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HomeMy Public PortalAboutP.A.W.SCONTRACT FOR SERVICES October 1,, ,2015,�1— September 30, 2016 THIS CONTRACT, made and entered into this "AO 'day of , 2015 between the Panhandle Animal Welfare Society, Inc., (hereinafter referred to as "PAWS") and the CITY OF Crestview, FLORIDA (hereinafter referred to as "City"). Witness: WHEREAS, the parties do agree that the purpose of this contract is to establish PAWS as the administrative and enforcement agency for any Okaloosa County Animal Control Ordinances, City Ordinances and applicable Florida statutes pertaining to animals; NOW, THEREFORE, in consideration of the covenants and agreements herein contained, the parties hereto agree as follows: 1. The City will pay the annual sum of $85,000.00 by Fiscal Year to be disbursed in monthly payments of $7,083.33. Such annual amounts are based on a per capita division of costs among local governments which contract for PAWS services. Payment shall be made upon receipt of a monthly statement submitted by PAWS to the City. 2. Fees collected by PAWS pursuant to this contract shall be retained by PAWS to assist in offsetting the cost to the City of animal control. In the event that impound fees collected by PAWS during the term of this Contract exceeds the total budget established by PAWS in any fiscal year for animal control, PAWS shall pay a portion of the excess collections based upon a per capita division among those local governments that contract for PAWS services during each fiscal year. PAWS agrees within one hundred eighty (180) days after the completion of each approved fiscal year of this contract to provide the City an audit of animal control income and expenses performed by an independent certified accountant. PAWS shall not be responsible for the removal of dead animals on public property or public right of way. Dead animals on private property may be picked up for a fee as determined by PAWS, after the fee has been paid by the owner of the animal or the owner of the property. 4. PAWS will enforce all applicable Okaloosa County ordinances, City Ordinances and Florida statutes relating to animal control, including the following duties and responsibilities: Provide appropriate equipped, certified Animal Control Officers during the normal business hours of 8:00A.M to 5:00 P.M. Monday through Friday to enforce the ordinances of Okaloosa County and Florida statutes. Operations will be via demand / response system which prioritize incoming animal control demands for services from citizens, and dispatches calls to Animal Control Offices in the field. Officers will respond to citizen request for assistance, and, when not actively engaged in answering dispatched calls, will perform routine patrolling of the service area. Issue citations against and / or impound animals determined to be in violation of applicable County ordinances or Florida statutes; manage the investigation and prosecution of cruelty, abuse, neglect and abandonment cases, including the designation and supervision of dogs classified pursuant to Florida's "Dangerous Dog" statutes. Provide adequate food, shelter and emergency care as necessary for all impounded animals and stray animals apprehended in the field of surrendered at the PAWS shelter until placed or otherwise humanely destroyed according to law. Maintain suitable office hours at the PAWS animal shelter for the purpose of transacting business in connection with the duties under this contract, including, but not limited to, receiving stray or owner surrendered animals and handling transactions for the redemption or impounded and stray animals. House each impounded and stray animal for the period of time specified by applicable County ordinance or Florida statutes and quarantine bite cases pursuant to a cooperative agreement with the County Health Department. An Animal Control Officer will remain on -call after hours to respond to emergencies involving injured animals; vicious animals that have bitten or inflicted an injury on a person or other animal; cruelty cases; and other situations reasonably considered to constitute a physical threat to humans or animals. 