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O• 1 T momzmo momzmtn <. c. T nCCNV) nCCNV) • • Z• oC Oz m OZ m • • -I• V-1 <-4>o <-IDN ■m m. X. m. 1. W• <• C. <. C• • M • • Z. • . Z. NO • • ...I• • . -.1. or or 4on < r r n N N r m DD 0 0 '-46) 0 0 MIT N N 0000000 •• 1-.NJ rrU1 11... r 4NN4) No0 t714) N V n i r r 0 ' o OO U) U)o to o to 1,4 NNO owo 0N1. 0 1■ ZV NO r r O o C7 a 04000-4 -IN Leagu Minnesota Cities Insuran ruse' , �� ,, Group f-Insured Workers' Compensati lan ;, fI 145 University Avenue West St. Paul, MN 55103-2044 ; ;'. RENEWAL DATA ` I, The "City:" OAK PARK HEIGHTS, CITY OF Agreement No. : 0200072917 PO BOX 2007 Quote To: OAK PARK HEIGHTS MN 55082 Quote Due On: 6/01/04 Agreement Expires: 7/07/04 Your coverage under the LMCIT Self-Insured Workers' Compensation program will expire soon. This Renewal Data sheet will be used to generate a premium quote for the different workers' compensation plans available. A copy of the City's previous year's selected coverages and premiums is attached for your reference. Coverage Options All of the options available to the City are outlined below, and described in the accompanying memo, Things to Think About When Renewing Your City's Workers' Compensation Coverage.You can select any coverage options in which the City may be interested. Premium quotes for all coverage options will be provided, and a fmal coverage decision can be made at the time you receive the complete quote. Elected Officials: Please indicate if the City would be interested in covering elected officials. Yes X No If yes, please list the estimated annual payroll for all elected officials the City would like to cover under workers' compensation. The 2002 premium rate for mayors and council members is $.37 per$100 of payroll. This rate is applied to the greater of either the official's actual salary or an imputed salary of$70 per week. Note: Coverage for elected officials requires a resolution passed by the City Council. Payroll Description Code Amount Elected Officials 9411 $ 26000 Members of Separate Administrative Boards:Please indicate if the City would be interested in covering members of separate administrative boards. Yes X No If yes, please select any separate administrative boards the City would like to cover under workers' compensation. (This coverage includes Board Members only.) 1. Utility or utility commission 5. Welfare or public relief agency 2. Port authority 6. School board 3. Housing and redevelopment authority 7. Joint powers board 4. Hospital or nursing home board or commission 8. N. Other EDA, Parks & Planning commission(volunteers & staff Employees of Separate Administrative Boards:If the City has elected to cover specific Board Members above, the City can also choose to cover employees of those boards. Please indicate which type of quote the City would like: No quote for administrative board employees. Combined quote to include employees of both the administrative board and the City. Separate quote for employees of the City and each administrative board selected above. Volunteers: Please indicate if the City would be would like to cover City volunteers not designated as employees, such as coaches, instructors, event workers, "clean-up"day volunteers, etc. (Volunteer firefighters, ambulance attendants, first reponders, law enforcement assistance volunteers, civil defense volunteers, and any other volunteers defined by statute as employees for purposes of work comp coverage are already covered and are not part of this election.) Yes No x (over) City Employees: Please indicate the estimated payroll for City employees for the coming policy year. The payroll descriptions and codes provided are the most commonly used. If you need to add additional payroll descriptions, please use the blank spaces and the codes on the attached list. Sick, holiday, and vacation pay should be included in the payroll totals. Do not reduce payrolls for sick, holiday, and vacation pay. Does your City have a flexible benefits plan such as a cafeteria plan, Section 125 plan, or flexible reimbursement account plan? Yes X No Employee contributios to a flexible benefits plan should be included in the payroll figures you provide. City contributions should not be included. (This is similar to how these plans are treated under PERA.) Payroll Description Code Amount Payroll Description Code Amount Ambulance Services(Not Volunteer) 7380 $ Sewage Plan 7580 $ 52014 Ambulance Services(Volunteer) 7381 $ Off Sale Liquor Store 8017 $ Building Operations 9015 $ Street and Road Construction 5506 $ 13870 City Shop and Yard 8227 $ Waterworks 7520 $ 86689 Clerical Office 8810 $349018 Other: Rink Attendants 9016 $ 11372 Electric and Steam Power 7539 $ Other: $ Firefighters(Not Volunteer) 7706 $ Other: $ Firefighters(Volunteer) 7708 pop Other: $ Municipal Employees 9410 $ 74900. Other: $ Parks 9102 $ 12136 Other: $ Police 7720 $678375 Other: $ Restaurant and Bars(on sale) 9084 $ Other: $ PREMIUM OPTIONS Please select the premium options below in which the City is most interested. All of the premium options selected will be quoted to City; however, only one premium option can be ultimately assigned for the coming plan year. Regular Premium Option: Please indicate if the City would be interested in the regular premium option. Yes X No Deductible Options: Please Indicate the deductible level and associated premium discount the City would like to consider. Deductible Premium Credit $250 3.00% $500 4.50% $1,000 6.50% $2,500 10.00% $5,000 14.50% $10,000 20.00% Retrospective Rating:Please indicate if the City would be interested in retrospective rating (if applicable). Yes No X Managed Care Option: Please indicate if the City participates in a state-certified managed care organization (MCO) for workers' compensation benefits, and if so, the name of that organization. Yes X No MCO: Contact Information: Please provide us with a contact for questions about the City's workers' compensation coverage. City Contact Person Gary Brunckhorst Phone 651-439-4439 Email gbrunckhors t@citvof oakparkheiahts .corn Please fax this completed form to the League of Minnesota Cities Insurance Trust at 651-281-1297. If you have any questions, please contact Barb Meyer, Policy Services Technician, by phone at 651-215-4173 or 800-925-1122, or via email at bmeyer2 @lmnc.org. Prey. Yr 04' 05' Overtime 04' +05' earingio Council David Beaudet 3,000 3,000 $ 6,000 $ 6,000 Les Abrahamson 2,500 2,500 $ 5,000 $ 5,000 Jack Doer 2,500 2,500 $ 5,000 $ 5,000 Mary McComber 2,500 2,500 $ 5,000 $ 5,000 Mark Swenson 2,500 2,500 $ 5,000 $ 5,000 Total $ 26,000 $ 26,000 9411 Part Time Parks Andrew Kegley 11,320 11,660 $ 22,980 John Sortedahl 2,613 2,939 $ 5,552 Jeff Brown 1,442 $ 1,442 Tamara Chastain 692 $ 692 Nina Kellogg 829 $ 829 Mark Wolf 637 $ 637 Amy Engleman 1,315 904 $ 2,219 Total $ 34,351 9102 Police Stanley Buckley 30,449 31,362 2,906 1,781 $ 66,498 $ 63,243 1.05 Michael Hausken 34,521 35,557 3,051 390 $ 73,519 $ 70,219 1.05 Lindy Swanson 41,586 42,834 1,599 $ 86,019 $ 82,104 1.05 Kenneth Anderson 31,385 32,326 3,278 679 $ 67,668 $ 65,022 1.04 Paul Hoppe 34,521 35,557 3,173 - $ 73,252 $ 70,307 1.04 Fred Kropidlowski 30,449 31,362 2,691 1,985 $ 66,487 $ 64,525 1.03 Brian DeRosier 30,213 31,120 3,278 - $ 64,610 $ 62,322 1.04 Joseph Croft 30,171 31,077 2,906 5,369 $ 69,523 $ 62,169 1.12 David Kisch 30,171 31,077 2,799 229 $ 64,276 $ 61,294 1.05 Sandra Kruse-Roslin 22,917 23,605 $ 46,522 $ 44,502 1.05 Total $678,375 7720 Office Staff Gary Brunckhorst 25,493 26,258 - $ 51,751 $ 49,817 1.04 Judy Hoist 39,352 40,532 757 $ 80,641 $ 86,109 0.94 Julie Hultman 22,917 23,605 881 $ 47,403 $ 45,800 1.03 Eric Johnson 39,018 40,188 - $ 79,206 $ 51,520 1.54 Julie Johnson 21,235 21,872 816 $ 43,923 $ 42,027 1.05 Lisa Taube 22,706 23,388 - $ 46,094 $ 43,923 1.05 Total $349,018 8810 Building Insp. Jimmy Butler 32,626 33,605 $ 66,231 $ 63,352 1.05 9410 Breakdown Public Works Jeff Kellogg 25,493 26,258 7,240 $ 58,991 $ 56,750 1.04 '5506 13,870 New Hire 25,261 26,019 485 $ 51,765 $ 77,692 0.67 57520 86,689 Mark Robertson 16,817 17,322 5,504 $ 39,643 7580 52,014 -7720 678,375 Total $150,399 8810 349,018 Public Works Breakdown 9102 12,136 5506 8% $ 173,378 12,136 ',Parks" -9410 74,900 7520 50% 13,870 Streets -=9411 26,000 7580 30% 86,689 Water 9016 11,372 9102 7% 52,014 Sewer 9410 5% 8,669;Storm Sewer 1,304,374 11,371 Parks.Workers $ 1,304,374 0 . 2003 Holiday Pay Base Hours per Hours Per Holidays Pay Month Day Holidays Worked Kenny Andersen $4,734.45 173 8 10 9 $ 3,174.54 Stanley Buckley $4,509.00 173 8 10 7 $ 2,814.87 Joseph Croft $4,509.00 173 8 10 7 $ 2,814.87 Brian DeRosier $4,734.45 173 8 10 9 $ 3,174.54 Michael Hausken $5,112.67 173 8 11 3 $ 2,955.30 Paul Hoppe $5,112.67 173 8 11 4 $ 3,073.51 r2 David Kisch $4,509.00 173 8 10 6 $ 2,710.61 J Fred Kropidlowski $4,509.00 173 8 10 5 $ 2,606.36 j $23,324.60 . Lea f Minnesota Cities Insuran Trust Groulf-Insured Workers' Compensatfq.Plan 145 University Avenue West St. Paul,MN 55103-2044 Phone (651)215-4173 Information Page �� Agreement No.: 0200072917 1. The "City" �.�p��l�a� I��,�� 4 OAK PARK HEIGHTS, CITY OF �v-r PO BOX 2007 00 !v "City" is: x City OAK PARK HEIGHTS MN 55082 — Joint Powers Entity Other (describe) 2. The Agreement Period is from 12:01 a.m. 7/07/2003 to 12.01 a.m. 7/07/2004 at the "City's" address. 3. A. Workers' Compensation Coverage: Part One of the Agreement applies to the Workers' Compensation Law of any state of the United States of America and the District of Columbia. B. Employers Liability Coverage: Part Two of the Agreement applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury-Each Occurrence $1,000,000 Bodily Injury by Disease-Agreement Limit $1,000,000 C. Part Three of the Agreement applies to Infectious Disease Diagnostic Testing. D. Part Four of the Agreement applies to Peace Officers' Posttraumatic Stress Syndrome Benefit. E. This Agreement includes these amendments and schedules: 4. Retro-rating option selected? _Yes x No 5. Elected Officials Covered? Yes Boards and Commissions Covered (List) NONE 6. The premium for this Agreement will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. Premium Basis Rates Entries in this item,except as specifically provided Estimated Estimated Total Per$100 of Code elsewhere in this Agreement; Do not modify any of the Annual Annual Remuneration No. other provisions of the Agreement Premium Remuneration I IN�� jl �I'�ir i—,,SEE ATTACHED SCHEDULE FOR DETAILS DO NOT PAY Manual Premium 30786. Experience Modification .85 4618. Standard Premium 26168. Managed Care Credit 0% Deductible Credit .0 % Agent: 411709883 483.14 Premium Discount 2011. 00874 FOREST LAKE INSURANCE SERVICE DBA LANDMARK INSURANCE SVCS Net Deposit Premium 24157. 232 S LAKE ST FOREST LAKE MN 55025- 8/08/2003 LM 4670(12/99) Lea of Minnesota Cities Insura Trust G o elf-Insured Workers' CompensatiPlan 145 University Avenue West St. Paul, MN 55103-2044 (651)215-4173 The"City" Agreement No.: 0200072917 Agreement Period From: 7/07/2003 OAK PARK HEIGHTS, CITY OF To: 7/07/2004 PO BOX 2007 OAK PARK HEIGHTS MN 55082 CONTINUATION SCHEDULE FOR INFORMATION PAGE REMUNERATION RATE CODE DESCRIPTION EST. PREM 16489. 4.84 5506 STREET CONSTRUCTION 798. 103057. 2.65 7520 WATERWORKS 2731. 61834. 3.36 7580 SEWAGE DISPOSAL PLANT 2078. 658601. 3.31 7720 POLICE 21800. 337972. .47 8810 CLERICAL OFFICE EMPLOYEES NOC 1588. 27278. 2.87 9102 PARKS 783. 75781. 1.18 9410 MUNICIPAL EMPLOYEES 894. 26000. .44 9411 ELECTED OR APPOINTED OFFICIALS 114. Manual Premium 30786. EXPIRING INFORMATION DO NOT PAY • Agent: 411709883 00874 : FOREST LAKE INSURANCE SERVICE DBA LANDMARK INSURANCE SVCS 232 S LAKE ST FOREST LAKE MN 55025- 8/08/2003 LM 4680(8/99) ( fl-- sz • • L MC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence J Weh Site: http://www.Jmnc.org MINNESOTA WORKERS' COMPENSATION NOTICE OF RENEWAL This information is provided to assist you in understanding your workers' compensation coverage and renewal options. Please read all the information carefully before making selections for the next coverage period. The following information is included: • Renewal Data form • Copy of previous year's coverage selection and premium information page • Risk management memorandum: Things to Think About When Renewing Your City's Workers' Compensation Coverage If you have additional questions about the coverage options available to your City,please contact the League of Minnesota Cities Insurance Trust: Barb Meyer, Policy Services Technician Jan Kodet, Underwriting Supervisor Phone: 651-215-4173 Phone: 651-215-4082 Fax: 651-281-1297 Fax: 651-281-1298 Email: bmeyer2@lmnc.org Email: jkodet @lmnc.org Deb Anger, Account Manager Ann Gergen, Associate Administrator Phone: 651-215-4170 Phone: 651-281-1291 Fax: 651-281-1297 Fax: 651-281-1298 Email: danger @lmnc.org Email: agergen @lmnc.org Any of the above listed individuals can also be reached at 800-925-1122. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • LMCIT mCRisk Management Information League of Minnesota Cities 145 University Avenue West,St.Paul,MN 55103-2044 Cities promoting excellence Phone: (651)281-1200• (800)925-1122 Fax: (651)281-1298 • TDD (651)281-1290 www.lmcit.lmnc.org THINGS TO THINK ABOUT WHEN RENEWING YOUR CITY'S WORKERS' COMPENSATION COVERAGE The LMCIT workers' compensation program is specially designed for Minnesota cities. LMCIT's coverage is unique because it picks up some related risks that standard workers' compensation insurance policies don't cover. This program also offers a number of coverage and premium options, deductibles and credits. LMCIT tries to make buying coverage for the city's workers' compensation exposures as simple and straightforward as possible,but there are still a number of decisions the city needs to make in renewing its work comp coverage. This memo is intended to serve as a guide for cities and agents when thinking about purchasing or renewing work comp coverage. BOARDS AND COMMISSIONS Elected officials Unlike city employees, elected officials are not automatically covered by the work comp law. Cities wishing to cover elected officials need to pass an ordinance or resolution to make the elected officials"employees"for purposes of work comp coverage. If the city does not pass the resolution, a city official that is injured while on city business wouldn't receive any work comp benefits from the city. This mostly affects mayors and council members,but it could also apply to clerk,treasurers, and other officers in cities where those are elected positions. The 2004 premium rate for mayors and council members is$.37 per$100 of payroll. This rate is applied to the greater of either the official's actual-salary or an imputed salary of$70 per week. In case of injury, an elected official would receive the same work comp benefits as any other city employee. Indemnity benefits would be based on the sum of his/her earnings from his/her regular employment plus the actual salary(if any) s/he receives from the city. An alternative to work comp coverage for elected officials is to purchase LMCIT's board member accident coverage. Under this option, cities can provide more limited benefits to council members injured or killed in the course of performing their duties. Accident policy rates for 2001 are $12.75 per person per year. Benefits are paid for death or short-term disability. This program was originally developed a number of years ago as a low-cost alternative to work comp for elected officials. However, LMCIT has reduced the cost of work comp for elected officials very substantially since then, so the cost advantage of the accident coverage option is now minimal. • Here's a summary comparison of the two ways cities can cover elected officials through LMCIT: LMCIT elected officials work LMCIT elected officials accident comp coverage coverage Premium cost $.37 per$100 of actual payroll or $12.75 per person per year imputed salary Coverage benefits • Death • Death • Short-term disability • Short-term disability • Loss of wages • Rehabilitation • Medical expenses • Permanent disability For more information about coverage for elected officials,refer to the "Coverage for Injuries to Elected and Appointed Officials"memo, fax number 66040. Members of separate administrative boards Members of administrative boards that the city creates pursuant to statute or charter can also be covered by workers compensation in the same way as elected officials if the city passes the appropriate ordinance or resolution. Common examples of these types of boards include planning commissions, housing and redevelopment authorities,port authority boards, EDA boards,utilities commissions,park boards, and hospital or nursing home boards. The accident coverage alternative is also available for these positions. For more information about coverage for members of separate boards,refer to the "Coordinating Coverages for Separate City Boards and Commissions"memo, fax number 66260. Employees of separate administrative boards In some cases,the city may prefer that entities which are managed by a separate administrative board have their own work comp coverage separate from the city. HRAs, EDAs,port authorities, utilities commissions, and hospital or nursing home boards are examples. Alternately,these employees can be included under the city's general coverage. Having separate coverage may make it easier to allocate costs appropriately between the two budgets. Another reason cities sometimes choose to use separate coverage is so each operation stands on its own for purposes of the experience modification calculation. I.e., with separate coverage,the utilities commission's employees losses won't affect the city's experience modification, and vice versa. On the other hand,by separating the two,the city may lose some benefit of the volume discount on premiums. 2 411 . LMCIT can provide the coverage either way, but the important thing is to make sure that all parties involved are clear on what the intent is.Note that employees of an utilities commission, HRA, EDA,port authority, or hospital or nursing home board are not automatically covered by the city's LMCIT work comp coverage unless that board is specifically listed on the information page of the coverage document. Joint powers boards If a joint powers board has its own employees, it needs work comp coverage. Any joint powers board which has at least one city as a member is eligible for LMCIT work comp coverage. LMCIT can provide that coverage either by issuing separate coverage to the joint powers board, or by adding the joint powers board as a covered employer on the city's LMCIT work comp coverage. Advisory boards Unpaid members of advisory boards that do not have legal decision-making authority are not eligible to be covered by work comp. However, cities may obtain board accident coverage from LMCIT for members of advisory boards at the same rate as for administrative boards. VOLUNTEERS Volunteers considered employees Certain volunteers are defined by statute as employees for purposes of work comp coverage. These include volunteer firefighters, ambulance attendants, first responders, law enforcement assistance volunteers, and civil defense volunteers. These volunteers are entitled to receive work comp benefits if they are injured while performing volunteer services for the city, and are covered under the city's regular work comp policy. Volunteers in an Emergency City volunteers at work during an emergency are entitled by statute to work comp benefits under a city's policy. Emergency city volunteers must be registered with the city and work under the direction and control of the city. LMCIT does not charge any additional premium for this work comp exposure. (Like other city volunteers, emergency volunteers are also automatically "covered parties" under the city's LMCIT liability coverage.) For more information,refer to the "Providing Assistance in Emergencies: Coverage and Liability Issues"memo, fax number 66840. Other city volunteers Other city volunteers are not considered employees and are therefor not covered by workers' compensation. For these volunteers, LMCIT offers an optional volunteer accident coverage, which provides some limited "no-fault"benefits for volunteers injured while working for the city. Volunteers under this program receive limited death, disability and impairment benefits. 3 • • The city can also add coverage for up to $1,000 of medical costs for an additional charge. This coverage could help avoid litigation in cases where the city may be at fault, and it also provides some protection for people donating their time and effort to city projects. Volunteer accident coverage provides blanket coverage for all city volunteers working under city direction and control, such as coaches and instructors in recreation programs, or volunteers working on city-sponsored festivals or celebrations. The cost of volunteer work comp coverage is based on the city's population, with a basic annual charge of$.10 per capita subject to a minimum premium of$150 and a maximum premium of$1,500 annually. The charge to add volunteers working on a construction project is $300 per project. For more information,refer to the"Accident Coverage for City Volunteers"memo, fax number 66050; and the"Covering the City's Volunteers"memo, fax number 66030. PREMIUM OPTIONS LMCIT work comp members have a number of premium options as well as an option to close- out retro coverage from previous years. Members also have the option of using a managed care provider for the medical management of employees injured while at work. Regular Premium Under the regular premium option,the City's premium is calculated based on City payroll,by class. The premium is then adjusted by an experience modification factor, which reflects the City's previous loss experience. In the experience modification process, claims in the oldest three out of the past four years are considered. In other words,the most recent past year is not considered. If a city chooses the regular premium option,premium payments are the City's only responsibility or liability. The regular premium option is a"fully insured"option for the City to elect. Retrospective rating Under LMCIT's retro-rating plan, a city's final premium costs reflects its own, actual loss experience for the year. Cities with standard premiums of$25,000 or more are given the choice of three retrospective options, so that each city may select the amount of risk it wishes to retain. Retrospective rating gives cities the closest option to self-insurance. Since the final premium will be a function of the city's own losses, a good safety and loss control program can save the city money over the long run. On the other hand,the city would also be subject to premium increases if it experiences a big loss. Cities that select a retrospective rating option pay a deposit premium to LMCIT at the beginning of the agreement period. Six months after the end of the agreement year,the city's premiums are 4 • • adjusted up or down based on the city's actual incurred losses for that year. That adjustment is repeated annually until all claims from the agreement period are closed. Before selecting retro rating, a city may wish to do a"what if" calculation of what the city's premiums would have been for each of the past few years if the city had had a retrospective rating plan in place. This can be a useful tool for cities evaluating retrospective rating options. For more information about the retrospective rating options, refer to the"Workers' Compensation Retrospective Rating Options"memo, fax number 66360. Retro close-out option After five years participation in a retro program, cities have the option to close out retro-rated coverage from previous years. If a city closes out the retro, no further adjustments are then made to the city's premiums under the retro-rated formula,regardless of what future changes there may be in the city's paid or incurred losses. The charge for the close-out is a percentage of the city's incurred losses for the coverage year in question. You may call Barb Meyer at 651-215- 4173 to calculate your city's close-out charges. For more information about the retro close-out option,refer to the "Workers' Compensation Retro Close-Out Option"memo, fax number 66320. Deductible options Under a deductible option,the city pays lower premium in return for agreeing to reimburse LMCIT for paid medical losses up to a set deductible. If the city selects a deductible option, the deductible applies per occurrence to medical costs only. There are six deductible options ranging from a$250 deductible with a 3.0 percent premium credit to a$10,000 deductible with an 20.0 percent premium credit. Deductibles do not affect the experience modification calculation. Even though under a deductible option the city reimburses LMCIT for certain medical costs,those costs are still included in calculating the experience modification. For more information on deductible options,refer to the"Workers' Compensation Deductible Options"memo, fax number 66350. Managed care option Cities that enroll with a state-certified managed care organization (MCO)receive a 3%premium credit on their work comp coverage. MCOs attempt to reduce the total costs of work comp claims by providing care in a network setting, establishing cost effective treatment protocols, and working to return the employee to work as soon as possible. If the MCO is successful in reducing loss costs, the city would see additional savings in the form of an improved experience modification. 5 • • LMCIT has been monitoring cities' experience with MCOs for several years. The results are not clearcut,though the most recent review suggests that managed care may be producing at least some overall savings for some cities. There are a number of certified MCOs in Minnesota, but the two that cities have most often used to date are CMC (a Blue Cross subsidiary) and Corvel. Some factors to look at in selecting an MCO are whether the MCO has network providers in their area;the MCO's fees and charges; and whether the MCO's overall approach and philosophy matches the city's. For a list of certified MCOs, contact the Department of Labor and Industry at 800-342-5354 or www.doli.state.mn.us. Non-smoker credit for police and firefighters LMCIT offers member cities a 10 percent rate credit for non-smoking police and firefighters. To qualify for the credit,the city must obtain written statements of non-smoking from at least 90 percent of the members of the department. The statement must be signed and dated, and must state that the individual does not smoke and has not smoked within the previous six months. LMCIT gives this discount because several of the diseases presumed by statute to be job-related for firefighters and police officers—various heart diseases, lung diseases, and cancers—are also related to smoking. Fire or police departments with very few smokers represent a lower risk for claims for heart disease, lung disease, or cancer. For more information on how this credit works, refer to the"Workers' Compensation for Volunteer Firefighters"memo, fax number 66020. AG 9/01 6 • • LMC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence Web Site: nttp://www.lmnc.org March 2002 To: LMCIT Workers' Compensation member cities Re: Certification of non-smoking status for police and fire department members The League of Minnesota Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in the premium charged for workers' compensation coverage for police and fire departments,if the city can certify that at least 90 percent of the department's members are non-smokers. To certify non-smoking status,cities must ask police and fire department staff to fill out a form indicating that they do not smoke. This information is private employee data. LMCIT recommends that police and fire department members be provided with appropriate information about the request when it is made of them(Tennessen warning). It is the city's responsibility to provide appropriate information about why this private data is being requested from the employee,and also to maintain the information correctly. To help you with this process,LMCIT is providing a sample non-smoking certification that includes a Tennessen warning to the employee. This sample document is on the back of this page,and can be copied for city use. LMCIT will also accept other certification that the city might choose to submit from police or fire department staff. Please keep in mind the need to provide employees with information about why the request is being made,what the data will be used for,and who will have access to the data submitted. If you have any questions,please contact LMCIT at 651-281-1200 or 800-925-1122. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • Notice to Police and Fire Department Members City of Fire Department or Police Department The League of Minnesota Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments, if the city can certify that at least 90 percent of department members are non-smokers. The information below is requested in order for your city to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status.You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If you provide false or misleading information,it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are: employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data,and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to by (employee) (city contact) on at (date) (time) EMPLOYEE COMPLETES THIS PORTION: I acknowledge receiving this advisory. I do not smoke and have not smoked within the past six months. (signature) (date) League of Minnesota Cities Insurance Trust Group S nsured Workers' Compensatio any. 7 '_ r r 45 University Avenue West ___ St. Paul, MN 55103-2044 \' II • MAY 14 2001 \) \ Renewal Data \\ The"City:" CITY OF OAK PARK HEIGHTS Agreement No.: 02-729 Quote To: PO BOX 2007 Quote Due On: 5/24/01 OAK PARK HGTS, MN 55082-3007 Agreement Expires:: 7/1/01 Your coverage under the LMCIT Self-Insured Workers' Compensation program will expire soon. In order to avoid a lapse in coverage and allow us adequate time to process your renewal, please furnish us with estimates of your payroll for the coming policy year. Estimated Payroll for the Coming g P l' o icy Year Payroll Description Code Amount Payroll Description Code Amount Street and road construction 5506 $ 10235 Building operations 9015 $ Ambulance services 7380 $ Restaurant and bars(on sale) 9084 $ Volunteer ambulance 7381 _ $ Parks 9102 $ 19544 Waterworks 7520 $102346 Municipal employees 9410 $ 126706 Electric and steam power 7539 $ Elected officials 9411 $ 26000 Sewage plant 7580 $ - 81877 Hospitals&Nursing Homes Firefighters(not volunteer) 7706 $ Hospital professionals 8833 $ Firefighters(volunteer) 7708 population Hospital all other 9040 $ Police 7720 $ 610603 Nursing homes 8829 $ Store risk retail(off sale) 8017 $ Hospital clerical office 8810 $ City shop and yard 8227 $ Others;if not above,show on reverse Clerical office 8810 $ 407370 Sick,holiday,and vacation pay should be included in the payroll totals. Do not reduce payrolls 10%for sick,holiday,and vacation pay. Does your city have a flexible benefits plan such as a cafeteria plan, Section 125 plan,or flexible reimbursement account plan? Yes x No Employee contributions to a flexible benefits plan should be included in the payroll figures you provide. Employer contributions should not be included. (This is similar to how these plans are treated under PERA.) Independent administrative boards,commissions, agencies,etc.,which have their own employees,should have workers' compensation coverage. This can be provided either by including coverage for the board's employees under the city's workers' compensation coverage or by issuing separate workers' compensation coverage to the board, commission or agency. Please indicate if you have any of the following boards,commissions or agencies and wish to include coverage for the board's employees under the city's workers' compensation coverage. 1. L Utility or utility commission 5. 0 Welfare or public relief agency 2. [] Port authority 6. 0 School board 3. 0 Housing and redevelopment authority 7. 0 Any joint powers board park: & 4. 0 Hospital or nursing home board or commission 8. ® Other ,e -, • • .o _ r-F - • • •ng Commission (existing staff & Volunter Are these entities now covered for workers' compensation under another LMCIT agreement? 