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Home My WebLink AboutResolution - 2016-R0337 - Purchase - AXIS Surplus Insurance Co. - Property Deductible Buyback Insurance - 09/22/2016Resolution No.2016-R0337 Item No.6.21 September 22,2016 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the City Manager of the City of Lubbock is hereby authorized and directed to purchase for and on behalf of the City of Lubbock,property deductible buyback primary insurance coverage from AXIS Surplus Insurance Company,for a premium amount not to exceed $420,059;and THAT the City Manager may execute any routine documents and forms associated with said insurance coverage. Passed bythe City Council this September 22.2016 . DANIEL M.POPE.MAYOR ATTEST: JbgJL ^_* Rebecca Garza.City Secret APPROVED AS TO CONTENT Leisa Hutcheson,Director of Human Resources and Risk Management APPROVED AS TO FORM: Jeff Hartsell,Chief Litigation Attorney RES.Risk Mgmt-AXIS Surplus Ins.Co. September 15,2016 AmWINS BROKERAGE OF TEXAS An AmWINS Group Company DEDUCTIBLE BUY BACK QUOTATION INSURED: City of Lubbock MAILING ADDRESS: 1625 131h St P.O. Box 2000 Lubbock, TX 79401-3830 PERIOD: 10/01 /2016 to 10/01 /2017 (12:01 a.m., Standard Time at the Address of the Named Insured shown above) INSURERS: Primary: AXIS Surplus Insurance Company (Non -Admitted) A.M. Best A+ XV, S&P A+ Excess: Arch Specialty Insurance Company (Non -Admitted) A.M. Best A+ XV, S&P A+ PERILS: Section A: Windstorm or Hail Only Section B: Windstorm Only Excluding Hail INTEREST: Section A: Real Property on 71 locations as per schedule totaling $370,191,462 Section B: Personal Property on 33 locations as per schedule totaling $208,653,866 LIMIT OF LIABILITY: Primary: $5,000,000 per Occurrence and Annual Aggregate for AXIS Primary Participation in Ground Up 100% Program Limit of Liability being 2% per unit of insurance up to $9,500,000 per Occurrence and Annual Aggregate Excess: $4,500,000 per Occurrence and Annual Aggregate excess of $5,000,000 per Occurrence and Annual Aggregate SUBLIMITS OF LIABILITY: Sublimits as per American Home Assurance Company Policy; except: $10,000 Annual Aggregate for Pollutant Cleanup and Removal All are per Occurrence and are part of, not in addition to, the policy limits. DEDUCTIBLE: OPTION 1: 1% per unit of insurance, subject to a minimum of $500,000 per Occurrence and a maximum of $2,500,000 per Occurrence OPTION 2: 1% per unit of insurance, subject to a minimum of $500,000 per Occurrence and a maximum of $1,000,000 per Occurrence CONDITIONS: Policy Form: AXIS Primary Difference in Conditions Form Coinsurance: N/A Valuation: Replacement Cost 90 days Notice of Cancellation/Non-Renewal, except 10 days for Non -Payment of Premium 35% Minimum Earned Premium at inception of coverage AXIS Manuscript Endorsement Exclusions: Asbestos, Mold/Fungus, Terrorism, Cyber, Pollution, Nuclear, Biological, Chemical, and as more fully described in policy. Arch Specialty Excess Follow Form, including mandatory company endorsements PREMIUM: OPTION 1: $349,999.65 AXIS Surplus Insurance Company $111,562.50 Arch Specialty Insurance Company $461,562.15 Total Premium Including Taxes & Fees OPTION 2: $420,058.80 AXIS Surplus Insurance Company $119,437.50 Arch Specialty Insurance Company $539,496.30 Total Premium Including Taxes & Fees INFORMATION: Total Insurable Values: Section A: $370,191,462 Real Property Only Section B: $208,653,866 Personal Property Only Grand Total: $578,845,328 The basis of the Section A values includes qualifiers. We are only including locations with a roof age of 2001 or newer and that have a value of $500,000 or greater. There are 71 locations meeting these qualifications. Section B is comprised of 33 locations with Contents values only. There are no qualifiers set on these properties as they were isolated by the insured. Loss History: As provided by Wells Fargo Insurance Services USA, Inc. Scott Wolf Executive Vice President I AmWINS Brokerage of Texas, Inc. T 214.561.6854 1 M 469.222.1877 1 F 214.528.9101 1 scott.wolf@amwins.com 5910 North Central Expressway I Suite 500 1 Dallas, TX 75206 ( amwins.com In California: AmWINS Brokerage of Texas Insurance Services I License