs(Flnn) Name: Grant, Fridkin Pearson Arban & Crown P.A. Slr.al Address: 5 id ew IP 0 80, ncl .cceptlblll City: Naples Phone: ( 239) 514-1000 SII'": Flori.diil Zip Code: 08 Fax: Applicanls Contscl E.MaIl: WebslleAddress:.!JM}1.wac.com Plel.. 01\0"" aU.t 01111 !lrJ!!M Ind secondery 10""llons end a copy o.tha Appllcantll.llarhead. Form of Buslne..: 0 Sole P,,,,liIlon.. 0 P.rtnorstip 0 Prolaaslonal.....oc. o llrn~ld Usblllty Plrt..rship/Corp 0 Professionol Corporation flJ COfl'O'lUon DESIRED DEDUCTIBLE 0$0 o $1,000 o S5.000 0$10.000 illOlher: $50,000 DESIRED COVERAGE o $100.~00.000 o $200.0001$600.000 o $500,0001$1 M O$ltoA1$lM DOth.r: o $2M1$2M o S3toA1$3M o $4MJ$.4M 41 $5r.t1$5M 0$15.000 o $20.000 o $25,000 ATTOIINEVIPIRM INFORMATION ,. Total Number of Atlomeys: - Pl8as. nsl all Attorney. working tor Applicant (includ. you_II' you Bre . sole practltloner), In the choI1 below. II -...../'f, sase continue on a H rat. thHt. ,6Itomey .m. .C,. $0 II oullty Number 13 2. 01 Hire (mmlddlYll '.....In Pr.Dlco , rs W.._ w.... - . . I,.,.! -, .". . . . 3. tOntgnaUon Codoc 0- Olllee... Diroct",", Sharohold..l. of tn. r.orporlllon who ...IIe"n..d Bllo,".y' l> . Solo Pr.ctltloner p. p.rtnef. K a Partnership E. ~mployed Morney C . Of Counsel Attomey IC . Independent Contractor PT. p.rt.Time Attorney (must pl8Clice law lower Inln lwenty.... (26) ho~' per week solely lor applicant ftrm) Hev. all olth. Attorneys IIsled In Quasi/on 2 taken Conllnulng leg.1 Education (ClE) cou...(s, In lI1e past [lYas 0 No lwelve (12) months? If the ~Ucemt is a sole practllloner. who Is lhe AUomey thai wi. handle the AppIlcanls easel in the ApplIcants absence? Neme: D_ halshe maintain prolesaionalliablllly coverBg'? Address: CltylSlale/Zlp: Does the Applicant sh....n o"lcI or suile with allome'/S "'her than those Matld In Question 2 above? If yes, _. Ihe AplllcanlBhe... .tatt or le"e, head? Whet dole was the ,o,ppUcant Istsbllshed? AGEllCY MA..ETIII8IEIWICES. lIIe. P.O. BOX 87218 ST. pm BEACH. Fl 33736-7218 OYas oNo 4. s. (mm/ddJYYYY' U-PL-9S6-C CW (01107) Page 1 01 5 DYe. lID No DYes DNo 01/01/199 50 ATTORNEV.f'IRM INFORMATION cant'd... 7. How many non-Attom.y employ... does1he Appllc.nt hllV8? 19 Agenda Item No. 16K6 December 1, 2009 Page 80 of 83 -"" 12. Provld. the dll. Ihl\ Iho Appllcanl h.. boan COnllnuou.ly Irsured lor I.wy.ro prot..eIonal RabWoty Cla/mo: (mm1dd1yyyy) Do.. the AppRcan!'. currenl prolO66lon.1 roobllily policy con1aln allmftat1cn on prior act. coverage {I.., relroactlve dale. prior acta exclu&!on. elc)7 II V.., pl.... provld. Ih. date: (mm/ddlyyyy) eo.. any Altorney in OJ..li"" 2 abovo have allm".U" on prior 001. coverago (I.. r.troecllva dale. prior octo ijQ v.s :;l No .""Iuoion. otc ) thalls dlllorenllrom Ihot 011110 Appllc.nt? II YES. pl.... isllh. n.m. oIlho AIIOrntl'(.).nd Iho prior.cts .lCClu.ion d.t. on. o.par.l. .ho.t. New attorneys as of date joined, Is Iny Attom.y In Question 2 above not c"""ntIy covor.d by lawyers p1ot.ssIonIIIlabUIty insurance? av.. 10 No II YES, pl.... 1161lh. nlm. 01 the Attomeyt.) ond Ihe ress... he/sh. i. not CO\Iered by insurance on 0 separate sheet. IcanlS Poriod 01/01/1~9 IDY.s ONo 01/01/1995 8. 