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Resolution - 2016-R0335 - Purchase - Zurich American Insurance Co - Property Insurance For Montford Dam - 09/22/2016
Resolution No.2016-R0335 Item No.6.19 September 22,2016 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock or his designee is hereby authorized and directed to purchaseforandon behalfof theCityof Lubbock,property insurance byand between theCity of Lubbock and Zurich American Insurance Company in the amount of S50,000.000 insurance coverage for Montford Dam, pursuant to the terms and conditions attached hereto as Exhibit "A,'* and in a final form acceptable to the City Manager and City Attorney for a total premium in an amount not to exceed $106,073.00;and THAT the City Manager or designee may execute any routine documents and forms associated with said insurance coverage. Passedbythe City Councilon September22, 2016 . ATTEST: Rebecca Garza.City Secretar APPROV Leisa Hutcheson.Director of Human Resources and Risk Management APPROVED AS TO FORM: .Ml./?**# Jeff Haftsedl.Chiet Litigation Attorney sj/ccdocs/Rcs.Risk Mgmi-Zurich American Ins. September 7.2016 DANIEL M.POPE,MAYOR Resolution No. 2016-RO335 Commercial property - John T. Montford Dam Named insured: John T. Montford Dam / City of Lubbock, TX, Lubbock, TX 79457 Insurance carrier: Zurich American Insurance Company — Admitted A.M. Best rating: A+, XV as of 2015 Policy number: TBD Policy term: October 1, 2ot6 to October 1, 2017 Premium for $50M loss limit Premium for $7o,74o,000 Coverage: Policy form: Perils covered: Total Insured Value of Dam: Loss of revenue: Accounts receivable: Civil or military authority: Expediting expense: Extra expense: Debris removal: Fire department service charges: Ingress & egress: Loss adjustment expenses: Newly acquired locations: ordinance or law / demolition and increased cost of construction: Transit per conveyance: Valuable papers: Terrorism: $ 1o6,o73 (Includes Terrorism Premium of $2,o85) Minimum earned premium $121,799 (Includes Terrorism Premium of $2,388) Minimum earned premium This policy insures against direct physical loss or damage to Real & Personal Property from a covered loss and any resulting Loss of Revenue as more fully defined within the Policy. Special Form Zurich Operational Civil Works Policy Risk of direct physical loss, subject to named policy terms, conditions and exclusions. Includes Equipment Breakdown. $70,740,000 Not quoted $50,000 14 days $500,000 $500,000 $5,000,000 or 25% of the amount of insured physical loss of or damage to Covered Property whichever is less $100,000 14 days $100,000 $500,000 $1,000,000 $2,500,000 $25,000 $50,000,000 Annual Aggregate Limits of Liability: Earthquake: $10,000,000 Flood: $10,000,000 Named storm: $10,000,000 Deductibles/Waiting Periods: $2,000,000 physical loss or damage to Covered Property per occurrence S 25,000 physical loss or damage to surveillance equipment $2,000,000 as respects Earthquake per occurrence $2,000,000 as respects Flood per occurrence This proposal is merely a descriptive summary of coverage provided by the Insurance companies being proposed and should be used for reference purposes only. This Is a quotation of coverage only. It Is not a binder. This proposal does not amend or alter the insurance contract. Please refer to the policy contract for specific terms, conditions, limitations, and exclusions. Proposal date: 9/6/2016 Prepared for City Of Lubbock Confidential. ® 2016 Wells Fargo Insurance Services USA, Inc. All Rights Reserved. Page 32 $2,000,000 as respects Named Storm Coverage extensions: Accounts Receivable; Transit; Extra Expense, Fire Department Service Charges; Debris Removal; Ordinance or Law / Demolition or Increased Cost of Construction; Loss Adjustment Expense; Ingress/Egress; Civil Authority; Valuable Papers and Newly Acquired Locations Property excluded: Aircraft; Rolling Stock; Watercraft; Land/Land Values; Electrical/Gas/Water or other transmission line and related plants and substations; Offshore Rigs & Platforms; Property sold under conditional sale; shipments by mail, parcel post and those shipments to and from Alaska or Hawaii; Overseas Shipments and others per the Policy. Exclusions: Consequential Loss; Error/Omission or deficiency in design, plans, workmanship, specifications or materials; Wear & Tear; War; Nuclear; Mysterious Disappearance & Inventory Shortage; Employee Dishonesty, Fraud & Infidelity; Fungus; Pollution & Contamination; Asbestos; Normal Subsidence & Settling; and other per the Policy. This proposal is merely a descriptive summary of coverage provided by the insurance companies being proposed and should be used for reference purposes only. This is a quotation of coverage only. It is not a binder. This proposal does not amend or alter the insurance contract. Please refer to the policy contract for specific terms, conditions, limitations, and exclusions. Proposal date: 9/6/2016 Prepared for City Of Lubbock Confidential. © 2016 Wells Fargo Insurance Services USA, Inc. All Rights Reserved. Page 33 CERTIFICATE OF INTERESTED PARTIES FORM 1295 1of1 Complete Nos. 1- 4 and 6:11' there are Interested parties. OFFICE USE ONLY Complete Nos.1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FLUNG Certificate Number: 2016-115526 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. Zurich North America Addison, TX United States Date Filed: 09/22/2016 2 Name of governmental entity or state agency that Is a party to the contract for which the form is being filed. City of Lubbock. TX Date Acknowledged: 3 Provide the Identification number used by the governmental entity or state agency to track or identify the contract, and provide a description of the services, goods, or other property to be provided under the contract IM 9808966-02 Insuring the John T. Montfort Dam for the City of Lubbock, TX. 4 Name of interested Party City, State, Country (place of business) Nature of Interest (check applicable) Controlling Intermediary City of Lubbock '' Lubbock, TX United States X Sanford, Douglas Lubbock, TX United States X John T. Montford Dam Lubbock, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, enalry of per) , tti a above disclosure is we and correcx. WANDA BATTLES Notary Public, State of Texas M Comm. Expires 06-12 2020 �� Notary ID 1198080-5 Signature of tuvized agent of contracting business entity AFFIX NOTARY STAMP ! SEAL ABOVE Sworn to and subscribed before me, by the said OA%('A_e y r'6 ...-_-- -,this the day of 20 , to certify which, witness my hand and seal of office. W-AwAiq 2)A-r-rL6.6 P404agx Signature of officer administering oath Printed name of officer administering oath Tithe of officef administering oath rorms proviaea py i exas tunics commission www.emtcs.statexcus Version V1.0.277