HomeMy WebLinkAboutPUBLIC OFFICIALS LIABILITY POLICY WITH ROYAL INSURANCE CO
Augusta Richmond GA
DOCUMENT NAME: Co V~ v-6..~ 'De..scr<?,,-o(\
DOCUMENT TYPE: Qc t
YEAR: :)t:>[)0
BOX NUMBER: } ?-
FILE NUMBER: J S L-/3 3,
NUMBER OF PAGES:
2~
,.~. ,\:\'
x.... ,-t
"
'.
II
PUBLIC OFFICIALS LIABILITY
'I
Named Insured:
Company Name:
Policy Term:
Augusta-Richmond County
Royal Insurance Company
04/19/99. to 04/19/00
Occurrence Basis
[Xl Claims Made Basis
Retroactive Date:
April 19, 1997
Limits
CoveraQe Description
$2,000,000
$ 2,000,000
$ 150,000
Per Claim
Aggregate
Retention
Public Officials Liability provides coverage for "Wrongful Acts" of the public entity and
the "Wrongful Acts" of individuals who act on behalf of the entity. A "Wrongful Act"
means any actual or alleged breach of duty, neglect, error, misstatement, misleading
statement, omission or Employment Practices violation by an insured solely in the
performance of duties for the public entity.
Litigation can be brought against the entity for discrimination in selecting, promoting,
disciplining or dismissing employees, violation of civil rights, lTlismanagement of, or
improper administration of funds, grants or budgets, improper zoning approvals or
denials, failure to protect public trust, including failure to properly insure, to attend
meetings or to examine documents.
2
Harison-Kerzic, Inc./2601 Commons Boulevard / P.O. Box 211110/ Augusta, Georgia 30917-1110 / (706) 737-8811
.'
Definition of Named Insured:
1. All persons who were, now are or shall be lawfully elected or appointed
officials or employees while acting on or behalf of the Public Entity.
2. Commissions, boards or other units, and members and employees thereof,
operated by and under the jurisdiction of such Public Entity and within an
apportionment of the total operating budget indicated in the application for
this policy.
3. Volunteers acting for or on behalf of, and at the request and under the direction
of, the Public Entity
4. Officials, and employees of the Public Entity appointed at the request of the
Public Entity to serve with an outside tax exempt entity.
3
Harison-Kerzic, Inc./2601 Commons Boulevard / P.O. Box 211110/ Augusta, Georgia 30917-1110/ (706) 737-8811
83/27/2881 15:47
7862628154
JSL/HARISON-KERZIC
PAGE 82
.
II
JSUHarison-Kerzic
l"",,,ri7J~ '''''pI, And 9>Ui"", Sir"~ ! 868
Date: March 27, 200 I
Customer #: 00003548
Phone: 821-2486
Augusta Richmond County
530 Green Street Room 217
Augusta, GA 30911
FOR QUESnONS, CALL:
Nancy Glass
DATE ISSUED
04/19/2001
TO EXPIRE
04119/2002
POLIcY DESCRIPTION
Public Officials Liability - Renewal
AMOUNT
$52,000
Thank you., we appreciate your business.
Insured Copy
~~
~~\
-~.::~
2601 CommoM .8lvd.. P.O. Box 211110, ADguso, G.A 30917
706.737.8811. Fax 706.7;.7.3413
R i . If P ,. .: <(.
I.....,.""',,....... ~'..
03/27/01 14:58
TX/RX NO.1570
P.002
.
RENEWAL CERTIfICATE - VALUABLE DOCUMENT - ATTACH TO YOUR POLICY
ROYAL & V
../1 SUNALLIANCE
~
THIS POLICY IS ISSUED BY THE COMPANY INDICATED BY "X" BEFORE THE COMPANY NAME BELOW
o Royal Indemnity Company
(A Delaware Stock Company)
~ Royal Surplus Lines Insurance Company
POLICY NO. KHP 607178
NAlVIED INSURED AND MAILING ADDRESS:
Augusta, Georgia
530 Greene Street
Room 217
Augusta, GA 30911
PRODUCER:
Royal Specialty Underwriting, Inc.
Resurgens Plaza
945 East Paces Ferry Road
Suite 1800
Atlanta, GA 30326
IN CONSIDERA. TION OF PAYMENT OF PREMIUM SHO\VN, THE POLICY IS RENEWED FOR THE PERIOD
INDICATED BELOW:
RENEWAL PERIOD: From April 19, 2000 to April 19, 2001
above.
12:0 I A.M. Standard Time at your Mailing Address
TOTAL RENEWAL PREMIUM: $ 50,000 + $2,000 (Co. Fee) = $52,000 Total Premium
THIS POLlCY IS RENEWED AS EXPIRING EXCEPT AS NOTED BELOW:
The maximum aggregate limit of liability is hereby reinstated for the renewal period.
DATE:
4/11/2000
AUTHORIZED REPRESENTATIVE:
,,~ 'Q. g.,-~
HP607178 .
COMPAN'(
: S:;BdL ".r
-,'~_'I
FC:.:8': SYMeOL & NUMBER
RENEWAL.
OF NUMBER Np.w
ut;ve Offices
Arrowpoint Blvd.
!':O. Box 1000
'u lotte, NC 28273
THIS POLICY IS ISSUED BY: Royal Surplus Lines Insurance Company
PRODUCER'S NAME AND ADDRESS
ITEM r
1.
PUBLIC ENTITY
AND
MAILING
ADDRESS
Augusta. Georgia
530 Greene Street
Room 217
Augusta, GA 30911
I
r ROYAL SPECIALTY UNDERWRlTING,INC.
Resurgens Plaza. Suite 1800
945 East Paces Ferry Road
Atlanta, GA 30326-1125
Tel: 404-231-2366
I
L
-.1
L
.J
ITEM 2. POLICY PERIOD:
FROM April 19, 1999 TO April 19, 2000
(At 12:01 AM Standard Time at the address of the Public Entity stated in Item 1)
ITEM 3. LIMIT OF L1ABILllY:
$ 2.000,000
Aggregate.
ITEM 4. RETENTION:
$ 150,000
each Wrongful Act other than an Employment Practices Violation
$ 150.000
each Employment Practices Violation
ITEM 5. PREMIUM:
$ 50,000 + $2,000 Premium Tax = $52,000 Total Premium
ITEM 6. POLICY FORM NUMBER AND ENDORSEMENTS ATTACHED AT ISSUANCE
Endorsements #1-5 (See Schedule of Endorsements); Manuscript Form
These Declarations along with the completed and signed Application and the Public Officials Liability Insurance
Policy, shall constitute the contract between the Insured, the Company and Royal Surplus Lines Insurance Company.