8. 10. f1. 13. Has any Attorney in QuestIon 2 above had hislher laWY8fs prcffJ$Slonal Uabilky insurance declined. canceled. non-r.n.wed or r.duced by .ny prol.ssional "oblllly in.urer during Ih. pest"w (5) y..rs? (que.tion not ""pIIcebl. in the SI.t. 01 Missouri) II YES, plea.. provide lhe n.m. oIlh. AIlomey and expIanlUon on a .opsrele .heel DV.. IDNo ,- AREAS OF PRACTICE SEE ATTACHED. 14. InllrucUono tor compl.tlng IhIs secllon ._ aooed upon 1110 loll f1.cal y.ar, plaose provide Iho perceri800 01 11m. devot.d ,,..,mb.r of hours actually wori<ed) 10 each are. of pr.cIIc. _ In the chart belOW. b. Illho AppIicanl noloo work lor any aro.. 01 practice In CAPS, p1_e complete lh. applicable !l\Jpplamenial appllcaUon tormo locIudod wilh the app-..... c. eoo. lhe AppIlcanl', pracllca inwln any AlIorney Bcling In the cepaollY of a medlalOr Ot .rtlIIr.tor7 II YES. indlcale Iho percentage 01 lima dlvotcd to aclinO" B medlalor or arbllrator Anlll of Pfactlc:. % Ate. or PrllCtlOlll Admir~arili,"" % Feder IlSIlte/LocallLo Anlltni6\f1',iida no ul8llon . .. % ~l n % , I ." '110 BuSln~:'l TrransacllO I' mmorckll 9N "1,% Iv 11110 % CoIloOllOn$ . % CommMrill1 P i - t:t GincS(i; U. ,.., 35 ,- CoIrllllttnicalions 1 MMIIl % Construcnon law '% Consumer Claims ... COPYRIGHT/TRAOEMARK % rate - BU&inlll FormaUon/AlteraUon '% Co rate - Bl.slnesl TrensactionslAdYice % Crlmln.1 Low % DiSIlbltll I SOCial Slcuril 'lC. Elder Law % Em ent % ENTERTAINMENT % E~RO~ENTAL % Eslotes/Wil1s ITNSII Prol>ate % Fsml Law % FlnancilllnstltuUons- Illl1ce % DYes IONo % % % --~.. .. % % % % % % % % % % % % % 1 % 0.. % % % % % 100 % U.PL.9!lS-C CW 10'107) Ptlge2of5 ._-- ,.._._._._._u -, '" ._'.-..._.-..._~,. -. .' [' Agenda Item No. 16K6 December 1, 2009 Page 81 of 83 AREAS OF PRACTICE conl'd... 16. If the Appllcanl has sla\Sd any percentage ollllndicsl Mslprlc1ioo . PlslnIIlI work in tha area of prac1Ioe chan .bow. please Indlcale in percantlg.. the amoult 01 work oUooatod to tho loIlowlng _": Nur Home. % OBlGYN % % Ponnanenl DI.obilll % Wron I Delth % Other' % 'If the "ppI1cenlslaled a perconlllga 01 work lor "Othor,' plasla e""aln Ihelype cI wor!< partormed on 0 soparelo shaa' 16. Does the Applicant engage In any Cia.. Acllon I Mess Tort wor!<? 0 Yes (ZNo II YES. plalse camplola the applicable Supplemental AppIcailon 17. Do.. ille "pplicanlaxpeCI any cI1anges 10 ita areas 01 practicsln Ihe ...'11weIve (12) monlhsl 0 Yes 19 No II YES, p1aa.. ellplaln on 0 .eparata shoal and ""oclllcaly Indi......tho new 0..18 of pracllce \0 be handled by illo /\pplicant DOCKET~ALENDARCONTROL 18. a. Does the "ppllclnt" docI<elJcalendar control syslam include thaloUowing? (PIe..o cI10ck all t1a1 apply) XX Single Calendar JO(Pual Colend.r !it Tocl<Ier Cordi IlII Malter Ustl", 10 Computer o other Iplesse dascribo): b. Indicate how frequentlv the jme deadlines are cro...cI1ecked: ~ Dally 0 Waekly 0 Monthly 0 Never RISK MANAGEMENT 19. Does the Applicant require the USf3' ot engagement letters including lee agreements on all new matters undertoken by \hel\nn? 20. Does the Applicant Issue dBclinalion leUers or non.engagemenlleners for an mBllers it dedines? 