5. PAWS will maintain accurate and detailed records of all stray, impounded or owner released animals, including dispositions; records of all bite cases and reports of investigations; and detailed financial records of all fines and impound fees collected. These records shall be open for inspection during normal business hours to persons designated by the City to review them. In addition, PAWS shall provide to the City a monthly animal control activity summary. 6. PAWS will initiate and maintain a program of public education concerning animal related laws; and promoting responsible pet ownership. 7. PAWS will assist any City -designated agency or group of volunteers on special tasks, such as responding to dog packs, emergency management, and other animal -related situations. Requirements for such assistance will be communicated by the City to PAWS in advance, either in writing or verbally, to permit rescheduling of work assignments. S. As a matter of convenience to private citizens, PAWS may provide pet euthanasia service and disposal of remains, for a reasonable fee determined by PAWS. 9. This contract is for the performance period October 1, 2015 through September 30, 2016 and shall remain in force for a period of one year, contingent upon the annual appropriation by the City legally available funds as provided in this section. City's obligation to pa the amount due hereunder in any fiscal year is contingent upon the appropriation by the City Council of legally available funds for the purpose set forth in this contract. City agrees and hereby directs its managers to provide for the amounts die hereunder in each annual proposed budget submitted to the City Council as a separately stated line item for animal control. In the event the City Council deletes such line item for the payment for the amounts due hereunder from the budget as finally enacted for such fiscal year, the same shall constitute an event of non -appropriation wit respect to this contract, and this contract and the terms contained herein shall terminate effective as of the end of the fiscal year of the City for which sums have been appropriated, and the parties shall be discharged from further responsibility to each other under this contract. The occurrence of an event of non -appropriation shall not be deemed an event of default hereunder but shall affect a mutual dissolution of this contract. 10. City shall have the right to immediately terminate this contract upon the occurrence of Okaloosa County agree and obligating itself to undertake funding though taxes, assessments, or any other means for the animal control services provided by PAWS as set forth in this contract within the jurisdictional limits of the City. 11. PAWS shall, during the term, and at its sole expense, obtain and keep in force, with the City named as additional insured: Commercial general liability insurance including personal injury, bodily injury, broad form property damage and operations hazard, and products and completed liability in limits not less than $1,000,000.00 for each occurrence and $2,000,000.00 in the aggregate. PAWS shall furnish evidence satisfactory to City of the existence of and maintain of such insurance prior or contemporaneous with the commencement of the term and thereafter at least (15) days prior to the date in which such policy is required to be renewed. PAWS shall obtain a written obligation on the part of each insurance company to notify the City at least thirty (30) days prior to the cancellation of each insurance. A policy of workers' compensation insurance in compliance with applicable Florida law. The workers' compensation insurance policy shall include employer's liability insurance with limits of liability not less than $500,000.00 for each accident/ $1,000,000.00 per employee for disease/ $1,000,000.00 policy limit for disease. A policy providing automobile liability insurance which provides a minimum of $1,000,000 coverage for the exposure created by the use of "any Auto", as described by the use of symbol 1 or the individual insurance company's' equivalent, in the policy. The City has the right to periodically review the insurance requirements of this lease and adjust the requirements in order to conform to common standards, practices and economic conditions in existence