0 Yes M No Please give the name and address of your agent of record for the coming year. Contact person Gary B run elchorst Phone 651-439-4439 Please return this form to the League of Minnesota Cities Insurance Trust with your estimate of payroll completed. Please call(651)215-4173 with any questions. LM 4450(9/99) 01' 02' toliday Overtime Council • David Beaudet 3,000 3,000 $ 6,000 $ 6,0u0 Lynae Byrne 2,500 2,500 $ 5,000 $ 5,000 Jack Doer 2,500 2,500 $ 5,000 $ 5,000 Mary McComber 2,500 2,500 $ 5,000 $ 5,000 Mark Swenson 2,500 2,500 $ 5,000 $ 5,000 Total $ 26,000 $ 26,000 9411 Part Time Parks John Sortedahl 1,964 2,565 $ 4,528 Jessica Schwie 801 615 $ 1,416 Brett Bernhjelm $ - Andrew Johnson 680 2,382 $ 3,062 Sara Miller 304 $ 304 Ray Nelson 3,149 11,522 $ 14,671 Nina Kellogg $ - Mark Robertson 394 12,920 $ 13,314 Total $ 37,295 9102 Part Time Office Roshelle Noeker 3,755 3,452 $ 7,207 Scott Johnson 788 3,122 $ 3,910 Total $ 11,117 8810 Police Stanley Buckley 27,665 28,495 2,752 2,695 $ 61,608 $ 57,188 1.08 Michael Hausken 31,368 32,309 3,228 2,361 $ 69,267 $ 64,504 1.07 Lindy Swanson 36,289 37,378 1,356 $ 75,022 $ 70,217 1.07 Kenneth Anderson 27,981 28,820 2,624 812 $ 60,238 $ 54,462 1.11 Paul Hoppe 31,368 32,309 2,690 2,455 $ 68,821 $ 61,704 1.12 Fred Kropidlowski 27,156 27,971 2,691 406 $ 58,225 $ 57,756 1.01 Brian DeRosier 27,448 28,271 2,183 779 $ 58,681 $ 52,176 1.12 Joseph Croft 26,903 27,710 2,629 2,667 $ 59,909 $ 58,761 1.02 David Kisch 26,903 27,710 2,221 276 $ 57,109 $ 45,607 1.25 Sandra Kruse-Roslin 20,437 21,050 242 $ 41,729 $ 39,258 1.06 Total $610,608 7720 Office Staff Gary Brunckhorst 21,446 23,859 $ 45,305 $ 37,909 1.20 Judy Holst 35,752 36,825 651 $ 73,228 $ 69,694 1.05 Julie Hultman 20,437 21,050 2,049 $ 43,536 $ 38,528 1.13 Kristin Danielson 35,426 36,489 1,323 $ 73,238 $ 60,729 1.21 Kimberly Kamper 25,114 25,868 501 $ 51,483 $ 36,071 1.43 Julie Johnson 17,373 17,894 964 $ 36,231 $ 30,935 1.17 Thomas Melena 45,361 46,722 $ 92,083 $ 85,902 1.07 Lisa Taube 20,630 21,248 $ 41,878 $ 30,873 1.36 Total $456,983 8810 Building Inspections Jimmy Butler 29,638 30,527 5,813 $ 65,977 $ 63,060 1.05 9015 Breakdown Public Works Jeff Kellogg 23,164 23,859 8,703 $ 55,726 $ 53,153 1.05 5506 10,235 Jay Johnson 35,753 36,825 1,335 $ 73,913 $ 69,695 1.06 7520 102,346' Rolland Staberg 20,055 20,657 6,355 $ 47,068 $ 44,715 1.05 7580 81,877- -7720 610,608 Total $176,707 8810 407,370 Public Works Breakdown 9102 19,544- 5506 5% 9410 126,706- 7520 50% -- 9411 26,000 7580 30% 9102 5% 9410 10% 1,384,686 • League iLMinnesota Cities Insures .,e Trust Grou If-Insured Workers' Compensai Plan administrator Berkley Administrators 145 University Avenue West St. Paul, MN 55103-2044 8 ,� r Renewal Data ---- -- The "City:" CITY OF OAK PARK HEIGHTS Agreement No.: 02-729 Quote to: PO BOX 2007 Quote Due On: 06/12/98 OAK PARK HEIGHTS, MN 55082-2007 Agreement expires:: 07/07/98 Your coverage under the LMCIT Self-Insured Workers' Compensation program will expire soon. In_order to avoid a lapse in coverage and allow us adequate time to process your renewal,please furnish us with estimates of your payroll for the coming policy year. Estimated Payroll for the Coming Policy Year Payroll Description Code Amount Payroll Description Code Amount Street and road contruction 5506 $ 14, 200 Building operations 9015 $ Ambulance services 7380 $ Restaurant and bars(on 9084 $ sale) Volunteer ambulance 7381 $ Parks 9102 $ 32 , 800 Waterworks 7520 $ 63 , 900 Municipal employees 9410 $ 63,000 Electric and steam power 7539 $ Elected officials 9411 $ 23 ,250 Sewage plant 7580 $ Hospitals&Nursing 49 , 700 Homes Firefighters(not volunteer) 7706 $ Hospital professionals 8833 $ Firefighters(volunteer) 7708 population Hospital all other 9040 $ Police 7720 $ 438,500 Nursing homes 8829 $ Store risk retail(off sale) 8017 $ Hospital clerical office 8810 $ City shop and yard - 8227 $ Others; if not above,show on reverse Clerical office 8810 $ 227 ,300 0 Are the payroll estimates listed above reduced 10% for sick.holiday and vacation pay? o Yes J No Independent administrative boards,commissions, agencies,etc.,which have their own employees,should have workers' compensation coverage.This can be provided either by including coverage for the board's employees under the city's workers' compensation coverage or by issuing separate workers' compensation coverage to the board,commission or agency. Please indicate if you have any of the following boards, commissions or agencies and wish to include coverage for the board's employees under the city's workers' compensation coverage. 1. 0 Utility or utility commission 5. 0 Welfare or public relief agency 2. 0 Port authority 6. El School board 3.R]Housing and redevelopment authority 7. 0 Any joint_powers board 4. 0 Hospital or nursing home board or commission 8. (;Other EDA (existing staff) Planning Commission (existing staff Are these entities now covered for workers' compensation under another LMCIT agreement? ❑Yes No & 5 volunteers) Please give the name and address of your agent of record for the coming year. Contact person Judy Hoist Phone 612-439-4439 Please return this form to the League of Minnesota Cities Insurance Trust with your estimate of payroll completed. Please call(612)215-4173 with any questions. LM 4450(12/97) - rd. • D — oo — 5-0 0 . -z) — n/77 1,7 Juec? — _ Pt, 3 8-o — 5 0-0 ,e4.1 s ,) 47 6 SDO ) 0, 7 12cro c;Jo , ) n ts 'Yg-0 I . / 2-0-0 , 31 DO o -3 Leag f Minnesota Cities Insure. Trust Group elf-Insured Workers' Compensation Plan ,c2),44t Administrator /��,� Berkley Administrators (�U C� 145 University Avenue West St. Paul,MN 55103-2044 Phone(612)215-, Information Page RENEWAL 1.The"City" Agreement No. 02-000729-12 OAK: PARK HEIGHTS "City" is:X City F'0 BOX 2007 Joint Powers Entity OAK PARK HEIGHT MN 55082-2007 Other(describe) 2. The Agreement period is from 12:01 a.m. 07/07/1998 to 12:01 a.m. 07/07/1999at the"City's"address. 3. A. Workers'Compensation Coverage: Part One of the Agreement applies to the Workers'Compensation Law of any state of the United States of America and the District of Columbia. B. Employers Liability Coverage: Part Two of the Agreement applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury-Each Occurrence$750,000. Bodily Injury by Disease-Agreement Limit$750,000. C. This Agreement includes these amendments and schedules: 4. Retro-rating option selected? NOT APPLICABLE 5. Elected Officials CoveredWEB Boards and Commissions Covered(List) EDA BOARD 6. The premium for this Agreement will be determined by our Manuals of Rules,Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. PREMIUM BASIS RATES ENTRIES IN THIS ITEM, EXCEPT AS SPECIFICALLY PROVIDED ESTIMATED ESTIMATED TOTAL PER$100 OF CODE ELSEWHERE IN THIS AGREEMENT; DO NOT MODIFY ANY OF THE ANNUAL ANNUAL REMUNERATION NO. OTHER PROVISIONS OF THIS AGREEMENT. PREMIUM REMUNERATION 14200. 4.12 5506 STREET CONSTRUCTION & MAINTENANCE 585. 63900. 2.90 7520 :IATERWORKS 1853. 49700. 2.82 7580 SEWAGE DISPOSAL PLANT 1402. 488500. 2.82 7720 OL I CE 13776. 227300. 0.44 B810 :LERICAL 1000. 32800. 2.41 9102 'ARKS 790. 63000. 0.89 9410 *tUN I C I PAL EMPLOYEES 561. 23250. 0.34 9411 E LECTED OR APPOINTED OFFICIALS 79. Manual Premium 20046. Experience Modification 0.81 Standard Premium 16237. Managed Care Credit 0% 0. Deductible Credit 0% 0. AGENT F-411709883 0.00 Premium Discount 1068. LANDMARK: INS SERVICE Discounted Standard Premium 15169. 232 S LK ST BOX 188 LMC Insurance Trust Discount 0% 0. FOREST LAKE,MN 55025 Net Deposit Premium 15169. DATE 07/10/1998 LM 4670 (1/98) • League of Minnesota Cities LMC Insurance Trust 145 University Avenue West St. Paul, MN 55103-2044 (612) 215-4173 League of Minnesota Cities Fax: (612) 281-1297 Cities promoting excellence J Workers' Compensation and Employers' Liability IMPORTANT Report all workers' compensation injuries to the office of: Berkley Administrators a member of the Berkley Risk Management Services Group 145 University Avenue West,St. Paul, MN 55103-2044 (612)215-4173 If an employee is injured: (1) Assist in obtaining medical attention if necessary. (2)Notify the office listed above. **IMPORTANT** PLEASE READ YOUR AGREEMENT LM 4660(12/97) • • In consideration of the deposit of the premium with the League of Minnesota Cities Insurance Trust(herein LMCIT)and in reliance upon the statements in the Information Page, and subject to all terms of this agreement and the LMCIT trust document,LMCIT, acting on behalf of its members, pursuant to their obligations, all acting through Berkley Administrators, which is the Administrator named in the Information Page made a part hereof, agrees with you,the City, named in the Information Page as follows: GENERAL SECTION A. The Agreement association and its officers, employees and members. This agreement includes at its effective date the Information Page and all amendments and C. Workers' Compensation Law schedules listed there. It is an agreement of participation between you(the employer named in Workers' Compensation Law means the workers' item I of the Information Page)and us(LMCIT). compensation law and occupational disease law of The only agreements relating to this plan are the States named in item 3.A of the Information stated in this agreement and the LMCIT Trust Page. It includes any amendments to that law document. The terms of this agreement may not which are in effect during the period of this be changed or waived except by amendment agreement. It does not include the provisions of issued by us to be part of this agreement. any law that provides non-occupational disability benefits. B. Who is Covered D. Locations You are covered if you are the"City" named in item 1 of the Information Page. "City" means the This agreement covers all of your workplaces city or other governmental body, political listed in items 1 or 5 of the Information Page; and subdivision, board or department or entity named it covers all other workplaces in any state unless in the Information Page. Unless specifically you have other insurance for such workplaces. named in the Information Page, "City" shall not include a gas, electrical or steam utilities E. Incidental Coverages commission; port authority, housing and redevelopment authority, or similar agency, board 1. Part One of this agreement applies to work or commission; hospital or nursing home board or performed by you subject to the Longshoremen's commission; welfare or public relief agency; and Harborworkers' Act. school board; or joint powers board. 2. Part Two of this agreement applies to work For purposes of Part Two- Employers' Liability performed by you subject to the Federal Coverage and for purposes of damages sought Employer's Liability Act. against them under Section 176.82 of the Minnesota workers' compensation law, the 3. Part Two of this Agreement applies to work following are additional covered parties for performed by you subject to the Jones Act or U.S. actions performed within the scope of their duties: Maritime Law. A member of the city council; a member of any board or commission of the city that is named in This paragraph does not apply to bodily injury the Information Page; an elected or appointed covered under any other policy, agreement or plan official of the city; an employee of the city; a issued to you. It does not apply even if the other volunteer person or organization while acting on policy, agreement or plan does not apply because behalf of the city; any other authorized person or of an other insurance clause, deductible or agent of the city while acting on behalf of the city, limitation of liability clause, or any similar clause. but excluding independent contractors; or a relief LM 4660 (1/98) Page I of 9 • PART ONE-WORKERS COMPENSATION COVERAGE A. How This Coverage Applies 4. Interest on a judgment as required by law until This workers' compensation coverage applies to we offer the amount due under this agreement; and bodily injury or death by accident or by disease, provided the following conditions are met: 5. Expenses we incur. 1. Bodily injury by accident must occur during E. Other Insurance the period of this agreement. We will not pay more than our share of benefits 2. Bodily injury by disease must be caused or and costs covered by this agreement and another aggravated by the conditions of your employment. insurance policy or self-insurance plan. Subject to The employee's last day of last exposure to the any limits of liability that may apply, all shares conditions causing or aggravating such bodily will be equal until the loss is paid. If any injury by disease must occur during the period of insurance policy or self-insurance plan is this agreement. exhausted, the shares of all remaining insurance policies or self-insurance plans will be equal until B. We Will Pay the loss is paid. We will pay promptly from the assets of LMCIT, F. Payments You Must Make when due,the benefits required of you by the workers' compensation law. You are responsible for any payments in excess of the benefits regularly provided by the workers' C. We Will Defend compensation law including those required because: We have the right and duty to defend, at LMCIT expense, any claim, proceeding or suit against you 1. Of your serious and willful misconduct; and any other covered party for benefits payable under this agreement. We have the right to 2. You knowingly employ an employee in investigate and settle these claims, proceedings or violation of law; suits. We have no duty to defend a claim, proceeding or suit that is not covered by this 3. You fail to comply with a health or safety law agreement. or regulation; or D. We Will Also Pay 4. You fail to comply with the reporting requirements of the Workers's Compensation Law, We will also pay from the assets of LMCIT these causing late payment of benefits to your employee costs, in addition to other amounts payable under and resulting in assessment of penalties. this agreement as part of any claim, proceeding or suit we defend: If we make any payments in excess of the benefits regularly provided by the workers' compensation 1. Reasonable expenses incurred at our request, law on your behalf, you will reimburse us but not loss of earnings; promptly. 2. Premiums for bonds to release attachments and G. Recovery From Others for appeal bonds in bond amounts up to the amounts payable under this agreement; We have your rights, and the rights of persons entitled to the benefits of this agreement, to 3. Litigation costs taxed to you; recover our payments from anyone liable for the LM 4660 (1/98) Page 2 of 9 • • injury. You will do everything necessary to 4. Jurisdiction over you is jurisdiction over us for protect those rights for us and to help us enforce purposes of the workers' compensation law. We them. are bound by decisions against you under the law, subject to the provisions of this agreement that are H. Statutory Provisions not in conflict with that law. These statements apply where they are required by 5. This coverage conforms to the parts of the law. workers' compensation law that apply to: 1. As between an injured worker and us, we have a. Benefits payable by this agreement; or notice of the injury when you have notice. b. Special taxes, payments into security or other 2. Your default or your bankruptcy or insolvency special funds, and assessments payable by us will not relieve us of our duties under this under that law. agreement after an injury occurs. 6. Terms of this agreement that conflict with the 3. We are directly and primarily liable to any workers'compensation law are changed by this person entitled to benefits payable under this statement to conform to that law. agreement. Those persons may enforce our duties; so may an agency authorized by law. Nothing in these paragraphs relieves you of your Enforcement may be against us or against you and duties under this agreement. us. PART TWO-EMPLOYERS LIABILITY COVERAGE A. How This Coverage Applies accident or by disease must be brought in the United States of America, its territories or This employers' liability coverage applies to possessions, or Canada. bodily injury or death by accident or by disease, provided the following conditions are met: B. We Will Pay 1. The bodily injury must arise out of and in the We will pay from the assets of LMCIT all sums course of the injured employee's employment by you legally must pay as damages because of you. bodily injury to your employees, provided the bodily injury is covered by this Employers' 2. The employment must be necessary or Liability coverage. incidental to your work. The damages we will pay, where recovery is 3. Bodily injury by accident must occur during permitted by law, include damages: the period of this agreement. 1. For which you are liable to a third party by 4. Bodily injury by disease must be caused or reason of a claim or suit against you by that third aggravated by the conditions of your employment. party to recover the damages claimed against such The employee's last day of exposure to the third party as a result of injury to your employee; conditions causing or aggravating such bodily injury by disease must occur during the period of 2. For care and loss of services; this agreement. 3. For consequential bodily injury to a spouse, 5. If you are sued,the original suit and any related child, parent, brother or sister of the injured employee; legal actions for damages for bodily injury by LM 4660 (1/98) Page 3 of 9 • • provided those damages are the direct for damages payable under this agreement. We consequences of bodily injury that arises out of have the right to investigate and settle these and in course of the injured employee's claims, proceedings and suits. We have no duty to employment by you; and defend a claim, proceeding or suit that is not covered by this agreement. We have no duty to 4. Because of bodily injury to your employee that defend or continue defending after we have paid arises out of and in the course of employment, our applicable limit of liability under this claimed against you in a capacity other than as an agreement. employer. E. We Will Also Pay C. Exclusions We will also pay these costs, in addition to other This agreement does not cover: amounts payable under this agreement as part of any claim, proceeding, or suit we defend: I. Liability assumed under a contract, except that this exclusion does not apply to a warranty that 1. Reasonable expenses incurred at our request; your work will be done in a workmanlike manner; but not loss of earnings; 2. Punitive or exemplary damages because of 2. Premiums for bonds to release attachments and bodily injury to an employee employed in for appeal bonds in bond amounts up to the limit violation of law; of our liability under this agreement; 3. Bodily injury to an employee while employed 3. Litigation costs taxed against you; in violation of law with your actual knowledge of the actual knowledge of any of your executive 4. Interest on a judgment as required by law until officers; we offer the amount due under this agreement; and 4. Any obligation imposed by a workers' 5. Expenses we incur. compensation, occupational disease, unemployment compensation, or disability F. Other Insurance benefits law, or any similar law; If any claim against you is also covered by another 5. Bodily injury intentionally caused or insurance policy or self-insurance plan, we will aggravated by you; pay only for our proportionate share of the loss. Our proportionate share will be determined by 6. Bodily injury occurring outside the United applying the ratio that the limit of liability States of America, its territories or possessions, provided by this agreement bears to the total of all and Canada, except that this exclusion does not limits of liability provided by all policies or plans apply to bodily injury to a citizen or resident of the in effect to the total amount payable for the loss. United States of America or Canada who is The limits of liability and amount payable under temporarily outside these countries; or this agreement and any other policy or plan shall be calculated as if each plan or policy were the 7. Damages arising out of the discharge of, only one applicable. The limits of liability and coercion of, or discrimination against any amount payable under any other policy or employee in violation of law. self-insurance plan in effect shall be included in the calculation, regardless of whether it is D. We Will Defend described as primary, excess, contributory, contingent, or otherwise, unless that policy or plan We have the right and duty to defend, at LMCIT is specifically described as providing coverage in expense, any claim, proceeding or suit against you excess of the limits of this agreement. LM 4660 (1/98) Page 4 of 9 • • G. Limits of Liability 3. We will not pay any claims for damages after we have paid the applicable limit of our liability Our liability to pay for damages is limited. Our under this agreement. limits of liability are shown in item 3.B. of the Information Page. They apply as explained H. Recovery From Others below: We have your rights to recover our payment from 1. Bodily Injury-Each Occurrence. The limit anyone liable for any injury covered by this shown for"Bodily Injury -Each Occurrence" is agreement. You will do everything necessary to the most we will pay for all damages covered by protect those rights for us and to help us enforce this agreement because of bodily injury by them. accident or disease to one or more employees in any one accident, regardless of the number of I. Actions Against Us claimants. There will be no right of action against us under 2. Bodily Injury by Disease-Agreement Limit. this agreement unless: The limit shown for"Bodily Injury by Disease- Agreement Limit" is the most we will pay for all 1. You have complied with all the terms of this damages covered by this agreement and arising agreement; and out of bodily injury by sustain bodily injury by disease,and regardless of the number of 2. The amount you owe has been determined with claimants. Bodily injury by disease does not our consent or by actual trial and final judgment. include disease that results directly from a bodily injury by accident. This agreement does not give anyone the right to add us as a defendant in an action against you to determine your liability. PART THREE-YOUR DUTIES IF INJURY OCCURS Tell us at once if injury occurs that may be legal papers related to the injury, claim, covered by this agreement. Your other duties are proceeding or suit. listed here: 4. Cooperate with us and assist us, as we may 1. Provide for immediate medical and other request, in the investigation, settlement or defense services required by the workers' compensation of any claim, proceeding or suit. law. 5. Do nothing after an injury occurs that would 2. Give us or our agent the names and addresses interfere with our right to recover from others. of the injured persons and of witnesses,and other information we may need. 6. Do not voluntarily make payments, assume obligations or incur expenses, except at your own 3. Promptly give us all notices, demands, and cost. LM 4660 (1/98) Page 5 of 9 r • PART FOUR-PREMIUM A. Our Manuals E. Final Premium All premiums for this agreement will be The premium shown on the Information Page, determined by our manuals of rules, rates, rating schedules, and amendments is an estimate. The plans and classifications. We may change our final premium will be determined after this manuals and apply the changes to this agreement. agreement ends by using the actual, not the estimated, premium basis and the proper classifications and rates that lawfully apply to the B. Classifications business and work covered by this agreement. If the final premium is more than the premium you Item 5 of the Information Page shows the rate and paid to us,you must pay us the balance. If it is premium basis for certain business or work less, we will refund the balance to you. The final classifications. These classifications were premium will not be less than the highest assigned based on an estimate of the exposures minimum premium for the classifications covered you would have during the period of this by this agreement. If this agreement is canceled, agreement. If your actual exposures are not final premium will be determined in the following properly described by those classifications, we way unless our manuals provide otherwise. will assign proper classifications, rates and premium basis by amendment to this agreement. 1. If we cancel, final premium will be calculated pro rata based on the time this agreement was in C. Remuneration force. Final premium will not be less than the pro rata share of the minimum premium. Premium for each work classification is determined by multiplying a rate times a premium 2. If you cancel, final premium will be more than basis. Remuneration is the most common pro rata. It will be based on the time this premium basis. This premium basis includes agreement was in force, and increased by our short payroll and all other remuneration paid or payable rate cancellation table and procedure. Final during the period of this agreement for the premium will not be less than the minimum services of: premium. 1. All your officers and employees engaged in F. Records work covered by this agreement; and You will keep records of information needed to 2. All other persons engaged in work that could compute premium. You will provide us with make us liable under Part One(Workers' copies of those records when we ask for them. Compensation Coverage)of this agreement. If you do not have payroll records for these persons, G. Audit the contract price for their services and materials may be used as the premium basis. This You will let us examine and audit all your records paragraph 2 will not apply if you give us proof that relate to this agreement. These records that the employers of these persons have lawfully include ledgers,journals, registers, vouchers, secured their workers' compensation obligations. contracts, tax reports, payroll and disbursement records, and programs for storing and retrieving D. Premium Payments data. We may conduct the audits during regular business hours during the period of this agreement You will pay all premium when due. You will pay and within three years after this agreement ends. the premium even if part or all of a workers' Information developed by audit will be used to compensation law is not valid. determine final premium. LM 4660 (1/98) Page 6 of 9 • • PART FIVE-CONDITIONS A. Duty to Indemnify C. Inspection Our duty to pay on behalf of or to indemnify a We have the right, but are not obliged to inspect covered party other than the "city" shall not apply your workplaces at any time. Our inspections are to any act, error or omission: not safety inspections. They relate only to coverage and the premiums to be charged. We 1. Which constitutes malfeasance in office; or may also recommend changes. While they may help reduce losses, we do not undertake to 2. Which constitutes willful neglect or duty; or perform the duty of any person to provide for the health or safety of your employees or the public. 3. Which constitutes bad faith; or We do not warrant that your workplaces are safe or healthful or that they comply with laws, 4. For which the "city" is not authorized to regulations, codes or standards. indemnify any person by statute; or D. Long Term Agreement 5. Which constitutes dishonesty on the part of a covered party; or If the period of this agreement is longer than one year and sixteen days, all provisions of this 6. Which constitutes the willful violation of a agreement will apply as though a new agreement statute or ordinance by any official, employee or were issued on each annual anniversary that this agent of the "city". agreement is in force. The terms "malfeasance", "willful neglect of E. Transfer of Your Rights and Duties duty", and "bad faith" shall be given the same meaning in this agreement as given in the Your rights or duties under this agreement may applicable statute with respect to the "city's" duty not be transferred without our written consent. to defend or indemnify its officials, employees or agents. F. Cancellation B. No Waiver of Statutory Liability I. You may cancel this agreement. You must Limitations or Immunities. mail or deliver advance written notice to us stating when the cancellation is to take effect. 1. It is the express intent of the city and of LMCIT that the procurement of this agreement 2. We may cancel this agreement. We must mail shall not waive any monetary limits of liability or deliver to you written notice of cancellation at provided by Minnesota Statute 466.04, by any least: comparable or successor statute,or by common law, which may be applicable to the "City" or to a. thirty days before the effective date of any other covered party; and that any previous cancellation if LMCIT cancels for nonpayment waiver of liability limits is revoked to the extent of premiums; or that it may apply to claims covered under this agreement. b. sixty days before the effective date of cancellation if LMCIT cancels for any other b. It is the express intent of the "City" and of reason. LMCIT that the procurement of this agreement shall not waive any other immunities, limitations, Mailing the notice to you at your mailing address or defenses imposed by or available under any shown in item 1 of the Information Page will be statute or common law which is applicable to the sufficient to prove notice. "City" or to any other covered party. LM 4660 (1/98) Page 7 of 9 3. The period of this agreement will end on the expenses of the program. The amount of any g P P g Y day and hour stated in the cancellation notice. liabilities in excess of assets may be assessed to the participants when a deficiency is identified. 4. Any of these provisions that conflicts with a law that controls the cancellation of the coverage H. Sole Representative in this agreement is changed by this statement to comply with that law. The City first named in item 1 of the Information Page will act on behalf of all covered entities to G. Assessability change this agreement, receive return premium, and give or receive notice of cancellation. All "cities" who participate in this program are jointly and severally liable for all claims and PART VI. INFECTIOUS DISEASE DIAGNOSTIC TESTING A. We Will Pay any one employee is$1,000. Subject to the conditions listed below, LMCIT 3. An Exposure Incident does not alone constitute agrees to pay from its assets the usual and a"Personal Injury"as that term is defined under customary costs and expenses associated with Minnesota Workers' Compensation law. diagnostic testing of your employees who have Accordingly, absent actual contraction of an had an Exposure Incident that could result in an Infectious Disease, payment for diagnostic testing Infectious Disease. subsequent to an Exposure Incident is not required under Minnesota Workers' Compensation Law. B. Definitions Rather, payment for diagnostic testing as described in this endorsement is made independent For purposes of this Coverage Part,the following of the city's obligations, if any, under Minnesota definitions apply: Workers' Compensation Law and is intended to meet the city's obligation under Federal OSHA 1. Exposure Incident means a specific eye, law to provide at no cost to the employee, medical mouth, or other mucous membrane, non-intact evaluations and treatment after an Exposure skin or parenteral contact with blood or other Incident. potentially infectious materials that result from the performance of an employee's duties. 4. In accordance with the provisions of Minn. Stat. Sec. 176.221 subd. I, payment for diagnostic 2. Infectious Disease means any form of viral or testing as described in this agreement is not an g g infectious hepatitis, human immunodeficiency admission that an employee's contraction of an virus(HIV), acquired immunodeficiency Infectious Disease constitutes a compensable syndrome(AIDS), and tuberculosis(TB). Occupational Disease under Minnesota Workers' Compensation law; and it does not constitute a C. Limits and Conditions waiver of the city's or LMCIT's right to contest the issue of whether an employee's contraction of LMCIT's responsibility to pay costs and expenses an Infectious Disease constitutes a compensable for diagnostic testing is limited and conditioned as Occupational Disease under Minnesota Workers' follows: Compensation law. 1. The Exposure Incident must occur during the 5. LMCIT reserves the right to discontinue term of this agreement. payment of costs and expenses for diagnostic testing if in its opinion further diagnostic testing is 2. The most LMCIT will pay for diagnostic no longer medically appropriate under the testing associated with an Exposure Incident to particular circumstances of the Exposure Incident. LM 4660 (1/98) Page 8 of • • IN WITNESS WHEREOF, the City agrees to look solely to the League of Minnesota Cities Insurance Trust for reimbursement of all losses, costs and expenses arising under this agreement; and further agrees that in no event shall claim be made or asserted against the revenues or property, real or personal,of the League of Minnesota Cities. Acceptance of this agreement by the City constitutes acceptance of all terms hereof. League of ' nesota ities Insurance Trust By: ,-7-4-,/ Its Authorized Re.resentative LM 4660 (1/98) Page 9 of 9 • OA) ,`.` 2 9199R I [.4 1 145 University Avenue - St. Paul, MN"551 2044 g f Phone- ,2 -4173 League o Minnesota Cities �''�'} Cities promoting excellence Fax: (612) 281-1297 -11313--(61.2) 281-1290 Enclosed is your: ❑ Coverage Document for Minnesota Workers' Compensation Please carefully review your Policy or Agreement, the Information Page and any Endorsements to ensure that the coverages you want or need are included and that they are accurately prepared. If you have one, your agent will also receive copies of your Information Page and any Endorsements. Please communicate with your agent or the League of Minnesota Cities Insurance Trust if there are errors or if changes are necessary. Also included for your review are the forms and instructions you need to report all workers' compensation claims to the League of Minnesota Cities Insurance Trust. N Minnesota Workers' Compensation Renewal Document Please carefully review your renewal Policy Agreement, the Information Page and an Y or 9 9 any Endorsements to ensure that the coverages you want or need are included and that they are accurately prepared. ❑ New supply of First Report of Injury forms and/or the other information you requested. Mandatory Fraud Notice A person who submits an application or files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime. Minnesota Statute 60A.955. You must maintain an adequate supply of First Report of Injury forms. They should be kept where they are accessible to the person who is responsible for completing the form and sending it to the League of Minnesota Cities Insurance Trust. If you have run out of forms or can't find your supply, please complete the form below and return it to the League of Minnesota Cities Insurance Trust. We will gladly send you a supply of forms and provide any other information you request. Please do it today because you never know when an injury might be reported by one of your employees. 02-000729 OAK PARK HEIGHTS Please send the following information to the attention of: PO BOX 2007 OAK PARK HEIGHT MN 55082-2007 at the address at left. ❑ First Report of Injury forms ❑ Supervisor's Report of Accident forms ❑ Minnesota Workers' Compensation booklet Clip and mail to: ❑ Employer's Injury Management Guide ❑ Employer's Loss Control booklet League of Minnesota Cities Insurance Trust ❑ Deductible information 145 University Avenue West St. Paul, MN 55103-2044 LM 3110(3/98) 0 ! . 