21. Does !he l\ppIicanl outline and reduce to wrllng lis bIlnng policy and procedures whan agreelng 10 represant a 08W cUenl? 22. Does the "Wlicanl hava a procedure for evalueting prDlpecllve cIion1s, Incloolng such factors os Iho prospective cuenls' financlal strength. management expeJltse, reputation or history 01 changing attorneys'! Does the Applicant reduce to writing tne scope of its servIces ~en taking on new matters 'or 8x1sting clients? Doeslhe Applicant hove formal wriUon procodures regarding Ihe molnlenance end revIeW 01 custodial accounls BOO escrOW lunda? D08s tl1e Applicant have B computer b~k.up 5Yftem Of some other form of emergency back~up 5yslem In the 8Wn1 011 disruplion or interruption or bUsiness? Doeo any Alfomey in OIIeotlon 2 abOve haY. ony la'" pariners, associales, 01 counsel Of employed allu.,.eyl olher Ihlll th09. Rstod In OIIMlioll 2 abOVe or is any I\Ilorncy lI"tad In auestlon 2 100V. omployod by or PI~O"" IEoO.1 work for an enllly oCh.r than II,. AppicBnI? II Yf's. pl.... .",laln on I .eparale shoet 0000 the Applie~nl or any AlIarnoy io QullstKJn 2 ulJuYel flrm lWYIlIu' Oircator. officer, empluyee. Of' other management cap;IlJ1y tor . pul or ploson! Dllenl? II Yes, .,woe explain on . oeporllllSh8l1, .Per,,-cmAl., RCIl T.ll~t.. Tru.t- ^riv:lEOl', GUllruian "ri. Litem. D"'" me "PIl'IC~m dr ally "".t Ul ,nsent IIItorneyeTlI1Il"l\l>PllQO 1 own .n oqll1ly ....""'1111 any pool 0' t,.'lrren! rolte"1 ollho Agpllc:l!lt' If YES pI..Sf": ol'\mC)1tJ1e 1he c;;ontroUlmI hltWf1lSls 9tJDP\emelUl Form. L-u ,w8nly.five perc:.Mt (2!'r%) Dr"mlJ11i1 QI the Appllcantl, 1'e'W'Muee-ni1moW(rom ;a-ny loon 01 1li!1il stumnO.I!lUU- contracliog OJ H:lerral wnrk1 II r~s. p1ciJoce expLail on II sapar"tft IIheet. Does (.he Applicant have anyone cllent thai represents 1en percent 11 0%) 01 more 01 the ApplicanCs blKlngs? If YES, please .'plaln and sp.clfy 1he area of pr.cllca and type ol....rk perIonned for !hat cIIenl on a separate sheet. Provide clonl nama nndlor nature or busln.. enlky Does the /\pp1k:ent have procedures lor Identllying and ,esolvng potentia' C>' Ictuel corlllelS of inte..st, Inducting cross checking of former, extsUng Of potenUal cItents? If YES, is tho procedure compu\erize<l? Has 'ha Applicant initiated lewsulls or arbitrllion procedures during \he past live (5) yoars 10 enlorce colecllon 01 unpeid fees lor lhe AppIIcIIt? a. If YES. how many matter&? b. How may 01 these mattBI'5 have been resolved successlully? c. How many or lhese matlErrs aRl slm unresolved? 23. 24. 26. 26. 27. 18. ;lV. 30. 31. 32. XlVes DNo KJY.. DNo IOVe.ONo DVes !lINo 19 Yes 0 No DVos El No lOVes DNo OVe. @No IOY"" ONe t;JV..I)ilNn o Viii ElNo DYes G No ~Vas DNo !9vos ONo DVes l\INo U.Pl.....C ~ (01107l page 3 01 5 Agenda Item No. 16K6 December 1, 2009 Page 82 of 83 LOSS HISTORY If the answer is YES 10 any ollhllollowlng quesUons, complele tho Notlce 01 Orcumstanoe Ie","" Reporting FO/m induded With Ihe eppllcltlon and anach Iddtionalsheets e. ........ry 33. During the pasl t.n (101 years hIs any Momey In Question 2 abollll or employee 01 the AppIioant been lhe 0 Yes Illl No ,ubJect of e crlmlne' .eIlon. r"",lmend, disciplinary Icllon, bar complalnl, Invealigetion, or olheT athies proceeding? 