at the time of such review. Rating: All policies required to be maintained by PAWS pursuant to this section shall be issued in a form acceptable to the City by insurance companies having and maintaining at least an A- rating in the most currently available "Best Insurance Reports" and qualified to do business in Florida. In no event shall any policy or policies provided for a deduction for any type of coverage in excess of $1,000.00. Failure to provide or maintain coverage as provided in this section shall be deemed an event of default hereunder. Indemnity: PAWS shall protect, defend, indemnify and hold the City's officials and employees, harmless from all claims, demands causes of action or liability, resulting from injury to or death of persons or damage to or loss of property sustained and arising from PAWS operations or as a proximate result of the acts or omissions of PAWS insurer is responsible under this section. This provision does not apply, however, to any such liability as may be the result of the direct and proximate negligence or willful misconduct of City of City's employees or agents acting within the scope of their employment. Party Responsibility and Sovereign Immunity: To the extent allowed by the Laws of the State of Florida and pursuant to Florida Statute 768.28, each party hereby agrees to be responsible for all claims, demands, liabilities, and suits of any nature arising out of, because of, or due to any negligent act or occurrence, omission or commission of the party, it's officers, employees, or agents, except as insured by PAWS insurance coverage provided herein. Nothing is intended to serve as a waiver of the sovereign immunity of the City. IN ITNESS WHEREOF, the parties have hereunto executed this contract this,O1 `day of 2015. Approved: Panhandle Animal Welfare Society L CONTRACT FOR SERVICES October 1, 2015 — September 30, 2016 THIS CONTRACT, made and entered into this ,p day of ' S, 2015 between the Panhandle Animal Welfare Society, Inc., (hereinafter referred to as "PAWS") and the CITY OF Crestview, FLORIDA (hereinafter referred to as "City"). Witness: WHEREAS, the parties do agree that the purpose of this contract is to establish PAWS as the administrative and enforcement agency for any Okaloosa County Animal Control Ordinances, City Ordinances and applicable Florida statutes pertaining to animals; NOW, THEREFORE, in consideration of the covenants and agreements herein contained, the parties hereto agree as follows: 1. The City will pay the annual sum of $85,000.00 by Fiscal Year to be disbursed in monthly payments of $7,083.33. Such annual amounts are based on a per capita division of costs among local governments which contract for PAWS services. Payment shall be made upon receipt of a monthly statement submitted by PAWS to the City. 2. Fees collected by PAWS pursuant to this contract shall be retained by PAWS to assist in offsetting the cost to the City of animal control. In the event that impound fees collected by PAWS during the term of this Contract exceeds the total budget established by PAWS in any fiscal year for animal control, PAWS shall pay a portion of the excess collections based upon a per capita division among those local governments that contract for PAWS services during each fiscal year. PAWS agrees within one hundred eighty (180) days after the completion of each approved fiscal year of this contract to provide the City an audit of animal control income and expenses performed by an independent certified accountant. 3. PAWS shall not be responsible for the removal of dead animals on public property or public right of way. Dead animals on private property may be picked up for a fee as determined by PAWS, after the fee has been paid by the owner of the animal or the owner of the property. 