0 • 145 University Avenue West, St. Paul, MN 55103-2044 League of Minnesota Cities Phone: (612) 281-1200 • (800) 925-1122 Cities promoti1ng excellence Fax: (612) 281-1299 • TDD (612) 281-1290 , 4 August 25, 1997 To: Member cities - LMCIT workers compensation program From LMCIT Board of Trustees - Jim Antonen, City Manager,Moorhead \,;1 SEP 15 � '1 i `' - Karen Anderson, Mayor, Minnetonka - Todd Prafke, City Administrator,Blooming Prairie i - Les Heitke, Mayor, Willmar —'' - Jim Miller, Executive Director, LMC Re: 1997 dividend LMCIT workers compensation A check for your city's dividend from the L program is enclosed. ro p p g LMCIT is returning a total of$8.5 million to member cities. The $8.5 million is LMCIT's share of the surplus funds which the state Workers Compensation Reinsurance Association(WCRA)is returning to its member insurers and self-insurers. answer most of the questions you may have about these We've tried in the following section to answ q Y Y funds. If you have further questions or need any other information,please feel free to call Pete Tritz or Tom Grundhoefer at the League offices. How is each city's share calculated? The LMCIT Board of Trustees directed that the funds be allocated among LMCIT's current members based on each member's total earned premiums and total losses for all the years the city has been a member of LMCIT. For purposes of calculating the dividend, large losses are capped at$50,000. The Board also specified that each current member should receive a minimum dividend of at least 10%of the city's 1996 premiums, even if the city's total losses actually are greater than the city's premiums. The premium and loss totals used to calculate your city's dividend are shown on the enclosed sheet. Why did the Trustees select this allocation formula? The formula reflects LMCIT's basic purpose: cities cooperating to meet their risk management needs. The reason LMCIT is able to return these funds to the cities is because LMCIT is in strong, solid financial shape. LMCIT's financial condition is really a function of the difference between the total premiums cities have contributed and the total losses they've incurred. Cities AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER I that have been members the longest and have done the best job of controlling their losses have effectively contributed the most to LMCIT's current strong financial condition. The formula gives those cities a comparatively greater share of the refund. This is very similar to the way LMCIT has calculated dividends in the property/casualty program for many years. Where did the$8.5 million come from? In 1979,the legislature created the Workers Compensation Reinsurance Association(WCRA). The WCRA is a non-profit reinsurance company. Every insurance company that writes workers compensation insurance, every employer that self-insures workers compensation, and every self-insurance group in Minnesota is required to purchase reinsurance from the WCRA. At the end of 1996, the WCRA found itself with a substantial amount of surplus funds. Because the WCRA operates on an non-profit basis,the WCRA Board decided early this year to return about $471 million of surplus funds to its members. LMCIT's share of the WCRA funds came to $8.3 million, but interest earnings from last January to now brought the total up to just over $8.5 million. To put that amount into context, it's equal to slightly more than half of LMCIT's total annual work comp premiums at current rates. How did the WCRA come to accumulate that much surplus money? Two main factors account for it: First, the 1992 and 1995 workers compensation reform legislation helped reduce the cost of workers compensation in Minnesota generally,which in turn reduced the WCRA's liabilities below what they had earlier projected. Second,the WCRA has investment returns over the past few years. achieved some very good p Y rY g If the WCRA Board declared the dividend last January,why are we only now receiving the funds? Two factors delayed the WCRA distribution. First, any dividend the WCRA pays must be approved by the commissioners of both the Commerce Department and the Labor and Industry Department. Both commissioners took several months to review it before giving their approval, and they in fact ordered some changes in how WCRA proposed to allocate the funds. Second, several insurance companies filed suit early this summer challenging how the funds are being allocated. The dispute is over how much of the refund should go directly to employers who buy workers compensation insurance, and how much should go to the insurance companies. That litigation further delayed the distribution. However,because that dispute doesn't affect how much self-insurers and group self-insurers like LMCIT receive,v ,the WCRA was recently cleared to distribute the self-insurers' shares. The insurance companies' and insurance buyers' shares won't be distributed until that litigation is resolved, which could take some time. • • Should we expect additional workers compensation dividends in the future? There's no way to say for sure. The WCRA has twice returned dividends to its members, in 1993 and again this year. Both times LMCIT has been able to pass the WCRA refund on to member cities. It's certainly possible that WCRA might again return a dividend some time in the future, but at this point that's only speculation. And while we'll do our best to keep LMCIT financially strong and solvent, we obviously can't guarantee what LMCIT's financial condition might be at some undefined future date, or whether LMCIT would again be able to pass a future WCRA refund through to members. It's also possible that LMCIT's own operations might at some point generate some surplus funds that could be distributed to members, as the property/casualty program has for the past several years. However, compared to the property/casualty program, the "cushion" or contingency margin we build into the LMCIT work comp rates is substantially smaller. It's a bit of an over-simplification, but essentially the margin is what produces the dividends: The margin provides the funding cushion if losses should turn out to be greater than anticipated; if losses turn out to be at or below projections,that cushion isn't needed and can be returned to members as a dividend. In short,future work comp dividends are certainly possible,but whether,when, and how much they might be is purely speculative at this point. n • 1997 LMCIT Wor ers Compensation Program Dividend City Oak Park Heights Total Earned Premium $214,805 Total Incurred Losses $17,786 Adjusted Losses $17,786 1 . Dividend $10,460 1 5 1997 WCRA Refund Berkley Administrators PO Box 59143,MpIs.,MN 55459-0143 8441 Wayzata Blvd.,Mpls.,MN 55426 Phone(612)544-0311 Fax(612)591-7404 July 24, 1997 J.T..i Judy Hoist 2 8 1997 City Of Oak Park Heights L Po Box 2007 CITY of OAK PARK HEIGHTS Oak Park Heights,MN 55082-2007 RE: Workers'Compensation Premium Audit Policy Number: 02-729 Policy pe riod: 07/07/96 to 07/07/97 Dear Ms. Hoist: I will be in your area on Thurs. Aug. 7 at about AM for purposes of auditing your workers' compensation policy. l� I� Y. It is important that the audit be completed on the scheduled date in order to determine whatever refund might be due you or any additional premium owed. Please make the following records available to me: A copy of resolution or ordinance providing WC coverage for elected or appointed officials,Cash Disbursement Journal or Check Register, Federal 941,Fire contracts with other cities&townships,Individual Earnings Records Cards, MN Jobs&Training Quarterly Return,Payroll Journals,Payroll(Labor)Distribution, Summary of worker hours for Volunteer Ambulance Police Reserves and 1st responders or Rescue Squad, Workers'Compensation Certificates from Sub-Contractors If, for some reason you are unable to keep this appointment, please call me to arrange an P ply p alternate time. Also,if the audit is to be done at a location other than the address on this letter please let me know who I am supposed to contact and the address. Or, if the address is a P.O. Box#,please call and leave directions. You can call my voice mail and leave a message and I will get back to you. My number is 612-591-7460,mail box# 860. You can call this number 24 hours a day to leave a message. Y g Sincerely, SLti \ Le ue of Minnesota Cities Insu.e Trust Group Self-Insured Workers'Compensation Plan Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis,MN 55459-0143 Phone (612) 544-0311 ParADEnEMIUMOPTIONS The 'City' Agreement No.: 02-000729-11 OAK: PARK: HEIGHTS Agreement Period: From: 07/07/1997 PO BOX 2r,07 To: 07/07/1998 OAK PARK: HEIGHT MN (5.5082-2007 Enclosed is a quotation for workers'compensation deposit premium.Deductible options are now available in return fora premium credit applied to your estimated standard premium of$ 18089. . The deductible will apply per occurrence topai. medical costs only.There is no aggregate limit. Please indicate below the premium option you wish to select. You may choose onlyQne�and you cannot change options during the agreement period. OPTIONS NET DEPOSIT PREMIUM 1)8i Regular Premium Option 16846. Deductible Premium Credit per Occurrence Credit Amami 2 ❑ $250 3% 543. 16303. 3 ❑ 500 4.5% 814. 16032. 4 ❑ 1,000 6% 1085. 15761. 5 ❑ 2,500 10% 1809. 15037. 6 ❑ 5,000 13.5% 2442:. 14404. 7 ❑ 10,000 18% 3256. 13590. This should be signed by an authorized representative of the city requesting coverage.shic of the above options must be selected. Please return a signed copy of this notice to the Administrator with payment and make checks payable to the LMCIT. 6/e97 rgnature Title Date For more information on the premium options that apply to your city,refer to the enclosed brochure. BA4501(12/96) Lee of Minnesota Cities Insure Trust roup Self-Insured Workers' Compensa Plan • Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Self-Insured Workers' Compensation Quotation (RENEWAL of Agreement No. 02-000729_10) OAK PARK HEIGHTS 07/07/1997 07/07/1998 ESTIMATED DEPOSIT CODE RATE PAYROLL PREMIiUM GENERAL MAINTENANCE 5506 4.62 86805. 4010. POLICE 7720 3.36 474844. 15955. CLERICAL 8610 0.42 133710. 562. PARKS 9102 2.62 62296. 1632. MUNICIPAL EMPLOYEES 9410 1 . 19 54314. 646. ELECTED OR APPOINTED OFFICIALS 9411 0.45 20500. 92. Manual Premium 22897. Experience Modification 0.79 Standard Premium 18089. Manacled Care Credit 0% 0. Deductible Credit 0% 0. Premium Discount 1243. Discounted Standard Premium 16846. L MC Insurance Trust Discount 0% 0. Net Deposit Premium 16846. The foregoing quotation is for a deposit premium based on your estimate of payroll. Your final actual premium will be computed after an audit of payroll subsequent to the close of your agreement year and will be subject to revisions in rates, payrolls and experience modification. While you are a member of the LMCIT Workers' Compensation Plan, you will be eligible to participate in distributions from the Trust based upon claims experience and earnings of the Trust. If you desire the coverage offered above, please complete the enclosed "Application for Coverage" and return it and your check for the deposit premium (made payable to the LMC Insurance Trust) to the Plan Administrator, Berkley Administrators. BA 441CG (12/92) Landmark Insurance ices M O Page 1 PO Box 188 ACCOUNT NO. OP DATE Forest Lake,MN 55025 OAKPA-1 TL 06/04/97 Phone: 612-464-3333 Support: 612-464-7596 POLICY INFORMATION POLICY# CMC16674 TYPE EFFECTIVE EXPIRATION CP 07/07/96 07/07/97 City of Oak Park Heights Mike Robertson,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 Mike, Re: Endorsement Enclosed please find an endorsement effective 5/28/97 which deletes the 1987 Ford Pickup and adds the 1997 Chev Pickup with full coverage as per Judy' s recent request . There is no change in premium. Please review and call us if you have any questions . Thank you. Sincerely, ; i� .a 1_x1-.7 _ j 11 i JUN 5 1997 Tracey Lund I l L L^ J� ENDORSEMENT # 2• • 6/3/97 JMS CITY OF OAK PARK HEIGHTS 1 CMC 16674 5/28/97 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages =Z11997 CHEVY PICK-UP, #6571 ALL LIABILITY COVERAGES f ACV $500. DED. COMP. $500, DED. COLL. 1987 FORD 3/4 TON PICK-UP, #7594 ALL COVERAGES RECEIVED Val 0 it 1947 Total Endorsement Premium: $NO CHANGE (See Below for Billing information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged. Executive Director, LMCIT LMCIT ME020(1/95) Page 1 of 1 Leagues Minnesota Cities Instrance Trust Group Self-Insured Workers' Compensation Plan administrator Berkley Administrators PO Box 59143 • Minneapolis, MN 55459-0143 • Phone (612) 5. . uy `� �Renewal Data 6 1997 MAY - City CITY OF OAK PARK HEIGHTS Agreement No.: 02-729 PO BOX 2007 Quote to: OAK PARK HEIGHTS,MN 55082 Quote Due On: 05-15-97 expires:: Agreement 07-07-97 9 P Your coverage under the LMCIT Self-Insured Workers' Compensation program will expire soon.In order to avoid a lapse in coverage and allow us adequate time to process your renewal,please furnish us with estimates of your payroll for the coming policy year. Estimated Payroll for the Coming Policy Year Payroll Description Code Amount Payroll Description Code Amount Street and road contruction 5506 $ 86 ,805 Building operations 9015 $ Ambulance services 7380 $ Restaurant and bars(on 9079 $ sale) Volunteer ambulance 7381 $ Parks 9102 $ 62 , 296 Waterworks 7520 $ Municipal employees 9410 $ 5 4,314 Electric and steam power 7539 $ Elected officials 9411 $ 20,500 plant a lant 7580 $ Hospitals&Nursing g Homes Firefighters(not volunteer) 7706 $ Hospital professionals 8833 $ Firefighters(volunteer) 7708 population Hospital all other 9040 $ Police 7720 474,844 Nursing homes 8829 $ Store risk retail(off sale) 8017 $ Hospital clerical office 8810 $ City shop and yard 8227 $ Others;if not above,show on reverse Clerical office 8810 $ 133,710 Are the payroll estimates listed above reduced 10%for sick,holiday and vacation pay? 0 Yes 10 No Independent administrative boards,commissions,agencies,etc.,which have their own employees,should have workers' compensation coverage.This can be provided either by including coverage for the board's employees under the city's workers' compensation coverage or by issuing separate workers' compensation coverage to the board,commission or agency.Please indicate if you have any of the following boards,commissions or agencies and wish to include coverage for the board's employees under the city's workers' compensation coverage. 1.0 Utility or utility commission 5.0 Welfare or public relief agency 2.0 Port authority 6.0 School board 3.al-lousing and redevelopment authority 7.D Any joint powers board 4.0 Hospital or nursing home board or commission 8.0 Other Are these entities now covered for workers' compensation under another LMCIT agreement?0 Yes E3 No Please give the name and address of your agent of record for the coming year. Contact person Judy Holst Phone 612-439-4439 Please return this form to Berkley Administrators with your estimate of payroll completed. BA 4450(4/96) • S-f',m� -c 7- I � 7 � 61,_rk _ � 0 L.4-i?c / / — q `/1J r( f<� 5 , 34. 6-1( �� s ©4) 6—L/c? t?1 0 /33, 7io d /11/46,„ - 8 £saS JJ 772 - `OY FSLIC( , f X1,311 8C6'10 - 133,7i0 t4J8 �l?9 5 I0)- 6.21,075'4 - Sy 3/4( 3 g, - a20 , 5-00 ac, 11D oT 'jq� �ly t 41, Sao — -sy, 3 / yD, a7� l o,Go 1 °t--- /6, St)--D )3/, 1/0 1 R • k„. League of Minnesota Cities Insurance Trust Soup Self-insured Workers'Compensatian orkers'Compensation and Employers'Liability A ent Administrator Berkley Administrators P.O.Box 59143 Minneapolis,MN 55459.0143 Phone(612)544-0311 n •i .1 . el Lid1 I .AUDIT ADJUSTMENT The'City' U ' Agreement No. flr-00 72c_c j , OAK PARK HEIGHTS `'J Agreement Period: From 07/07/1995 To 07/07/1994 PG BOX 2007 OAK OF OAK PARK HEIGHTS OAK PARK HEIGHT MN 55082-2007 Rates Audited Annual Per$100 Of Code Audited Remuneration Remuneration No. Classification Premium 43611. 7.20 5506 GENERAL MAINTENANCE 3140. 370829. 5.23 7790 POs I rE 19Q94. 143174. 0.65 8810 CLERICAI 931 . 80771. 4.09 9102 PARKS 3304. 43600. 1 .95 9410 MUNICIPAL EMPLOYEES 807. 1.6390. 0.69 9411 ELECTED nR APPOINTED OFFICIALS 113. 498365. Manual Premium x7689. Experience Modification 0.77 Standard Premium 21321 . Managed (are Credit 0% 0. Deductible Credit 0% 0. Premium viscount <1, 50.:', Discounted Standard Premium 19771 . 1 {qtr'. Insurance Trust Discount 0% 0. _ Net Actual Premium 19771. Less Deposit Premium 21095.00 Balance Due City 1324.00 The foregoing statement is for the year end adjustment to your workers'compensation desposit premium. It was prepared after an audit of your payroll records and a final determination of your experience modification factor for the period indicated above. lithe final balance shown is due to your city, a check will accompnay this form. If the final balance shown is due to the LMCIT,please forward your remittance,payable to the LMC Insurance Trust,to the adminsitrator at the address indicated above. Agegd_4 1 1 709883 LANDMARK INS SERVICE 232 S LK ST BOX 188 FOREST LAKE.MN 55025 BA 446C0(5191) Date: El. J. M. OCT 17 '96 BERKLEY ADMINI TORS AMERIB _ 357786 TRUST ACCOUNT 02 1809 PLWUTH ROAD SOUTH 02 P.O. BOX 5914 MINNETONKA, MN 55343 MINNEAPOLIS, MN 55459-0143 75-1498/910 PAY #02-000729 368397 October 18, 1996 AMOUNT ONE THOUSAND, THREE HUNDRED, TWENTY-FOUR AND 00/100 DOLLARS *$1, 324 .00* TO THE ORDER'OF \ ,.OAK`PARK HEIGHTS ` PO BOX 2007 OAK PARK HEIGHT MN 55082-2007 _ 8(°`(lit`A-■ e tAilidit - , SDC:AMW THIS IS WATERMARKED PAPER•DO NOT ACCEPT WITHOUT VERIFYING CHAIN WATERMARK.HOLD TO LIGHT TO VERIFY WATERMARK II' 3 5 7 78611' 1:0910 L498 21: L00...646011' i CHECK NO. YN 368397 8800 RETURNED PREMIUM TYPE 2, COVERAGE BEGINNING 07/07/95 1324 . 00 I C ) =-� ACCOUNT NO. 02-000729 SDC:AMW 357786 /-,-, ENCLOSURE i 1 • M O . Page i Landmark Insurance Services 232 S.Lake St.P O Box 188 ACCOUNT NO. O1 DATE Forest Lake,MN 55025 0AKPA-1 KF 09/23/96 Phone : 612-464-3333 Support: PULICY INFORMATION POLICY# 7-7-96 Renewals TYPE EFFECTIVE EXPIRATION City of Oak Park Heights r.�- Mike Robertson,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 ! ) , SEP 2 5 1996 H4 j Dear Mike Re: 7-7-96 Renewals As promised, I have enclosed the Renewal Premium Comparison, the Policy Coverage Checklist and Vehicle ID Cards for the current year. I have 9 Y sent two copies of the ID cards so that you may keep one copy in the vehicles and keep one copy in your files . Mike, if you have any questions or need any further information for the III 96/97 renewal term, please do not hesitate to call . Sincerely, is I � Katie Farrell it • • City of Oak Park Heights Renewal Premium/Comparison by Landmark Insurance Services July 7, 1996 Renewals Coverage 1995-96 1996-97 Property $6,220. $6,231. Inland Marine $574. $843. Municipal Liability $24,428. $24,916. Automobile Liability $2,280. $2,180. ,Automobile Physical Damage $1,072. $1,217. Miscellaneous Equipment (Auto) $8. Included PACKAGE TOTAL $34,582. $35,387. PUBLIC EMPLOYEE BLANKET BOND $1,035. $1,035. UMBRELLA $10,229. $7,176. OPEN MEETING LAW $500. $500. (94-95 short term Nov 94- Jul 95) WORKERS COMPENSATION $21,095. $17,608. TOTALS $67,441. $61,706. I • Municipality Quick Checklist for the City of OAK PARK HEIGHTS Landmark Insurance Services July 7, 1996 Renewal Policies Property Coverages X Buildings X Contents Business Income Extra Expense Personal Property of Others 1 X Property in the Open Boiler& Machinery Glass Liability Coverages X Municipal Liability X Limited Pollution Liability X Lead or Asbestos Liability X Land Use Regulation Liability X Open Meeting Law Liability Petrofund Reimbursement Liability X Excess Liability Inland Marine X Mobile Equipment X EDP Equipment Data/Media X Miscellaneous Equipment Valuable Papers Signs Crime Theft, Disappearance & Destruction(Money & Securities) Forgery& Alteration Public Employee Dishonesty Coverage X Public Employee Faithful Performance Coverage Workers Compensation X Statutory Work Comp Volunteer Accident Automobile X Liability X Physical Damage A quick check of coverages included-subject to all Policy forms, limits & conditions. r - INSURANCI DENTIFICATION CARD OP 4111CF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED :1 LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE MODEL VEHICLE IDENTIFICATION NUMBER 1987 CHEV 1 TON 6960 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) Two Copies OF E cL ID Card • Copy For ✓thic.i e Ores For Your Fk INSURANC•DENTIFICATION CARD OP 411KF STATE MN' COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1987 CHEV 1 TON 6960 IN CASE OF ACCIDENT: Report alt accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) 7 INSURANC DENTIFICATION CARD OP 411KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED j LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1987 FORD 3/4 TON 7594 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) ' 1 INSURANCODENTIFICATION CARD OP •KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1987 FORD 3/4 TON 7594 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 P assenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) 1 17 INSIIRANC#DENTIFICATION CARD OP KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1990 OLDS 1936 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark 'Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) INSURANCSDENTIFICATION CARD OP RF •STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1990 OLDS 1936 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) . 3 ' 1 ' 6 INSURANCIODENTIFICATION CARD OP •KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1990 OLDS CIERRA 0610 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) • • J INSURANC.DENTIFICATION CARD OP •KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1990 OLDS CIERRA 0610 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) J INSURANC DENTIFICATION CARD OP SKY STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1993 CHEV CAPRICE 0238 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) INSURANCODENTIFICATION CARD OP •ICF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1993 CHEV CAPRICE 0238 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) li 1 INSURANCIODENTIFICATION CARD OP OKF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 - YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1994 CHEV CAPRICE 9481 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) ' a ' 3 i i INSURANCI.DENTIFICATION CARD OP SKF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1994 CHEV CAPRICE 9481 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) a • INSURANC.DENTIFICATION CARD OP • KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1995 CHEV CAPRICE 4521 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) 3 I 3 INSURANIOEDENTIFICATION CARD OP • KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1995 CHEV CAPRICE 4521 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) • INSURANCeDENTIFICATION CARD OP 0 KF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1995 FORD CROWN VI 1817 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) INSURANCIWDENTIFICATION CARD OP •ICF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1995 FORD CROWN VI 1817 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) INSURANCWDENTIFICATION CARD OP •RF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE • CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1996 FORD CROWN VI 6000 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) ' a 9i! 1 INSURAN DENTIFICATION CARD OP •RF STATE MN COMPANY NUMBER COMPANY THIS CARD MUST BE KEPT IN THE INSURED LMCIT-Berkley Risk Services, I VEHICLE AND PRESENTED UPON DEMAND POLICY NUMBER EFFECTIVE DATE EXPIRATION DATE CMC16674 07/07/96 07/07/97 YEAR MAKE/MODEL VEHICLE IDENTIFICATION NUMBER 1996 FORD CROWN VI 6000 IN CASE OF ACCIDENT: Report all accidents to your Agent/Company as soon as possible. AGENCY/COMPANY ISSUING CARD Obtain the following information: Landmark Insurance Services Landmark Insurance Services 1. Name and address of each driver, 612-464-3333 passenger and witness. INSURED 2. Name of Insurance Company and policy City of Oak Park Heights number for each vehicle involved. Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater MN 55082 COVERAGE MEETS MINIMUM LIABILITY INSURANCE PRESCRIBED BY LAW 50 (1/83) IIII li II it ACORD CERTIFUCO'E OF LIABILITY INStIANCEAKPALl DATE INIM/DD/YY) 07/22/96 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION Landmark Insurance Sery i ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE (Formerly Forest Lake I,- ' HOLDER.THIS CERTIFICATE DOES NOT AMEND,EXTEND OR 232 S S. Lake St. P 0 So ? ►�F ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Forest Lake MN 55025 `J`�+- 2 4 !'iV; COMPANIES AFFORDING COVERAGE Brian Alm I COMPANY Phone No. 612-464-3333 Fa No. A LMCIT-Berkley Risk Services, I INSURED COMPANY B City of Oak Park Heights COMPANY Mike Robertson, City Admin. C 14168 N 57th St, Box 2007 COMPANY Stillwater MN 55082 D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED,NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO TYPE OF INSURANCE I POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR DATE(MM/DD/YY) DATE(MMIDDiYY) GENERAL LIABILITY GENERAL AGGREGATE $ 600,000 A X COMMERCIAL GENERAL LIABILITY CMC 15650 07/07/96 07/07/97 PRODUCTS-COMP/OPAGG $ 600,000 X CLAIMS MADE OCCUR PERSONAL&ADV INJURY $ OWNERS&CONTRACTORS PROT EACH OCCURRENCE $ 600,000 FIRE DAMAGE(Any one fire) $ 50,000 MED EXP(Any one person) $ 1,000 AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) $ —1 HIRED AUTOS BODILY INJURY NON-OWNED AUTOS (Per accident) $ PROPERTY DAMAGE $ GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: . EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ 1,000,000 A X UMBRELLA FORM MEL-2351 07/07/96 07/07/97 AGGREGATE $ 1, 000,000 OTHER THAN UMBRELLA FORM $ WORKERS COMPENSATION AND WC STATU- I 1OTH- I TORT LIMITS I 1 ER EMPLOYERS'LIABILITY EL EACH ACCIDENT $ 200000 A THE PROPRIETOR/ --, INCL 02000729-10 07/07/96 07/07/97 EL DISEASE-POLICY LIMIT $ 600000 PARTNERS/EXECUTIVE OFFICERS ARE: EXCL EL DISEASE-EA EMPLOYEE $ 600000 OTHER DESCRIPTION OF OPERATIONSILOCATIONSNEHICLES/SPECIAL ITEMS City - Municipal Liability CERTIFICATE HOLDER CANCELLATION WASHI-3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF,THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Washington Cty. Dept of Health Attn: Tom Haugen SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY 14900 North 61st Street OF ANY KIND UPON THE COMPANY,ITS AGENTS OR REPRESENTATIVES. Stillwater MN 55082 AUTH�-IZEDREpRESENTATIVE ACORD 25-S(1195) Br( ©ACORD CORPORATION 1988 ACORD U g� �E '� CSR KF DATE(MMlDDlYY) al if 07/01/96 THIS BINDER IS A TEMPORARY INSURANCE CONTRACT,SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER PHONE COMPANY BINDER# {A/C,No,Ext): 612-464-333 3 34 Landmark Insurancel.6 eovitces LMCIT-Berkley Risk Services, I EFFECTIVE EXPIRATION (Formerly Forest Lake Ins.) DATE TIME DATE TIME 232 S. Lake St. P 0 Box 188 X AM X 12:01 AM Forest Lake MN 55025 07/07/96 12:01 PM 08/07/96 NOON Landmark Insurance Services THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE: SUB CODE: X PER EXPIRING POLICY#: SEE BELOW CUSTOMER ID: OAKPA-1 DESCRIPTION OF OPERATIONSNEHICLES/PROPERTY(Including Location) INSURED Per expiring policy and renewal City of Oak Park Heights applications/statement of values. Mike Robertson PO Box 2007 Stillwater MN 55082-2007 COVERAGES LIMITS TYPE OF INSURANCE COVERAGE/FORMS AMOUNT DEDUCTIBLE COINS PROPERTY CAUSES OF LOSS BASIC BROAD SPEC ..^, r. GENERAL LIABILITY JUL 'HH GENERAL AGGREGATE $ COMMERCIAL GENERAL LIABILITY I�, PRODUCTS-COMP/OP AGG $ CLAIMS MADE OCCUR PERSONAL&ADV INJURY _ $ OWNER'S&CONTRACTORS PROT I _ �T EACH OCCURRENCE $ --•- ---- FIRE DAMAGE(Any one fire) $ RETRO DATE FOR CLAIMS MADE: MED EXP(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS MEDICAL PAYMENTS $ NON-OWNED AUTOS PERSONAL INJURY PROT $ UNINSURED MOTORIST $ $ AUTO PHYSICAL DAMAGE DEDUCTIBLE ALL VEHICLES SCHEDULED VEHICLES ACTUAL CASH VALUE COLLISION: STATED AMOUNT $ OTHER THAN COL: OTHER GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE $ OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: SELF-INSURED RETENTION $ STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT $ AND EMPLOYER'S LIABILITY DISEASE-POLICY LIMIT $ DISEASE-EACH EMPLOYEE $ SPECIAL Coverage per expiring policy and updated renewal applications. Policy CONDITIONS! numbers CMC15650, MEL2351, OML394, 51062482, 02000729-9. OTHER COVERAGES NAME&ADDRESS MORTGAGEE ADDITIONAL INSURED LOSS PAYEE LOAN# AUT ORIZED REPRESENT IVE / !_1 I a dmark Insurance Services ACORD 75-S:(12193) NOTE:IMPORTANT STATE INFORMATION ON ATTACHED PAGE ©ACORD CORPORATION 1093 • J 1, , u _„,_ 1 t zi 0Berkley JUL 5 e� ± Administrators CITY OF PO Box 59143, Mpls., MN 55459-0143 • 8441 Wayzata Blvd., Mpls., t f N 554AIK PARK HEIGHTS Phone (612) 544-0311 • Fax (612) 591-7404 Enclosed is your: ❑ Coverage Document for Minnesota Workers' Compensation Please carefully review your Policy or Agreement, the Information Page and any Endorsements to ensure that the coverages you want or need are included and that they are accurately prepared. If you have one, your agent will also receive copies of your Information Page and any Endorsements. Please communicate with your agent or Berkley Administrators if there are errors or if changes are necessary. Also included for your review are the forms and instructions you need to report all workers' compen- sation claims to Berkley Administrators. 1 Minnesota Workers' Compensation Renewal Document Please carefully review your renewal Policy or Agreement, the Information Page and any Endorse- ments to ensure that the coverages you want or need are included and that they are accurately prepared. ❑ New supply of First Report of Injury forms and/or the other information you requested. MANDATORY FRAUD NOTICE A person who submits an application or files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime. Minnesota Statute 60A.955. You must maintain an adequate supply of First Report of Injury forms. They should be kept where they are accessible to the person who is responsible for completing the form and sending it to Berkley. If you have run out of forms or can't find your supply, please complete the form below and return it to Berkley. We will gladly send you a supply of forms and provide any other information you request. Please do it today because you never know when an injury might be reported by one of your employees. r Please send the following information to the I attention of: 02-000729 at the address at left. OAK PARK HEIGHTS PO BOX 2007 OAK PARK HEIGHT MN 55082-2007 El FIRST REPORT OF INJURY forms t- I ❑ Supervisor's Report of Accident forms ❑ Minnesota Workers' Compensation booklet Clip and mail to: ❑ Employer's Injury Management Guide ❑ Hiring Practices and Disabilities booklet ❑ Employer's Loss Control booklet BERKLEY ADMINISTRATORS ❑ Deductible Information PO BOX 59143 MINNEAPOLIS, MN 55459-0143 SAVE TIME: USE A WINDOW ENVELOPE. BA 3110 CG (10/94) Lee of Minnesota Cities Insure Trust Group Self-Insured Workers' Compensation Plan Workers' Compensation and Employers' Liability Agreement Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Information Page RENEWAL 1. The "City" Agreement No. 02-000729-10 OAK: PARK HEIGHTS "City" is: XCity PO BOX 2007 Joint Powers Entity OAK PARK HEIGHT MN 55082-2007 Other (describe) 2. The Agreement period is from 12:01 a.m. 07/07/1996 to 12:01 a.m. 07/07/1997 at the "City's" address. 3. A. Workers' Compensation Coverage: Part One of the Agreement applies to the Workers' Compensation Law of any state of the United States of America and the District of Columbia. B. Employers Liability Coverage: Part Two of the Agreement applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury-Each Claimant $200,000. Bodily Injury-Each Occurrence $600,000. Bodily Injury by Disease-Agreement Limit $600,000. C. This Agreement includes these amendments and schedules: 4. Retro-rating option selected? NOT APPLICABLE 5. Elected Officials Covered? NO Boards and Commissions Covered (List) NONE 6. The premium for this Agreement will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. PREMIUM BASIS ESTI- RATES ENTRIES IN THIS ITEM,EXCEPT AS SPECIFICALLY PROVIDED ESTIMATED MATED TOTAL PER $100 OF CODE ELSEWHERE IN THIS AGREEMENT; DO NOT MODIFY ANY OF THE ANNUAL ANNUAL REMUNERATION NO. OTHER PROVISIONS OF THIS AGREEMENT. PREMIUM REMUNERATION 94770. 4.96 5506 GENERAL MAINTENANCE 4120. 462800. 3.53 7720 POLICE 16337. 127700. 0.44 8010 CLERICAL 562. 62520. 2.76 9102 PARKS 1726. 50175. 1 .25 9410 MUNICIPAL EMPLOYEES 627. Manual Premium $3372. Experience Modification 0.91 Standard Premium 18931. Manaaed Care Credit 0% 0. Deductible Credit 0% 0. AGENT F-41170988; 0.00 Premium Discount 1323. LANDMARK INS SERVICE Discounted Standard Premium 17608. 232 S LK ST -- 8X 188 LMC In=surance Trust Discount 0% 0. FOREST LAKE. MN 55025 Net Deposit Premium 17608. BA 467CG (12/92) DATE 06/13/1996 • • _ 111.1 I League of Minnesota Cities Insurance Trust 3490 Lexington Avenue North St. Paul, MN 55126-2977 (612) 490-5600 Workers ' Compensation and Employers ' Liability IMPORTANT Report all workers' compensation injuries to the office of: Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis Minnesota 55459-0143 (612) 544-0311 Administered By: Berkley Administrators If an employee is injured: P.O. Box 59143 Minneapolis, MN 55459-0143 (1) Assist in obtaining medical attention if necessary. (2) Notify the office listed above. I **IMPORTANT** PLEASE READ YOUR AGREEMENT BA 466 (8/92) In consideration of the deposi f the premium with the ant to their obli ions,all acting through Berkley Adminis- League of Minnesota Cities Insurance Trust(herein LMCIT) trators,which is the Administrator named in the Information and in reliance upon the statements in the Information Page, Page made a part hereof,agrees with you,the City,named in and subject to all terms of this agreement and the LMCIT trust the Information Page as follows: document,LMCIT, acting on behalf of its members,pursu- GENERAL SECTION A. The Agreement C. Workers' Compensation Law This agreement includes at its effective date the Informa- Workers'Compensation law means the workers'compen- tion Page and all amendments and schedules listed there. It sation law and occupational disease law of the States named is an agreement of participation between you(the employer in item 3.A of the Information Page. It includes any named in item 1 of the Information Page)and us(LMCIT). amendments to that law which are in effect during the period The only agreements relating to this plan are stated in this of this agreement. It does not include the provisions of any agreement and the LMCIT Trust document. The terms of this law that provides non-occupational disability benefits. agreement may not be changed or waived except by amend- ment issued by us to be part of this agreement. D. Locations B. Who is Covered This agreement covers all of your workplaces listed in items 1 or 5 of the Information Page; and it covers all other ■ You are covered if you are the "City"named in item 1 of workplaces in any state unless you have other insurance for the Information Page. "City" means the city or other such workplaces. governmental body, political subdivision, board or depart- ment or entity named in the Information Page. Unless E. Incidental Coverages specifically named in the Information Page, "City" shall not include a gas, electrical or steam utilities commission, port 1. Part One of this agreement applies to work performed authority, housing and redevelopment authority, or similar by you subject to the Longshoremen's and Harbor agency, board or commission, hospital or nursing home Workers' Act. board or commission,welfare or public relief agency, school board, or joint powers board. 