Q.~~'
6/30/99
DATE
Countersigned:
ROYAl&~' '
, '~"7' Su NAlLIAJ\J CE
PUBLIC OFFICLALS AND EMPLOYMENT PRACTICES LIABILITY POLICY
In consideration of the premium charged, and in reliance upon the statements in the application attached hereto and made a part
hereof, and subject to the Limit of Liability stated in Item 3 of the Declarations and the terms and conditions contained herein. The
Company and the Insured agree as 'follows:
1. INSURING AGREEMENTS
To pay on behalf of the Insured all sums which the Insured shall become legally obligated to pay
as Damages resulting from any Claim first made against the Insured during the Policy Period or
the Discovery Period (if applicable) and reported to the Company pursuant to the terms of this
policy for any Wrongful Act of the Insured in the performance of duties for the Public Entity.
2. DEFENSE PROVISIONS
a) The Company shall, in addition to the Limit of Liability, appoint an attomey and defend any
Claim against the Insured alleging a Wrongful Act, even if such Claim is groundless, false or
fraudulent; and pay on behalf of the Insured Defense Costs.
b) The Insured shall not admit liability or settle any Claim or incur any cost or expense without the written consent of the
Company. The Company shall have the right to make such investigation and negotiations and, with the written consent of the
Public Entity, such settlement of any Claim as the Company deems expedient. If the Public Entity refuses to consent to any
settlement recommended by the Company, the Insured shall thereafter negotiate or defend such Claim independently of the
Company and the liability of the Company shall not exceed the amount for which the Claim could have been settled plus
Defense Costs incurred with the Company's consent up to the date of such refusal.
c) The Company shall not be obligated to pay any Damages or Defense Costs or to undertake or continue defense of any Claim
after the Limit of Liability has been exhausted by payment of Damages or after deposit of the applicable limit of the Company's
liability in a court of competent jurisdiction, and in such case the Company shall have the right to withdraw from the further
defense thereof by tendering control of said defense to the Insured.
3. DEFINITIONS
a) "Arising Out or means originating from, having its origin in, growing out of, flowing from,
incident to or having connection with, whether directly or indirectly:
b) "Claim" means a judicial proceeding alleging a Wrongful Act that is filed against an
Insured in a court of law or equity and which seeks Damages or other relief. Claim shall
also mean an administrative proceeding alleging a Wrongful Act, provided an enforceable
award of Damages can be made against an Insured at the administrative proceeding.
c) "Damages" means a monetary judgment or settlement agreed to with the consent of the
Company.
d) "Defense Costs" means reasonable and necessary fees, costs, and expenses incurred by
the Company, or incurred by the Insured with the written consent of the Company,
(including premiums for any appeal bond, attachment bond, or similar bond but without
any obligation to apply for or fumish any such bond) resulting from the investigation,
adjustment, defense, and appeal of a Claim against any Insured; provided, however, that
Defense Costs do not include salaries of employees or officers of the Company.
(e) "Employment Practice Violation(s)" means any actual or alleged:
(1) wrongful dismissal, discharge or termination (either actual or constructive) of employment including breach of an
implied contract;
1 of8
ROYA~' .
" . '. '. SUNALLlANCE
(2) harassment (including sexual harassment whether "quid pro quo", hostile work
environment or otherwise);
(3) discrimination, (including but not limited to discrimination based upon age,
gender, race, color, national origin, religion, sexual orientation or preference,
pregnancy or disability);
(4) Retaliation (including lockouts);
(5) employment-related l}1isrepresentation(s) to an employee or applicant for
employment with the Public Entity;
(6) wrongful failure to employ or promote;
(7) wrongful deprivation of career opportunity, wrongful demotion or negligent
employee evaluation, including the giving of negative or defamatory statements in
connection with an employee reference;
(8) wrongful discipline;
(9) failure to grant tenure;
(10) failure to provide or enforce adequate or consistent policies and procedure
relating to any Employment Practices Violation;
(11) violation of an individual's civil rights relating to any of the above
but only if the Employment Practices Violation relates to an employee or applicant for employment with the Public Entity whether
direct, indirect, intentional or unintentional.
(1) "Insured' means the Public Entity and:
(1) all persons who were, now are or shall be lawfully elected or appointed officials or
employees while adlng for or on behalf of the Public Entity;
(2) commissions, boards, or other units, and members and employees thereof,
operated by and under the jurisdiction of such Public Entity and within an
apportionment of the total operating budget indicated in the application for this
policy;
(3) volunteers acting for or on behalf of, and at the request and under the direction
of, the Public Entity;
(4) officials, and employees of the Pubic Entity appointed at the request of the Public
Entity to serve with an outside tax exempt entity.
(g) "Policy Period" means the period from the inception date of this policy shown in Item 2 of
the Declarations to the earlier of the expiration date shown in Item 2 of the Declarations
or the effective date of cancellation of this policy.
(h) 'Public Entity" means the municipality, governmental body, department or unit which is
named in Item 1 of the Declarations.
(I) "Retaliation" means a wrongful act of an Insured relating to or alleged to be in response to
any of the following activities: (1) the disclosure or threat of disclosure by an Employee of
the Public Entity to a superior or to any governmental agency of any act by an Insured
which act is alleged to be a violation of any federal, state, local or foreign law, common or
statutory, or any rule or regulation promulgated thereunder. (2),the actual or attempted
exercise by an Employee of the Public Entity of any right that such employee has under
law, including rights under workers' compensation laws, the Family and Medical Leave
Act, the Americans with Disabilities Act or any other law relating to Employee rights; (3)
the filing of any claim under the Federal False Claims Act or any other federal, state, local
20f8
; ROYAl&bl l
" . . .J1 SUNALLIANCE
or foreign "whistle-blower" law; (4) strikes by Employees of the Public Entity or (5)
political affiliation:
0> 'Wrongful Act" means any actual or alleged breach or duty, neglect, error, misstatement,
misleading statement, omission or Employment Practices Violation by an Insured solely
in the performance of duties for the Public Entity.
4, EXTENSIONS
Subject otherwise to the terms here'lf, the policy shall cover Claims made against the estates,
heirs, or legal representatives of deceased Insureds, and the legal representatives of Insureds in
the event of an Insured's incompetency, insolvency or bankruptcy, who were Insureds at the time
the Wrongful Acts upon which such Claims are based were committed.