4. PAWS will enforce all applicable Okaloosa County ordinances, City Ordinances and Florida statutes relating to animal control, including the following duties and responsibilities: Provide appropriate equipped, certified Animal Control Officers during the normal business hours of 8:00A.M to 5:00 P.M. Monday through Friday to enforce the ordinances of Okaloosa County and Florida statutes. Operations will be via demand / response system which prioritize incoming animal control demands for services from citizens, and dispatches calls to Animal Control Offices in the field. Officers will respond to citizen request for assistance, and, when not actively engaged in answering dispatched calls, will perform routine patrolling of the service area. Issue citations against and / or impound animals determined to be in violation of applicable County ordinances or Florida statutes; manage the investigation and prosecution of cruelty, abuse, neglect and abandonment cases, including the designation and supervision of dogs classified pursuant to Florida's "Dangerous Dog" statutes. Provide adequate food, shelter and emergency care as necessary for all impounded animals and stray animals apprehended in the field of surrendered at the PAWS shelter until placed or otherwise humanely destroyed according to law. Maintain suitable office hours at the PAWS animal shelter for the purpose of transacting business in connection with the duties under this contract, including, but not limited to, receiving stray or owner surrendered animals and handling transactions for the redemption or impounded and stray animals. House each impounded and stray animal for the period of time specified by applicable County ordinance or Florida statutes and quarantine bite cases pursuant to a cooperative agreement with the County Health Department. An Animal Control Officer will remain on -call after hours to respond to emergencies involving injured animals; vicious animals that have bitten or inflicted an injury on a person or other animal; cruelty cases; and other situations reasonably considered to constitute a physical threat to humans or animals. 5. PAWS will maintain accurate and detailed records of all stray, impounded or owner released animals, including dispositions; records of all bite cases and reports of investigations; and detailed financial records of all fines and impound fees collected. These records shall be open for inspection during normal business hours to persons designated by the City to review them. In addition, PAWS shall provide to the City a monthly animal control activity summary. t. PAWS will initiate and maintain a program of public education concerning animal related laws; and promoting responsible pet ownership. 7. PAWS will assist any City -designated agency or group of volunteers on special tasks, such as responding to dog packs, emergency management, and other animal -related situations. Requirements for such assistance will be communicated by the City to PAWS in advance, either in writing or verbally, to permit rescheduling of work assignments. 8. As a matter of convenience to private citizens, PAWS may provide pet euthanasia service and disposal of remains, for a reasonable fee determined by PAWS. 9. This contract is for the performance period October 1, 2015 through September 30, 2016 and shall remain in force for a period of one year, contingent upon the annual appropriation by the City legally available funds as provided in this section. City's obligation to pa the amount due hereunder in any fiscal year is contingent upon the appropriation by the City Council of legally available funds for the purpose set forth in this contract. City agrees and hereby directs its managers to provide for the amounts die hereunder in each annual proposed budget submitted to the City Council as a separately stated line item for animal control. In the event the City Council deletes such line item for the payment for the amounts due hereunder from the budget as finally enacted for such fiscal year, the same shall constitute an event of non -appropriation wit respect to this contract, and this contract and the terms contained herein shall terminate effective as of the end of the fiscal year of the City for which sums have been appropriated, and the parties shall be discharged from further responsibility to each other under this contract. The occurrence of an event of non -appropriation shall not be deemed an event of default hereunder but shall affect a mutual dissolution of this contract. 