34. During the paslllve (5) yeelll hu ....y clllim 0/ suH erising oul 01 the rendilion 01 legal sel1llcllS been made 10 Yes 0 No agllnsl any AlIomey in Question 2 aboVe or employ.. oIlhe ApplIcant 1 35. Is Iny Anomey In Que.tlon 2 above or employee oIlhe AppDconl aWlre of Iny clrcumsllf\CB, Incident, act, 1!3 Yes 0 No error 0/ omission Ihll coUd ,.suH in a claim ... suit Igllnslthl ~Ilcant or any ",edoces.or or any of the IO/m.. or cooent AlIom or em ellS of Ihe Ani? -."^ IT IS AGREED THAT IF THE RESPONSE TO QUESTIONS 33, 34 AND 3S ARE IN THE AFFIIlIIATlVE, ANY CLAIM OR CIRCUMSTANCE THAT COULD RESULT IN A CLAIM WILL BE EXCLUDED FROII THE PRoPOSED COVERAGE. The'" Ira ITl8ny laclors used ill' the Company 10 evaluale an Application lor Lawye" Professional L1lbUlly lnourlnce Such tactors may include a law ftrm's ereas of praclice,lO&Ii hislory, risk management and an Insurance score. An Insurance scorets developed Iran a mathamatl..1 modal thlt weigh. and mOUUfOS c,.dlllnlom1allon such as paymenl hlslory. Ihe number 01 coIlecllons_ benkruplcies. outstanding debt. lenglh 01 credK hlslory.lypes 01 credit In use and Ihe number of new applicallons for credit These lectors have been shown to correlate wilh Insunn:e kJss acIMty. You may be eDglb&e lor a premium discounl based upon your Insurance score. An insurance score Wi. not resu" In a premium increase. The insurance SCOnt is also never lhe basis on which 'he company will accept or retecl an application tor ao lnsuraoCB poltcy., " you do nol wish 10 loa.... YO"" insurlf1CO .core computed, plelae check the box 0 By allJ11ng Ihls appIlcalilln on Ihe lolowing page the appHcant agr_ lhal a1ler Inquiy 01 011 p~ctlYllIn,,",ede, no pe..on proposed lor COI'lll'age Is aware 01 any fact or c1.cumstsnce which re..onably mlghl give rise to a future claim Ihat would fall wilhln the scope of Ihe proposed coverage Recslpt and ",view 01 this appllcallon does nol bind the Insurer 10 provide Ihis Insuranca . It i. agreed by the appli;anl and Ihe In&urar that the panlcula," ard slalemenls made In IhIs application, logelher with all atllchmenls to this eppl/callcn and any other mllerilis submllted to the InSOfer (an of which atlschme"'s and mal8rials sbo' ba <10_ anamed 10 tho policy asil physically anached therelo) &hall belhe rapresentatlons 01 the appllcent and the prospactivo Insureds. It Is funher all'8od by the appIlcanl and tho prospective Insuredslhal this policy, r .sued,1s Isaued in .el.... upon tho lruth of such reprasentetlons lhal are IncDrporaled into and modo pan 01 II>Is polley. MOl inquiry olllll<ospecllve Insureds, the undersigned authorized officer 01 Ih, opplloant representJ that the olelemenm sellorth In IhiG epplilation end tis Itlaohmant" and other mllertsls submitted 10 us are 1ruI and eDrr"" Signing 01 'his llIppliclllion doea not bind the appllcBnl Dr 1hB tnaurGr Thl undersigned further declares that any ..e'" tlklng plaGll beI.....n lhe dllll thlo oppllolllon WaS