Subject otherwise to the terms hereof, this policy shall cover Claims made against the lawful
spouse (whether such status is derived by reason of statutory law, common law or otherwise of
. any applicable jurisdiction in the world) of an Insured for all Claims arising solely out of his or her
status as the spouse of an Insured, including a Claim that seeks damages recoverable from
marital community property, property jointly held by the Insured and the spouse, or property
transferred from the Insured to the spouse; provided, however, that this extension shall not afford
coverage for any Claim for any Wrongful Act of the spouse, but shall apply only to Claims Arising
Out Of the Wrongful Acts of an Insured, subject to the policy's terms, conditions and exclusions.
5. EXCLUSIONS
This policy does not apply to any Damages or Claim:
(a) alleging fraud, dishonesty or criminal acts or omissions; however, the Insured shall be
reimbursed for the reasonable amount which would have been collectible under this
policy if such allegations are not subsequently proven;
(b) seeking relief or redress in any form other than Damages, or attorney's fees, costs or
expenses which the Insured shall become obligated to pay as a result of an adverse
judgment or settlement for a Claim seeking such relief; tiowever, the Company shall
defend such a Claim in accordance with Clause 2, subject to a Policy Period aggregate
limit of $1 00,000 This limit shall be part of the Limit of Liability stated in Item 3 of the
Declarations;
(c) Arising Out Of (1) false arrest, detention or imprisonment, (2) libel, slander or defamation
of character, (3) assault or battery, (4) malicious prosecution or abuse of process, (5)
wrongful entry or eviction, or invasion of any right of privacy, (6) any allegation relating to
the foregoing exclusions 5(c)(1) through 5(c)(5) that an Insured negligently employed,
investigated, supervised or retained any person, or based on an alleged practice, custom
or policy and including, without limitation, any allegation that the violation of a civil right
caused or resulted from such Damages or Claim;
(d) Arising Out Of (1 )bodily injury to, or sickness, disease, emotional distress or death of any
person, (2) damage to or destruction of any property, including the loss of use thereof, (3)
any allegation relating to the foregoing exclusions 5(d)(1) through 5(d)(2) that an Insured
negligently employed, investigated, supervised or retained a person, or based on an
alleged practice, custom or policy and including, without limitation, any allegation that the
violation of a civil right caused or resulted from such Damages or Claim;
(e) Arising Out Of inverse condemnation, temporary or permanent taking, adverse
possession or dedication by adverse use;
(f) Arising Out Of strikes, riots or civil commotions;
(9) Arising Out Of the failure to effect or maintain any insurance or bond, which shall include,
but not be limited to, insurance provided by self-insurance arrangements, pools, self-
insurance trusts, captive insurance companies, retention groups, reciprocal exchanges or
any other plan or agreement of risk transfer or assumption; however, the Company will
defend such a Claim but without obligation to pay Damages;
30f8
ROYAL & ~
. /, . /1SUNALLlANCE
(h) Arising Out Of the gaining in fact of any profit or advantage to which the Insured is not
legally entitled; the return of taxes, assessments, penalties, fines or fees; any award of
salary, wages or earnings;
(~ alleging, Arising Out Of, based upon, attributable to, or in any way involving, directly or
indirectly: .
(1) the actual, alleged or threatened discharge, dispersal, release or escape of
Pollutants, or
(2) any direction or request to test for, monitor, clean up, remove, contain, treat,
detoxify or neutralize Pollutants.
.Pollutants' include, but are not limited to, any solid, liquid, gaseous or thermal irritant or
contaminant, including smoke, vapor, soot, fumes, acids, alkalis, chemicals, asbestos,
lead and Waste. "Waste" includes, but is not limited to, materials to be recycled,
reconditioned or reclaimed;
(j) Arising Out Of the planning, construction, maintenance, operation or use of any nuclear
reactor, nuclear waste storage or disposal site or any other nuclear facility, or the
transportation of nuclear material;
(k) Arising Out Of a breach of fiduciary duty, responsibility or obligation in connection with
any employee benefit or pension plan, or to any amount due under any fringe benefit or
retirement program; however, the Company will defend such a Claim but will have no
obligation to fumish any benefits due or pay Damages;
(I) brought by or on behalf of one Insured against another Insured, however, as respects
any Claim alleging an Employment Practices Violation, this exclusion shall only apply to
cross-claims or counter-claims brought by one Insured against another Insured;
(m) Arising Out Of breach of contract, except this exclusion shall not apply to any Claim
alleging an Employment Practices Violations;
(n) Arising Out Of the operation of or activities of any schools, airports, transit authorities,
hospitals, clinics, nursing homes or other health care operations, utilities, housing
authorities, jails or detention facilities, law enforcement agencies or fire fighting
authorities unless specifically included by endorsement attached;
(0) for fines, penalties, or punitive, exemplary or the multiplied portion of multiplied Damages;
however, only where permitted by law, this policy shall cover, subject to all the terms,
conditions and exclusions contained herein, up to $50,000 punitive, exemplary or the
multiplied portion of multiplied Damages, as part of and not in addition to the Limit of
Liability of the Company otherwise afforded by this policy;
(p) arising from all pending or prior litigation or hearing as well as future Claims Arising Out
Of said pending or prior litigation or hearing. If this policy is a renewal of a policy issued
by the Company, this exclusion shall only apply with respect to a pending or prior
litigation or hearing prior to the effective date of the first policy issued and continuously
renewed by the Company;
(q) Arising Out Of, based upon or attributable to the facts alleged, or to the same or related
Wrongful Acts alleged or contained, in any Claim which has been reported, or in any
circumstances of which notice has been given, under any policy of which this policy is a
renewal or replacement or which it may succeed in time; .