10. City shall have the right to immediately terminate this contract upon the occurrence of Okaloosa County agree and obligating itself to undertake funding though taxes, assessments, or any other means for the animal control services provided by PAWS as set forth in this contract within the jurisdictional limits of the City. 11. PAWS shall, during the term, and at its sole expense, obtain and keep in force, with the City named as additional insured: Commercial general liability insurance including personal injury, bodily injury, broad form property damage and operations hazard, and products and completed liability in limits not less than $1,000,000.00 for each occurrence and $2,000,000.00 in the aggregate. PAWS shall famish evidence satisfactory to City of the existence of and maintain of such insurance prior or contemporaneous with the commencement of the term and thereafter at least (15) days prior to the date in which such policy is required to be renewed. PAWS shall obtain a written obligation on the part of each insurance company to notify the City at least thirty (30) days prior to the cancellation of each insurance. A policy of workers' compensation insurance in compliance with applicable Florida law. The workers' compensation insurance policy shall include employer's liability insurance with limits of liability not less than $500,000.00 for each accident/ $1,000,000.00 per employee for disease/ $1,000,000.00 policy limit for disease. A policy providing automobile liability insurance which provides a minimum of $1,000,000 coverage for the exposure created by the use of "any Auto", as described by the use of symbol 1 or the individual insurance company's' equivalent, in the policy. The City has the right to periodically review the insurance requirements of this lease and adjust the requirements in order to conform to common standards, practices and economic conditions in existence at the time of such review. Rating: All policies required to be maintained by PAWS pursuant to this section shall be issued in a form acceptable to the City by insurance companies having and maintaining at least an A- rating in the most currently available "Best Insurance Reports" and qualified to do business in Florida. In no event shall any policy or policies provided for a deduction for any type of coverage in excess of $1,000.00. Failure to provide or maintain coverage as provided in this section shall be deemed an event of default hereunder. Indemnity: PAWS shall protect, defend, indemnify and hold the City's officials and employees, harmless from all claims, demands causes of action or liability, resulting from injury to or death of persons or damage to or loss of property sustained and arising from PAWS operations or as a proximate result of the acts or omissions of PAWS insurer is responsible under this section. This provision does not apply, however, to any such liability as may be the result of the direct and proximate negligence or willful misconduct of City of City's employees or agents acting within the scope of their employment. Party Responsibility and Sovereign Immunity: To the extent allowed by the Laws of the State of Florida and pursuant to Florida Statute 768.28, each party hereby agrees to be responsible for all claims, demands, liabilities, and suits of any nature arising out of, because of, or due to any negligent act or occurrence, omission or commission of the party, it's officers, employees, or agents, except as insured by PAWS insurance coverage provided herein. Nothing is intended to serve as a waiver of the sovereign immunity of the City. IN WITNESS WHEREOF, the parties have hereunto executed this contract this lir day of rj eAc L-L-2015. City of restview Approved: Panhandle Animal Welfare Society \t.✓Yl. fi 1 (C- t 1 Property Limits and Locations Panhandle Animal Welfare Society, Inc. Insuring Company Policy Term Lod Bid Address 1 1 752 Lovejoy Road Fort Walton Beach, FL 32548 1 1 752 Lovejoy Road Fort Walton Beach, FL 32548 1 1 752 Lovejoy Road Fort Walton Beach, FL 32548 2 1 179 North Eglin Pkwy Fort Walton Beach, FL 32548 2 1 179 North Eglin Pkwy Fort Walton Beach, FL 32548 2 1 179 North Eglin Pkwy Fort Walton Beach, FL 32548 3 1 3731 Ebenezer Rd Laurel H111, FL 32567 4 1 760 Lovejoy Rd Fort Walton Beach, FL 32548 4 1 760 Lovejoy Rd Fort Walton Beach, FL 32548 Aspen Specialty Insurance Company 6/16/2017 - 6/16/2018 Subject of insurance