2. Part Two of this agreement applies to work performed by you subject to the Federal Employer's Liability For purposes of Part Two-Employers'Liability Coverage Act. and for purposes of damages sought against them under Section 176.82 of the Minnesota workers'compensation law, 3. Part Two of this agreement applies to work performed the following are additional covered parties for actions by you subject to the Jones Act or U.S.Maritime Law. perfomed within the scope of their duties: A member of the city council;a member of any board or commission of the city This paragraph does not apply to bodily injury covered that is named in the Information Page;an elected or appointed under any other policy, agreement or plan issued to you. It official of the city;an employee of the city;a volunteer person does not apply even if the other policy, agreement or plan or organization while acting on behalf of the city; any other does not apply because of an other insurance clause,deduct- authorized person or agent of the city while acting on behalf ible or limitation of liability clause, or any similar clause. of the city,but excluding independent contractors;or a relief association and its officers, employees and members. PART ONE-WORKERS' COMPENSATION COVERAGE A. How This Coverage Applies The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by disease must occur during the period of this agreement. This workers' compensation coverage applies to bodily g P g injury by accident or bodily injury by disease. Bodily injury includes resulting death. B. We Will Pay 1. Bodily injury by accident must occur during the period We will pay promptly from the assets of LMCIT, when of this agreement. due, the benefits required of you by the workers'compensa- tion law. 2. Bodily injury by disease must be caused or aggravated by the conditions of your employment. BA 466 (4/92) -1- C. We Will Defend • If we make any paymn in excess of the benefits regularly provided by the workers'compensation law on your behalf, We have the right and duty to defend,at LMCIT expense, you will reimburse us promptly. any claim, proceeding or suit against you and any other covered party for benefits payable under this agreement. We G. Recovery From Others have the right to investigate and settle these claims,proceed- ings or suits.We have no duty to defend a claim,proceeding We have your rights, and the rights of persons entitled to or suit that is not covered by this agreement. the benefits of this agreement, to recover our payments from anyone liable for the injury. You will do everything D. We Will Also Pay necessary to protect those rights for us and to help us enforce them. We will also pay from the assets of LMCIT these costs,in addition to other amounts payable under this agreement as H. Statutory Provisions part of any claim, proceeding or suit we defend: These statements apply where they are required by law. 1. reasonable expenses incurred at our request, but not loss of earnings; 1. As between an injured worker and us,we have notice of the injury when you have notice. 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amounts 2. Your default or your bankruptcy or insolvency will not payable under this agreement; relieve us of our duties under this agreement after an injury occurs. 3. litigation costs taxed against you; 3. We are directly and primarily liable to any person 4. interest on a judgment as required by law until we offer entitled to the benefits payable by this agreement. the amount due under this agreement, and Those persons may enforce our duties; so may an agency authorized by law. Enforcement may be 5. expenses we incur. against us or against you and us. E. Other Insurance 4. Jurisdiction over you is jurisdiction over us for purposes of the workers' compensation law. We are We will not pay more than our share of benefits and costs bound by decisions against you under the law,subject covered by this agreement and another insurance policy or to the provisions of this agreement that are not in self-insurance plan. Subject to any limits of liability that may conflict with that law. apply, all shares will be equal until the loss is paid. If any insurance policy or self-insurance plan is exhausted, the 5. This coverage conforms to the parts of the workers' shares of all remaining insurance policies or self-insurance compensation law that apply to: plans will be equal until the loss is paid. a. benefits payable by this agreement; F. Payments You Must Make b. special taxes, payments into security or other You are responsible for any payments in excess of the special funds, and assessments payable by us benefits regularly provided by the workers' compensation under that law. law including those required because: 6. Terms of this agreement that conflict with the workers' 1. of your serious and willful misconduct; compensation law are changed by this statement to conform to that law. 2. you knowingly employ an employee in violation of law; Nothing in these paragraphs relieves you of your duties under this agreement. 3. you fail to comply with a health or safety law or regulation; or 4. you fail to comply with the reporting requirements of the workers' compensation law causing late payment of benefits to your employee and resulting in assessment of penalties. BA 466 (4/92) -2- 1 •ART TWO-EMPLOYERS'LIABILITY ItERAGE A. How This Coverage Applies C. Exclusions This employers'liability coverage applies to bodily injury This agreement does not cover: by accident or bodily injury by disease. Bodily injury includes resulting death. 1. liability assumed under a contract. This exclusion does not apply to a warranty that your work will be 1. The bodily injury must arise out of and in the course done in a workmanlike manner; of the injured employee's employment by you. 2. punitive or exemplary damages because of bodily 2. The employment must be necessary or incidental to injury to an employee employed in violation of law; your work. 3. bodily injury to an employee while employed in 3. Bodily injury by accident must occur during the period violation of law with your actual knowledge or the of this agreement. actual knowledge of any of your executive officers; 4. Bodily injury by disease must be caused or aggravated 4. any obligation imposed by a workers'compensation, by the conditions of your employment. The employee's occupational disease, unemployment compensation, last day of last exposure to the conditions causing or or disability benefits law, or any similar law; aggravating such bodily injury by disease must occur during the period of this agreement. 5. bodily injury intentionally caused or aggravated by you; 5. If you are sued, the original suit and any related legal actions for damages for bodily injury by accident or by 6. bodily injury occurring outside the United States of disease must be brought in the United States of America, its territories or possessions, and Canada. America, its territories or possessions, or Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America or B. We Will Pay Canada who is temporarily outside these countries; We will pay from the assets of LMCIT all sums you legally 7. damages arising out of the discharge of, coercion of, must pay as damages because of bodily injury to your or discrimination against any employee in violation of employees, provided the bodily injury is covered by this law. Employers' Liability coverage. D. We Will Defend The damages we will pay, where recovery is permitted by law, include damages: We have the right and duty to defend,at LMCIT expense, any claim, proceeding or suit against you for damages 1. for which you are liable to a third party by reason of payable under this agreement. We have the right to investi- a claim or suit against you by that third party to recover gate and settle these claims,proceedings and suits. We have the damages claimed against such third party as a result no duty to defend a claim, proceeding or suit that is not of injury to your employee; covered by this agreement. We have no duty to defend or continue defending after we have paid our applicable limit of 2. for care and loss of services;and liability under this agreement. 3. for consequential bodily injury to a spouse, child, E. We Will Also Pay parent, brother or sister of the injured employee; We will also pay these costs, in addition to other amounts provided that these damages are the direct payable under this agreement as part of any claim, proceed- consequence of bodily injury that arises out of and in ing, or suit we defend: the course of the injured employee's employment by you; and 1. reasonable expenses incurred at our request; but not loss of earnings; 4. because of bodily injury to your employee that arises out of and in the course of employment; claimed 2. premiums for bonds to release attachments and for against you in a capacity other than as employer. appeal bonds in bond amounts up to the limit of our liability under this agreement; BA 466 (4/92) -3- 3. litigation costs taxed against youu, pay for all damag overed by this agreement because of bodily injury by accident or disease to one or more 4. interest on a judgment as required by law until we offer employees in any one accident, regardless of the the amount due under this agreement; number of claimants. 5. expenses we incur. 3. Bodily Injury by Disease - Agreement Limit. The limit shown for"bodily injury by disease-agreement F. Other Insurance limit"is the most we will pay for all damages covered by this agreement and arising out of bodily injury by If any claim against you is also covered by another disease, regardless of the number of employees who insurance policy or self-insurance plan,we will pay only for sustain bodily injury by disease,and regardless of the our proportionate share of the loss. Our proportionate share number of claimants. will be determined by applying the ratio that the limit of liability provided by this agreement bears to the total of all Bodily injury by disease does not include disease that limits of liability provided by all policies or plans in effect to results directly from a bodily injury by accident. the total amount payable for the loss. The limits of liability and amount payable under this agreement and any other 4. We will not pay any claims for damages after we have policy or plan shall be calculated as if each plan or policy were paid the applicable limit of our liability under this the only one applicable. The limits of liability and amount agreement. payable under any other policy or self-insurance plan in effect shall be included in the calculation, regardless of whether it H. Recovery From Others is described as primary,excess,contributory,contingent,or otherwise,unless that policy or plan is specifically described We have your rights to recover our payment from anyone as providing coverage in excess of the limits of this agree- liable for any injury covered by this agreement. You will do ment. everything necessary to protect those rights for us and to help us enforce them. G. Limits of Liability I. Actions Against Us Our liability to pay for damages is limited. Our limits of liability are shown in item 3.B. of the Information Page. There will be no right of action against us under this They apply as explained below: agreement unless: 1. Bodily Injury-Each Claimant. The limit shown for 1. You have complied with all the terms of this "bodily injury-each claimant"is the most we will pay agreement; and to any one claimant for all damages covered by this agreement because of bodily injury by accident or 2. The amount you owe has been determined with our disease to one or more employees in any one accident. consent or by actual trial and final judgment. 2. Bodily Injury-Each Occurrence. The limit shown for This agreement does not give anyone the right to add us as "bodily injury-each occurrence"is the most we will a defendant in an action against you to determine your liability. PART THREE-YOUR DUTIES IF INJURY OCCURS Tell us at once if injury occurs that may be covered by this 4. Cooperate with us and assist us,as we may request,in agreement. Your other duties are listed here: the investigation, settlement or defense of any claim, proceeding or suit. 1. Provide for immediate medical and other services required by the workers' compensation law. 5. Do nothing after an injury occurs that would interfere with our right to recover from others. 2. Give us or our agent the names and addresses of the injured persons and of witnesses, and other 6. Do not voluntarily make payments, assume information we may need. obligations or incur expenses,except at your own cost. 3. Promptly give us all notices, demands, and legal papers related to the injury,claim,proceeding or suit. BA 466 (4/92) -4- • PART FOUR-PREMIUM A. Our Manuals E. Final Premium All premiums for this agreement will be determined by our The premium shown on the Information Page, schedules, manuals of rules,rates,rating plans and classifications. We and amendments is an estimate. The final premium will be may change our manuals and apply the changes to this determined after this agreement ends by using the actual,not agreement. the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered B. Classifications by this agreement. If the final premium is more than the premium you paid to us,you must pay us the balance. If it Item 5 of the Information Page shows the rate and premium is less,we will refund the balance to you. The final premium basis for certain business or work classifications. These will not be less than the highest minimum premium for the classifications were assigned based on an estimate of the classifications covered by this agreement. If this agreement exposures you would have during the period of this agree- is cancelled,final premium will be determined in the follow- ment. If your actual exposures are not properly described by ing way unless our manuals provide otherwise. those classifications, we will assign proper classifications, rates and premium basis by amendment to this agreement. 1. If we cancel,final premium will be calculated pro rata based on the time this agreement was in force. Final C. Remuneration premium will not be less than the pro rata share of the minimum premium. Premium for each work classification is determined by multiplying a rate times a premium basis. Remuneration is 2. If you cancel, final premium will be more than pro the most common premium basis. This premium basis rata. It will be based on the time this agreement was includes payroll and all other remuneration paid or payable in force, and increased by our short rate cancellation during the period of this agreement for the services of: table and procedure. Final premium will not be less than the minimum premium. 1. all your officers and employees engaged in work covered by this agreement; and F. Records 2. all other persons engaged in work that could make us You will keep records of information needed to compute liable under Part One (Workers' Compensation premium. You will provide us with copies of those records Coverage) of this agreement. If you do not have when we ask for them. payroll records for these persons,the contract price for their services and materials may be used as the G. Audit premium basis. This paragraph 2 will not apply if you give us proof that the employers of these persons You will let us examine and audit all your records that relate lawfully secured their workers' compensation to this agreement. These records include ledgers,journals, obligations. registers, vouchers, contracts, tax reports, payroll and dis- bursement records, and programs for storing and retrieving D. Premium Payments data. We may conduct the audits during regular business hours during the period of this agreement and within three You will pay all premium when due. You will pay the years after this agreement ends. Information developed by premium even if part or all of a workers' compensation law audit will be used to determine final premium. is not valid. PART FIVE-CONDITIONS A. Duty to Indemnify 4. For which the "city is not authorized to indemnify any person by statute; or Our duty to pay on behalf of or to indemnify a"covered party" other than the "city" shall not apply to any act, 5. Which constitutes dishonesty on the part of a error or omission: "covered party"; or 1. Which constitutes malfeasance in office; or 6. Which constitutes the willful violation of a statute or ordinance by any official,employee or agent of the 2. Which constitutes willful neglect or duty; or "city". 3. Which constitutes bad faith; or BA 466 (4/92) -5- 1 The terms"malfeasance", "willful neglect f •duty",and"bad Mailing the notice you at your mailing address faith" shall be given the same meaning in this agreement as shown in item 1 of the Information Page will be given in the applicable statute with respect to the"city's"duty sufficient to prove notice. to defend or indemnify its officials, employees or agents. 3. The period of this agreement will end on the day and B. Inspection hour stated in the cancellation notice. We have the right, but are not obliged to inspect your 4. Any of these provisions that conflicts with a law that workplaces at any time. Our inspections are not safety controls the cancellation of the coverage in this inspections. They relate only to coverage and the premiums agreement is changed by this statement to comply with to be charged. We may also recommend changes. While they that law. may help reduce losses,we do not undertake to perform the duty of any person to provide for the health or safety of your F. Assessability employees or the public. We do not warrant that your workplaces are safe or healthful or that they comply with All"cities"who participate in this program are jointly and laws, regulations, codes or standards. severally liable for all claims and expenses of the program. The amount of any liabilities in excess of assets may be C. Long Term Agreement assessed to the participants when a deficiency is identified. If the period of this agreement is longer than one year and G. Sole Representative sixteen days, all provisions of this agreement will apply as though a new agreement were issued on each annual anniver- The City first named in item 1 of the Information Page will sary that this agreement is in force. act on behalf of all covered entities to change this agreement, receive return premium,and give or receive notice of cancel- D. Transfer of Your Rights and Duties lation. Your rights or duties under this agreement may not be IN WITNESS WHEREOF, the City agrees to look solely transferred without our written consent. to the League of Minnesota Cities Insurance Trust for reimbursement of all losses,costs and expenses arising under E. Cancellation this agreement;and further agrees that in no event shall claim be made or asserted against the revenues or property,real or 1. You may cancel this agreement. You must mail or personal,of the League of Minnesota Cities. Acceptance of deliver advance written notice to us stating when the this agreement by the City constitutes acceptance of all terms cancellation is to take effect. hereof. 2. We may cancel this agreement. We must mail or League o - eta ities Insurance Trust deliver to you not less than ten days in advance written /1fri notice stating when the cancellation is to take effect. By: Its ut' •ri -d •epresentative 1 BA 466 (4/92) -6- t • Berkley Administrators PO Box 59143, Mpls., MN 55459-0143 • 8441 Wayzata Blvd., Mpls., MN 55426 Phone (612) 544-0311 • Fax (612) 591-7404 This folder contains important documents and instructions for filing claims for your employees. Please read everything carefully now so you will know what to do when an injury occurs. If you have any questions, please contact your agent or Berkley Administrators. CRITICAL INFORMATION Any serious (life threatening) injury or injury causing death must be reported to us by phone immedi- ately. Dial (612) 544-0311. In all other situations state law requires you, the employer, to report all injuries and illnesses which your employees claim are related to work. You must report their claim using a FIRST REPORT OF INJURY form. Berkley Administrators must receive the original report within 10 days of the date you have knowledge of the claimed injury. The law also requires prompt payment of any benefits which may be due. Payment for lost wages must be made within 14 days of the first day of lost time from work. The Department of Labor and Industry can and does impose fines and penalties against employers if they do not comply with these standards. To avoid substantial penalty expenses for late reporting of an injury or for late payment for benefits, you must report injuries and lost time from work to us as soon as possible. To help you do that, you will find detailed instructions for completing the First Report of Injury form on Page 3 of this folder. If you need additional copies of any of the enclosed forms, please complete and mail the order form sent with this folder. PREVENT WORK INJURIES For your benefit and assistance, we offer safety services which can be tailored to your needs to help prevent work-related injuries. Our Loss Control Representatives are available for consultation regard- ing safety in the workplace and for safety surveys of your facilities. They can also assist you in compliance with OSHA regulations and the development of your own program of accident prevention and loss control. These services are provided at no additional charge to you. Call (612) 591-7498 to schedule a visit or for more information on safety and loss control topics. MANDATORY FRAUD NOTICE A person who submits an application or files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime. Minnesota Statute 60A.955. BA 2530(10/94) Mi esota Workers' Compensation IfRUCTIONS FOR EMPLOYERS 141) WHAT TO REPORT State law requires that you report any and all injuries and illnesses that your employees believe are work-related. Berkley Administrators will then determine if any workers'compensation benefits are payable to the injured employee. Remember, filing a First Report of Injury with us does not mean that you are admitting any liability. It means only that you are reporting a claimed injury or condition which your employee thinks is related to work activities. WHO REPORTS AN INJURY The injured employee is required to report an injury to you, the employer, within 180 days of its occurrence. You, the employer, are then required to report that claimed injury to us on a First Report of Injury form. It is neither the injured employee's responsibility to report the injury to us nor is it your insurance agent's duty. Do not ask the injured employee or your agent to complete the form. If they cause any delay in reporting the injury to us, you, the employer, can be penalized by the Minnesota Department of Labor and Industry. WHEN TO REPORT AN INJURY If an employee is killed or suffers a life-threatening injury (amputation of limb, massive internal injuries, etc.) you must report by phone to Berkley Administrators within 48 hours of the occurrence. You must also send a completed First Report of Injury form to us within 7 days of the injury. You must report any other work-related injury or illness within 10 days of your first knowledge of its occurrence. If the employee's supervisor or manager knows about the injury, then you, the employer, have knowledge of it even if your home office or headquarters staff is unaware of the injury. The injury must be reported on a First Report of Injury form and we must receive it within 10 days. Because of possible delays by the Postal Service, we recommend that you complete and mail the original First Report on the same day you are notified of the injury. Do not wait for the employee to return to work or for medical bills or other information. Any delay in this process can result in a penalty assessment against you by the Minnesota Department of Labor and Industry. You can be fined up to$200 for late reporting. If that late report results in late payment of benefits to your employee, you can be penalized up to$3,838 plus 10 percent of the delayed payment. it is very important that you report all claimed injuries as soon as possible. ' HOW TO REPORT AN INJURY State law requires that you use a Minnesota First Report of Injury form. Always keep a supply of forms on hand. When your supply runs low, use the order form sent with this folder to request more forms. When an accident occurs, have the employee's supervisor complete the Supervisor's Report of Accident (SRA). This form will assist in your internal investigation of the accident and what caused it. Then you, the employer, should com- plete the First Report of Injury form using information from the SRA, personnel records, and elsewhere. If there are any unusual circumstances or you need to provide more information, you should attach a letter to the report. Send the original First Report and SRA to Berkley Administrators. Keep a copy of each for your records. Also give a copy of the First Report of Injury to the injured employee; this is required by law. Detailed, line-by-line instructions for the First Report begin on Page 3. REMINDERS AND ADVICE • If an employee begins to lose time from work after you've mailed the First Report, call us immediately to let us know. Then we can pay any benefits due on time and you can avoid any penalties for late payment. • Call us as soon as an employee returns to work after a work-related injury. We can then discontinue time-loss benefits and avoid the possibility of overpaying your employee. • Promptly send us all injury-related medical bills you or your employee receive. Medical providers often bill only one party, so if you receive a bill, it probably means that we have not. Before we pay a bill, we review it to ensure that it's related to the work injury and we request medical records for it. The law allows us 30 days from the date we receive those records to pay a bill so it may sometimes be several months from the date of treatment before we're able to pay. • Do not pay medical bills for your employees' work-related injuries. First, it may be illegal for you to do so. Second,by paying a bill, you may be legally accepting liability for an injury which is not really work-related. Third, because of the Medical Fee Schedule, we can often pay less than what the medical provider charges which saves you money. • Do not deliberately obstruct oempt to prevent an employee from seeki orkers'compensation benefits. If you do, you could be liable for any workers'compensation benefits plus triple damages to that employee. By law you must post the name and address of your workers'compensation carrier (Berkley Administrators) in a conspicuous place. You may use our"Employees' Rights" poster for that purpose. If an employee claims a work-related injury, report it to us along with all relevant information. Let us investigate and determine if any workers'compensation benefits are due; we are experts in Minnesota workers'compensation. • Don't ignore your injured employees. Communicate with them regularly and let them know you are concerned about them. It is especially important, if they are losing time from work, that you keep them mentally"connected" to their job. If at all possible, provide light duty or part-time work to help return them to health and productivity as soon as possible. This is not only good for your employees, it also helps to reduce your claim costs. • Be accessible and provide us with the information we need when we request it. This will allow us to be more effective in managing your claims and controlling your workers' compensation costs. FIRST REPORT OF INJURY INSTRUCTIONS Box 1 Enter the case number from your company's OSHA 200 log. Box 2 Enter the injured employee's name. Box 3 Enter the injured employee's social security number. This must be completed because the State of Minnesota uses it as its file number. Box 4 Enter the employee's current mailing address including the county. Box 5 Enter the date that the injury occurred. If not known, enter the approximate date or"unknown". Box 6 Indicate the employee's gender. Box 7 Indicate the employee's marital status. Box 8 Enter the employee's job title or a description of the work done for your organization (Example: Class A Machinist, Carpenter's Helper). Box 9 Enter the employee's birth date. Box 10 Enter the date that the employee began working for your organization. Box 11 Provide the name of the department or unit where the employee usually works (e.g. welding dept., loading dock, accounts receivable unit). If your organization has no formal departments, leave this box blank. Box 12 Enter the employee's home phone number including area code. Box 13 If the employee is in a union apprenticeship program or some other formal apprentice program indicate that in this box. Box 14 Enter the employee's average gross weekly wage before any deductions for taxes, etc. If the employee is salaried, write "salary" and the gross amount and the period it is paid for(e.g. $500/week salary, $2,000/month salary). If you are continuing to pay full wages or sick/vacation leave beyond the first day of lost time, indicate this by writing in "full wage continuation". Box 15 Enter the hourly wage rate for employees paid by the hour. Box 16 Enter the usual number of hours the employee works each day. Box 17 Enter the usual number of days the employee works each week and indicate which days are usually worked e.g. M - F, Tu-Su, or M,W,F. Box 18 If the employee receives meals or lodging from you as part of their pay, enter their value here. If the employee also works somewhere else full or part-time, enter their average weekly earnings at that job and provide us with the name of the other employer. Box 19 Put an X by the description which best indicates the employee's work status. If the employee is a police officer or firefighter, indicate their smoking habits. Box 20 Indicate the location where the injury occurred and whether or not it occurred on your premises. Box 21 If your employee has lost any time at all (even just 10 minutes)from work, you must report it. Enter the date when lost time first occurred. If there has been no lost time, write "NONE" in the box. Box 22 Enter the date on which you first had knowledge of your employee's injury. Box 23 If the employee has already ret d to work, enter the date returned. If theiloyee has not returned to work, leave this box empty. Box 24 Sometimes employee's are injured but don't lose time from work until days or weeks later or they lose time but don't notify you that it is related to their work injury. In any case, provide the date you were notified that the employee was losing time from work due to a work injury. Box 25 If your employee has died as a result of their work-related injury or illness, enter the date of death in this box. A work- related death or life-threatening injury must be reported to us by phone immediately. Box 26 Indicate the approximate time that the injury occurred. Box 27 Enter the type of injury he/she has. Indicate all body parts which were injured. Be specific. Write "left low back and left index finger" rather than "back and hand". If the injury is not obvious, write something like "possible fracture" or 1 "apparent allergic reaction". Box 28 Briefly but accurately describe the circumstances that caused the injury. Don't just write "fell onto sidewalk" if in fact the employee was "on roof repairing chimney, safety harness broke,fell 20' onto concrete sidewalk". Also, circum- stances surrounding the injury are complex, unusual,or suspicious, attach a detailed explanatory letter to the First Report of Injury form and SRA that you send to us. Box 29 Provide the name, address, and phone number of the doctor who treated the employee for the injury. If the employee received no medical treatment, write "first aid only" in this box. Box 30 Provide the name, address and phone number of the clinic or hospital where the employee was treated for the injury. Box 31 Provide the names of coworkers who may have witnessed the accident or who worked with the employee on the date of the injury. We may need to contact these people to obtain more information about the circumstances that lead to the injury. Box 32 Enter the name and address of your organization. If you do business using a different name than you are insured under, please indicate that. For example: John Doe dba J.D. Enterprises or J.D. Widgets Division of John Doe Enterprises. Box 33 Enter the date that you, the employer, completed the form. Box 34 Enter your Unemployment Insurance ID number. This number is assigned to you by the Department of Jobs and Training. Call them at (612) 296-6141 if you do not know your ID number. Box 35 Enter the proper SIC code for your organization. This number is also assigned by the Department of Jobs and Train- ing. Call them at (612) 296-6141 if you do not know your SIC code. If you know the payroll classification code for the injured employee, enter it in the box to the right of Box 35. Box 36 Enter the name and work phone number of the injured employee's supervisor. Box 37 Enter the name, title, and work phone number of the person in your organization whom we should contact to obtain more information about this claim. Boxes 38-44 Do not fill in these boxes. Berkley Administrators will complete this part of the form. amBerkley Administrators PO Box 59143, Mpls., MN 55459-0143 • 8441 Wayzata Blvd., Mpls., MN 55426 Phone (612) 544-0311 • Fax (612) 591-7404 Minnesota Department of Labor and Industry First Report of Injury Workers'Compensation Division 443 Lafayette Road North •A Chef St.Paul,MN 661664306 Instructions in folder accompanying forms. (8121 298-2432 Type or Print.t be entered in MMJDD/YY format. 