(r) Arising Out Of any Wrongful Act prior to the inception date of the first policy issued by the
Company and continuously renewed and maintained, if on or before such date any
Insured knew or could have reasonably foreseen that such Wrongful Act could lead to a
Claim,
The following exclusions shall also apply to any Claim alleging an Employment Practices Violation(s)
40f8
ROYAL & V
, , . /1sUNALLIAt'lCE
This policy does not apply to any Damages or Claim:
(5) Arising Out Of any obligation pursuant to any worker's compensation, disability benefits,
unemployment compensation, unemployment insurance, retirement benefits, social
security benefits or similar law; provided. however, this exclusion shall not apply to a
Claim for Retaliation; ,
(t) Arising Out Of any violation of the Employee Retirement Income Security Act of 1974, the
Fair Labor Standards Act (except the Equal Pay Act), the National Labor Relations Act,
the Worker Adjustment and Retraining Notification Act, the Consolidated Omnibus Budget
Reconciliation Act, the Occupational Safety and Health Act, any rules or regulations of
the foregoing promulgated thereunder and amendments thereto or any similar provisions
of any federal, state, local or foreign statutory law or common law; provided however, this
exclusion shall not apply to a Claim for Retaliation;
(u) Arising Out Of any costs or liability incurred by any Insured to modify any building,
property or facility to make said building, property or facility more accessible or
accommodating to any disabled person as mandated by the Americans With Disabilities
Act Of 1992, and as amended, or any similar federal, state or local law, regulation or
ordinance.
6. LIMIT OF LIABILITY
(a) The total liability of the Company for all Damages arising from all Claims made against
the Insured during the Policy Period and during the Discovery Period (if applicable), shall
not exceed the Limit of Liability stated in Item 3 of the Declarations. The inclusion herein
of more than one Insured shall not increase the Limit of Liability of the Company. The
Limit of Liability stated in Item 3 of the Declarations shall apply to all Claims Arising Out
Of the same Wrongful Act or related Wrongful Acts.
(b) If additional Claims are subsequently made which Arise Out Of the same Wrongful Act or
series of continuous, repeated or interrelated Wrongful Acts as Claims already made and
reported to the Company, then all such Claims, whenever made, shall be considered first
made within the Policy Period or the Discovery Period (if applicable) in which the earliest
Claim Arising Out Of such Wrongful Act or series of continuous, repeated or interrelated
Wrongful Acts was first made and reported to the Company, and all" such Claims shall be
subject to one such Limit of Liability.
7. DEDUCTIBLE
Subject to theUmit of Liability, exclusions and other terms of this policy, the Company shall only
be liable for those Damages and Defense Costs which are in excess of the Deductible stated in
Item 4 of the Declarations. This Deductible shall apply to each Wrongful Act or
Employment Practice Violation or series of continuous, repeated or interrelated Wrongful Acts or
Employment Practice Violations and shall be bome by the Public Entity and remain uninsured.
The Public Entity shall also be responsible for payment of the Deductible The Company may
direct the Public Entity to make partial or full payment of the Deductible to others.
8. NOTICE! CLAIM REPORTING PROVISIONS
Notice hereunder shall be given in writing to Royal Specialty Underwriting, Inc., at the address indicated on the
Declarations Page.
If mailed, the date or mailing shall constitute the date that such notice was given and proof
of mailing shall be sufficient proof of notice. A Claim shall be considered to have been
first made against an Insured when written notice of such Claim is received by any
Insured, by the Public Entity on the behalf of any Insured or by the Company, whichever
comes first.
50f8
ROYAL & V
. /1SUNALLIANCE
(a) The Public Entity or the Insureds shall, as a condition precedent to the obligations of the
Company under this policy, give written notice to the Company of any Claim made
against an Insured as soon as practicable and either:
(1) anytime during he Policy Period or during the Discovery Period (if applicable)
(2) within 30 days after the end of the Policy Period or the Discovery Period (If
applicable), as long as such Claim is reported no later than 30 days after the date
such Claim was first made against an Insured.
(b) If written notice of a Claim has been given to the Company pursuant to Clause 8(a)
above, then any Claim which is subsequently made against the Insureds and reported to
the Company Arising Out Of the facts alleged in the Claim for which such notice has been
given, or alleging any Wrongful Act which is the same as or related to any Wrongful Act
alleged in the claim of which such notice has been given, shall be considered made at the
time such notice was given.
(c) If during the Policy Period or during the Discovery Period (If applicable) the Public Entity
or the Insureds shall become aware of any circumstances which may reasonably be
expected to give rise to a Claim being made against the Insureds and shall give written
notice to the Company of the circumstances and the reasons for anticipating such a
Claim, with full particulars as to dates, persons and entities involved, then any Claim
which is subsequently made against the Insureds and reported to the Company Arising
Out Of such circumstances or alleging any Wrongful Act which is the same as or related
to any Wrongful Act alleged or contained in such circumstances, shall be considered
made at the time such notice of such circumstances was given.
9. DISCOVERY CLAUSE
(a) Automatic Discovery Period
If the Company or the Public Entity shall cancel or refuse to renew this policy and the
Public Entity does not obtain replacement coverage as of the effective date of such
cancellation or non-renewal, the Public Entity shall have the right to a period of sixty (60)
days following the effective data of such cancellation or non-renewal in which to give
written notice to the Company of any Claim made against the Insured during said 60 day
period for any Wrongful Act before the end of the Polley Period. This Automatic
Discovery Period shall immediately expire upon the purchase of replacement coverage
by the Public Entity.
(b) Optional Discovery Period
If the Company or the Public Entity shall cancel or refuse to renew this policy, the Public
Entity shall have the right, upon payment of an additional premium of 50% of the total
policy premium, to a period of twelve (12) months following the effective date of such
cancellation or non-renewal in which to give written notice to the Company of any Claim
made against the Insured during said twelve (12) month period for any Wrongful Act
before the end of the Policy Period. This right shall terminate, however, unless written
notice of such election together with the additional premium due is received by the
Company within thirty (30) days after the effective date of cancellation or non-renewal.
This clause and the rights contained herein shall not apply to any cancellation resulting
from non-payment of premium.
10. CANCELLATION CLAUSE
This policy may be canceled by the Public Entity by surrender of this policy or by giving written
notice to the Company stating when thereafter such cancellation shall be effective. This policy
may also be canceled by the Company by delivering to the Public Entity or by mailing to the
Public Entity by registered, certified, or other first class mail, at the address shown in Item 1 of the
Declarations, written notice stating when, not less than thirty (30) days thereafter, the cancellation
shall be effective. However, if the Company cancels this policy because the Pubic Entity has
failed to pay a premium when due, or has failed to reimburse the Company such amounts as the
Company has paid as Damages or Defense Costs within the amount of the applicable Deductible,
or excess of the Limit of Liability, this policy may be canceled by the Company by mailing to the
Public Entity by registered, classified, or other first class mail, at the address shown in Item 1 of the
Declarations, written notice stating when, not less than ten (10) days thereafter, the cancellation
60f8
ROYAL&V . _
, '.' /1SUNALLIANCE
shall be effective. The mailing of such notice as aforesaid shall be sufficient proof of notice and
this policy shall terminate at the date and hour specified in such notice.