Business Income with Extra Expense Business Personal Property Building Business Income with Extra Expense Business Personal Property Building Business Personal Property Business Personal Property Modular Building Amount $150,000 $150,000 90% R $500,000 90% R $280,000 $100,000 90% R $400,000 90% R $50,000 90% R $50,000 90% R $38,000 90% R Coins. Val. Deductibles: • $1,000 per occurrence deductible • 3% Wind and Hail deductible for 179 N Eglin Pkwy., Fort Walton Beach, FL 32548 and 3731 New Ebenezer Rd., Laurel Hill, FL 32567 Subject to a minimum deductible per occurrence of $5,000 Wind and Hail deductible applies per total insured value per location This policy does not provide wind or hail at 752 Lovejoy Rd. or 760 Lovejoy Rd., Fort Walton Beach, FL 32548. Valuation (A) Actual Cash Value (B) Business Income Changes — Time Period (C) Agreed Amount (waived coinsurance) (D) Reproduction (E) Agreed Amount (F) Functional Replacement Cost (G) Guaranteed Replacement Cost (I) Invoice Cost (L) Actual Loss Sustained (M) Market Value (0) ©her (P) Selling Price (R) Replacement Cost (S) Stated Amount (T) Total insured Value (U) Full Value Replacement Cost (V) Agreed Value (X) Extended Value Replacement Cost The property values illustrated are estimates only and are based upon the information you have furnished. Fisher Brown Bottrell Insurance, Inc. assumes no responsibility for the accuracy of these values. If you are not sure of the accuracy of the values stated, a property appraisal should be obtained from a qualified, licensed real estate appraiser or contractor. Page 5 of 23 Fisher Brown Bottrell Insurance, Inc. Exclusions: Flood coverage is excluded. Coverage quotes available upon request. Earthquake coverage is excluded. Coverage quotes available upon request. Endorsements included but not limited to: CP1033 Theft Exclusion CP1054 Wind and Hail Exclusion ASPC0002 Service of Suit ASPC0023 Nuclear, Biological, Chemical or Radiological Terrorism Exclusion ASPC01114 Policyholder Disclosure Notice of Terrorism Insurance Coverage ASPPR001 Occurrence Limit of Liability Endorsement ASPPR072 Minimum Earned Premium Clause Percentage ASPPR081 Exclusion Seepage Pollution Contamination ASPPR082 Exterior Insulation and Finishing Systems ASPPR08g Fungus Exclusion and Limited Additional Coverage ASPPR100 Policyholder's Guide to Reporting a Property Claim ASPPR142 FL Declaration Aspen Specialty ASPPR145 Commercial Property Coverage Part Declarations CP0090 Commercial Property Conditions CP1033 Causes of Loss - Special Form CP0126 Florida Changes 1L0017 Common Policy Conditions IL0636 Exclusion of Certain Computer Related Losses ASPC0023 NBCR Terrorism Exclusion IL 09 63 Exclusion of Certified Acts Of Terrorism 25% Minimum Earned Premium Page 6 of 23 Fisher Brown Bottreli Insurance, Inc. Loc Bld 1 1 1 1 Wind Limits and Locations Panhandle Animal Welfare Society, Inc. Insuring Company Policy Term Address 752 Lovejoy Road Fort Walton Beach, FL 32548 752 Lovejoy Road Fort Walton Beach, FL 32548 752 Lovejoy Road Fort Walton Beach, FL 32548 Lloyds of London 6/16/2017 - 6/16/2018 Subject of Insurance Amount Coins. Ded Business Personal Property $150,000 90% 5% $150,000 Business Income % monthly Building Val. R $500,000 90% 5 R Deductible: 5% Windstorm 8 Hail per occurrence percentage deductible. The property values illustrated are estimates only and are based upon the information you have furnished. Fisher Brown Bottrell Insurance, Inc. assumes no responsibility for the accuracy of these values. If you are not sure of the accuracy of the values stated, a property appraisal should be obtained from a qualified, licensed real estate appraiser or contractor. Exclusions: Flood coverage is excluded. Coverage quotes available upon request. Earthquake coverage is excluded. Coverage quotes available upon request. Endorsements included but not limited to: 2001AML00001 ARE !LONE ILP001 0104 NMA1191 NMA2342 NMA2916 NMA2918 CP0090 CP1032 FL-PHN LMA6020 LMA5021 LSW 1681 LSW 1682 LSW1001 LSW1136 NMA1331 PFSLC3 PFSLC3DEC 90°% Chemical, Biological and Nuclear Explosion, Pollution or Contamination Exclusion Clause Absolute Micro Organism Exclusion (AWLIN) Certain Computer Related Losses U.S. Treasury Department's Office of Foreign Assets