111111111111111111111111111111 EMPLOYEE 2.Name(last,first.middle) 3.EMPLOYEE SOCIAL SECURITY NO: 4.Home address(include county and zip) 5.DATE OF CLAIMED INJURY: Do Not Use this Space 6.Sex: Male Female 7.Marital Status: 'Warded Not 8.Occupation: 9.Date of Birth: / 10.Date Hired: / / 11.Regular Dept 12.Home Phone No.IA/C,No.) 13.Apprentice: No Yes WAGE INFORMATION 15.Rate per hour. 16.Hours per day: 14.Average wage/week 17. Days per week: 18.What is the weekly value of MEALS: $ LODGING: ! 2nd INCOME: $ 19.Employment Status: _Full time _Part time _Seasonal _Volunteer(Attach 26 week wage statement for part time or irregularly scheduled employee.) - - Ge P �9 �Y { If employee is a police officer or firefighter: Smoker: Yes No OCCURRENCE 20.PLACE(include dept&full address) 21.Date of first 22.Date employer day of lost time: / / notified of Injury: / 24.Date employer notified 23.Return to work date: I /! Y of lost time: / / 26.Time of day Q AM r� 25.Date of death: / of injury ,On employer's premises? 1 1 Yes 1 I No - 0 PM 27.DESCRIBE NATURE OF INJURY OR ILLNESS IN DETAIL,BE SPECIFIC(include partial of body affected,e.p.amputation of right index timer at 2nd joint,fractured arm.lead poisemnp) 28.DESCRIBE EMPLOYEE'S ACTIVITIES WHEN INJURY OCCURRED WITH DETAILS OF HOW EVENT OCCURRED (include name of other individuals involved,tools,machinery,objects.vapors, chemicals.radiations,unnatural motion of employee) 29. PHYSICIAN (full name,title,address and phone number) 30.HOSPITAL/CLINIC(name and address) 31.Witness and phone number. 32.Legal name&mailing address incl.zip 34.U m l0 ID No.: EMPLOYER a na p 3 ne p y o N . S 33.Date form completed: / / OAK PARK HEIGHTS p PO BOX 2007 OAK: PARK HEIGHT MN 55082-2007 35.SIC code Payroll Class Code 36.Print supervisor's name and phone number: 37.Employer's Representative,print full name,title and phone number. SEND REPORT IMMEDIATELY - DO NOT WAIT FOR DOCTOR'S REPORT CONTAINS ALL ITEMS REQUIRED BY OSHA FORM 101 EMPLOYER STOP HERE-DO NOT USE THIS SPACE N P S T 0CC INSURANCE 38.CARRIER 39.Insurer ID No: 40.ADJUSTER N/A Berkley Administrators SELF-f N S U R E D 41•Insurance Class Code: P•�. Box 59143 Mpls., MN 55459-0143 (612) 544-0311 43.Data insurer received notice: 42.CARRIER CLAIM NUMBER 02-000729 44.Adjuster ID No: 0698639002 LI-20320-05 11-92) Original to Berkley Administrators BA 251 S/I (4/92) Copies to Employer, Employee and Workers' Compensation Division •A. LAkue of Minnesota Cities Insu ce Trust E C E `- '_` • Group Self-Insured Workers' Compensation Plan i J Administrator JUN f 7 1996 Berkley Administrators ' , a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 54,-0311 NOTICE OF PREMIUM OPTIONS • The 'City" Agreement No.: 02-000729-10 OAK PARK HEIGHTS Agreement Period: From: 07/07/1906 PO BOX 2007 07,07/1997 OAK PARK HEIGHT MN 55082-2007 To: Enclosed is a quotation for workers' compensation deposit premium. Deductible options are now available in return for a premium credit applied to your estimated standard premium of$ 18931 . . The deductible will apply per occurrence to paid medical costs only. There is no aggregate limit. Please indicate below the premium option you wish to select. You may choose only one and you cannot change options during the agreement period. OPTIONS NET DEPOSIT PREMIUM 1 Regular Premium Option 17608. Deductible Premium Credit E'er Occurrence Credit Amount 2 ❑ $250 2% 379. 17229. 3 ❑ 500 4% 757. 16851. 4 ❑ 1,000 5% 947. 16661. 5 ❑ 2,500 9% 1704. 15904. 6 ❑ 5,000 12% 2272. 15336. 7 ❑ 10,000 17% 3215. 14390. This should be signed by an authorized representative of the city requesting coverage. One of the above options must be selected. Please return a signed copy of this notice to the Administrator with payment and make checks payable to the LMCIT. ::‹ 2.)///1/6/1T/M:157--1- )C/' igna re Title Date For more information on the premium options that apply to your city, refer to the enclosed brochure. BA 4501CG (4/93) Lee of Minnesota Cities InsurAlp Trust 11 .� roup Self-Insured Workers' Compensate Ian Administrator 111. Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 44-0311 CITY OF OAK PARK HEIGHTS Self-Insured Workers' Compensation Quotation 'RENEWAL of Agreement No. 02-000729-9) OAK PARE: HEIGHTS 07/07/1996 07/07/1997 ESTIMATED DEPOSIT CODE RATE PAYROLL PREMIUM GENERAL MAINTENANCE 5506 4.36 84770. 4120. POLICE 7780 3.53 462800. 16337. CLERICAL 8810 0.44 127700. 562. PARKS 9102 2.76 62520. 1726. MUNICIPAL EMPLOYEES 9410 1.25 50175. 627. Manual Premium 23372. Experience Modification 0.81 Standard Premium 18931. Managed Care Credit 0% 0. Deductible Credit 0% 0. Premium Discount 1323. Discounted Standard Premium 17608. LMC Insurance Trust Discount 0% 0. CITY OF OAK PARK HEIGff ^ Net Deposit Premium 17608. CLAIMS ENDORSEMENT ALLOWED IN THE SUM OF $ ...__DISALLOWED IN THE SUM OF $ ' DATE SIGMA -� % �/�.� ' The foregoing quotation is for a deposit premium based on your estimate of payroll. Your final actual premium will be computed after an audit of payroll subsequent to the close of your agreement year and will be subject to revisions in rates, payrolls and experience modification. While you are a member of the LMCIT Workers' Compensation Plan, you will be eligible to participate in distributions from the Trust based upon claims experience and earnings of the Trust. If you desire the coverage offered above, please complete the enclosed "Application for Coverage" and return it and your check for the deposit premium (made payable to the LMC Insurance Trust) to the Plan Administrator, Berkley Administrators. .- BA 441CG (12/92) LSue of Minnesota Cities lnsuillice Trust Group Self-Insured Workers' Compensation Plan J Administrator ,UN 1 , Berkley Administrators ; ; a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 54 -0311 NOTICE OF PREMIUM OPTIONS The "City" 02-000729-10 OAK PARK HEIGHTS Agreement No.: Agreement Period: From: 07/07/1996 PO BOX 2007 To: c s /C>7I i g7 OAK: PARIS:: HEIGHT MN 55082-2007 Enclosed is a quotation for workers' compensation deposit premium. Deductible options are now available in return for a premium credit applied to your estimated standard premium of$ 18931' . The deductible will apply per occurrence to paid medical costs only. There is no aggregate limit. Please indicate below the premium option you wish to select. You may choose only one and you cannot change options during the agreement period. OPTIONS NET DEPOSIT PREMIUM 1 ;Ri, Regular Premium Option 17608. Deductible Premium Credit per Occurrence Credit Amount 2 ❑ $250 2% 379. 17229. 3 ❑ 500 4% 757. 16851 . 4 ❑ 1,000 5% 947. 16661. 5 ❑ 2,500 9% 1704. 15904. 6 0 5,000 12% 2272. 15336. 7 ❑ 10,000 ,17% 3218. 14390. This should be signed by an authorized representative of the city requesting coverage. One of the above options must be selected. Please return a signed copy of this notice to the Administrator with payment and make checks payable to the LMCIT. 6')/y/#,M))4/2571-i,)6-- i g na are '� Title 7 Date For more information on the premium options that apply to your city, refer to the enclosed brochure. BA 4501CG (4/93) *ue of Minnesota Cities Insualce Trust Group Self-Insured Workers' Compens n Plan Workers' Compensation and Employers' Liability Agreement Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Important Information Inclusion of Sick, Holiday and Vacation Pay Sick pay, holiday pay and vacation pay is included in the remuneration base on all Workers' Compensation agreements issued with effective dates of 1/1/96 or later. 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O (� g E•O ►nt 2 y 5 f.o ., 0 t- Vi r7`' t° rii ° , y ", co Al "P-X'd = 7't CA CA o' 0.57� z _ z y r tD to X Cl)rIl M gr a.'to N .-'cA 1D p, t° CD A,'C P tD 5:t0i, F i 9, 5 CD fW∎ O 2 R ."y .9,sl M i? 2 . tD r co 0 (i) ta ea 94 - w 040 CV Q a ff. n HQO c v a ra ••=1."� o GC o A �; , 1111i1111 • 0 2 6.. al w lib'g • d •C o 0 ` ° x�r� i n `4 g • W w aC h. 4) 9 4) ,= o 83 00 : g es In 4 a 4) 0 CY • ' `°V ,, g 241712 a as s c 0 ct ' li d g t t 1 O d ° ° o w g ao g d 'S�,Xp4 • • • s M 0' ii N r4 At CO I I • • LMC 145 University Avenue West, St. Paul, MN 55103-2044 League of Minnesota Cities Phone: (612) 281-1200 • (800) 925-1122 Cities promoting excellence Fax: (612) 281-1299 • TDD (612) 281-1290 May 30 1996 !i JUN - 3 1996 Mr. Mike Robertson City of Oak Park Heights P.O. Box 2007 Oak Park Heights, MN 55082-2007 Re: BRS File No.: 11013474 Trust Member: City of Oak Park Heights Plaintiff: Junker Landfill Trust, A Minnesota Business Trust Dear Mr. Robertson: T his letter will formally acknowledge receipt of the 1 su it in which the City of Oak Park Heights is named as one of the defendants in the amended lawsuit filed in United States District Court, Western District of Wisconsin, entitled: "Junker Landfill Trust, A Minnesota Business Trust, Plaintiff, vs. City of Oak Park Heights." Please be advised that the League of Minnesota Cities Insurance Trust (LMCIT) for the reasons stated below, concludes that no coverage is afforded to Oak Park Heights for this matter under any of the policies/covenants issued by LMCIT. COVERAGE OF OAK PARK HEIGHTS LMCIT issued the following policy covenants to Oak Park Heights: COVENANT TERM DATES MP 824012 R 07/07/86-87 MCM 85418 07/07/87-88 CMC 0942609 07/07/88-89 CMC 1023590 07/07/89-90 CMC 1105591 07/07/90-91 CMC 1193 892 07/07/91-92 CMC 1280293 07/07/92-93 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • Mr. Mike Robertson BRS File No.: 11013474 May 30, 1996 CMC 1374694 07/07/93-94 CMC 1471595 07/07/94-95 CMC 1565096 07/07/95-96 U 000273 07/07/86-87 UEL 6278 07/07/87-88 MEL 0082209 07/07/88-89 MEL 0101190 07/07/89-90 MEL 0120991 07/07/90-91 MEL 0142792 07/07/91-92 MEL 0164393 07/07/92-93 MEL 0187094 07/07/93-94 MEL 0211695 07/07/94-95 EML 0235196 07/07/95-96 BACKGROUND FACTS Oak Park Heights received an amended Summons and Complaint naming Oak Park Heights as a responsible party that had generated hazardous substances and/or arranged for disposal of hazardous substances at the landfill. COVERAGE ISSUES We set forth the following provisions as the basis for our determination of non-coverage. This discussion is without prejudice to LMCIT's right to raise other defenses to coverage and the listing of potentially applicable covenant provisions is nonexclusive. I. THE ABSOLUTE POLLUTION EXCLUSION PRECLUDES COVERAGE The absolute pollution exclusion contained in the policies/covenants issued to Oak Park Heights precludes coverage for the Junker Landfill matter. In its current form, that provision excludes the following from liability coverage. d. Any loss, cost, or expense arising out of any direction, demand, or request by the government or any other entity that the"city" or any other entity test for, monitor, clean up, remove, contain, treat, detoxify or neutralize pollutants; or Damages arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants: 2 • • Mr. Mike Robertson BRS File No.: 11013474 May 30, 1996 (1) At or from premises the"city" owns, rents, leases, uses or occupies, and premises the"city" no longer owns, rents, leases, uses or occupies. (2) At or from any landfill, dump, or other site or location presently or formerly used by or for the"city" or others for the handling, storage, disposal, processing of treatment of pollutants; (3) Which are or were at any time transported, handled, stored, treated, disposed of, or proceeded as waste by or for the"city" or any person or organization for whom the"city" may be legally responsible; or The exclusion does not apply to any of the following: (2) Any Limited Pollution Liability Claim. The covenant defines Limited Pollution Liability Claim as follows: 10. Limited Pollution Liability Claim means any claim for damages which resulted from a sudden occurrence which took place on or after the retroactive date shown in the Declarations and prior to the expiration date of this covenant, and which: a. Was caused by an actual, alleged, or threatened discharge, dispersal, release, or escape of pollutants which took place entirely above ground and not within or on the surface of any lake, stream, surface water or other body of water, and in which any resulting damages occurred entirely above ground and not within or on the surface of any lake, stream, surface water, or other body of water; or b. Arises from the accidental rupture, backup or overflow of the"city's" sanitary sewer, storm sewer, or water supply systems. The covenant defines"pollutants," "damages," "occurrence," and "sudden occurrence" all of which definitions are called to your attention and are incorporated herein fully. The pollution exclusion provides that no coverage will be afforded for contamination caused by depositing wastes in a landfill. The limited exception to the exclusion for"limited pollution liability claims" does not apply because of its terms and because Oak Park Heights's retroactive date for Limited Pollution Liability Claims is 01/01/89, which is after any"occurrence" may have taken place. 3 • • Mr. Mike Robertson BRS File No.: 11013474 May 30, 1996 SECTION I- COVERAGES COVERAGE A. MUNICIPAL LIABILITY COVERAGE (CLAIMS MADE BASIS) 1. COVERAGE AGREEMENT a. Except as otherwise provided in this agreement, LMCIT will pay on behalf of the"covered party" all sums which the"covered party" shall become legally obligated to pay as damages as a result of an occurrence, if the following conditions are met: (1) The claim for such damages must be first made against the"covered party" during the coverage period; and (2) The date of the occurrence giving rise to the claim for damages must be on or after the retroactive date, if any, shown in the Declarations;... B. Coverage is Precluded Because Damages are Not Sought. The LMCIT covenants require not only that a claim be made, but that the claim be for"damages." The covenant contains the following definition of"damages": 5. Damages means money damages... Damages does not include any of the following: d. Injunctive or equitable relief, or quasi judicial or administrative orders. Junker Landfill Trust claims that Oak Park Heights should participate in remediation at the Junker Landfill is specifically excluded under the definition of"damages". As no covered "damages" are sought, the LMCIT covenant does not provide coverage. C. Coverage is Precluded Because of the Absence of an"Occurrence" After the Retroactive Date. As indicated above, the claims-made covenants require that the"occurrence" take place after the Retroactive Date for Oak Park Heights, which is 07/07/87. The covenant defines "occurrence" as follows: 4 • Mr. Mike Robertson BRS File No.: 11013474 May 30, 1996 13. Occurrence means: a. With respect to Coverage A [Municipal Liability], a wrongful act or a series of related wrongful acts. "Wrongful act" is in turn defined as follows: 10. Wrongful act means any actual or alleged error, statement, act, omission, offense, neglect, accident, or violation. The covenant states the following as to the date of"occurrence": 2. CLAIM AND OCCURRENCE DATES A. For any claim for damages, the date of the occurrence shall be deemed to be as follows: (1) For claims for bodily injury or property damage, the date of the occurrence is the date on which the bodily injury or property damage first took place or is alleged to have taken place. It is alleged that Oak Park Heights may have deposited wastes at the landfill in the 1970's to the present. Contamination was detected as early as 1984. LMCIT's covenants do not apply to any occurrence taking place before the Retroactive Date of 07/07/87. CONCLUSION The foregoing is not intended to be an exhaustive list of all the terms, exclusions and conditions of the LMCIT covenants issued to Oak Park Heights that may limit or preclude coverage. Other provisions of the LMCIT covenants may apply to limit or preclude coverage. LMCIT reserves the rights to raise such further provisions if applicable. If you have information that you believe LMCIT should consider in reviewing its coverage determination, or if you become aware of such information in the future, please bring it to our attention immediately. Likewise, if you obtain information that is inconsistent in this letter, please advise us immediately. 5 • Mr. Mike Robertson BRS File No.: 11013474 May 30, 1996 If ou should have any questions, please feel free to contact me. Y Y9 Respectfully, 44jItiat , CtIlenrk uhe Lassonde Claims Adjuster JL:dlm\I3474.L c: Mark Vierling, City Attorney c: Forest Lake Insurance Agency 2323 South Lake Forest Lake, MN 55025 c: Bob Weisbrod Berkley Risk Services 6 */** 110 League of Minnesota Cities Insurance Trust MAY - 3 Group Self-Insured Workers' Compensation Plan Administrator CITY OF Berkley Administrators OAK PARK HEIGHTS a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Self-insured Workers' Compensation Renewal Data City: Agreement No. 02-729 Quote to: CITY OF OAK PARK HEIGHTS Quote Due on: 05-17-96 PO BOX 2007 Agreement expires: 07-07-96 OAK PARK HGTS. , MN 55082-2007 Your coverage under the LMCIT Self-Insured Workers' Compensation Plan will expire soon. In order to avoid a lapse in coverage and allow us adequate time to process your renewal, please furnish estimates of your payroll for the coming year. STATEMENT OF ESTIMATED PAYROLL FOR COMING YEAR Payroll Description Code Amount Payroll Description Code Amount Street and Road Construction 5506 $ 84, 770 Building Operations 9015 S Ambulance Service 7380 S Restaurant and Bars (On Sale) 9079 S Volunteer Ambulance 7381 S Parks 9102 $ 6 2 ,520 Waterworks 7520 S Municipal Employees 9410 $50, 175 Electric and Steam Power 7539 S Elected Officials 9411 S Sewage Plant 7580 S HOSPITALS&NURSING HOMES Hospital Professionals 8833 S Firefighters (Not Volunteer) 7706 S Hospital All Other 9040 S Firefighters (Volunteer) 7708 population 462 800 Nursing Homes 8829 S Police 7720 $ , Hospital Clerical Office 8810 S Store Risks Retail (Off Sale) 8017 S Others;if not above, show on City Shop &Yard 8227 S reverse side. Clerical Office 8810 $ 127, 700 ARE THE PAYROLL ESTIMATES USTED ABOVE REDUCED 10% FOR SICK, HOUDAY,AND VACATION PAY7 YES D NO Independent administrative Boards, Commissions, Agencies, etc., which have their own employees should have workers' compensation coverage. This can be provided either by including coverage for the Board's employees under the city's workers' compensation coverage, or by issuing separate workers' compensation coverage to the Board, Commission, or Agency. Please indicate if you have any of the following Boards, Commis- sions, or Agencies and wish to include coverage for the Board's employees under the city's workers' compensation coverage. 1.) Utility or Utility Commission , 2.) Port Authority , 3.) Housing and Redevelopment Authority X , 4.) Hospital or Nursing Home Board or Commission , 5.)Welfare or Public Relief Agency , 6.) School Board , 7.) Any Joint Powers Board , 8.) Other Are these entities now covered for Workers'Compensation under another LMCIT Agreement? Yes No X . PLEASE GIVE THE NAME AND ADDRESS OF YOUR AGENT OF RECORD FOR THE COMING YEAR Name of person we should contact if we have questions or need additional information Judy Hoist Daytime Phone Number(612 ) 439-4439 PLEASE MAIL THIS COMPLETED DATA SHEET TO THE ADMINISTRATOR AT THE ADDRESS SHOWN ABOVE. BA 445 (4/93) 11 •E:c f, ,,,ea 7-f-� - 10 746°?'7 _ ran..' (-t.._. I.' _S./F4_7147.0 as-to -./2_ ,-lo — — - 5t-L `Soy St-4- eiO - — 11'T_ .21 ,S i o F Ri o i4i -"-7, ‘.3 . , _, , ___ _ 1 . 1 1,I _. 1,1 EA..., ►c., 1G, 1, 70o ---- 1, ..,.....,...... 1 rS;r1' 5 200 Jo — 4.,4757? .t' 33; c)-0 = 't/42 77� ��„, - l0 `t' ' 71 ,i.- ?moo 17Y _._.. f D i 139so Dal) . 6-5-0 , r • / 1 1 ► , . 06. 750 . 5-50c II r p--T_- 1 9 a -. ` o( , i = - Ii Lei be of Minnesota Cities Insure Trust Group Self-Insured Workers' Compensation Plan Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 NOTICE OF PREMIUM OPTIONS The "City' Agreement No.: 02-000729-9 OAK PARK HEIGHTS Agreement Period: From: 07/07/1995 PO BOX 2007 To: 07/07/1996 OAK PARK HEIGHT MN 55082-2007 Enclosed is a quotation for workers' compensation deposit premium. Deductible options are now available in return for a premium credit applied to your estimated standard premium of$ 22784. . The deductible will apply per occurrence to paid medical costs only. There is no aggregate limit. Please indicate below the premium option you wish to select. You may choose only one and you cannot change options during the agreement period. OPTIONS NET DEPOSIT PREMIUM 1 Regular Premium Option 21095. Deductible Premium Credit per Occurrence Credit Amount 2 ❑ $250 2% 456. 20639. 3 ❑ 500 4% 911. 20184. 4 ❑ 1,000 5% 1139. 19956. 5 ❑ 2,500 9% 2051. 19044. 6 ❑ 5,000 12% 2734. 18361. 7 ❑ 10,000 17% 3873. 17222. This should be signed by an authorized representative of the city requesting coverage. One of the above options must be selected. Please return a signed copy of this notice to the Administrator with payment and make checks payable to the LMCIT. -"i n ure g Title / Date For more information on the premium options that apply to your city, refer to the enclosed brochure. BA 4501 CG (4/93) Lel ie of Minnesota Cities Insure Trust • Group Self-Insured Workers' Compensation Plan Workers' Compensation and Employers' Liability Agreement Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Information Page 1. The "City" RENEWAL Agreement No. 02-000729-9 OAK PARK HEIGHTS "City" is: ity 2oint Powers Entity PO BOX 2007 OAK PARK HEIGHT MN 55082-2007 Other (describe) 2. The Agreement period is from 12:01 a.m. to 12:01 a.m. at the "City's" address. 07/07/1995 07/07/1996 3. A. Workers' Compensation Coverage: Part One of the Agreement applies to the Workers' Compensation Law of any state of the United States of America and the District of Columbia. B. Employers Liability Coverage: Part Two of the Agreement applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury-Each Claimant $200,000. Bodily Injury-Each Occurrence $600,000. Bodily Injury by Disease-Agreement Limit $600,000. C. This Agreement includes these amendments and schedules: 4. Retro-rating option selected? NOT APPLICABLE 5. Elected Officials Covered? YES Boards and Commissions Covered (List) NONE 6. The premium for this Agreement will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. PREMIUM BASIS ESTI- RATES ENTRIES IN THIS ITEM,EXCEPT AS SPECIFICALLY PROVIDED ESTIMATED MATED TOTAL PER $100 OF ANNUAL CODE ELSEWHERE IN THIS AGREEMENT;DO NOT MODIFY ANY OF THE ANNUAL REMUNERATION REMUNERATION NO. OTHER PROVISIONS OF THIS AGREEMENT. PREMIUM 81800 7.20 5506 GENERAL MAINTENANCE 5890. 439800 5.23 7720 POLICE 23002. 97400 0.65 8810 CLERICAL 633. 58100 4.09 9102 PARKS 2376. 46000 1 .85 9410 MUNICIPAL EMPLOYEES 851 . 18200, 0.69 9411 ELECTED OR APPOINTED OFFICIALS 126. Manual Premium 32878. 10% Sick, Holiday, & Vacation Allowance 3288. Adj . Manual Premium 29590. Experience Modification 0.77 Standard Premium 22784. Managed Care Credit 0% 0. AGENT Deductible Credit 0% 0. F-411709883 0.00 Premium Discount 1689. LANDMARK INS SERVICE Discounted Standard Premium 21095. 232 S LK ST - BX 188 LMC Insurance Trust Discount 0% 0. FOREST LAKE, MN 55025 Net Deposit Premium 21095. BA 467CG (12/92) DATE 05/11/1995 • =NEN League of Minnesota Cities Insurance Trust 3490 Lexington Avenue North St. Paul, MN 55126-2977 (612) 490-5600 Workers ' Compensation and Employers ' Liability IMPORTANT Report all workers' compensation injuries to the office of: Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis Minnesota 55459-0143 (612) 544-0311 Administered By: Berkley Administrators If an employee is injured: P.O. Box 59143 Minneapolis, MN 55459-0143 (1) Assist in obtaining medical attention if necessary. (2) Notify the office listed above. **IMPORTANT** PLEASE READ YOUR AGREEMENT BA 466 (8/92) In consideration of the depose f the premium with the ant to their obli ions,all acting through Berkley Adminis- League of Minnesota Cities Insurance Trust(herein LMCIT) trators,which is the Administrator named in the Information and in reliance upon the statements in the Information Page, Page made a part hereof,agrees with you,the City,named in and subject to all terms of this agreement and the LMCIT trust the Information Page as follows: document,LMCIT, acting on behalf of its members,pursu- GENERAL SECTION A. The Agreement C. Workers' Compensation Law This agreement includes at its effective date the Informa- Workers'Compensation law means the workers' compen- tion Page and all amendments and schedules listed there. It sation law and occupational disease law of the States named is an agreement of participation between you(the employer in item 3.A of the Information Page. It includes any named in item 1 of the Information Page)and us(LMCIT). amendments to that law which are in effect during the period The only agreements relating to this plan are stated in this of this agreement. It does not include the provisions of any agreement and the LMCIT Trust document. The terms of this law that provides non-occupational disability benefits. l' agreement may not be changed or waived except by amend- ment issued by us to be part of this agreement. D. Locations B. Who is Covered This agreement covers all of your workplaces listed in items 1 or 5 of the Information Page; and it covers all other You are covered if you are the "City" named in item 1 of workplaces in any state unless you have other insurance for the Information Page. "City" means the city or other such workplaces. governmental body, political subdivision, board or depart- ment or entity named in the Information Page. Unless E. Incidental Coverages specifically named in the Information Page, "City" shall not include a gas, electrical or steam utilities commission, port 1. Part One of this agreement applies to work performed f authority, housing and redevelopment authority, or similar by you subject to the Longshoremen's and Harbor t agency, board or commission, hospital or nursing home Workers' Act. board or commission,welfare or public relief agency, school E board, or joint powers board. 2. Part Two of this agreement applies to work performed by you subject to the Federal Employer's Liability For purposes of Part Two-Employers'Liability Coverage Act. and for purposes of damages sought against them under Section 176.82 of the Minnesota workers'compensation law, 3. Part Two of this agreement applies to work performed the following are additional covered parties for actions by you subject to the Jones Act or U.S.Maritime Law. I perfomed within the scope of their duties: A member of the city council;a member of any board or commission of the city This paragraph does not apply to bodily injury covered that is named in the Information Page;an elected or appointed under any other policy, agreement or plan issued to you. It official of the city;an employee of the city;a volunteer person does not apply even if the other policy, agreement or plan or organization while acting on behalf of the city; any other does not apply because of an other insurance clause,deduct- authorized person or agent of the city while acting on behalf ible or limitation of liability clause, or any similar clause. of the city,but excluding independent contractors;or a relief association and its officers, employees and members. PART ONE-WORKERS' COMPENSATION COVERAGE A. How This Coverage Applies The employee's last day of last exposure to the conditions causing or aggravating such bodily injury by This workers' compensation coverage applies to bodily disease must occur during the period of this agreement. injury by accident or bodily injury by disease. Bodily injury includes resulting death. B. We Will Pay 1. Bodily injury by accident must occur during the period We will pay promptly from the assets of LMCIT, when of this agreement. due, the benefits required of you by the workers'compensa- tion law. 2. Bodily injury by disease must be caused or aggravated by the conditions of your employment. BA 466 (4/92) -1- C. We Will Defend • If we make any pay sin excess of the benefits regularly provided by the workers'compensation law on your behalf, We have the right and duty to defend, at LMCIT expense, you will reimburse us promptly. any claim, proceeding or suit against you and any other covered party for benefits payable under this agreement. We G. Recovery From Others have the right to investigate and settle these claims,proceed- ings or suits.We have no duty to defend a claim,proceeding We have your rights, and the rights of persons entitled to or suit that is not covered by this agreement. the benefits of this agreement, to recover our payments from anyone liable for the injury. You will do everything D. We Will Also Pay necessary to protect those rights for us and to help us enforce them. We will also pay from the assets of LMCIT these costs, in addition to other amounts payable under this agreement as H. Statutory Provisions part of any claim, proceeding or suit we defend: These statements apply where they are required by law. 1. reasonable expenses incurred at our request, but not loss of earnings; 1. As between an injured worker and us,we have notice of the injury when you have notice. 2. premiums for bonds to release attachments and for appeal bonds in bond amounts up to the amounts 2. Your default or your bankruptcy or insolvency will not payable under this agreement; relieve us of our duties under this agreement after an injury occurs. 3. litigation costs taxed against you; 3. We are directly and primarily liable to any person 4. interest on a judgment as required by law until we offer entitled to the benefits payable by this agreement. the amount due under this agreement, and Those persons may enforce our duties; so may an agency authorized by law. Enforcement may be 5. expenses we incur. against us or against you and us. E. Other Insurance 4. Jurisdiction over you is jurisdiction over us for purposes of the workers' compensation law. We are We will not pay more than our share of benefits and costs bound by decisions against you under the law,subject covered by this agreement and another insurance policy or to the provisions of this agreement that are not in self-insurance plan. Subject to any limits of liability that may conflict with that law. apply, all shares will be equal until the loss is paid. If any insurance policy or self-insurance plan is exhausted, the 5. This coverage conforms to the parts of the workers' shares of all remaining insurance policies or self-insurance compensation law that apply to: plans will be equal until the loss is paid. a. benefits payable by this agreement; F. Payments You Must Make b. special taxes, payments into security or other You are responsible for any payments in excess of the special funds, and assessments payable by us benefits regularly provided by the workers' compensation under that law. law including those required because: 6. Terms of this agreement that conflict with the workers' 1. of your serious and willful misconduct; compensation law are changed by this statement to conform to that law. 2. you knowingly employ an employee in violation of law; Nothing in these paragraphs relieves you of your duties under this agreement. 3. you fail to comply with a health or safety law or regulation; or 4. you fail to comply with the reporting requirements of the workers' compensation law causing late payment of benefits to your employee and resulting in assessment of penalties. BA 466 (4/92) -2- •RT TWO -EMPLOYERS'LIABILITY RAGE A. How This Coverage Applies C. Exclusions This employers'liability coverage applies to bodily injury This agreement does not cover: by accident or bodily injury by disease. Bodily injury includes resulting death. 1. liability assumed under a contract. This exclusion does not apply to a warranty that your work will be 1. The bodily injury must arise out of and in the course done in a workmanlike manner; of the injured employee's employment by you. 2. punitive or exemplary damages because of bodily 2. The employment must be necessary or incidental to injury to an employee employed in violation of law; your work. 3. bodily injury to an employee while employed in 3. Bodily injury by accident must occur during the period violation of law with your actual knowledge or the of this agreement. actual knowledge of any of your executive officers; 4. Bodily injury by disease must be caused or aggravated 4. any obligation imposed by a workers' compensation, 1 by the conditions of your employment. The employee's occupational disease, unemployment compensation, last day of last exposure to the conditions causing or or disability benefits law, or any similar law; aggravating such bodily injury by disease must occur during the period of this agreement. 5. bodily injury intentionally caused or aggravated by you; 5. If you are sued, the original suit and any related legal actions for damages for bodily injury by accident or by 6. bodily injury occurring outside the United States of disease must be brought in the United States of America, its territories or possessions, and Canada. America, its territories or possessions, or Canada. This exclusion does not apply to bodily injury to a citizen or resident of the United States of America or B. We Will Pay Canada who is temporarily outside these countries; We will pay from the assets of LMCIT all sums you legally 7. damages arising out of the discharge of, coercion of, must pay as damages because of bodily injury to your or discrimination against any employee in violation of employees, provided the bodily injury is covered by this law. Employers' Liability coverage. D. We Will Defend The damages we will pay,where recovery is permitted by I law, include damages: We have the right and duty to defend, at LMCIT expense, any claim, proceeding or suit against you for damages 1. for which you are liable to a third party by reason of payable under this agreement. We have the right to investi- a claim or suit against you by that third party to recover gate and settle these claims,proceedings and suits. We have i the damages claimed against such third party as a result no duty to defend a claim, proceeding or suit that is not of injury to your employee; covered by this agreement. We have no duty to defend or continue defending after we have paid our applicable limit of 2. for care and loss of services; and liability under this agreement. 