If this policy shall be canceled by the Public Entity, the Company shall retain the customary short
rate proportion of the premium hereon. If this policy shall be canceled by the Company, the
Company shall retain the pro rata proportion of the premium hereon. Payment or tender of any
unearned premium by the Company shall not be a condition precedent to the effectiveness of
cancellation, but such payment shall be made as soon as practicable,
11. REIMBURSEMENT OF THE COMPANY
If the Company has paid any Damages in excess of the Umit of Uability or Damages or Defense
Costs within the applicable Deductible, the Insureds, jointly and severally, shall be liable to the
Company for any and all such amounts and, upon demand, shall pay such amounts to the
Company.
12. SUBROGA nON
In the event of any payment under this policy, the Company shall be subrogated to all the
Insured's rights of recovery against any person or organization, and the Insured shall execute and
deliver all instruments and papers and do whatever else is necessary to secure such rights for the
Company. The Insured shall do nothing to prejudice such rights. Any amount recovered in
excess of the total payment by the Company shall be restored to the Insured, less the cost to the
Company of recovery.
13. OTHER INSURANCE
Such Insurance as is provided under this policy shall apply only as excess
over any other valid and collectible insurance, self insurance, or indemnification or any similar
agreement, whether such other insurance or agreement is stated to be primary, pro rata,
contributory, excess, contingent or otherwise.
14. COOPERATION CLAUSE
The Insured shall cooperate with the Company and, upon the Company's request. assist in
making settlements and in the conduct of Claims. The Insured shall attend hearings and trials
and assist in securing and giving evidence and obtaining the attendance of witnesses. The
Insured shall not, except at the Insured's own cost, voluntarily make any payment, assume any
obligation or incur any expense.
15. NOTICE AND AUTHORITY
By the acceptance of this policy, the Public Entity agrees to act an behalf of all Insureds with
respect to the giving of notice of Claim, the giving or receiving of notice of cancellation or non
renewal, the payment of premiums, the receiving of any premiums that may become due under
this policy, consenting to any settlement and exercising the right to the Discovery Period. All
Insureds agree that the Public Entity shall act on their behalf.
16. ASSIGNMENT
Assignment of interest under this policy shall not bind the Company until its consent is endorsed
hereon; however, subject otherwise to the terms hereof, this policy shall cover the estate heirs,
legal representatives or assigns of the Insured in the event of the death, bankruptcy or insolvency
of the Insured or the Insured being adjudged incompetent
17. ACTION AGAINST THE COMPANY
No action shall lie against the Company unless, as a condition precedent thereto, the Insured
shall have fully complied with all the terms of this policy, nor until the amount of the obligation of
the Insured to pay shall have been finally determined either by judgment against the Insured after
actual trial or by written agreement of the Insured, the claimant and the Company.
70f8
ROYAL&V. .
. '" ',}4 SUNALLlANCE
Any Insured or the legal representative thereof who has secured such judgment or written
agreement shall thereafter be entitled to recover under this policy to the extent of the insurance
afforded by this policy. No Insured shall have any right under this policy to join the Company as a
party to any action against other Insureds or the Public Entity to determine the Insureds' liability,
nor shall the Company be impleaded by the Insureds or the Public Entity or their legal
representatives. Bankruptcy or insolvency of th~ Insured or the estate of the Insured shall not
relieve the Company of any obligation hereunder.
18. REPRESENTATIONS AND SEVERABILITY
In granting coverage under this policy, it is agreed that the Company has relied upon the
statements and representations contained in the application for this policy (including materials
submitted thereto, and if this is a renewal application, all such previous policy applications for
which this policy is a renewal) as being accurate and complete. All such statements and
representations shall be deemed to be material to the risk assumed by the Company, are the
basis of this policy and are to be considered as incorporated into this policy.
With respect to such statements, and representations, no knowledge or information possessed by
any Insured shall be imputed to any other Insured. If any person who executed the application
knew that such statement or representation was inaccurate or incomplete, such statement shall
not be imputed to any Insured other than such signator and any other Insureds who knew such
statement or representation was inaccurate or incomplete.
19. POLICY TERRITORY
This policy applies to Wrongful Acts committed anywhere in the world provided Claim is made in
The United States of America, its territories or possessions, or Canada.
20. HEADINGS
The descriptions in the headings of this policy are solely for convenience, and form no part of the
terms and conditions of coverage.
80f8
ROYAL & k( .
-~-':-t7tsu NALLlAN CE
I .
This Endorsement Changes The Policy. Please Read It Carefully.
Schedule of Endorsements
1
2
3
4
5
Extended Discovery Period
Georgia Amendatory Endorsement
Pending and/or Prior Litigation Endorsement
Minimum Earned Premium Clause - Percentage
Service of Suit
00132
THE ABOVE SCHEDULE OF ENDORSEMENTS IS FOR ILLUSTRATIVE AND
CONVENIENCE PURPOSES ONLY AND FORMS NO PART OF THE TERMS AND
CONDITIONS OF COVERAGE.
All other terms, conditions and warranties remaining unchanged.
Attached to and forming part of the Policy No.
Issued to
If this endorsement is listed in the policy declarations, it is in effect from the time coverage under this policy commences.
Otherwise, the effective date of this endorsement is as shown below at the same time or hour of the day as the policy
became effective.
Effective Date:
Endorsement No.
Countersigned By:
Authorized Representative
Date
...~
ROYAL &"' '.
.,' ; SUNALLIANCE
This Endorsement Changes The Policy. Please Read It Carefully.
In consideration of the premium charged, it is hereby understood and agreed that Clause 9, Discovery
Clause, is deleted in its entirety and replaced by the following:
9. EXTENDED DISCOVERY PERIOD
If the Company or the Insureds shall cancel or non-renew this Policy the Insureds shall have the right,
upon payment of the additional premium of 200% of the total Policy premium hereunder, to an
extension of the coverage granted by this Policy in respect of any claim or claims first made against the
Insureds and reported to the Company during the period of three (3) years after the effective date of .
such cancellation or refusal to renew but only in respect of any Wrongful Act committed before the
effective date of such cancellation or refusal to renew and otherwise covered by this Policy.
This right shall terminate, however, unless written notice of such election together with the additional
premium due is received by the Company not later than thirty (30) days after the effective date of
cancellation or refusal to renew.