No.: OF41749 An AmWINS Group Company IMPORTANT NOTICE: THE NONADMITTED & REINSURANCE REFORM ACT (NRRA) WENT INTO EFFECT ON JULY 21, 2011. ACCORDINGLY, SURPLUS LINES TAX RATES AND REGULATIONS ARE SUBJECT TO CHANGE WHICH COULD RESULT IN AN INCREASE OR DECREASE OF THE TOTAL SURPLUS TAXES AND FEES OWED ON THIS PLACEMENT. IF A CHANGE IS REQUIRED, WE WILL PROMPTLY NOTIFY YOU. ANY ADDITIONAL TAXES OWED MUST BE PROMPTLY REMITTED TO AMWINS. SURPLUS LINES DISCLOSURE Texas This insurance contract is with an insurer not licensed to transact insurance in this state and is issued and delivered as surplus line coverage under the Texas insurance statutes. The Texas Department of Insurance does not audit the finances or review the solvency of the surplus lines insurer providing this coverage, and the insurer is not a member of the property and casualty insurance guaranty association created under Chapter 462 Insurance Code. Chapter 225, Insurance Code, requires payment of a 4.85 percent tax on gross premium. Surplus Lines Licensee Name: Am WINS Brokerage of Texas, Inc. IMPORTANT NOTICE To obtain information or make a complaint: You may contact the Texas Department of Insurance to obtain information on companies, coverages, rights or complaints at 1-800-252-3439 You may write the Texas Department of Insurance: Post Office Box 149104 Austin, Texas 78714-9104 Fax:512-490-1007 Web: http://www.tdi.texas.gov E-mail: ConsumerProtection@tdi.state.tx.us PREMIUM OR CLAIM DISPUTES: Should you have a dispute concerning your premium or about a claim you should contact the agent first. If the dispute is not resolved, you may contact the Texas Department of Insurance. ATTACH THIS NOTICE TO YOUR POLICY: This notice is for information only and does not become a part or condition of the attached document. AVISOIMPORTANTE Pam obtener information o Para someter una queja: Puede comunicarse con el Departamento de Seguros de Texas para obtener information acerca de companies, coberturas, derechos o quejas al: 1-800-252-3439 Puede escribir al Departamento de Seguros de Texas: Post Office Box 149104 Austin, Texas 78714-9104 Fax:512-490-I007 Web: http://www.tdi.texas.gov E-mail: ConsumerProtection@tdi.state.tx.us DISPUTAS SOBRE PRIMAS O RECLAMOS: Si tiene una disputa concemiente a so prima o a un reclamo, debe comunicarse con el agente primero. Si no se resuelve la disputa, puede entonces comunicarse con el departamento (TDI). UNA ESTA AVISO A SU POLIZA: Este aviso es solo para proposito de information y no se convierte en pane o condition del documento adjunto. CERTIFICATE OF INTERESTED PARTIES FORM 1295 l of l Complete Nos. 1- 4 and 6 if there are interested parties. OFFICE USE ONLY Complete Nos. 1, 2, 3, 5, and 6 if there are no interested parties. CERTIFICATION OF FILING Certificate Number: 1 Name of business entity filing form, and the city, state and country of the business entity's place of business. 2016-115890 Arch Capital Group Ltd Jersey City, NJ United States Date Filed: 09/23/2016 2 Name of govemmen entity or state agency that is a party to the contract for which the orm -is being filed. City of Lubbock 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. 13079 Property Insurance Deductible Buyback Excess 4 Nature of interest Name of Interested Party City, State, Country (place of business) (check applicable) Controlling I Intermediary Sanford, Douglas Lubbock, TX United States X Wolf, Scott Dallas, TX United States X 5 Check only if there is NO Interested Party. ❑ 6 AFFIDAVIT I swear, or affirm, under penalty of perjury, that the above disclosure is true and correct. ,>„�.,µ%'"t LAUREL DIANE DODD ?+P'• *$_ Notary Public, State of Texas /I -/. My Commisslon Expires I Signature of authorized agent of contracting business entry AFFIX NOTARY STAMP / SEAL ABOVE Sworn to and subscribed before me, by the said 'L+.ik1Z.01Z this the day of�� 20/6 , to certify which, witness my hand and seal of office. ,( n 4ell�0. /C/. Q� �r�urLl ✓ IiAGt /�,5✓.i 411v-1ht , l 1 f &e- sfignature of officer administgring oath Printed name of officer administering oath Title of officer ilklministering oath Forms provided by Texas Ethics Commission www.ethics.state.tx.us Version V1.0.277