3. for consequential bodily injury to a spouse, child, E. We Will Also Pay parent, brother or sister of the injured employee; We will also pay these costs, in addition to other amounts provided that these damages are the direct payable under this agreement as part of any claim, proceed- consequence of bodily injury that arises out of and in ing, or suit we defend: the course of the injured employee's employment by you; and 1. reasonable expenses incurred at our request; but not loss of earnings; 4. because of bodily injury to your employee that arises out of and in the course of employment; claimed 2. premiums for bonds to release attachments and for against you in a capacity other than as employer. appeal bonds in bond amounts up to the limit of our liability under this agreement; BA 466 (4/92) -3- 3. litigation costs taxed against yo pay for all dams overed by this agreement because of bodily injury by accident or disease to one or more 4. interest on a judgment as required by law until we offer employees in any one accident, regardless of the the amount due under this agreement; number of claimants. 5. expenses we incur. 3. Bodily Injury by Disease - Agreement Limit. The limit shown for "bodily injury by disease-agreement F. Other Insurance limit"is the most we will pay for all damages covered by this agreement and arising out of bodily injury by If any claim against you is also covered by another disease, regardless of the number of employees who insurance policy or self-insurance plan,we will pay only for sustain bodily injury by disease,and regardless of the our proportionate share of the loss. Our proportionate share number of claimants. will be determined by applying the ratio that the limit of liability provided by this agreement bears to the total of all Bodily injury by disease does not include disease that limits of liability provided by all policies or plans in effect to results directly from a bodily injury by accident. the total amount payable for the loss. The limits of liability and amount payable under this agreement and any other 4. We will not pay any claims for damages after we have policy or plan shall be calculated as if each plan or policy were paid the applicable limit of our liability under this , the only one applicable. The limits of liability and amount agreement. payable under any other policy or self-insurance plan in effect shall be included in the calculation, regardless of whether it H. Recovery From Others is described as primary,excess,contributory,contingent,or otherwise,unless that policy or plan is specifically described We have your rights to recover our payment from anyone as providing coverage in excess of the limits of this agree- liable for any injury covered by this agreement. You will do ment. everything necessary to protect those rights for us and to help us enforce them. G. Limits of Liability I. Actions Against Us Our liability to pay for damages is limited. Our limits of liability are shown in item 3.B. of the Information Page. There will be no right of action against us under this They apply as explained below: agreement unless: 1. Bodily Injury-Each Claimant. The limit shown for 1. You have complied with all the terms of this "bodily injury-each claimant"is the most we will pay agreement; and to any one claimant for all damages covered by this agreement because of bodily injury by accident or 2. The amount you owe has been determined with our disease to one or more employees in any one accident. consent or by actual trial and final judgment. 2. Bodily Injury-Each Occurrence. The limit shown for This agreement does not give anyone the right to add us as "bodily injury-each occurrence"is the most we will a defendant in an action against you to determine your liability. PART THREE -YOUR DUTIES IF INJURY OCCURS Tell us at once if injury occurs that may be covered by this 4. Cooperate with us and assist us,as we may request,in agreement. Your other duties are listed here: the investigation, settlement or defense of any claim, proceeding or suit. 1. Provide for immediate medical and other services required by the workers' compensation law. 5. Do nothing after an injury occurs that would interfere with our right to recover from others. 2. Give us or our agent the names and addresses of the - injured persons and of witnesses, and other 6. Do not voluntarily make payments, assume information we may need. obligations or incur expenses,except at your own cost. 3. Promptly give us all notices, demands, and legal papers related to the injury,claim,proceeding or suit. BA 466 (4/92) -4- • PART FOUR-PREMIUM • A. Our Manuals E. Final Premium All premiums for this agreement will be determined by our The premium shown on the Information Page, schedules, manuals of rules, rates, rating plans and classifications. We and amendments is an estimate. The final premium will be may change our manuals and apply the changes to this determined after this agreement ends by using the actual,not agreement. the estimated, premium basis and the proper classifications and rates that lawfully apply to the business and work covered B. Classifications by this agreement. If the final premium is more than the premium you paid to us, you must pay us the balance. If it Item 5 of the Information Page shows the rate and premium is less,we will refund the balance to you. The final premium basis for certain business or work classifications. These will not be less than the highest minimum premium for the classifications were assigned based on an estimate of the classifications covered by this agreement. If this agreement exposures you would have during the period of this agree- is cancelled,final premium will be determined in the follow- ment. If your actual exposures are not properly described by ing way unless our manuals provide otherwise. those classifications, we will assign proper classifications, rates and premium basis by amendment to this agreement. 1. If we cancel, final premium will be calculated pro rata based on the time this agreement was in force. Final C. Remuneration premium will not be less than the pro rata share of the minimum premium. Premium for each work classification is determined by multiplying a rate times a premium basis. Remuneration is 2. If you cancel, final premium will be more than pro the most common premium basis. This premium basis rata. It will be based on the time this agreement was includes payroll and all other remuneration paid or payable in force, and increased by our short rate cancellation during the period of this agreement for the services of: table and procedure. Final premium will not be less than the minimum premium. 1. all your officers and employees engaged in work covered by this agreement; and F. Records 2. all other persons engaged in work that could make us You will keep records of information needed to compute liable under Part One (Workers' Compensation premium. You will provide us with copies of those records Coverage) of this agreement. If you do not have when we ask for them. payroll records for these persons,the contract price for their services and materials may be used as the G. Audit premium basis. This paragraph 2 will not apply if you give us proof that the employers of these persons You will let us examine and audit all your records that relate lawfully secured their workers' compensation to this agreement. These records include ledgers,journals, obligations. registers, vouchers, contracts, tax reports, payroll and dis- bursement records, and programs for storing and retrieving D. Premium Payments data. We may conduct the audits during regular business hours during the period of this agreement and within three You will pay all premium when due. You will pay the years after this agreement ends. Information developed by premium even if part or all of a workers' compensation law audit will be used to determine final premium. is not valid. PART FIVE -CONDITIONS A. Duty to Indemnify 4. For which the "city is not authorized to indemnify any person by statute; or Our duty to pay on behalf of or to indemnify a "covered party" other than the "city" shall not apply to any act, 5. Which constitutes dishonesty on the part of a error or omission: "covered party"; or 1. Which constitutes malfeasance in office; or 6. Which constitutes the willful violation of a statute or ordinance by any official, employee or agent of the 2. Which constitutes willful neglect or duty; or "city". 3. Which constitutes bad faith; or BA 466 (4/92) -5- The terms"malfeasance", "willful negl•duty",and"bad Mailing the no& you at your mailing address faith" shall be given the same meaning in this agreement as shown in item 1 of the Information Page will be given in the applicable statute with respect to the"city's"duty sufficient to prove notice. to defend or indemnify its officials, employees or agents. 3. The period of this agreement will end on the day and B. Inspection hour stated in the cancellation notice. We have the right, but are not obliged to inspect your 4. Any of these provisions that conflicts with a law that workplaces at any time. Our inspections are not safety controls the cancellation of the coverage in this inspections. They relate only to coverage and the premiums agreement is changed by this statement to comply with to be charged. We may also recommend changes. While they that law. may help reduce losses,we do not undertake to perform the duty of any person to provide for the health or safety of your F. Assessability employees or the public. We do not warrant that your workplaces are safe or healthful or that they comply with All "cities"who participate in this program are jointly and laws, regulations, codes or standards. severally liable for all claims and expenses of the program. The amount of any liabilities in excess of assets may be C. Long Term Agreement assessed to the participants when a deficiency is identified. 1 If the period of this agreement is longer than one year and G. Sole Representative sixteen days, all provisions of this agreement will apply as though a new agreement were issued on each annual anniver- The City first named in item 1 of the Information Page will sary that this agreement is in force. act on behalf of all covered entities to change this agreement, receive return premium,and give or receive notice of cancel- D. Transfer of Your Rights and Duties lation. Your rights or duties under this agreement may not be IN WITNESS WHEREOF, the City agrees to look solely transferred without our written consent. to the League of Minnesota Cities Insurance Trust for reimbursement of all losses,costs and expenses arising under E. Cancellation this agreement;and further agrees that in no event shall claim be made or asserted against the revenues or property,real or 1. You may cancel this agreement. You must mail or personal,of the League of Minnesota Cities. Acceptance of deliver advance written notice to us stating when the this agreement by the City constitutes acceptance of all terms cancellation is to take effect. hereof. 2. We may cancel this agreement. We must mail or League o • - .to ities Insurance Trust deliver to you not less than ten days in advance written • notice stating when the cancellation is to take effect. By: �� Its ut s ri -d 'epresentative BA 466 (4/92) -6- S IV Berkley Administrators PO Box 59143, Mpls., MN 55459-0143 • 8441 Wayzata Blvd., Mpls., MN 55426 Phone (612) 544-0311 • Fax (612) 591-7404 This folder contains important documents and instructions for filing claims for your employees. Please read everything carefully now so you will know what to do when an injury occurs. If you have any questions, please contact your agent or Berkley Administrators. CRITICAL INFORMATION Any serious (life threatening) injury or injury causing death must be reported to us by phone immedi- ately. Dial (612) 544-0311. In all other situations state law requires you, the employer, to report all injuries and illnesses which your employees claim are related to work. You must report their claim using a FIRST REPORT OF INJURY form. Berkley Administrators must receive the original report within 10 days of the date you have knowledge of the claimed injury. The law also requires prompt payment of any benefits which may be due. Payment for lost wages must be made within 14 days of the first day of lost time from work. The Department of Labor and Industry can and does impose fines and penalties against employers if they do not comply with these standards. To avoid substantial penalty expenses for late reporting of an injury or for late payment for benefits, you must report injuries and lost time from work to us as soon as possible. To help you do that, you will find detailed instructions for completing the First Report of Injury form on Page 3 of this folder. If you need additional copies of any of the enclosed forms, please complete and mail the order form sent with this folder. PREVENT WORK INJURIES For your benefit and assistance, we offer safety services which can be tailored to your needs to help prevent work-related injuries. Our Loss Control Representatives are available for consultation regard- ing safety in the workplace and for safety surveys of your facilities. They can also assist you in compliance with OSHA regulations and the development of your own program of accident prevention and loss control. These services are provided at no additional charge to you. Call (612) 591-7498 to schedule a visit or for more information on safety and loss control topics. MANDATORY FRAUD NOTICE A person who submits an application or files a claim with intent to defraud or helps commit a fraud against an insurer-is guilty of a crime. Minnesota Statute 60A.955. BA 2530(10/94) Mi esota Workers' Compensation II> RUCTIONS FOR EMPLOYERS WHAT TO REPORT State law requires that you report any and all injuries and illnesses that your employees believe are work-related. Berkley Administrators will then determine if any workers'compensation benefits are payable to the injured employee. Remember, filing a First Report of Injury with us does not mean that you are admitting any liability. It means only that you are reporting a claimed injury or condition which your employee thinks is related to work activities. WHO REPORTS AN INJURY The injured employee is required to report an injury to you, the employer, within 180 days of its occurrence. You, the employer, are then required to report that claimed injury to us on a First Report of Injury form. It is neither the injured employee's responsibility to report the injury to us nor is it your insurance agent's duty. Do not ask the injured employee or your agent to complete the form. If they cause any delay in reporting the injury to us, you, the employer, can be penalized by the Minnesota Department of Labor and Industry. WHEN TO REPORT AN INJURY If an employee is killed or suffers a life-threatening injury (amputation of limb, massive internal injuries, etc.) you must report by phone to Berkley Administrators within 48 hours of the occurrence. You must also send a completed First Report of Injury form to us within 7 days of the injury. You must report any other work-related injury or illness within 10 days of your first knowledge of its occurrence. If the employee's supervisor or manager knows about the injury, then you, the employer, have knowledge of it even if your home office or headquarters staff is unaware of the injury. The injury must be reported on a First Report of Injury form and we must receive it within 10 days. Because of possible delays by the Postal Service, we recommend that you complete and mail the original First Report on the same day you are notified of the injury. Do not wait for the employee to return to work or for medical bills or other information. Any delay in this process can result in a penalty assessment against you by the Minnesota Department of Labor and Industry. You can be fined up to$200 for late reporting. If that late report results in late payment of benefits to your employee, you can be penalized up to $3,838 plus 10 percent of the delayed payment. It is very important that you report all claimed injuries as soon as possible. HOW TO REPORT AN INJURY State law requires that you use a Minnesota First Report of Injury form. Always keep a supply of forms on hand. When your supply runs low, use the order form sent with this folder to request more forms. When an accident occurs, have the employee's supervisor complete the Supervisor's Report of Accident (SRA). This form will assist in your internal investigation of the accident and what caused it. Then you, the employer, should com- plete the First Report of Injury form using information from the SRA, personnel records, and elsewhere. If there are any unusual circumstances or you need to provide more information, you should attach a letter to the report. Send the original First Report and SRA to Berkley Administrators. Keep a copy of each for your records. Also give a copy of the First Report of Injury to the injured employee; this is required by law. Detailed, line-by-line instructions for the First Report begin on Page 3. REMINDERS AND ADVICE • If an employee begins to lose time from work after you've mailed the First Report, call us immediately to let us know. Then we can pay any benefits due on time and you can avoid any penalties for late payment. • Call us as soon as an employee returns to work after a work-related injury. We can then discontinue time-loss benefits and avoid the possibility of overpaying your employee. • Promptly send us all injury-related medical bills you or your employee receive. Medical providers often bill only one party, so if you receive a bill, it probably means that we have not. Before we pay a bill, we review it to ensure that it's related to the work injury and we request medical records for it. The law allows us 30 days from the date we receive those records to pay a bill so it may sometimes be several months from the date of treatment before we're able to pay. • Do not pay medical bills for your employees'work-related injuries. First, it may be illegal for you to do so. Second,by paying a bill, you may be legally accepting liability for an injury which is not really work-related. Third, because of the Medical Fee Schedule, we can often pay less than what the medical provider charges which saves you money. • Do not deliberately obstruct tempt to prevent an employee from seekiiorkers' compensation benefits. If you do, you could be liable for any workers' compensation benefits plus triple damages to that employee. By law you must post the name and address of your workers' compensation carrier (Berkley Administrators) in a conspicuous place. You may use our"Employees' Rights" poster for that purpose. If an employee claims a work-related injury, report it to us along with all relevant information. Let us investigate and determine if any workers'compensation benefits are due; we are experts in Minnesota workers' compensation. • Don't ignore your injured employees. Communicate with them regularly and let them know you are concerned about them. It is especially important, if they are losing time from work, that you keep them mentally"connected" to their job. If at all possible, provide light duty or part-time work to help return them to health and productivity as soon as possible. This is not only good for your employees, it also helps to reduce your claim costs. • Be accessible and provide us with the information we need when we request it. This will allow us to be more effective in managing your claims and controlling your workers'compensation costs. FIRST REPORT OF INJURY INSTRUCTIONS Box 1 Enter the case number from your company's OSHA 200 log. Box 2 Enter the injured employee's name. Box 3 Enter the injured employee's social security number. This must be completed because the State of Minnesota uses it as its file number. Box 4 Enter the employee's current mailing address including the county. Box 5 Enter the date that the injury occurred. If not known, enter the approximate date or "unknown". Box 6 Indicate the employee's gender. Box 7 Indicate the employee's marital status. Box 8 Enter the employee's job title or a description of the work done for your organization (Example: Class A Machinist, Carpenter's Helper). Box 9 Enter the employee's birth date. Box 10 Enter the date that the employee began working for your organization. Box 11 Provide the name of the department or unit where the employee usually works (e.g. welding dept., loading dock, accounts receivable unit). If your organization has no formal departments, leave this box blank. Box 12 Enter the employee's home phone number including area code. Box 13 If the employee is in a union apprenticeship program or some other formal apprentice program indicate that in this box. Box 14 Enter the employee's average gross weekly wage before any deductions for taxes, etc. If the employee is salaried, write "salary" and the gross amount and the period it is paid for (e.g. $500/week salary, $2,000/month salary). If you are continuing to pay full wages or sick/vacation leave beyond the first day of lost time, indicate this by writing in "full wage continuation". Box 15 Enter the hourly wage rate for employees paid by the hour. Box 16 Enter the usual number of hours the employee works each day. Box 17 Enter the usual number of days the employee works each week and indicate which days are usually worked e.g. M - F, Tu-Su, or M,W,F. Box 18 If the employee receives meals or lodging from you as part of their pay, enter their value here. If the employee also works somewhere else full or part-time, enter their average weekly earnings at that job and provide us with the name of the other employer. Box 19 Put an X by the description which best indicates the employee's work status. If the employee is a police officer or firefighter, indicate their smoking habits. Box 20 Indicate the location where the injury occurred and whether or not it occurred on your premises. Box 21 I your employee has lost any time at all (even just 10 minutes) from work, you must report it. Enter the date when lost time first occurred. If there has been no lost time, write "NONE" in the box. Box 22 Enter the date on which you first had knowledge of your employee's injury. Box 23 If the employee has already ret d to work, enter the date returned. If the Ioyee has not returned to work, leave this box empty. Box 24 Sometimes employee's are injured but don't lose time from work until days or weeks later or they lose time but don't notify you that it is related to their work injury. In any case, provide the date you were notified that the employee was losing time from work due to a work injury. Box 25 If your employee has died as a result of their work-related injury or illness, enter the date of death in this box. A work- related death or life-threatening injury must be reported to us by phone immediately. Box 26 Indicate the approximate time that the injury occurred. Box 27 Enter the type of injury he/she has. Indicate all body parts which were injured. Be specific. Write "left low back and left index finger" rather than "back and hand". If the injury is not obvious, write something like "possible fracture" or "apparent allergic reaction". Box 28 Briefly but accurately describe the circumstances that caused the injury. Don't just write "fell onto sidewalk" if in fact the employee was "on roof repairing chimney, safety harness broke, fell 20' onto concrete sidewalk". Also, circum- stances surrounding the injury are complex, unusual, or suspicious, attach a detailed explanatory letter to the First Report of Injury form and SRA that you send to us. Box 29 Provide the name, address, and phone number of the doctor who treated the employee for the injury. If the employee received no medical treatment, write "first aid only" in this box. Box 30 Provide the name, address and phone number of the clinic or hospital where the employee was treated for the injury. Box 31 Provide the names of coworkers who may have witnessed the accident or who worked with the employee on the date of the injury. We may need to contact these people to obtain more information about the circumstances that lead to the injury. Box 32 Enter the name and address of your organization. If you do business using a different name than you are insured under, please indicate that. For example: John Doe dba J.D. Enterprises or J.D. Widgets Division of John Doe Enterprises. Box 33 Enter the date that you, the employer, completed the form. Box 34 Enter your Unemployment Insurance ID number. This number is assigned to you by the Department of Jobs and Training. Call them at (612) 296-6141 if you do not know your ID number. Box 35 Enter the proper SIC code for your organization. This number is also assigned by the Department of Jobs and Train- ing. Call them at (612) 296-6141 if you do not know your SIC code. If you know the payroll classification code for the injured employee, enter it in the box to the right of Box 35. Box 36 Enter the name and work phone number of the injured employee's supervisor. Box 37 Enter the name, title, and work phone number of the person in your organization whom we should contact to obtain more information about this claim. Boxes 38-44 Do not fill in these boxes. Berkley Administrators will complete this part of the form. • Berkley Administrators PO Box 59143, Mpls., MN 55459-0143 • 8441 Wayzata Blvd., Mpls., MN 55426 Phone (612) 544-0311 • Fax (612) 591-7404 Minnesota Department of Labor and Industry Workers'Compensation Division First Report of Injury 443 Lafayette Road North St.Paul,MN 66166.4306 Se instructions in folder accompanying forms. A 11111111 I 11111 II'I�II III (8121 296-2432 All dates must be entered in MM/DD/YY format. Type or Print. EMPLOYEE 2.Name (last,first,middle) 3.EMPLOYEE SOCIAL SECURITY NO: 4.Home address(include county and zip) 5.DATE OF CLAIMED INJURY: Do Not Use this Space 6.Sex: _Male Female 7. Marital Status: Married Not 8.Occupation: 9.Date of Birth: -/_/- 10.Date Hired: / / 11.Regular Dept: 12.Home Phone No.(A/C,No.) 13.Apprentice: No Yes WAGE INFORMATION 15.Rate per hour. 16.Hours per day: 14.Average wage/week 17.Days per week: 18.What is the weekly value of MEALS: $ LODGING: $ 2nd INCOME: $ 19.Employment Status: _Full time _Part time _Seasonal _Volunteer(Attach 26 week wage statement for part time or irregularly scheduled employee.) If employee is a police officer or firefighter: Smoker: Yes_ No_ OCCURRENCE 20. PLACE(include dept&full address) 21.Date of first 22.Date employer day of lost time: -/ / notified of injury: -/-/ 23.Return to work date: _/-/ 24.Date employer notified of lost time: / / 26.Time of day ❑ AM f--1 l �1 of in 25.Date of death: -/_/ On employer's premises? I Yes I I No jam: ❑ PM 27.DESCRIBE NATURE OF INJURY OR ILLNESS IN DETAIL,BE SPECIF IC(include partlsl of body affected,e.g.amputation of right index finger at 2nd joint,fractured arm,lead poisoning) 28.DESCRIBE EMPLOYEE'S ACTIVITIES WHEN INJURY OCCURRED WITH DETAILS OF HOW EVENT OCCURRED (include name of other individuals involved,tools,machinery,objects,vapors, chemicals,radiations,unnatural motions of employee) 29. PHYSICIAN (full name,title,address and phone number) 30.HOSPITAL/CLINIC(name and address) 31.Witness and phone number. EMPLOYER 32.Legal name&mailing address incl.zip 34.Unemploy ID No.: OAK PARK HEIGHTS 33.Date form completed: / /_ PO BOX 2007 OAK PARK HEIGHT MN 55082-2007 35.SIC code Payroll Class Code 36. Print supervisor's name and phone number 37.Employer's Representative,print full name,title and phone number. SEND REPORT IMMEDIATELY - DO NOT WAIT FOR DOCTOR'S REPORT CONTAINS ALL ITEMS REQUIRED BY OSHA FORM 101 EMPLOYER STOP HERE-DO NOT USE THIS SPACE N P S T OCC INSURANCE 38.CARRIER 39.Insurer ID No: 40.ADJUSTER N/A Berkley Administrators 41.Insurance Class Code: S ELF- INSURED P.O. Box 59143 Mpls., MN 55459-0143 (612) 544-0311 43.Data insurer received notice: 42. CARRIER CLAIM NUMBER 44.Adjuster ID No: 0a-000729 0698639002 LI.20320-06(1-921 Original to Berkley Administrators BA 251 S/I (4/92) Copies to Employer, Employee and Workers' Compensation Division • • Berkleyi bod Administrators PO Box 59143, Mpls., MN 55459-0143 • 8441 Wayzata Blvd., Mpls., MN 55426 Phone (612) 544-0311 • Fax (612) 591-7404 Enclosed is your: ❑ Coverage Document for Minnesota Workers' Compensation Please carefully review your Policy or Agreement, the Information Page and any Endorsements to ensure that the coverages you want or need are included and that they are accurately prepared. If you have one, your agent will also receive copies of your Information Page and any Endorsements. Please communicate with your agent or Berkley Administrators if there are errors or if changes are necessary. Also included for your review are the forms and instructions you need to report all workers' compen- sation claims to Berkley Administrators. XMinnesota Workers' Compensation Renewal Document Please carefully review your renewal Policy or Agreement, the Information Page and any Endorse- ments to ensure that the coverages you want or need are included and that they are accurately prepared. ❑ New supply of First Report of Injury forms and/or the other information you requested. MANDATORY FRAUD NOTICE A person who submits an application or files a claim with intent to defraud or helps commit a fraud against an insurer is guilty of a crime. Minnesota Statute 60A.955. You must maintain an adequate supply of First Report of Injury forms. They should be kept where they are accessible to the person who is responsible for completing the form and sending it to Berkley. If you have run out of forms or can't find your supply, please complete the form below and return it to Berkley. We will gladly send you a supply of forms and provide any other information you request. Please do it today because you never know when an injury might be reported by one of your employees. r Please send the following information to the attention of: 02-000729 at the address at left. OAK PARK HEIGHTS PO BOX 2007 OAK PARK HEIGHT MN 55082-2007 ❑ FIRST REPORT OF INJURY forms ❑ Supervisor's Report of Accident forms L ❑ Minnesota Workers' Compensation booklet Clip and mail to: ❑ Employer's Injury Management Guide ❑ Hiring Practices and Disabilities booklet ❑ Employer's Loss Control booklet BERKLEY ADMINISTRATORS ❑ Deductible Information PO BOX 59143 MINNEAPOLIS, MN 55459-0143 SAVE TIME: USE A WINDOW ENVELOPE. BA 3110 CG (10/94) • LMCIT EXCESS LIABILITY COVERAGE Cities obtaining excess coverage from the League of Minnesota Cities Insurance Trust must decide whether or not to waive the statutory liability limits to the extent of the excess coverage purchased. This decision must be made by the city council. CITIES PURCHASING EXCESS COVERAGE MUST COMPLETE AND RETURN THIS FORM TO LMCIT BEFORE THE EFFECTIVE DATE OF THE COVERAGE. For further information, refer to the accompanying memo. City officials may also want to discuss these issues with the city attorney. The City of at Po Jht-<accepts excess liability coverage limits of$ _isa z from the League of Minnesota Cities Insurance Trust. Check one: The city DOES NOT WAIVE the monetary limits on tort liability established by Minnesota Statutes 466.04. / - OR - V The city ty WAIVES the monetary limits on tort liability established by Minnesota Statutes 466.04, to the extent of the limits of the excess liability coverage obtained from the League of Minnesota Cities Insurance Trust. Date of city council meeting: C5 - - Signature Position: Return this completed form to Berkley Risk Services, 920 Second Avenue South, Suite 700, Minneapolis, MN 55402-4023. 4/92 LMCIT31 (2) GLeague of Minnesota Cities Insurance/Mist roup Self-Insured Workers' Compensa> Plan • Workers' Compensation and Employers' Liability Agreement Administrator Berkley Administrators P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 STATEMENT OF PREMIUM AUDIT ADJUSTMENT The "City" ( Agreement No. 02.000729-8 1 E 1 r _ V OAK PARK HEIGHTS 11 , Agreement Period: From 07/07/1994 To 07/07/1995 PO BOX 2007 OCT 1 z ,_,._ OAK PARK HEIGHT MN 55082-200 CITY Of _ 0 K PARK HEIGHTS Rates L Audited Annual Per $100 Of Code Audited Remuneration Remuneration No. Classification Premium 70672. 7.47 5506 GENERAL MAINTENANCE 5279. 335546. 6.54 7720 POLICE 21945. 140264. 0.54 8810 CLERICAL 757. 41206. 4.17 9102 PARKS 1718. 31709. 2.31 9410 MUNICIPAL EMPLOYEES 732. 16380. 2.31 9411 ELECTED OR APPOINTED OFFICIALS 378. 5009. 4.36 9016 SKATING RINK OPERATION 218. 640786. Manual Premium 31027. Experience Modification 0.79 Standard Premium 24511. Managed Care Credit 0% 0. Deductible Credit 0% 0. Premium Discount <1854.> Discounted Standard Premium 22657. LMC Insurance Trust Discount 0% 0. Net Actual Premium 22657. Less Deposit Premium 0 Balance Due City �' 1835.00 The foregoing statement is for the year end adjustment to your workers' compensation desposit premium. It was prepared after an audit of your payroll records and a final determination of your experience modification factor for the period indicated above. If the final balance shown is due to your city, a check will accompnay this form. If the final balance shown is due to the LMCIT, please forward your remittance,payable to the LMC Insurance Trust, to the adminsitrator at the address indicated above. Agent F-411709883 0.00 g? 4 LANDMARK INS SERVICE /// 4( G 232 S LK ST - BX 188 r_q FOREST LAKE, MN 55025 .4 BA 446CG (5/91) Date: • .t . 2 i Lea of Minnesota Cities Insure Trust , roup Self-Insured Workers' Compensation Plan Workers' Compensation and Employers' Liability Agreement Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Information Page RENEWAL 1. The "City" Agreement No. 02-000729-8 OAK PARK HEIGHTS "City" is: >City PO BOX 2007 Joint Powers Entity OAK PARK HEIGHT MN 55082-2007 Other (describe) 2. The Agreement period is from 12:01 a.m. to 12:01 a.m. at the "City's" address. 