This clause and the rights contained herein shall not apply to any cancellation resulting from non-
payment of premium.
This endorsement effective
forms part of Policy Number KHP607178
issued to
by
Endorsement No.: 1
. ROYAL '& ~'
-:. 71 SUNALLIANCE
This Endorsement Changes The Policy. Please Read It Carefully.
GEORGIA AMENDATORY ENDORSEMENT
In consideration of the premium charged, it is hereby understood and agreed that wherever used in this
endorsement:
(1) Company means the insurance company which issued this policy;
(2) Insured means the person or entity who is afforded coverage by this policy.
It is further understood and agreed as follows that the Cancellation Provision of this policy is amended to
include the following:
CANCELLA TION
A notice of termination, including a notice of cancellation or nonrenewal, by the Company, a notice of an
increase in premium rates, other than an increase in premium rates due to a change in risks or exposure,
which exceeds 15 percent (15%) of the current policy's premium, or a notice of a change in any policy
provision which limits or restricts coverage; shall be delivered to the Insured or mailed to the Insured by first-
class mail, at least forty-five (45) days prior to the policy termination date.
If the Company fails to comply with the above requirements, the Insured shall be entitled to purchase, under
the same premium rate and policy terms and conditions, an additional thirty (30) day period of insurance
coverage beyond the termination date of such policy; provided, however, that the Insured tenders the pro-
rata premium amount to the Company on or before the termination date. The insurance coverage is not
required to be extended for more than thirty (30) days from the policy termination date.
It is further understood and agreed that the Insured first named in' Item 1 of the Declarations shall be the sole
agent of all Insureds for the purpose of effecting cancellation or nonrenewal or the giving or receiving of
notice thereof.
This endorsement effective
forms part of Policy Number KHP607178
issued to
by
Endorsement No.: 2
ROYAL & ~
, /1 SUNALLIANCE
This Endorsement Changes The Policy. Please Read It Careful/y.
PENDING AND/OR PRIOR LITIGATION ENDORSEMENT
In consideration of the premium charged, it is hereby understood and agreed that this policy excludes all
claims arising from all pending or prior litigation, as well as future claims arising out of said pending or
prior Iitigation(s), effective April 19, 1997.
This endorsement effective
forms part of Policy NUmber KHP607178
issued to
by
Endorsement No.: 3
ROYAL &:~(
"/1 SUNALLIAt'JCE
This Endorsement Changes The Policy. Please Read It Carefully.
MINIMUM EARNED PREMIUM CLAUSE - PERCENTAGE
In the event of cancellation of this policy by the Insured, a minimum premium of 25% of the
original policy premium shall become earned; any conditions of the policy to the contrary
notwithstanding.
Failure of the Insured to make timely payment of premium shall be considered a request by the
Insured for the Company to cancel. In the event of such cancellation by the Company for
non-payment of premium, the minimum premium shall be due and payable; provided, however,
such non-payment cancellation shall be rescinded if the Insured remits the full premium due within
10 days of receiving it.
In the event of any other cancellation by the Company, the earned premium shall be computed pro
rata, not subject to the minimum premium.
This endorsement effective
forms part of Policy Number KHP607178
issued to
by
Endorsement No.: 4
:
ROYAL&V .
~~ SUNALLlANCE
This Endorsement Changes The Policy. Please Read It Carefully.
SERVICE OF SUIT CLAUSE
It is agreed that in the event of the failure of the Insured Organization to pay any amount
claimed to be due hereunder, the Insured Organization, at the request of the Insured Persons,
will submit to the jurisdiction of any court of competent jurisdiction within the United States
and will comply with all requirements necessary to give such court jurisdiction and all matters
arising hereunder shall be determined in accordance with the law and practice of such court.
It is further agreed that service of process in such suit may be made upon the highest one in
authority bearing the title "Commissioner", "Director" or "Superintendent" of Insurance of the
state or commonwealth wherein the Insured Organization named in Item 1 of the Declarations
Page of this policy is located, and that in any suit instituted against it upon this contract the
Insured Organization will abide by the final decision of such court or any appellate court in the
event of an appeal. The one in authority bearing the title "Commissioner", "Director" or
Superintendent" of Insurance of the state or commonwealth wherein the Insured Organization
named in Item 1 of the Declarations Page of this policy is located is hereby authorized and
directed to accept service of process on behalf of the Insured Organization in any such suit
and/or upon the Insured Persons request to give a written undertaking to the Insured Persons
that they will enter a general appearance upon the Insured Organization's behalf in the event
such a suit shall be instituted.
This endorsement effective
forms part of Policy Number KHP607178
issued to
by
Endorsement No,; 5
11rIl- ...merican International CO.......tpanies@
Name of Insurance Company
To Which Application is Made:
National Union Fire Insurance Company
(herein called the Company
PUBLIC OFFICIALS AND EMPLOYMENT PRACTICES LIABILITY RENEWAL APPLICATION
1m)
MuniPro5M
NOTICE: THIS IS AN APPUCATION FOR INSURANCE WRITTEN ON A CLAIMS MADE BASIS. FURTHER NOTE
THATTHE DEDUCTIBLE FOR THIS POLICY SHALL APPLY TO BOTH DAMAGES AND DEFENSE COSTS. IF A
POUCY IS ISSUED, THE APPLICATION WILL BECOME PART OF THE POLICY AS IF PHYSICALLY ATTACHED.
THEREFORE, IT IS NECESSARY THAT ALL QUESTIONS BE ANSWERED ACCURATELY AND COMPLETELY.
INSTRUCTIONS
Answer all questions completely. Please type or print clearly.
When requested, please answer on a separate sheet and indicate the question number, If the answer to any
question is NONE please state NONE. Any questions considered "not applicable", please explain why.
This Application must be signed and dated by either (a) the highest ranking elected or appointed member of the
board of the applicant (b) the business manager or risk manager of the applicant, or (c) the Treasurer or Comptroller
of the applicant.
I. GENERAL INFORMATION
Expiring Polley Number 485-27-54
1. Legal Name of Public Entity: Augusta.GecI"'"31Q:..
Address: 530 Greene Street
Expiration Date
4-19-99
City: Augusta
Internet Web Page address: htto://www.
2. Type of Public Entity. Check a/l that apply, Including component units.
State: GA
Zip Code: 30911
(A) Local Government (city, county, village, township, etc)
(8)
D
Special District
Port Authority (Air or Water)
Housing Authority
Transit Authority
Utility (Electricity, Gas, Cable, etc) 0
Water/Sewer Authority C
Development/Finance Authority 0
Sports/Convention Center/Parks Department 0
[]
o
c
(C) Section -13(f) Entities
See Attachment (A)
68931 (10/97)
(C) Other Describe In Detail
3. (a) Present Population:
1990
189,719
4.