Control (O7FAC) Radioactive Contamination Exclusion Clause - Physical Damage - Direct Seepage and/or Pollution and/or Contamination Exclusion U.SA. & Canada Electronic Oata Endorsement B War & Terrorism Exclusion Endorsement Commercial Property Conditions Water Exclusion Endorsement Florida Policy Holder Notice (contains form LSW1661, LSW1682) Service of Suit Clause Applicable Law (U.3.A) Florida Guaranty Act Notice Florida Rates and Forms Notice Several Liability Notice Privacy Statement Cancellation Notice or applicable state form Policy Jacket DeciaraUons Page Co-insurance Clause IWnimum Earned Premium Endorsement Schedule of Properties Wind Deductible Endorsement W00010 Windstorin or Hail Causes of Loss Endorsement All Wind or Hall Deductible Applies as Follows: Per Total Insured Value 2001 AML00036 Marijuana and Schedule / Controlled Substance Exclusion Page 7 of 23 Fisher Brown Bottrell Insurance, Inc. General Liability Panhandle Animal Welfare Society, Inc. Insuring Company Scottsdale Insurance Company Policy Term 6/16/2017 - 6/16/2018 Description Limits General Aggregate Limit $2,000,000 Products/Completed Operations Aggregate Limit Excluded Personal/Advertising Injury Limit $1,000,000 Each Occurrence $1,000,000 Fire Damage Limit $100,000 Medical Expense Limit $5,000 Employee Benefits Not Included Deductibles Property Damage Bodily Injury 25% Minimum Eamed Premium $500 $500 Fisher Brown Bottrell Insurance, Inc. Page 8 of 23 Loc Bldg Class # # Code Hazard Schedule Classification 1 1 99851 Veterinarian Or Veterinary Hospitals 1 1 45450 Kennels -breeding, Boarding Or Sales 2 1 18437 Profit - Stores - Noc - No Food Or Drink 3 1 45450 Kennels -breeding, Boarding Or Sales 4 1 61226 Profit - Buildings Or Premises - Other - Noc 4 1 45450 Kennels -breeding, Boarding Or Sales Forms and Endorsements included but not limited to: CO 21 16 CO 21 49 GLS-28s GLS-55s GLS-149s 0 LS-160s UTS-180g CG 21 39 GLS-176s CG 21 68 UTS-COVPO oPSG-1 UTS SP-2 UTS-SP-3 CLS-SD-1 L CLS-SP-1L CO 00 01 CG 21 73 CO 24 26 GLS-289s UTS-t28s GLS-47s GLS-94s Rating Basis Payroll - Per $1,000/Pay Unit - Per Unit Gross Sales - Per $1,000/Sales Other Area - Per 1,000/Sq Ft Other Exclusion • Designated Professional Services "Any and all professional exposures" Total Pollution Exclusion Stable Liability Exclusion Property Damage Extension (Care, Custody and Control) (5500 per occurrence i S1,000 aggregate ) Injury to Volunteers Exclusion Blanket Addkional Insured Endorsement Communicable Disease Exclusion Contractual Liability Limitation Limitation of Coverage to Designated Premises Exclusion - Professional Veterinary Services Cover Page Common Policy Declarations Schedule of Forms and Endorsements Schedule of Locations Commercial General Liability Coverage Part Supplemental Declarations Commercial General Liability Coverage Part Extension of supplemental Declarations Commercial General Liability Coverage Part Exclusion of Certified Acts Of Terrorism Amendment of insured Contract Definklon Known Injury or Damage Exclusion - Personal and Advertising Injury Optional Provisions Endorsement Minimum and Advance Premium Endorsement Deductible Endorsement Annual Exposure $151,121 58 $100,000 16 2128 26 Subject to Audit The proposed premium is based on the above estimates of annual exposures. This policy is subject to an Annual audit. A deposit premium will be collected at the time of inception. Adjustments in the premium will be done when the policy expires. Uninsured Subcontractors who are unable to provide evidence of insurance will be picked up on your final audit and premium will be charged. insured Subcontractors should be included in the appropriate subcontractor code. Fisher Brown Bottrell Insurance, Inc. Page 9 of 23 Issuing Company Policy Term Symbol (1) ANY AUTO Symbol (2) ALL OWNED AUTOS Symbol (3) OWNED PRIVATE PASSENGER AUTOS Coverage Liability Medical payments Comprehensive/OTC Collision Hired Auto Liability Non Owned Liability Hired Physical Damage Business Automobile Panhandle Animal Welfare Progressive Express Insurance Company 5/10/2017 - 11/10/2017 AUTOMOBILE LIABILITY COVERAGE SYMBOLS Symbol (4) OWNED AUTOS OTHER THAN PRIVATE PASSENGER Symbol (5) ALL OWNED AUTOS WHICH REQUIRE NO-FAULT COVERAGE Symbol (6) OWNED