07/07/1994 07/07/1995 3. A. Workers' Compensation Coverage: Part One of the Agreement applies to the Workers' Compensation Law of any state of the United States of America and the District of Columbia. B. Employers Liability Coverage: Part Two of the Agreement applies to work in each state listed in item 3.A. The limits of our liability under Part Two are: Bodily Injury-Each Claimant $200,000. Bodily Injury-Each Occurrence $600,000. Bodily Injury by Disease-Agreement Limit $600,000. C. This Agreement includes these amendments and schedules: 4. Retro-rating option selected? NOT APPLICABLE 5. Elected Officials Covered? Boards and Commissions Covered (List) YES NONE 6. The premium for this Agreement will be determined by our Manuals of Rules, Classifications, Rates and Rating Plans. All information required below is subject to verification and change by audit. PREMIUM BASIS ESTI- RATES ENTRIES IN THIS ITEM,EXCEPT AS SPECIFICALLY PROVIDED ESTIMATED MATED TOTAL PER $100 OF CODE ELSEWHERE IN THIS AGREEMENT;DO NOT MODIFY ANY OF THE ANNUAL ANNUAL REMUNERATION NO. OTHER PROVISIONS OF THIS AGREEMENT. PREMIUM REMUNERATION 64350 7.47 5506 GENERAL MAINTENANCE 4807. 412800, 6.54 7720 POLICE 26997. 130700 0.54 8810 CLERICAL 706. 70700, 4. 17 9102 PARKS 2948. 62700 2.31 9410 MUNICIPAL EMPLOYEES 1448. 18200 2.31 9411 ELECTED OR APPOINTED OFFICIALS 420. Manual Premium 37326. 10% Sick, Holiday, & Vacation Allowance 3733. Adj . Manual Premium 33593. Experience Modification 0.79 Standard Premium 26538. Managed Care Credit 0% 0. Deductible Credit 0% 0. AGENT F-411709883 0.00 Premium Discount 2046. FOREST LAKE INS AGCY Discounted Standard Premium 24492. 232 S LK ST — BX 188 LMC Insurance Trust Discount OY. 0. FOREST LAKE, MN 55025 Net Deposit Premium 24492. BA 467CG (12/92) DATE 04/15/1994 Leaa of Minnesota Cities Insura Trust Group Self-Insured Workers' Compensation Plan Administrator Berkley Administrators a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Self-Insured Workers' Compensation Renewal Data City: Agreement No. 02-729 Quote to: CITY OF OAK PARK HEIGHTS Quote Due on: 04-25-94 P.O. BOX 2007 Agreement expires: 07-07-94 OAK PARK HEIGHTS, MN 55082-2007 Your coverage under the LMCIT Self-Insured Workers' Compensation Plan will expire soon. In order to avoid a lapse in coverage and allow us adequate time to process your renewal,please furnish estimates of your payroll for the coming year. STATEMENT OF ESTIMATED PAYROLL FOR COMING YEAR Payroll Description Code Amount Payroll Description Code Amount Street and Road Construction 5506 8 Building Operations 9015 $ 62 , 700 Ambulance Service 7380 $ Restaurant and Bars(On Sale) 9079 S Volunteer Ambulance 7381 $ Parks 9102 $ 70, 700 Waterworks 7520 $ Municipal Employees 9410 $ Electric and Steam Power 7539 $ Elected Officials 9411 $ 12 , 600 Sewage Plant 7580 $ HOSPITALS&NURSING HOMES Hospital Professionals 8833 $ Firefighters(Not Volunteer) 7706 $ Hospital All Other 9040 $ Firefighters (Volunteer) 7708 population Nursing Homes 8829 $ Police 7720 $ 412 , 800 Hospital Clerical Office 8810 $ Store Risks Retail (Off Sale) 8017 $ 64 350 Others;if not above, show on City Shop&Yard 8227 $ ► reverse side. Clerical Office 8810 $ 130, 700 ARE THE PAYROLL ESTIMATES LISTED ABOVE REDUCED 10%FOR SICK,HOLIDAY,AND VACATION PAY? YES 0 NO D Independent administrative Boards,Commissions, Agencies,etc., which have their own employees should have workers' compensation coverage. I This can be provided either by including coverage for the Board's employees under the city's workers' compensation coverage, or by issuing } separate workers' compensation coverage to the Board, Commission,or Agency. Please indicate if you have any of the following Boards, Commis- sions, or Agencies and wish to include coverage for the Board's employees under the city's workers' compensation coverage. ! 1.) Utility or Utility Commission , 2.) Port Authority , 3.) Housing and Redevelopment Authority X , 4.) Hospital or Nursing Home Board or Commission , 5.)Welfare or Public Relief Agency , 6.)School Board , 7.) Any Joint Powers Board , 8.) Other . Are these entities now covered for Workers' Compensation under another LMCIT Agreement? Yes No X PLEASE GIVE THE NAME AND ADDRESS OF YOUR AGENT OF RECORD FOR THE COMING YEAR. Karen Alm , Forest Lake Insurance Agency 232 S. Lake St. , P.O. Box 188 Forest Lake, MN 55025 Judy Holst Name of person we should contact if we have questions or need additional information y Daytime Phone Number(612 )439-4439 PLEASE MAIL THIS COMPLETED DATA SHEET TO THE ADMINISTRATOR AT THE ADDRESS SHOWN ABOVE. BA 445 (4/93) . 6„,z,„,_ , fit' 7- /-9 7 -/- 9S' 9 S t-la.-,. _ v -r i lbj" c!-z .2 7, (//y.,2 8 �?8 317. 2 ^ ° - a-" 56,' .1.5 1 �. 7.Yy a I el 5 2 a 85.1. 9 /i 73 y o53, 4, a�,�9 3, 3 l 3 9, D.,,-,k - .S1 . ,2,4s733(, 2s02/1• 17 2686•gT 17/7 Va ,3, ) 93 , 1 ? lam, - 9(4,, a , 16-s 52 022,7`13. 4986 r aoo,o-o A17, 84. 3c - o?151SD a,7, 08/•CO 7/ •g / 37//• G3 6.2 03(....cZ /(.,331,0, /8,2z/4., JD ,,7,)4e. 5 1, /Gg.3Rs' 3$, 5l • /9 r c 1 , 33 15 181$YG,6o . /4,4, -s9 3, 102. 75 4/0 .1A.C,•?� F /6,,3 31. . a 1�,75'D.0() 0,.5.1-02.93 c,2, /551/ 3 7, 77 . 3L 2ci-y, i ,.2i. o /4,,/74.y/ _' 0 - 200.00 0 I,Cj o a.e90 P--r .2 71.60 _.3 ose26)`( - a - -- v — _ 6 o--9. (...41 / 8', 100.74 /K,.5-oz. 70 /7, 230,(Di /4‘,qS z<. 4//2, -7.29.73 •� 8yd I L, 3 15,00 l�' c 025 a 18,t o i g j 71.'1 q -0- U - 6 a, yo Y. l `ki 22, 22P `i� 3,U.,2(..coif - `)--- 3aa. oo A140, -299.6'1 9haA.,- 1 l -' ?l , / .033. 30 v - �3 Say 5Y 13 877.7P c/,. 31.17 ' - 360.a6 / 3 0,-709.4?`� 8aa , .2l, LL./ LU a-a dclo. ,'a - u- 1/..04/7.Y0 '17,886..22. i -Z2:67' 15 5. 14, 23l Jo 0— byg.77 gi'..O 7 -' .3,, ,-i83 - 3 8,•y P-/.302- ' `i, . -2./7 tl O, o. . 1 q Cd2t6 18, 0 I ( ( .)ç., )- C`/-78`. S) '`11 , 9 ?,44. ' -T s-7-1 i.1a 6 .o a, ? -- v - —0 - /2 27.14. il G 5d°%i `j'cl 24,71-34i,./...74., go i, - 19, L.,?&,.S),., 20,7R�_(o — U - 1v $ J �s.G�� i o , go3•4,a -r i 5 8 -0.ou _ /5- ®.Ord 35 _5(3 .52.. ad, -5(• `10 - - „ig/5?.�� 62;6023.40 • 07‘-iii�w�� 300 ,od �300 o a /v eb--) ov I s Lee of Minnesota Cities Insure. Trust Group Self-Insured Workers' Compensation Plan Administrator Berkley Administrators formerly EBA a member of the Berkley Risk Management Services Group P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 Self-Insured Workers' Compensation Renewal Data City: Agreement No. 02-729 City of Oak Park Heights Quote to: Box 2007 Quote Due on: 05-25-92 Oak Park Heights Mn 55082 Agreement expires: 07-07-92 Your coverage under the LMCIT Self-Insured Workers' Compensation Plan will expire soon. In order to avoid a lapse in coverage and allow us adequate time to process your renewal, please furnish estimates of your payroll for the coming year. Population: (if you have a Volunteer Fire Deparment) STATEMENT OF ESTIMATED PAYROLL FOR COMING YEAR Payroll Description Code Amount Payroll Description Code Amount Street and Road Construction 5506 $ Building Operations 9015 $ 35 ,500 Ambulance Service 7380 S Restaurant and Bars (On Sale) 9079 $ Volunteer Ambulance 7381 $ Parks 9102 $ 74, 800 Waterworks 7520 $ Municipal Employees 9410 $ Electric and Steam Power 7539 $ Elected Officials 9411 $ 12 , 600 Sewage Plant 7580 $ HOSPITALS &NURSING HOMES Hospital Professionals 8833 3__ Firemen (Not Volunteer) 7706 $ Hospital All Other 9040 $ Policemen 7720 $ 336 ,000 Nursing Homes 8829 $ Store Risks Retail (Off Sale) 8017 S Hospital Clerical Office 8810 City Shop &Yard 8227 $ 45 500 S Others; if not above, show on Clerical Office 8810 $ 108 , 100 reverse side. If you have any of the following Boards, Commissions, Agencies, etc.,they should be included for Workers' Compensation Coverage. Please indicate which and provide the full legal name of the entity. City of Oak Park Heights - HRA 1.) Utility or Utility Commission , 2.) Port Authority , 3.) Housing and Redevelopment Authority X , 4.) Hospital or Nursing Home Board or Commission , 5.)Welfare or Public Relief Agency , 6.)School Board , 7.) Any Joint Powers Board , 8.) Other Are these entities now covered for Workers' Compensation under another LMCIT Agreement? Yes No x PLEASE GIVE THE NAME AND ADDRESS OF YOUR AGENT OF RECORD FOR THE COMING YEAR. Dean McGowan Forest Lake Insurance Agency 232 S. Lake St. , P.O. Box 188 Forest Lake, MN 55025 Name of person we should contact if we have questions or need additional information Judy Hoist Daytime Phone Number( 612) 439-4439 PLEASE MAIL THIS COMPLETED DATA SHEET TO THE ADMINISTRATOR AT THE ADDRESS SHOWN ABOVE. BA 445CG (10/91) . i . +, ,, `if/ C s- Ci- 'f? 7- /-9 2 z) °7-/ _______ _ ii_ q_2- 3 )--4.1--e _ oil _ _ _ --r-c) 7.49 1.-- _ il aS G72,Le - 4 , -- _', "._.-- o?s c, a.0 _ } `/., t9 .0 //0„q41-7 e (�,6GD,00 //a 0 9/, /948 ..,_ _ .mac. ._ _. `s4 . .3, 3 5.sc. 23,5'63,17 _- - .2,97 /6. ‘,04:1,0o ...__ g3--/-/� 1t 5_2, Yat - - may.9 ,?) _ 0 — --. — ye a/11, 5-.3 ._._1 rts_ 4?�f5 /?gy 41 2 g,2% F,7 2�� ,. d0 c3.J, 6, - ° - /a 7&'// tl / off®,vv i 3 874.yk p1 , /e, 5 0 0 °7' fi 7_.tJZ> / 0 ___ _____ 242. 4.2...._..) ....„.. iV 62, `rs `l_.-. .453 9. 7c _ �! tad. o 8, 9ua. 03s k35,6 ..___.. . r , _ ft 0641,0,..(... l' ,?`�06/. 32-- 2'y Yt5(.7,5' !1 8 `z'. ,4....7 __nr �3 � 3� _ _ S 70, iG 1 s,_6 __.s� � 1, 20?33-6...6) 3, Pa...--? .3;6,2S,01 . 45 ,.5dam-% a r.f n &34--3 !7 /73_0. �7 _ v - .5,22 9. jS s 30 E 6,0 l°XS.. ___�..�-� �.�,1.4 _1Jy:.?z /..Q, `l�? 7 - `' .-". X31 / 0- "%�5. el-Fr __.__.: _:. Z. ____ ...4,, ate.s3 -- ' --- f; t ; � Pks u d//. 3s 53 07s(.. !(:) -. _.__. /'.P? ._, Y .. __ _ , 1 7 5 71 60 /7926..la 3_S S-00. 0 e-i (ten- ,i 6S,3U .A30o. r� .-_ ' -- ," `' `- _/d?, 6 . r S Berkley Administrators formerly EBA a member of the Berkley Risk Management Services Group 8441 Wayzata Boulevard PO Box 59143 Minneapolis Minnesota 55459-0143 (612)544-0311 ft E M 15 E V 1 "� APR 2 7 1992 TO: CITIES CITY OF OAK PARK HEIGHTS FROM: BERKLEY ADMINISTRATORS RE: GROUP SELF-INSURED ACCIDENT PLAN FOR CITY VOLUNTEERS Please refer to the attached memo and election form sent by the League of Minnesota Cities Insurance Trust on April 19, 1991 . If the city desires the Group Self-Insured Accident Plan for City Volunteers for the upcoming year, please fill out and return the election form with your Workers' Compensation data sheet. If you have any questions, feel free to contact our office. Self-Funded Insurance Specialists . _ 41/ 183 University Ave.East St.Paul,MN 55101-2526 League of Minnesota Cities (612)227-5600(FAX:221-0986) April 19, 1991 To: Cities and agents - LMCIT workers compensation program From: LMCIT Board of Trustees Re: Accident coverage for city volunteers The LMCIT Board of Trustees is pleased to announce a new program to provide accident protection to city volunteers. This program provides a schedule of benefits to compensate city volunteers who are injured while performing volunteer services for the city. This optional coverage is available to member cities of the LMCIT workers compensation program. Whom will the new program cover? With only a few exceptions, all city volunteers working under the city's direction and control will be automatically covered on a blanket basis if the city chooses to add this coverage. This could include, for example, coaches and instructors in recreation programs, volunteers working on a city-sponsored festival or celebration, "clean-up day" volunteers, etc. The city will not need to list the individuals who are to be covered, either by name or by project; nor will the city need to keep track of the time the various volunteers put in. There are four classes of volunteers who would not be automatically covered: 1. Volunteers who are covered by workers compensation. Certain volunteers are defined to be "employees" for purposes of workers compensation, and are therefor eligible for workers compensation benefits if they are injured. These include volunteer firefighters, ambulance attendants, first responders, law enforcement assistance volunteers, and civil defense volunteers. Since these volunteers are already protected by workers compensation, they are not covered under this plan. 2 . City council, board, committee, and commission members. Other coverage options are already available for these people. The workers compensation law gives cities the option to extend workers compensation coverage to elected and appointed officials. LMCIT has also for several years offered an accident policy underwritten by CIGNA for members of city councils, boards, and committees. -1- i 411 '., ! . 3 . Members of private organizations which provide services or participate in city-sponsored activities as a group. 4 . Volunteers working on construction or demolition projects. These volunteers will not be covered automatically. However, for an additional charge, the city can add coverage for volunteers on a specific construction or demolition project. What benefits would an injured volunteer receive? The plan will provide three basic benefits: 1. Disability benefit. A volunteer who is unable to engage in the activites of his/her normal occupation because of an injury suffered while performing volunteer services for the city will receive a disability benefit of $400/week for up to 26 weeks. 2 . Death benefit. If a volunteer dies as a result of an injury suffered while performing volunteer services for the city, a death benefit of $100,000 will be paid to the volunteer's survivors or estate. 3 . Impairment benefit. If a volunteer suffers a permanent impairment or disability as a result of an injury suffered while performing volunteer services for the city, the volunteer will receive a lump sum payment as compensation for that impairment. Payments are based on the percentage of disability, ranging from $750 for a 1% disability to $100,000 for 100% disability. The percentage of disability is determined in the same manner used for impairment compensation in the workers compensation system. For an additional charge the city can add coverage for up to $1000 of medical costs. This limited medical coverage is intended to pick up relatively minor first aid costs. On more serious injuries, it could also be applied to costs which the individual would otherwise have to bear under his/her own health coverage's deductible or co-pay provisions. What does it cost? The cost is based on the city's population. The basic annual charge is $. 10 per capita, subject to a minimum premium of $150 and a maximum premium of $1500. The additional cost to add the optional medical coverage is 45% of the basic premium. Coverage for volunteers working on a construction or demolition project can be added for a charge of $300 per project, or $435 per project if the optional medical coverage is included. -2- , 110 411 The expiration date of this coverage will be coordinated with the city's LMCIT workers compensation coverage. For cities that add this coverage mid-term, the initial premium will be pro-rated. Why would the city want this coverage? Aren't injuries to volunteers already covered under the city's liability coverage? An injury to a volunteer would be covered by the LMCIT liability coverage only if the city was legally liable for that injury; that is, if the injury was caused by some negligence by the city or a city officer or employee or another city volunteer. However, just as with any other tort claim, the city would not be liable for an injury to a volunteer if the volunteer him/herself were more at fault than the city, or if the injury were simply an accident that really wasn't anyone's fault. A volunteer coach being hit in the head by a batted baseball might be an example of the latter situation. The volunteer accident protects a rotects the volunteer on a "no-fault" basis. The benefits are automatically payable if the injury occurs while the volunteer is performing services for the city, regardless of whose fault it was. Besides protecting the volunteer whose injury isn't caused by the city's negligence, having these no-fault benefits available could also help avoid litigation in cases where the city (or a city officer, employee, or other volunteer) is or may be at fault. The injured volunteer can receive these benefits without getting into an adversary situation against the city. Of course, if the volunteer's injuries exceeded the benefits paid under this coverage, he/she would still be able to make a tort claim against the city for those excess damages, if the injury was caused by the city's negligence. Why did LMCIT create a whole new program? Why not just offer a "voluntary workers compensation endorsement" and provide workers compensation benefits to volunteers? The LMCIT Board chose this approach for several reasons. First, this approach is substantially less expensive to the city than providing workers compensation benefits would be. The basic premiums are roughly a fifth of the cost of workers compensation benefits, reflecting the more limited scope of benefits provided. Second, administration is simpler for the city, since the city doesn't have to keep records of how many hours were worked by how many volunteers, etc. Third, it eliminates the problem of determining what the appropriate indemnity rate is for an unpaid volunteer. (This is particularly problematic with volunteers who don't have other paying employment. ) -3- . 411 4 Fourth, providing voluntary workers compensation coverage would create a potentially unlimited risk for LMCIT, since the reinsurance LMCIT purchases from the state workers compensation reinsurance association wouldn't apply to this exposure. The LMCIT Board was very concerned about the danger of assuming an open-ended risk that conceivably could jeopardize the financial stability of the entire pool in a catastrophic situation. How do we enroll? To enroll, complete the attached form and return it to Berkley Administrators. (Don't worry, this isn't someone new. EBA has just changed its name. It's still the same company that has administered LMCIT's workers compensation program since 1980. ) They will bill the city for the premium. Further information Call Pete Tritz or Pat Deshler at the League office if you have any questions or need any additional information. -4- • 410 411 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST ACCIDENT PLAN FOR CITY VOLUNTEERS Application for Coverage The City of hereby requests coverage under the League of Minnesota Cities Insurance Trust's Accident Plan for City Volunteers effective and agrees to pay the premium established by LMCIT for that coverage. Optional coverages to be included: $1000 medical coverage Yes No Construction or demolition project Yes No Please describe each construction or demolition project to be covered, including the nature and scope of the project, the dates, and the approximate number of volunteers who viii be involved. Signature Position Date Return this form to: Berkeley Administrators P.O. Box 59143 Minneapolis, Mn. 55459-0143 S ! . Berkley Administrators a member of the Berkley Risk Management Services Group PO Box 59143 Minneapolis Minnesota 55459-0143 (612) 544-0311 THIS FOLDER CONTAINS IMPORTANT DOCUMENTS AND INSTRUCTIONS FOR FILING CLAIMS FOR YOUR EMPLOYEES. PLEASE READ EVERYTHING CAREFULLY NOW SO YOU WILL KNOW WHAT TO DO WHEN AN INJURY OCCURS. IF YOU HAVE ANY QUESTIONS, PLEASE CONTACT YOUR AGENT, IF YOU HAVE ONE, OR BERKLEY ADMINISTRATORS. CRITICAL INFORMATION Any serious (life threatening) injury or injury causing death must be reported to us by phone immediately. Dial (612) 544-0311 In all other situations state law requires you, the employer, to report all injuries and illnesses which your employees claim are related to work. You must report their claim using a FIRST REPORT OF INJURY form. Berkley Administrators must receive the original report within 10 days of the date you have knowledge of the claimed injury. The law also requires prompt payment of any benefits which may be due. Payment for lost wages must be made within 14 days of the first day of lost time from work. The Department of Labor and Industry can and does impose fines and penalties against employers if they do not comply with these standards. TO AVOID SUBSTANTIAL PENALTY EXPENSES FOR LATE REPORTING OF AN INJURY OR FOR LATE PAYMENT OF BENEFITS, YOU MUST REPORT INJURIES AND LOST TIME FROM WORK TO US AS SOON AS POSSIBLE. To help you do that, you will find detailed instructions for completing the First Report of Injury form on Page 3 of this folder. If you need additional copies of any of the enclosed forms, please complete and mail the order form sent with this folder. PREVENT WORK INJURIES For your benefit and assistance, we offer safety services which can be tailored to your needs to help prevent work-related injuries. Our Loss Control Representatives are available for consulta- tion regarding safety in the workplace and for safety surveys of your facilities. They can also assist you in compliance with OSHA regulations and the development of your own program of accident prevention and loss control. These services are provided at no additional charge to you. Call (612) 591-7498 to schedule a visit or for more information on safety and loss control topics. BA 253 (4/92) Ilinesota Workers' Compensation MISTRUCTIONS FOR EMPLOYERS WHAT TO REPORT State law requires that you report any and all injuries and illnesses that your employees believe are work-related. Berkley Administrators will then determine if any workers' compensation benefits are payable to the injured employee. Remember, filing a First Report of Injury with us does not mean that you are admitting any liability. It means only that you are reporting a claimed injury or condition which your employee thinks is related to work activities. WHO REPORTS AN INJURY The injured employee is required to report an injury to you, the employer, within 180 days of its occurrence. You, the employer, are then required to report that claimed injury to us on a First Report of Injury form. It is neither the injured employee's responsibility to report the injury to us nor is it your insurance agent's duty. DO NOT ask the injured employee or your agent to complete the form. If they cause any delay in reporting the injury to us, you, the employer, can be penalized by the Minnesota Department of Labor and Industry. WHEN TO REPORT AN INJURY If an employee is killed or suffers a life-threatening injury (amputation of limb, massive internal injuries, etc.) you must report by phone to Berkley Administrators within 48 hours of the occurrence. You must also send a completed First Report of Injury form to us within 7 days of the injury. You must report any other work-related injury or illness within 10 days of your first knowledge of its occurrence. If the employee's supervisor or manager knows about the injury, then you, the employer, have knowledge of it even if your home office or headquarters staff is unaware of the injury. The injury MUST BE REPORTED on a First Report of Injury form and we MUST RECEIVE it within 10 days. Because of possible delays by the Postal Service, we recommend that you complete and mail the original First Report on the same day you are notified of the injury. DO NOT wait for the employee to return to work or for medical bills or other information. Any delay in this process can result in a penalty assessment against you by the Minnesota Department of Labor and Industry. You can be fined up to 5200 for late reporting. If that late report results in late payment of benefits to your employee, you can be penalized up to $3,838 + 10% of the delayed payment. IT IS VERY IMPORTANT THAT YOU REPORT ALL CLAIMED INJURIES AS SOON AS POSSIBLE. HOW TO REPORT AN INJURY State law requires that you use a Minnesota First Report of Injury form. Always keep a supply of forms on hand. When your supply runs low, use the order form sent with this folder to request more forms. When an accident occurs, have the employee's supervisor complete the Supervisor's Report of Accident (SRA). This form will assist in your internal investigation of the accident and what caused it. Then you, the employer, should complete the First Report of Injury form using information from the SRA, personnel records, and elsewhere. If there are any unusual circumstances or you need to provide more information, you should attach a letter to the report. Send the original First Report and SRA to Berkley Administrators. Keep a copy of each for your records. Also give a copy of the First Report of Injury to the injured employee; this is required by law. Detailed, line-by-line instructions for the First Report begin on Page 3. REMINDERS AND ADVICE • If an employee begins to lose time from work after you've mailed the First Report, call us immediately to let us know. Then we can pay any benefits due on time and you can avoid any penalties for late payment. • Call us as soon as an employee returns to work after a work-related injury. We can then discontinue time-loss benefits and avoid the possibility of over-paying your employee. • Promptly send us all injury-related medical bills you or your employee receive. Medical providers often bill only one party, so if you receive a bill, it probably means that we have not. Before we pay a bill, we review it to ensure that it's related to the work injury and we request medical records for it. The law allows us 30 days from the date we receive those records to pay a bill so it may sometimes be several months from the date of treatment before we're able to pay. • • BOX 20 Indicate the location where the injury occurred and whether or not it occurred on your premises. BOX 21 If your employee has lost any time at all (even just 10 minutes) from work, you must report it. Enter the date when lost time first occurred. If there has been no lost time, write "NONE" in the box. BOX 22 Enter the date on which you first had knowledge of your employee's injury. BOX 23 If the employee has already returned to work, enter the date he/she returned. If the employee has NOT returned to work, leave this box empty. BOX 24 Sometimes employee's are injured but don't lose time from work until days or weeks later or they lose time but don't notify you that it is related to their work injury. In any case, provide the date you were notified that the employee was losing time from work due to a work injury. BOX 25 If your employee has died as a result of their work-related injury or illness, enter the date of death in this box. A work-related death or life-threatening injury must be reported to us by phone immediately. BOX 26 Indicate the approximate time that the injury occurred. BOX 27 Enter the type of injury he/she has. Indicate all body parts which were injured. Be specific. Write "left low back and left index finger" rather than "back and hand". If the injury is not obvious, write something like "possible fracture" or apparent allergic reaction". BOX 28 Briefly but accurately describe the the circumstances that caused the injury. Don't just write "fell onto sidewalk" if in fact the employee was "on roof repairing chimney, safety harness broke, fell 20' onto concrete sidewalk". Also, identify any machine, tool, equipment, or substance involved in the injury. If the circumstances surrounding the injury are complex, unusual, or suspicious, attach a detailed explanatory letter to the First Report of Injury form and SRA that you send to us. BOX 29 Provide the name, address, and phone number of the doctor who treated the employee for the injury. If the employee received no medical treatment, write "first aid only" in this box. BOX 30 Provide the name, address, and phone number of the clinic or hospital where the employee received treat- ment for the injury. BOX 31 Provide the names of co-workers who may have witnessed the accident or who worked with the employee on the date of the injury. We may need to contact these people to obtain more information about the circumstances that lead to the injury. BOX 32 Enter the name and address of your organization. If you do business using a different name than you are insured under, please indicate that. For example: John Doe dba J.D. Enterprises or J.D. Widgets Division of John Doe Enterprises. BOX 33 Enter the date that you, the employer, completed the form. BOX 34 Enter your Unemployment Insurance ID number. This number is assigned to you by the Department of Jobs and Training. Call them at (612) 296-6141 if you do not know your ID number. BOX 35 Enter the proper SIC code for your organization. This number is also assigned by the Department of Jobs and Training. Call them at (612) 296-6141 if you do not know your SIC code. If you know the payroll classification code for the injured employee, enter it in the box to the right of Box 35. BOX 36 Enter the name and work phone number of the injured employee's supervisor. BOX 37 Enter the name, title, and work phone number of the person in your organization whom we should contact to obtain more information about this claim. BOXES 38-44 Do not fill in these boxes. Berkley Administrators will complete this part of the form. bo Berkley Administrators a member of the Berkley Risk Management Services Group PO Box 59143 Minneapolis Minnesota 55459-0143 (612) 544-0311 • • Do not pay medical bills for your employees' work-related injuries. First, it may be illegal for you to do so. Second, by paying a bill, you may be legally accepting liability for an injury which is not really work-related. Third, because of the Medical Fee Schedule, we can often pay less than what the medical provider charges which saves you money. • Do not deliberately obstruct or attempt to prevent an employee from seeking workers' compensation benefits. If you do, you could be liable for any workers' compensation benefits plus triple damages to that employee. By law you must post the name and address of your workers' compensation carrier (Berkley Administrators) in a conspicuous place. You may use our "Employees' Rights" poster for that purpose. If an employee claims a work-related injury, report it to us along with all relevant information. Let us investigate and determine if any workers' compensation benefits are due; we are experts in Minnesota workers' compensation. • Don't ignore your injured employees. Communicate with them regularly and let them know you are concerned about them. It is especially important, if they are losing time from work, that you keep them mentally "connected" to their job. If at all possible, provide light duty or part-time work to help return them to health and productivity as soon as possible. This is not only good for your employees, it also helps to reduce your claim costs. • Be accessible and provide us with the information we need when we request it. This will allow us to be more effective in managing your claims and controlling your workers' compensation costs. FIRST REPORT OF INJURY INSTRUCTIONS BOX 1 Enter the case number from your company's OSHA 200 log. BOX 2 Enter the injured employee's name. BOX 3 Enter the injured employee's social security number. This MUST be completed because the State of Minnesota uses it as its file number. BOX 4 Enter the employee's current mailing address including the county. BOX 5 Enter the date that the injury occurred. If not known, enter the approximate date or "unknown". BOX 6 Indicate the employee's gender. BOX 7 Indicate the employee's marital status. BOX 8 Enter the employee's job title or a description of the work done for your organization (Example: Class A Machinist, Carpenter's Helper). BOX 9 Enter the employee's birth date. BOX 10 Enter the date that the employee began working for your organization. BOX 11 Provide the name of the department or unit where the employee usually works (e.g. welding dept., loading dock, accounts receivable unit). If your organization has no formal departments, leave this box blank. BOX 12 Enter the employee's home phone number including area code. BOX 13 If the employee is in a union apprenticeship program or some other formal apprentice program indicate that in this box. BOX 14 Enter the employee's average GROSS weekly wage before any deductions for taxes, etc. If the employee is salaried, write "salary" and the gross amount and the period it is paid for (e.g. $500/week salary, $2,000/ month salary). If you are continuing to pay full wages or sick/vacation leave beyond the first day of lost time, indicate this by writing in "full wage continuation". BOX 15 Enter the hourly wage rate for employees paid by the hour. BOX 16 Enter the usual number of hours the employee works each day. BOX 17 Enter the usual number of days the employee works each week and indicate which days are usually worked e.g. M - F, Tu - Su, or M,W,F. BOX 18 If the employee receives meals or lodging from you as part of their pay, enter their value here. If the employee also works somewhere else full or part-time, enter their average weekly earnings at that job and provide us with the name of the other employer. BOX 19 Put an X by the description which best indicates the employee's work status. If the employee is a police officer or firefighter, indicate their smoking habits. 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CODE# CODE# CODE# CODE# 30 31 'TOTAL 31 - 32 GROSS r 32 33 OPT _ 33 34 EXCESS 0 34 35 EXCLUDE 35 36 ADDITIONS ( 36 37 SUB TOTAL 37 36SHV it 3H as NET I ( I I 39 League of Minnesota Cities Insuranc st TE © EEOWE17 roup Self-Insured Workers' Compensat Plan Workers' Compensation and Employers' Liability Agreement -. 2 8 1; Administrator Berkley Administrators - � 'i P.O. Box 59143 Minneapolis, MN 55459-0143 Phone (612) 544-0311 STATEMENT OF PREMIUM AUDIT ADJUSTMENT The "City" Agreement No. 5 Ct2-�>c�0729-s OAK PARK HEIGHTS Agreement Period: From 07/07/1991 To 07/07/1992 14168 57TH STREET, BOX 2007 STILLWATER MN 55082-0000 Rates Audited Annual Per $100 Of Code Audited Remuneration Remuneration No. Classification Premium 56345. 9.79 5506 GENERAL MAINTENANCE 5516, 278952. 5.48 7720 POLICE 15287. 109300. 0.47 8810 CLERICAL 514. 40932. 6.06 9102 PARKS 2480. 16380. 3.52 9411 ELECTED OR APPOINTED OFFICIALS 577. 54567. 3.52 9410 MUNICIPAL EMPLOYEES 1921. 3123. 3.80 9016 SKATING RINK OPERATION 119. 