(b)
(a)
Name of largest City: Augusta
Population: 1990
189,:719
Names and Official Title of Governing Board Members: use a separate sheet of paper If additional space /s
required
NAME
TITLE
ELECTED
o
APPOINTED
o
0 0
0 0
0 0
0 0
Single member district 0
At large 0
Combination of both 0
(b) If Board Members are elected, are they elected via:
If Board Members are appointed, whom are they appointed by.
II. FINANCIAL INFORMATION
5. (a) Fisca.l Year 1-1-99 to 12-31-99
Figures shown below are to include the totals from the Public Entity and all component units (if applicable) as
indicated in item 1.
(b)
cutr~~~ear
82,753,540
82,753,540
1998
Prior Year
Budget Next Yr.
Total Revenue
87,307,805
87,300,000
Total Expenditures
Surplus/Deficit
3,007,805
Please clarify on a separate page the circumstances surrounding any large or ongoing deficits, unexpended
appropriations or surpluses reflected in the above figures.
PLEASE ATTACH A COPY OFYOUR MOST RECENT COMPREHENSIVE ANNUAL FINANCIAL REPORT
6. Does the Public Entity anticipate any special projects which will result in a substantial budget increase or
decrease in the next 3 years.
NONE
7. (a) Total amount of outstanding Bonds $ 83 , 598 , 846
(b) Latest Moody's and/or Standard and Poor's Bond rating: A1
IF NOT RATED, PLEASE EXPLAIN
(c) Has the Public Entity been in default on principal or interest at any Bond.
If yes, attach a statement of details.
Yes 0 No l[]
(d)
Please include a copy at the Bond Offering Statement or prospectus for all Bonds issued in'the past year.
68931 (10/97)
2
8. Are all investments made by or on behalf of the Public Entity rated at or above
Baa by Moody's Investors Services or BBB by Standard & Poor's Corporation. Ves ~ No 0
If no, please attach the most current investment portfolio.
III. OPERATIONS
9. Does the authority of the Public Entify cover any of the operations listed below. Ves IX] No 0
If so, indicate the total amount of current year expenditures from Question 5(b) allocated to each operation:
Current Year Check here if
Expenditures coverage is
Covered Operation included in item 6(b) Current Vear Expenditures requested
(a) port authority Ves 0 No :J $ 0
(b) housing authority Ves 0 No 0 $ 0
(c) transit authority Yes 0 No 0 $ 0
(d) utilities Ves 0 No C $ 0
(e) water/sewer authority Ves 0 No 0 $ 0
(f) hospital, clinic, nursing
home or other health
care operations Ves 8 No 0 $ N/A
(g) school Ves 0 No 0 $ N/A
;
(h) jails or detention
facilities Ves ."l No 0 $ -- N/A
(i) law enforcement
agencies Yes 0 No 0 $ N/A
Q) fire fighting authorities Ves 0 No L; $ N/A
NOTE: COVERAGE IS NOT PROVIDED FOR THE ABOVE UNLESS SPECIFICAllV INDICATED ON THE
DECLARATIONS PAGE OR BY ENDORSEMENT TO THE POUCY. REQUESTING COVERAGE FOR THESE
OPERATIONS DOES NOT NECESSARILY MEAN IT WILL BE GRANTED. NOTE ALSO THAT WHERE
INDICATED ABOVE AS "N/A" THERE IS NO COVERAGE UNDER THE POLICY FORM.
IV. EMPLOYMENT PRACTICES
1 0, Total number of Employees (Including Elected and Apoointed Public Officials)
11 . Number of Elected/Appointed Officials or employees tho are:
2,660
Attorneys
Architects
1
1
Accountants
Engineers
5
4
Is Professional Uability Insurance purchased for these individuals
12. Do you anticipate any layoffs within the next 12 months?
If yes please explain.
Ves 0 No 0
Ves 0 No ~
V. INSURANCE AND LOSS HISTORY
13. Name of primary General Uability Insurance carrier NONE
Name of Law Enforcement/Police Professional Uability Insurance carrier NONE
68931 (10197)
3
".
UAmerican International Cvmpariies<!l
m!j
MuniPro !,IJ
::::;-...:.;.-:..;;-::~-;;;:-~~, N .~~ EM P co Y M ENT:P .RACTICES:S U PP L:EM ENT AL~Q U EST! 0 N S::i~:"""::"'-::'-"~;J.~;:.:.-.~~
14. Does the Public Entity have ~ Human Resources department
6a Yes Number of Emp{oye~s in the HUr.1an Rescurc~s Departl1ent 14
o No Explain how this func:ioCl is hancled
15.
Does the PL:blic Entity have a written human resources manual
If no. pleaSe: explain what guidelines are followed
Yes~ NoD
10. Total numi::er of Employees and ElectedlP-.ppointed Officials who have resigned, been terminated (with or
without cause) or retired within the last 24 months.
Employees 975 Elected/Appointed Officials 9
17. Has any Employe~ or Elected/Appointed Official made allegations of unfair or improper
treatrne.fl,t regarding hiring, remuneration, advancement, or termination of employment Yes iXl. No 0
18. Does the Public Entity:
~) Use an employment application {or aU.of your applicants for hire
(bl Use any tests to screen applicants for employment or to promote employees
(c) Have a formal orientation program for aU new employees
(d) .Publish an employment handbook Policy & Procedure Manual
If yes, do you distribute to all employees
(el Provide regular. written performance evaluation.s for alfemployees
(f) Have a formally implemented and adopted anti-sexual harassment policy
If yes, is it distributed annually to aU wor'J<ers .
(g) Have a written procedure for handling employee complaints of discrimination
and saxual harassment
(h) Have a policy on AIDS or on assisting employees with lifa-threatening or
communicable diseases
(D Have a policy on accommodating the disabled as required by the Americans
with Disabilities Act
U) Comply with the Famity Medical Leave Act
19. Does the Public Entity require terminations to be reviewed by its:
Human Resources Department
legal Depar\ment
Outside counsel
20. Does the pl.;~lic Entity have a formal out-placement program which assists
terminated or"laid orr employees in finding other jo'bs
21. Does the Public Entity concuct exit intervie'''/s
Yes ID NoO
Yes &l NoD
Yes &l NoO
Yes~ NoO
Yes~ NoO
Yes~ NoO
Yes~ NoO
YesO No 12
Yes !Xl No 0
YesD NoK)
Yes~ NoO
Yes rll NoO
Yes GEl NoD
YesO NoD
YesO ~loD
YesO No~
Yes0 NoD
. .