signed and lhe effective dale ollhe tnauroncc ~ied for yJ,ich may rand&1lnaCCUltllle. IIntru., or incompJe;o any IntormRtlon Ih thlR applicalfon, wi" Immedialef)t ba reponed In writing to ... and we may wilhdraw or modny eoy """'landing quotations sneller luthorizatlon Dr agraement to bind \he InsurancB. ' The llppiicon\ reprc.clllo l"1II111e QbOVQ Plalamanu: 8re lrut and corrllCllD tha bellI (II hill 0' h., k,,~ and 11>.1 no material or ,elevant loct. heVD been .upprc..ed or millctcleo and lWU thlll tl19 potIey, r.IiSUVO, wlll "" I"uu~ '" II" ~ance of "ueh reresenlnlinn.... Nolie. In N.b",oka APOIIc8nI: No mtereprQf"",tlons 01 WarranlV m.d. by ,h. Inoured or on hi. boh.U In I'"' nO(lullatlon or epplicallon 01 Ihle I'olkly or nnnlranl of Inall'.....a lhall "_lor "Old th9 polloy or oomroct or ."..llh. "","""oy'. obll(/lOtlon und.. t.... policy or contracl un...... ....h m1sreprovenlallOn 01 WarrPnlY "I.. m...rlol, wac mad. !mowlngty wlIh tha Inlent '0 cJeg..ve, we. relied Ind eCled upon by Iha c....pony Ind decatVI" tnc oompany to llc Injury. The _eh 01 a .....r.nly or condlllon In .ny conl,"ct or policy of Inaurance &hall not void tha poll.y or alow Ihe cempony to ovoid lIeblllty unl... such breach eldals et Ihe lime 01 Ihe leu and conlrlbutes to the loss. F N Notice 10 Arkansa. Applicant Any person who knowingly pro sonts a false or frludulonl clelm for plymanl of 81_ or benef1t or knowingly presenlo tllse Information In any eppllcellan for inaurance Is guUty of a crime and moy be aubJectlo fines Ind confinemenl in prison. NoIIce 10 Colorado Applicant: 11 II unlawlul to knowingly provide fllllO, Incomplete, or misleading facta or InlormaUon I. on Insurance compeny for the purpose of defrauding or attempllng to "afrMId the company. Panallle" mlY Include Imprlsonmenl, fines, denial of Insurance, and civil "amagea. Any IMUrance company or agent of In Insurance who knowingly provides false, Inoomple'.. 0' misleading facta or Informallon to e polcyholcler or clalmont lor the purposa of """alldlng or a\lemptlng 10 defraud the policyholder or claimant with regard 10 a oalll......1 or award payabll from Inaurlnce proceeda shall be raported to the CoIoredo OMslon of Insurence within the deplrtment .1 regulalory all""ol... - U-PL-966-C CW (011ll7) PBge4af5 ~--+.._'.<~,~ -, ..,-~._._~..., - -- ~~~,--=,,-=_._-- '~r Agenda Item No. 16K6 December 1, 2009 Page 83 of 83 Nollce 10 Dstricl of Columbia Applicanl: It I. a crlm. to provide IIlle or mlaleldlng Inlormellon \0 an Insurer for !he plWpo" 01 d_dlng Ihe Inourer or .ny oilier perlOn. Penalllo. Includo Impl1eanmem ondlor fino. In oddlUon, .n Inourer moy deny Inouranco b.neOt. H lals. InlormsUon 181_ to 0 clolm _ provided bV th. oppllcanL Nollce 10 Florida Applicanl: AnV p..oon who knowingly ond w"" Inlent to Inlura, detraud, or d.celve anv Inlurer fII.. a _oment of cl.lm or an .ppllcotlon contalnk1g Iny false, Inoomplolo, or ...ateldlng information I. guilty of . folony 01 tho third dogr... Nollc. 