AUTOS SUBJECT TO COMPULSORY U.M. LAW Uability Limits Symbol(s) 7 7 7 7 Forms and Endorsements included but not limited to: Form Number Endorsement Name RI No. Year Make/Model 1 2002 Chevrolet / Tahoe C1500/K15 2 2006 Chevrolet / Express G2500 3 2011 Chevrolet / Express G2500 4 2012 GMC / Savana G2500 5 1990 Dodge! D100/D150M/1 00/ 7 2015 Ford / Transit Connect VIN Symbol (7) AUTOS SPECIFIED ON SCHEDULE Symbol (8) HIRED AUTOS Symbol (9) NON -OWNED AUTOS Limit/Deductible $1,000,000 $5,000 Per Schedule Per Schedule $0 Named insured only $10,000 CSL Ea person Deductible Deductible applies to Ea accident Comprehensive Deductible: Collision Deductible: Vehicle Schedule 1GNEK13VF23309522 1 GCGG25V861145798 1 GCW GFCASB 1108852 1G1W7FCA6C1123460 3B7GE13Z2LM040632 NMOGE9E76F1210662 Gar. Llab Med UM Comp Coll Cost Loc. New X X No Cov. No Cov. $31,731 X X X X X X X X X X No Cov. $250 $250 No Cov. $250 No Cov. $250 $250 No Cov. $250 $27,300 $29,500 $10,000 $13,751 Fisher Brown Bottrell Insurance, Inc. Page 10 of 23 Worker's Compensation Panhandle Animal Welfare Society, Inc. Insuring Company Zenith Insurance Company Policy Term 8/20/2017 - 8/20/2018 Coverage A Limits: Statutory States Covered: FL *In Ohio, Washington, North Dakota and Wyoming. The state itself is the ONLY Workers' Compensation insurer; if you have employees in any of these states, you are required to purchase Workers' Compensation coverage through that state's workers' Compensation insurance fund. Employers Liability — Bodily Injury by Accident (Each Accident) Employers Liability — Bodily injury by Disease (Policy Limit) Employers Liability — Bodily Injury by Disease (Each Employee) Name Individuals Included/Excluded Title Classifications ST Loc Class Code Description FL FL 1 8810S Clerical Office Employees NOC FL 1 8831S Hospital -Veterinary & Drivers Increased Limits Employers Liability Waiver of Subrogation Experience Mod Schedule Debit/Credit Drug Free Workplace Premium Discount TRIA Expense Constant Total $1,000,000 $1,000,000 $1,000,000 Include/Exclude Estimated Payroll Rate $116,624 $690,243 0.26 2.33 1.40 Estimated Premium $ 303 16,083 83% ($2,915.00) -2.5% ($345.00) $200.00 $13,326.00 Experience Modification A modification is applied based on the loss experience for the past four (4) years. The Experience Modification • used in preparing this quote was: 81% Page 13 of 23 Fisher Brown Bottrell Insurance, Inc. Directors' & Officer's Liability Li Panhandle Animal Welfare Society, Inc. Insuring Company Policy Term Aggregate Limit Per Claim Limit Retention Retroactive Date CNA Insurance Company 6/4/2017 - 6/4/2018 $1,000,000 $1,000,000 $2,500 06/04/2007 s Retroactive Date: Subject to the prior acts dates and all conditions and exclusions set forth in the policy form. Name Entity Type Affiliation Additional Coverages Included but not limited to: • Employment Practices Liability Aggregate Limit $1,000,000 Deductible: $5,000 Forms and Endorsements included but not limited to: Coverage Parts and Endorsements: Epack Extra - Employment Practices Liability Covage Part Epack Extra - Directors d 0Mcers Llablllty Coverage Part Wage and Hour Law Claims Defense Cost Coverage Endorsement Professional Services Exclusion Absolute Bodily Injury / Property Damage Exclusion Amendatory Endorsement Florida Cancellation/Non-Renewal Endorsement Florida Amend Defense Settlement And Consent Cap On Losses From Certified Acts Of Terrorism Endorsement Independent Contractors Coverage Endorsement Notice Offer Of Terrorism Coverage Disclosure Of Premium Confirmation of Acceptance General Conditions GSL 12040XX 03/2010 GSL24342XX 01/2011 GSL11160XX 03/2010 GSL24356XX 01/2011 GSL24375XX 01/2011 GSL-46199-FL 10/2011 GSL-7541-FL 09/2011 GSL-57799-XX 02/2012 CNA-8175I-XX 03/2015 GSL24362XX 01/2011 CNA-81758-XX 03/2015 Confirmation the insured's has written anti -harassment. Anti -discrimination, and American's with Di;abllitles Act policies/procedures in place. What were the changes to the board end why did they occur? Page 16 of 23 Fisher Brown Bottrell Insurance, Inc. 10 No. Year MakelModel VIN Gar. Uab Med UM Comp Coll Cost Loc. New 8 2015 Ford J Transit NMOGE9E70F1209698 X X $250 $250 $13,751 Connect Page 11 of 23 Fisher Brown Bottrell Insurance, Inc.