,"
~OTlCE TO MINNESOTA APPLICANTS: "ANY PERSON WHO SUBMITS AN APPLICATION OR FILES A CLAIM
WITH INTENT TO DEFRAUD OR HELPS COMMIT A FRAUD AGA!NST AN INSURER IS GUILTY OF A CRIME."
NOTICE TO NEW JERSEY APPLICANTS: "ANY PERSON WHO INCLUDES ANY FALSE OR MISLEADING
INFORMATION ON AN APPLICATION FOR AN INSURANCE POLICY IS SUBJECT TO CRIMINAL AND CIVIL
PENALTIES."
NOTICE TO NEW YORK APPLICANTS: "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
INSURANCE ACT, WHICH IS A CRIME, AND SHALL ALSO BE SUBJECTTO A CIVIL PENALTY NOTTO EXCEED
FIVE THOUSAND DOLLARS AND THE STATED VALUE OF THE CLAIM FOR EACH SUCH VIOLATION,"
NOTIce TO OHIO APPLICANTS: "ANY PERSON WHO, WITH 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."
NOTICE TO PENNSYLVANIA APPUCANTs: "ANY PERSON WHO KNOWINGLY AND WITH INTENTTO 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
INSURf\NCE ,l\CT, WHICH IS A CRIME AND SUBJECTS SUCH PERSON TO CRIMINAL AND CIVIL PENALTIES."
PLEASE READ THE FOLLOWING STATEMENT CAREFULLY AND SIGN BELOW WHERE INDICATED. IF A
POLICY IS ISSUED, THIS STATEMENT IS INCORPORATED IN AND BECOMES A PART OF SUCH POLICY.
;
The undersigned authorized representative of the Public Entity hereby acknowledges that Defense Costs that are
incurred will be applied against the Deductible.
ublic Entity
Date
if /1~/r9
I ,
TItle
(Must be sIgned by the hIghest ranking elected or appointed
member of the board of the Public Entity, or the business
manager or risk manager of the Public Entity, or the
'T)'essurer or Comptroller of the Public Entity)
f~ ~\ ~
/IIfII.~D~.,a~r @(!tJ.,/d_IJ;.tI.ttQ. US
E.mail
Submitted by (Insurance Agent/Broker):
PHIL S. HARISON, JR.
Insurance Agency/Brokerage:. _
Harison-Kerzlc, Inc.
Insurance Agency/Brokerage T. IlK 2601 Commons Boulevard
P.O. Box211110
Address: Augusta. Georgia 30917-1110
Hlllioon. Kenlc, 'nc. Phone (706) 737-8811
'nauranceBrolnlra FAX (706) 737-3413
E-mail:
Telephone:
Facsimile:
68931 (1 0/97)
5
Fsb-2!-QQ 03:58pm Fram-SWETT ~ CRAWFORD
+404Z5210Z7
T-S9Z P.04/0S F-T50
and il9r~~ lruiurer's reca.ipr of sucn wrinen rapen. prior TO l~e inCflption ot IMe pOlicy
applie.d tar, is a.coMillon :Jrecedant 10 coverage.
". It mis IS a Renewal ApphC<lllon, il snail oe a supplement to me Apphcatlon(s) anacned to me current POliCY and
~cauons tog"ether wiUllt1is Renawal APPlicalion constih.ite inS complere Ap~tlon which snail De the
Dasis of me contract should a policy be issued ana will be anacned to ana oecome pan at tne policy.
Tne-sigAiRg ,of ,tffis.-Applicarion doeS-ncLDiu1.ttlB..under&lgned 10 p....rcnasa 1118 insurance, 90r does review of tile
Application Dind.Ih ranee comp.~Y}O ISSue a policy. Tnis Application shall De tne baSIS of tne contract should
a.~~
Harison-Kerzic, Inc.
2601 Commons Boulevard
P.O, Box211110
Augusta, Georgia 30917-1110
Herfaon- Kerzlc,lnc. Phone (706) 737-8811
!neuronc. Brokers FAX (706) 737-3413
Nama of 'Agency
FUll Address.
City. Staie. Zip~_
'\
Contact Name ana pnone
Surplus Llfles Lican!.:e Number
AdmiRed 'LjcBnSe"~mDer
Cor~Q!~ Counters!srlng Agent?"O' Ys's 0" NO'
Stars 'Tax 'IO'~ber
. COA-OCG"13::S1-'~~ ..
PAGE 3 OF ..
Augusta-Riclunond County, GA
Section 13(F) Entities
AnllnalControlBo~d
Augusta-Richmond County Library Bo~d
Augusta-Richmond County Personnel Bo~d
Augusta-Richmond County Planning Commission
Augusta-Richmond County Tree Commission
Augusta Aviation Commission - Bush Field
Board of Zoning Appeals
Consolidated Historic Preservation
General Aviation - Daniel Field
Human Relations Commission
Riverfront Development Review
Attachment (A)
04/16/99
CLAIM NOTICE
Please notify Royal Specialty Underwriting, Inc.
of all claims
Royal Specialty Underwriting, Inc.
945 East Paces Ferry Road
Suite 1890
Atlanta, GA 30326
Attention: Claims Department
J'
. ....
,,'
IlK
Harison - Kerzic, Inc.
Insurance Brokers
July 19, 1999
Augusta Richmond County
Attention: Sandy Wright
530 Green Street Room 217
Augusta, GA 30911
Re: Renewal of General Liability.
04/19/1999 to 04/19/2000
Swett & Crawford
Dear Ms. Wright,
Enclosed please find the renewal policy mentioned above which will continue your coverage for
another year.
In the event of a loss or if any changes in your operations or status occur during the policy term,
please notify us at once so that we may make adjustments accordingly.
In our initial review, no discrepancies were noted. However, if you find anything which should
be corrected please let us mow.
Thank you for your opportunity to serve your insurance needs and please call whenever we can
assist you.
Sincerely,
~~
Nancy Glass
Service Agent
Enclosure
Harison-Kerzic, Inc./2601 Commons Boulevard / P.O, Box 211110 / Augusta, Georgia 30917-1110 / (706) 737-8811