10 Konlucky AppIicanl: Any pllllDn who knowlnglv Ind w"" Intolll \0 delrlllld ""y In""...... Oomplny or other parson III.. an appllc.lIon lor Insuran.o contllnlng onv materlel1V laloa Inform.Uon or concul.. lor the purpolO 01 misleading, IlIlonnltlon concerning onv f.et metorllllhorelo commits 0 tr""dulenllnsuranotl oct, which Is I crime. Nollee 10 louisiana Applicanl: Any person who knowtnglv pre_I .lalo. ar llsudul.m clolm ler peymonl .f I loBS or benelll or knowingly prellnts Ills. InformaUon In ... .ppllcotlon lor InoIl..... 10 guRtV 011 crimi and m.y be lubJect to fin.. .nd confinement in prison. Nollca Ie Malna Applicanl: ilia. crime 10 knowingly pr.vlde II.... lnaomple\e .r milleedlng Inlorm"'on 10 en In.urance _Iny lar Ihe purpose ef dafreudlng I,," corapany. P.n.llln mlY Includ. Imprloonment, lines or . denl.1 of In.urence benel1\a. Notfce to New Jersey Applcant: Any person who inclUdes any '.ls8 or mleleeding Information on In Ippllc8Uon tor an In.uranee polley is sublect 10 criminal and civil pen.fll.... . Nollce 10 New Moxleo Applicanl: NlV PERSON WHO KNOWlNGLV PRESENTS A FALSE OR FRAUDULENT CLAIM FOR PAYMENT OF A LOSS OR BENB'IT OR KNOWINGLY PRESENTS FALSE IIlFORMATION IN AN APPUCAllON FOR INSURANCE IS GUILTY OF A CRIME NlD MAV BE SUBJECl TO CIVIL AND CIlIMINAL PENALTIES. NoIlce of Ohio Applicant: Any person who, wllh Inlent t. defraud or knowlngly thet he/.h. I. tlClilallng . froud .galn.1 .ny Insurer, submlll.n ""pllcstlon or IIln e cl.lm containing liaise or dsc:opllv. atal_nl Is guilty of Inlll..nce "Iud. NoIlca 10 Oklahoma Applicant: WARNING: Any perlOn who knowingly, and wllh Inlenllo Injure, dolrsud or decelvo ony Insurer, mak.. ony cl.hn for Ih. proceede 01 en Insur.n.. policy contolnlng Iny '.Iso, Incomplete or mlsleedlni Inlonnallon Is iullty 01 . lelony. Notice 10 Pennsylvania Appteanl: Any person who knowlngfy and wIttt Intent to .fraud any ...aurance company or othe:r person fRu an Ippllc.llon for Inluranoa or 8tateraent Df alllm conllllnmg In, ImIterially fat.. In'ormatlon or conoeals for the purpo.. 01 mis~8dlng, Inronn8flon concerning an, fact meterlel thereto commits I fraudulent Insurance act, whlch ia . crime end aublecla .uch p.raon 10 crlllllnel.nd _ penaltle.. Notice to VermCllt Applicant: Any petBIN'l wbo knOWIngly Ind with Intent to defraud In, In.urance company Dr oUter person III.. .n application for Insurance or otatemenl of claim conlllnlng Iny 101.. Info,...."on or concealo lor Ihe pUlp". 01 mlaleedlng,lnlormallon con....nlng eny llOt melOrtallherlto, may h.... comml_ . t..udul.nlln......... act. Complolion .llhi. form does nol bind coversg.. Appllclnr. acceptance of company'. quolallon i. r.qulred prior 10 binding cover.ge Ind policy i..uano.. Ii la egreed tllll thIS appleellon "".11 be Ihe b88io of Ih. contract ollnsuranco .hould I policy be is.ued and " will be .ttached 10 the policy 5Ig""lure: ~ . . ..__ Princip.1~ r.rt""r'/ir Praoldonl D.le: ~~ - \ "2. -I:>, .~ Prlnt Nom.: R.ichuiL~.......Ql;mr .. . T11"'_J'r"~:f.dml: ._.u NOTE: THIS APPLICATION MUST BE 5IGNI:U UY A rnINClrAL. PARTNER OR PRESIDENT OF TIoIE FIRM ACTING A6 TilE AUTfJORIZED AClENT OF THF APPl Ir:ANT. U.pt.966-C CW 101/01) Pag& 5 01 5 .,_.,.,.,",.",,,,.,,,~.,,...,,.,,.,.o.",,.,._..._...<,.,..,,.,.,.,'.'