559599. Manual Premium 26414. Experience Modification 0.87 Standard Premium 22980. Premium Discount 1708. Discounted Standard Premium 21272. LMC Insurance Trust Discount 0% 0. Net Actual Premium 21272. Less Deposit Premium 25464.00 Balance Due City d Iz-o 4192.00 The foregoing statement is for the year end adjustment to your workers'compensation desposit premium. It was prepared after an audit of your payroll records and a final determination of your experience modification factor for the period indicated above. If the final balance shown is due to your city, a check will accompnay this form. If the final balance shown is due to the LMCIT, please forward your remittance,payable to the LMC Insurance Trust,to the adminsitrator at the address indicated above. Agent F-410678233 0.00 FOREST LAKE INS AGCY 232 S LAKE, BOX 188 FOREST LAKE, MN 55025 27612.00 2148.00 0.00 <4632.00> <440.00> 0.00 <4192.00> BA 446CG (5/91) Date: • • LK AUK 1 4'92 1 _ eague of Minnesota Cities Insurance 4 roup Self-Insured Workers'Compensation Plan ADMINISTRATOR EMPLOYEE BENEFIT ADMINISTRATION CO. 8441 Wayzata Blvd. Suite 200 P.O. Box 59143 Minneapolis, Minnesota 55459-0143 Phone(612)544-0311 Self-Insured Workers' Compensation Quotation (RENEWAL of Agreement No. 02-000729-4) Name of City: OAK PARK HEIGHTS Policy Period: From: 07/07/1991 To 07/07/1992 Estimated Annual Premium: ESTIMATED DEPOSIT CODE RATE PAYROLL PREMIUM ' GENERAL MAINTENANCE 5506 9.79 41100. 4024. POLICE 7720 5.48 336700. 18451. CLERICAL 8810 0.47 87860. 413. BUILDING MAINTENANCE & REPAIR 9015 12.01 32600. 3915. PARKS 9102 6.06 70860. 4294. ELECTED OR APPOINTED OFFICIALS 9411 3.52 18200. 641. Manual Premium 31738. Experience Modification 0.87 Standard Premium 27612. Premium Discount 2148. Discounted Standard Premium 25464. LMC Insurance Trust Discount 0% 0. Net Deposit Premium 25464. MAY 2 81991 CITY Of OAK PARK HEIGHTS The foregoing quotation is for a deposit premium based on your estimate of payroll. Your final actual premium will be computed after an audit of payroll subsequent to the close of your policy year and will be subject to revisions in rate or experience modification. While you are a member of the LMCIT Workers' Compensation Plan, you will be, eligible to participate in distributions from the Trust based upon claims experience and earnings of the Trust. Employee Benefit Administration Co. • i EBA 441 CG(11/87) League of Minnesota Cities Insurance Trus •up Self-Insured Workers'Compensation Administrator Employee Benefit Administration Co. A Member of the Berkley Risk Management Services Group P.O.Box 59143.Minneapolis.MN 55459-0143 Phone(612)544-0311 NOTICE OF PREMIUM REFUND OPTION At the end of each year (January 1) of the League of Minnesota Cities Insurance Trust Self- Insured Workers' Compensation Program a distribution of excess surplus funds, if any, will be returned to participants under a formula taking into account the earnings and claims experi- ence of the Trust, as well as the loss records of individual participants. As an alternative, participating cities with a discounted standard premium in excess of $25,000 may elect to have their distribution made to them in an amount determined by their individual loss experience and premium size. Final net cost to an electing participant will be discounted standard premium times minimum factor, plus losses times loss multiplier, not to exceed standard premium times maximum factor. Payroll amounts audited after the close of the year will be used in the determination of final net cost. For cities with a discounted standard premium of 25,000 - 50,000 Over 50,000 Minimum = Discounted Standard Premium x 70% 47% Loss Multiplier 120% 120% Maximum = Standard Premium x 115% 130% If this election is made, the final net cost of your workers' compensation insurance for the coming agreement year, based on estimated payroll, would be between a minimum of $ 17,825.00 and a maximum of$ 35,896.00 depending upon your losses. Adjust- ments will be made six months after the close of your agreement year and annually thereafter. Please return a signed copy of this notice to the administrator with your application for cover- age if you wish to elect this option. If this election is not made you will share in the regular distribution of surplus funds, if any. Yes, we wish to select the Alternative Refund Option. Agreement Period: Name of City: City of Oak Park Heights 02-729 07-07-91 to 07-07-92 By: Title: Date: This election cannot be accepted unless received in the offices of the plan administrator by the beginning of your agreement period. EBA 450 (10/90) • • League of Minnesota Cities Insurance Trust Group Self-Insured Workers' Compensation Plan AOMINtSTRATOR EMPLOYEE BENEFIT ADMINISTRATION CO. 8441 Wayzata Blvd. Suite 200 P.O. Box 59143 Minneapolis, Minnesota 55459-0143 Phone(612)544-0311 Application for Coverage (RENEWAL of Agreement No. 02-000729-4) The City of OAK PARK HEIGHTS Minn. hereby requests coverage under the League of Minnesota Cities Self-Insured Workers' Compensation Program for the period to 07/07/1991 07/07/1992 and agrees to pay a deposit premium of$ 25,464.00 One copy of this application should be signed by an authorized representative of the city requesting coverage and returned to the program administrator: EMPLOYEE BENEFIT ADMINISTRATION CO. 8441 WAYZATA BLVD. SUITE 200 P.O.BOX 59143 MINNEAPOLIS,MINNESOTA 55459-0143 Phone(612)544-0311 Signature Title Date R[TEN THIS COr 01173) VOW) PAYJWT FBA 442 CG(11/87) a -- • LMCIT EXCESS LIABILITY COVERAGE Cities obtaining excess coverage from the League of Minnesota Cities Insurance Trust must decide whether or not to waive the statutory liability limits to the extent of the excess coverage purchased. This decision must be made by the city council. CITIES PURCHASING EXCESS COVERAGE MUST COMPLETE AND RETURN THIS FORM TO LMCIT BEFORE THE EFFECTIVE DATE OF THE COVERAGE. For further information, refer to the accompanying memo. City officials may also want to discuss these issues with the city attorney. The City of accepts excess liability coverage limits of $ from the League of Minnesota Cities Insurance Trust. Check one: The city DOES NOT WAIVE the monetary limits on tort liability established by Minnesota Statutes 466. 04. - OR - The city WAIVES the monetary limits on tort liability established by Minnesota Statutes 466.04, to the extent of the limits of the excess liability coverage obtained from the League of Minnesota Cities Insurance Trust. Date of city council meeting: June 10 , 1991 signatu� � ,,mil f June 11 1991 ,?JA7E Position: C.Lty Adminibtta.tak/Tkecuufcen Return this completed form to North Star Risk Services, 1401 West 76th St. , Suite 500, Minneapolis, Mn. 55423 . CITY OF OAK PARK HEIGHTS • League of Minnesota Cities Insuran rust Group Self-Insured Workers'CompenWn Plan • Workers'Compensation and Employers'Liability Agreement Administrator Employee Benefit Administration Co. A Member of the Berkley Risk Management Services Group P.O.Box 59143,Minneapolis,MN 55459-0143 Phone(612)544-0311 STATEMENT OF PREMIUM AUDIT ADJUSTMENT The'City" Agreement No. 02-000729-4 OAK PARK HEIGHTS Agreement Period: From 07/07/1990 To 07/07/1991 14168 57TH STREET, BOX 2007 STILLWATER MN 55082 Audited Annual Rates Code Audited Remuneration Per$100 Of No. Classification Premium Remuneration 51852. 9.32 5506 GENERAL MAINTENANCE 4833. 271154. 5.22 7720 POLICE 14154. 93869. 0.45 8810 CLERICAL 422. 36415. 5.77 9102 PARKS 2101. 16380. 3.35 9411 ELECTED OR APPOINTED OFFICIALS 549. 2749. 3.62 9016 SKATING RINK OPERATION 100. 69913. 3.35 9410 MUNICIPAL EMPLOYEES 2342. 542332. Manual Premium 24501. Experience Modification 0.90 Standard Premium 22051. Premium Discount 1620. Discounted Standard Premium 20431. LMC Insurance Trust Discount 0% 0. Net Actual Premium 20431. Less Deposit Premium 22929.00 Balance Due City c7,1 2498.00 The foregoing statement is for the year end adjustment to your workers'compensation desposit premium. It was prepared after an audit of your payroll records and a final determination of your experience modification factor for the period indicated above. If the final balance shown is due to your city,a check will accompany this form. If the final balance shown is due to the LMCIT, please forward your remittance,payable to the LMC Insurance Trust,to the administrator at the address indicated above. Agent F-410678233 . 0.00 FOREST LAKE INS AGCY 232 S LAKE, BOX 188 FOREST LAKE, MN 55025 24811.00 1882.00 0.00 <2760.00:% <262.00> 0.00 <2498.00> EBA 446 CG(11/90) Date: T. G. 1 .7 • . 0 � 1048 G, E> LAKE ELMO JAYCEES CHARITABLE GAMBLING ACCT. III " �/��" e- /� 75-1019/919 19�ri `' ,rPAY , TO THE _ i _ � ORDER OF r if "or �4. L:C_ I $ a �•- 7-�- DOLLARS • E. e: ..• ME EIMq.MN SSW2 / 1 FOR Gam/- /I / 11'00 L048«'-- 1:09 L9 LO L961: 09111 L 5 LO %� �� r ■ Berkley Administrators formerly EBA a member of the Berkley Risk Management Services Group 8441 Wayzata Boulevard Suite 200 PO Box 59143 Minneapolis,Minnesota 55459-0143 (612)544-0311 TO OUR CLIENTS AND FRIENDS C(EBA) EMPLOYEE BENEFIT ADMINISTRATION CO. is now BERKLEY ADMINISTRATORS! lea We have been concerned for some time about the proliferation of companies that use the term,"Em- ployee Benefit" as part of their name and the confusion often caused by misidentification. We sought a new name that would identify both our company and our function, which continues to be the provision of top quality service in the administration of self-insured and residual market workers' compensation and property/casualty plans. Our association with the W.R. Berkley Corporation as a member of the Berkley Risk Management Services Group and our function as a Third Party Administrator logically led us to select the name, Berkley Administrators! We trust you will continue to look to us -- as Berkley Administrators -- for the quality administrative services you have come to expect. Please bear with us as we go through the name change process. It may be some time before "EBA" disappears entirely from our many printed materials but we will always be here -- for you -- our clients and friends. BA 011 (3/91) Self-Funded Insurance Specialists r CITY 0 40 OAK PARK HEIGHTS - 14168 North 57th Street • P.O. Box 2007 • Oak Park Heights, MN 55082-2007 • Phone:651/439-4439 • Fax:651/439-0574 To: Kate Tipping in —Landmark Insurance From: Judy Holst, City of Oak Park Heights Re: Renewal Application In reply to your fax of August 31, 2000, I hop e this will answer all the questions: stions: - Address& construction type of new pumphouse#2 is 5810 Norell Ave. N.; construction type is concrete block construction. - Make, model, year and serial number of generator is: Caterpillar 3306B TA Diesel 205KW Prime, 225 KW standby XQ225 portable generator set Manufactured 1995 Serial #8JJ00226 - Address and construction type of new lift station and force main at Kern Center is 5500 Stillwater Blvd.; submersible pumps with concrete tank and above ground controls. Uses two 20 horsepower pumps. Force main is 6 in. ductile iron pipe - Water and Sewer payroll are split 50/50. 2000 budget including FICA and Pera is $80,925 water and$80,925 sewer Enclosed is the signed and completed OML application. Give me a call if you need anything else. Tree City U.S.A. 08/31/2000 THU 13:38 FAX 6514647596 LANDMARK INSURANCE ( 1001/002 • • MEMO Pagel Landmark Insurance Services PO Box 188 AccovNTNO. OP DATE Forest Lake,MN 55025 OAKPA-1 KT 08/30/00 Phone: 651-464-3333 POLICY INFORMATION POLICY 8 CMC19785 TYPE EFFECTIVE EXPIRATION CP 07/07/00 07/07/01 City of Oak Park Heights 14168 Oak Park Blvd. Oak Park Heights,MN 55082-6476 Kris Re: LMCIT reply I don't know if you were sent a copy of this or not . . . #2) are the questions we went over by phone (the OML apps followg) . Let me know if you need anything further. Thank you. ft +0 TetZ-46-zy-- Kate Tipping 4t,3905- 7 `f 08/31/2000 THU 13:38 FAX 6514647596 LANDMARK INSURANCE l 002/002 „ t • • rL--\, ,7 145 University Avenue West, St. Paul, MN 55103-2044 , . \..Lmc Phone: (651)-281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting ono:leno: J Web Site: http://www.lmnc.org rPrJ I ,rr IVlerrio An 2 5 2060 gm Virll . 1. ......... .y.___._______ To: Kate Tipping- Landmark Insurance From: Don Daraskevich-LMCIT Date: 8/24/2000 Subject: City of Oak Park Heights,MN Kate, Following our telephone conversation this morning regarding city trail and 7/7/2000 renewal Application, I offer the following: (1)As respects to Trail Property Granted to the City from NSP, as long as the city is also granted the Authority to enforce it's city's ordinances, rules and regulations to this trail property as it would to any other city Park property and maintains direct control of it's regular day to day operation,then Municipal Liability coverage from the city's LMCIT covenant would extend to the city only for it's operation of this trail. (2)As respects to 7/7/2000 renewal application: � ,�,�. ° . -Need Address and construction type of new Pumphouse#2. S811). A P-41 r•" /ij. '4i /ems'-‘114'""- °' -Need Make, Model, Year and Serial Number of Generator at water tower. Since it could be moved, I think its best to classify it as Mobile Property. C44t- rg'//a I1od 3304- ' 8.a3"oo 1 .4. 1 iS'" -Need Address and Construction type of New Lift Station and Force Main at Kern Cen er ssav96//over u'r/�P. -Advise expenditure value of Water Department(Excluding Sewer Department ayrolt._ -Need Signed and Completed OML(Open Meeting Law)Application.,v-''''. (3) REMINDER: Please be certain you and your city have properly identified and communicated to us Flood and Non-Flood Properties(as determined by the NFIP),as the Flood Coverage Code can not be amended at or after the time of a loss. I ass.- . .,., t z Sa ? 5 vt- as 8 D 0 ---- < f,., , -. // 70v AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER I • l; 1 -.:a `b , "..444:4 1' illa'ex r ; •�a�� .r. .- 3 From: jjohnson [jjohnson @cityofoakt#parkheights.com] Sent: Thursday, September 07, 2000 10:20 AM To: 'jholst @cityofoakparkheights.com' Subject: RE: Insurance Information Generator Caterpillar 3306B TA Diesel 205KW Prime, 225 KW standby XQ225 Portable Generator Set Manufactured 1995 Pump house#2 is concrete block construction Kern Center Lift Station is Submersiable pumps with concrete tank and above ground controls. Use two 20 Horsepower pumps. Force Main is 6 in Ductile Iron Pipe Jay Original Message �y j� { •y �p � 1Hb. k I halite �}.of ak `.s8� s,1, :;,d``7$1 C rr.sl Fa r� * x k P:Y Sent: Thursday, September 07, 2000 9:26 AM To: 'Jay Johnson' Subject: Insurance Information Jay, I need some information from you for our City insurance. 1. What year is the generator? 2. Construction type of new pumphouse#2 (I assume they mean the one at Norell, although that is not new this year. If you think they are talking about something else, let me know. 3. Construction type of new lift station and force main at Kern Center. Please get me this info ASAP. Our policy was up July 00. Thanks Judy 08/31/2000 THU 13:42 FAX 651596 LANDMARK INSURANCE • iJ001/003 - LEAGUErOF MINNESOTA CITIES IN SURANCE TRUST ADMINISTERED BY: BERKLEY RISK ADMINISTRATORS COMPANY,LLC 145 University Avenue West St.Paul,MN 55103-2044 SUBMITTED BY: Landmark Insurance Services PRODUCER: Brian Alm ADDRESS: _ P.O. Rnx 1 RR 1anrest Lake, Imo- 55825 APPLICATION FOR OPEN MEETING LAW DEFENSE COST REIMBURSEMENT AGREEMENT APPLICANTS INSTRUCTIONS: 1. Please answer all questions. If the answer is NONE,please state NONE. 2. If space is insufficient to provide a complete response, attach a separate sheet. 3. The application must be signed by an authorized representative of the City. Special Note: Please answer all questions. These questions are intended to provide general information only. The information provided will also be used for a proactive loss control procedure if needed. APPLICANT 1. Name of city or other public entity whose city officials are to be covered under the Agreement. City of Oak Park Heights 2. Principal Address: 14168 Oak Park Boulevard North Oak Park Heights, MN 55082-2007 3. If Joint Powers entity,identify participants: None LMCITAPP.OML(11/97)(REV. 11/99) PAGE I OF 3 08/31/2000 THU 13:42 FAX 6514598 LANDMARK INSURANCE [j 002/003 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST CLAIM HISTORY List incidents of threatened or actual open meeting law litigation involving city related individuals in the last five years. For each incident give its approximate date and its resolution,including the penalty imposed, if any,and the amount of attorneys fees incurred in defending the incident. �x �t " a r a r:::;xs, .cwo a wa x a r s l c vw i .•�k o €r,a f 9_ S in`"•a{ rYk�Z i� Lr` `r< �'raN3�0^, x s S��7.•'`S, r •c t� �� 1..a a��c Kyx z x x > �s �• ^:?'.: �ro'^� �F`'�'aC+,,.,L �L ♦� � �' t� y y�i @ 1•� ,. pSp rP E��:KM;:x\::��•..r�{'a•rbr L a){v 5,_a�;,{;k.si-f..;a5 v3,2�r�,{>y,./�¢,:+�c I..,s�.y;.t 3<.ei'tc�ar.ti t�o r"',?s.\,��.}•..��.Yt..»'.<�,a;s.t.<.s,<Y�:r�Y.{.��ri.i vx`.r�•Yu.:S.:�x3{}..Yy}G+.cYc.a aY't J+,Cb1 X»4 n,✓l,y,��5 A.i:ti�.!-r-i�<n.kr..gs 3 r,k t`Y v tS��,\,t+�eY.>�t.-:s'�Ya rDL��3Z;;v.rti�k�6-{r��.>.cr;.♦.�.c Y'>'Utr.1'z3l}r,r'c,k,rx�y S{-V'k Xyf,fti�'v�k1'�r:i\.�e >i��*t'q.Y"�)v�3�!i`sti�rt:(,�V x s r�1 y'f,Ll"e--�a s\1.^_a:��',y M�'5l�E v<�v\�t�t��^.J a�fi 1♦)t�{��.�Z,�:i♦�s s♦s� t4, Pf,`i SP / CS#r rC k+.Vi ,;iu�{S;;; • ?x •P• .'*;`,44A kY ..a. « �� y ` _ None 2. Are you presently aware of any other incidents or situations which may result in an open meeting law claim or litigation against city related individuals? YES X NO If YES,give details: 3. What action has been taken to prevent future incidents or claims? None • _. - .. �..:•. - - LMCITAPP.OML(11/97)(REV. 11/99) PAGE 2 OF 3 08/31/2000 THU 13:43 FAX 65110596 LANDMARK INSURANCE ( J003/003 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST OPEN MEETING LAW QUESTIONNAIRE 1. Description of orientations and/or training provided for all el cted officials (GTS programs, League programs, Handbook for Minnesota Cities, loss control seminars ...) on the subject of the open meeting law: seminars for newly elected officials 2. Have all new members attended the League Conference for Newly Elected Officials? X YES NO 3. Do all officials understand the Open Meeting Law and the Cities' compliance procedures? X Yas NO 4. Description of method of documenting official meetings (written, audio, video, ...): Written minutes, video tapes - unofficial video kept for '60 days) 5. Does legal council attend all official meetings? x YES NO If no, describe service relationship with city attorney. 6. Is education provided for the elected officials in the proper policy and procedures? a) Land use decision making: x YES NO b) Employment practices: , X YES NO 7, Please indicate the percentage of reimbursement of defense costs. 80% 100% , x BY: 4, \i"\-N. (Signature and Title of Authorized Representative) • Thomas M. Melena City Administrator LMCITAPP.OML(11/97)(REV. 11-99) PAGE 3 OF 3 CITY 00 OAK PARK HEIGHTS 14168 North 57th Street • P.O. Box 2007 • Oak Park Heights,MN 55082-2007 • Phone:651/439-4439 • Fax:651/439-0574 July 3,2000 Brian Alm & Kate Tipping .. Land mark Insurance.Services 232 South Lake Street Forest Lake, MN 55025 Dear Mr. Alm and Ms.Tipping: I have enclosed the League of Minnesota Cities Insurance Trust insurance renewal forms for your review. We have made corrections throughout the document that should be noted before final submission of the forms to LMCIT. Some major changes that you should note include the following: Changes on the LMCIT Property Schedule Address Changes -Exclude y2k Coverage • Changes and additions to the Statement of Values worksheet Address Changes - Cost of frame shelter at Swager Park was$7,750:00 -Building Contents$213, 830.43 Generator, purchased on lease purchase with purchase price of$42,067.50.(does not include interest) It can be moved,but has been placed on cement pad with fencing with the intention of not leaving City Hall. -4 outdoor sirens, the last one cost$13, 456.28 -Bell Property on Stagecoach, Purchase price$124,969.23 - Kern Center Lift Sitation and Force main$207,367.50 as of 5/17/00 • Please update figures by 3% adjustment where necessary. • LMCIT Vehicle Schedule - Add 2000 Ford Expedition, $26,695.00 (sheets attached) We may want to explore the option of adding Boiler and Machinery coverage depending on the cost. Please feel free to contact me or Judy Hoist, Finance Director, if you have any questions. Sincerely, Kimberly Kamper Administrative Assistant Tree City U.S.A. r • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST Administered by: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103 (612)281-1200 APPLICATION FOR THE CITY OF: 0644' PctAr L am. County: �LL4`"""' 01'' Mailing Address: -Po Z°k 7 Phone:6,5i -439- 3 9 City, State, Zip: Si t.-w% -' > M N S5 O fi''2 -axv City Contact: .0~-010,0 /t1£ Title: C` 0 r14-4' 1990 Census Population: :'0Cp Current Estimated Population: 4 t© 0 Total Expenditures All Operations: � t'� „? /4/: Is the City a Member of The League of Minnesota Cities? x Yes No Submitting Agency: Ldr"a u"(e... 1 In c c (O-'C.J_ Sear c P C.a 2 Address: ?O 13O K l 8 Z City, State, Zip: Ai 5 S OZ Telephone: ( ( ) ` V4 3 3 3 3 Facsimile: (65l ) (14' ( 59 c Agency Contact: ;O-"` a I An I VaCte, l ; 6G); nor Date of Council Resolution or Contract Appointing the Agency: tl AGENT COMPENSATION: )( 10% City Will Compensate the Agent Directly Other Please specify: Standard Deductible: 6d© - (Applies to All Lines. Optional All Lines Deductibles are Available.) Current Information on Coverage You Are Applying For: Carrier Policy Type Expiration Date Premium 631 i1 t Q CI Nom- • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST PROPERTY Deductible:S (Standard) Limit of Coverage per occurrence to be established by LMCIT. This limit is established by totaling the replacement cost values of all your buildings/contents, property in the open and mobile property. MOBILE PROPERTY Mobile property with replacement cost values of$5,000 or less can be covered with no schedule. There is a flat premium charge. Do you want this coverage? 'Dq YES [ 1 NO /� 3 L�bCXC0 ..4.,s-LQ�-c�-` car CRIME COVERAGE -" t,-s.c., c.0-.c Form Location Limit Deductible L ,.,..N^ J 4C t" Forgery & Al ration (24/cc-L.' (Standard) Theft, Dis pearance & Dest ction (Standard) Please describe Safe and Vault • LMCITAPP.30(11/97) Page 2 of 19 (11 0 0 0 0 0 0 0 • 0 0 0 0 0 0 00 0 0zt �i o H H H H H H H H H 0 o Cu �7 al cn rA w N H 0 tO 3) 0 rn Vii IIN 0 0 H a A •• ro XI IV o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0zw •°• C0 o o 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 g 1-' x .� ' ' kcCZroairocro0 00 00 01...t 1-4rcnrwr44 cnElpi En En1..; ro1..$ rtoEnI., lc u, lc w0Dv o 0 :h ��f+ 0 t* ,P ,P t-+ F-+ E ►4 �' x °O P1 ,P w ,-+ :L7 ,'1", ,P ,�' yW '' ,P►-� R, C� O� � k7� P ►HC � 0HHHtr'� t�'� t�i � Qt�" � NH � �'irntrixtr, C�► a � t=iH7c7gg t= @ Cn E HCIDNl7 7d CD tD 't7 k toHtoHtofctai T' :vtai x zn to RI Co FO H (n0 IV c t1 t21 PO i-3 cg0 t1 0O0 t'' � l El rp 0 MI Pt 1! � yt� H HC 0 D' Fi- 1C 6 a,' H ° `4 VI z t=i x ►-+ d tsi :L7 Cii .. En zzzz 07� ti 0 ro H 4 r It C4 wHZ r 1-, P:i Z O t" RI r sip H d pi pi 0 Pi Pi pi t4 H ° L-1 r v H z g H o 0 0 F H m rr r Y N ti F 7 (D A r` p Cl. L c o Pq F ig AL 11 i bD ro ro ►d ro hl IV P1 bi CC CO tb MI C1 tzi IV tT1 P1 CO 0 Di H C) Ca r ►-+ H H 1-4 I' F"'' t-' r r t-' t-' r z t-' t-' t-' tr r r o n t., 0 0 0 0 0 o 0 t1 a ti a GHCV el t,1 a CI • c ro . 1-+ H F-+ tit Cl 4o Ch w w rn Ch CO CO CO w tO H m H CO PP ON • Vi H N a' CO O w to vi Ui CR CO (n O N CM ,P r.7 to CD an N K • • • • • • • • • • • • • • • • • • 0 W O CO (Al -.7 N rP H O O O O O an 0 o O O to O O O '1 W t4 O O CD CO a' C' a' O O O O O 0 0 0 O O O 000tD tD r+, O O N �7 tt11 Cn tO O O O O O O O O O O O 000 rl, .. 0 P 0 0 0 '4 '4 ; 0 ; ; ; OLIO tD rt O Pi • .N ill H O 1 to to r-' Z z z z z z z z z z z zzz z z z zzz 'cro t`oon Z 11-4 w o ° O \•4 n 0 0 0 0 0 0 0 0 0 0 0 0 0 0 000 0 0 0 000 \b O m o C0 CX lo $.4 A 0 rt City of Oak Park Heights IR 22-Jun-99 • STATEMENT OF VALUES LOC- COVG ITEM DESCRIPTION LIMIT TYPE Oc k '4rk Botidev,,c( Y1o,—rh 1-1 Water Tower, Well&Pump $1,287,500.00 PIO 1-2 Cement Block Garage& Municipal Bldg $1,545,000.00 / B Motor pump, Auto corn& Contents $206,000.00 C 2 )3 if 3 0,`13 Property in the open $3,168.91 PIO 4 ?6. 7.5 1-3 Pump house#2 (18 x 24 block& brick, stee $51,500.00 ,/ B Contents of the above $51,500.00 C 2-1h �� Yfx RAC 16 x 20 frame shelter $5,346.94 „- B 7 757). 00 .e Property in the Open $60,466.05 PIO 3-1i'A xt� � �hZn a� i Cement Block Recreation Building, concret $35,361.07 B Property in the open $68,568.62 PIO 4-1 28 x 44 Cement&Brick building,wood ro $74,244.43 / B Property in the open $36,786.65 PIO 5-1 1 ' Lift Station& Pump equipment, steel $50,702.53 /PIO 6-1 ktaR,',4g. 33 v' Lift Station& Pump equipment, steel $50,702.53 P10 7-1 .+ Cx, d<-i �` z/ ? �fYY �3 � Y Cement Block Building,wood roof $187,283.12 V B Property in the open $132,381.88 PIO Page 1 r -�.. Jrar City of Oak Park Heights 22-Jun-99 STATEMENT OF VALUES LOC- COVG ITEM DESCRIPTION LIMIT TYPE 8-1 „ yg $61,800.00 '�PIO s�.isr 9-1 Lift Station&Pump Equipment ,/ $81,954.53 PIO 10-1 as = s Water Tower&Well (500,000 gallon) / $1,545,000.00 PIO Lift Station&Force Main ✓ $114,189.97 PIO y ��S 7 r c{� S,4. I4c-c., 1-c-e-rn C. r- : 20 7 34.-2. •s—v G., s--17-4v a Page 2 City of Oak Park Heights • 22-Jun-99 . STATEMENT OF VALUES LOC- COVG I'ThM DESCRIPTION LIMIT TYPE All Replacement Cost Buildings $1,898,735.56 All Replacement Cost Contents $257,500.00 All Replacement Cost Property In The Open $3,493,221.68 Sub-total $5,649,457.23 90% of Sub-Total $5,084,511.51 Values for this "Statement of Values" consisting of 2 pages attached hereto were prepared for City of Oak Park Heights, 14168 57th Street North, Oak Park Heights, MN All values submitted are correct to the best of my knowledge and belief. Signed Title Date Building Inflation Factor 1.113945 Contents Inflation Factor 1.2116225818 Property In the Open Inflation Factor 1.092727 Page 3 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST PROPERTY and AUTOMOBILE PHYSICAL DAMAGE The new covenant provides Errors and Omissions coverage for Property and Automobile Physical Damage. The following information is needed to designate the entities that are to be covered. Please indicate if you want the following entities to have coverage for Property or Automobile Physical Damage. • AUTOMOBILE PROPERTY PHYSICAL DAMAGE HOSPITALS YES NO N/A X YES NO— N/A X NURSING HOME YES NO N/A X YES NO N/A S( HEALTH CLINICS YES NO— N/A k YES NO N/A X AIRPORTS YES NO— N/A .( YES NO— N/A. ELECTRIC UTILITY YES NO— N/A X YES NO— N/A ) GAS UTILITY YES NO— N/A )( YES NO— N/A 5( STEAM UTILITY YES NO— N/A )( YES NO— N/A X- HRA YES NO )t N/A_ YES NO X N/A— EDA YES X NO N/A— YES NO— N/A Z( PORT AUTHORITY YES NO— N/A J YES NO N/A x ADDITIONAL INFORMATION: LMCITAPP.I I (11/97) PAGE 3 OF 19 • • LMCIT EXPENDITURES WORKSHEET City Oak Park Heights Budget Year 2000 All Expenditures 4,863,395 II. Transfers 203,625 III. E&0 Deductions a) HRA b) EDA 22,000 c) Port Authority d) Nursing Homes e) Hospitals f) Airports g) Clinics h) Utilities (Water, Electric, Gas and Steam) I) Liquor Store Operations(Cost of goods sold) IV. Adjust Total Expenditures(E&0) 22,000 V. GL Deductions a) Contracted Services 1,630, 850 b) Debt Service 539 , 700 c) Water Department 185 ,080 d) Electric e) Steam • 0 Gas g) Liquor (Operating Expenses Only -Do Not Include cost of goods sold) h) Recreation Buildings(Arenas, Sr. Citizens Centers, Ice Arenas) I) Swimming Pools j) Golf Courses k) Individual Purchases which exceed 5% of the adjusted total expenditures (E&0) (List&Describe) 1) Operations or departments that have E&O Coverage with LMCIT, but have their own General Liability with another insurance company. m) Special Deductions (List and Describe) 220 ,000 Met Council-Environmental Svcs .-Sewer VI. Operating Expenditures (GL) 2,062 , 140 LMCITAPP.13(11/971 PAGE 4 OF 19 • • INSTRUCTIONS All expenditures - include all operating expenses, capital outlay, capital projects, debt service (principal and interest) for the following: General Fund 2,253,195 Debt Service 539, 700 Enterprise Fund 901, 300 Port Authority 0 Special Revenue Funds 4,000 Nursing Homes 0 Capital Improvement Funds 166,200 Hospitals 0 Airports 0 Clinics 0 HRA 0 Other _ Construction 977,000 EDA 22,000 II. Transfers III. Please list the expenditures for the categories shown in Item III. a - I). These expenditures may be deducted if LMCIT is NOT providing E & 0 Coverage for these operations. IV. Adjusted total expenditures is the total expenditures for those departments and operations that have E & 0 Coverage with LMCIT V. GL Deductions: A. Please list expenditures for the categories shown in Item V. a - m). These deductions are necessary to subtract expenditures for operations or departments where the exposures are individually rated. B. Work performed by contractors which includes capital projects or services are also subtracted For Your Information a) Contracted Services - All Operations: Expenditures should be deducted if the services are provided by others and they provide a Certificate of Insurance. b) Debt Service (principal and interest) c -j) Please indicate expenditures for these operations (minus contracted services and debt services) m) Special Deductions: There may be some special deductions that are appropriate. Please list these special deductions or list them with your underwriter. VI. The operating expenditures are the expenditures that will be used to develop a portion of the liability premium. Individually p I ldually rated exposures are used to develop the remainder of the final premium. LMCITAPP.13(11/97)(Rev. 2/99) PAGE 5 OF 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST MUNICIPAL LIABILITY-SEPARATELY RATED EXPOSURES DO NOT LEAVE ANY SPACES BLANK IF NO EXPOSURE PLEASE INDICATE N/A OR NONE City of d a)c- ?ea' Date 71 coo 1. Golf course annual receipts: G'- . Number of golf carts: h aY 2. Street mileage: )-1) (Round to nearest mile, i.e. 4.2 miles should be 4) 3. Area (square feet) of Exhibition Buildings, Recreation Centers, Arenas, Auditoriums or Community Centers: c,n„Q 4. Water Department payroll: t (X--) -7/ 700 J ?/ 704i\ Total gallons of water used annually: 200/0oO,GOO (Round to nearest million, i.e. 2,500,000 should be 3,000,000) 5. Electric Department payroll: inU 6. Gas Department payroll: 7. Steam Department payroll: 8. Number of powered boats: Horsepower and usage of each: 9. Number of boats and canoes not powered: Explain how they are used: 10. Municipal liquor store receipts: ►''ick Store 1 Store 2 Store 3 On Sale Off Sale LMCITAPP.01 (11/97) PAGE 6 OF 19 • i , i min... • , m r 1 ` i ' ►ter 1 i1 ,4.4t/4 • Cil (, 0. �„ ir��1�• �i kn �i As Ulu: CU 48 Co Co •i kb%1-< �•p�►' 0i�111 =d 3 co W ' . *.,0,10 ionau CD LO Ct Tllli/ r► "�� •� ��t��1 ►ham Q l:Z' N N �'2 4.sue CD (� !gal (74,716.04,2-114 i l��a �S1i■rfosivi.., iii ,ti, % . - '\St- - 00;111.11 cs...„.7, 1110 i p EL woo ..4.- i.\ _Tijillti I., am ..„,Emu win MINIM; . 1T-' ' 41;4 IN . 1 J!111 1 M,Mh0 E /I/ MIMI NH 44r*I1111111111111011 MIR '4' v..46A VIIVibliklillnY qlw i 1 - �l l'lV`sue rml.ig s-- Q n� ,r . 511 l ILiIiit1iL1 10:--]-,,, , s.,._ gimp Iwo Mira lrlaiiiiia•AMIIIII 1■.-Itili N , , S.a, iiii■-__BMW Ian 4 • a , i MIMI F1, Ilumurfrillin mem '111111111 111111111111111 'IN ''---' Mil la:Fri Ca 2 O. IN MI_ 11= rti L LIN "1;61 N.1.1 I.I.ISI %id11 - ` `� ENI C1=! aim _ /O il.al lI:1I1q� x a �rj1a s mum= i5 c-u X41 u ■ pai a i,__Z■,I N It.'��IiMI iii 1� 11 i S van WI ""u?:a NM �1��I�i Slag n 11/D/ Sq ion um r .•0, A5 _ i - 1111111111111111111111111 INI as E: gm 3 _w _.— u . C.q/=Ems num: --:--I NMI:i :U11I1111!.1111 111 i� ._ 1_ LII11 ullnl�i r..._ :., MUM IIII 11uIN1111) I -14111111. r a In11I1,1111115IN T snin511 a��K �11..L/ HIM/111111112 /l ■{(i.► 11 `l NMI MU Bann:Iuulnnl 411 \--, WilA a tom ismove■ MIME i_i_____Eilid,iismi mow ammin KE a-"':- ,i. mu i !111'1111111 111111//11 511111/11 :0 =1 _ N.NII,11:111 11111111 11111111 '"/ 11■2 ' if �ll�� (_ 1111115111111 11111!:1, pi B- I !1 [li(l�itr{III'fif 111111:1111 I o , V °V� /111011/111111111 11115111111=!a.i1.5 fj/)lp.l 4 at11U L =/N 111 C1 55��1/11111 SII 11111 111111 IIIIINII. Ir/ am sii ■au=;.■��_ 111111:1111111.1111111111: + m..M 51.■11 MN11 1:1:MIME I""f/iV Vdin1M= s I . n i Tall U dIM ��M 1 1 ill 'MU T 1'\� i ill ,T l�I11f11�J W1 0 \�_� 1'; T �!�u� yr�J �� / -- • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 11. Number of seasonal swimming pools: h fa.. Height of diving boards: 12. Number of inside swimming pools: (€z... Height of diving boards: 13. Number of swimming beaches: in 10- Height of diving boards: Number of docks and rafts: v■ (a 14. Number of water slides: h,la. Height: Length: Location: Seasonal: Year Round: 15. Number of staff attorneys: Do you want coverage to be excluded? Yes No Additional Information May Be Necessary • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST MUNICIPALITY QUESTIONNAIRE DO NOT LEAVE ANY SPACES BLANK IF NO EXPOSURE PLEASE INDICATE N/A OR NONE ?Cu(City of Oak IC" “ 14` Date 7 / 2_000 1. Does the city own or operate any of the following? *Municipal **Limits of ** Type of ** Is the city named Liability Coverage Provided Coverage provided by as an additional Governmental Coverage Desired Projected by the other insurance the other insurance insured on the other Body or Entity (Must See Below) Expenditures company company insurance company's (If Applicable) (If Applicable) policy? (If Applicable) Hospitals Yes _X No _Yes No Nursing _Yes ,.,„No _Yes No Homes Health Yes ._No Yes No Clinics Airports Yes X No _Yes No Comments: * Municipal Liability, except for bodily injury,_propertv damage or personal injury, is automatically provided for the City and the other Governmental Body or Entity. If you do not want coverage please notify LMCIT. ** These questions are intended to analyze the coverages provided by the other insurance companies. These other policies must provide bodily injury, property damage or personal injury coverage to the City and the other Governmental Body or Entity. • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 2. A. Damages arising out of the following activities are excluded unless such board, commission, authority, or agency is named in the Declarations, in which case the "city" will also be covered to the extent of coverage provided under this covenant to the named board, commission, authority or agency for damages arising out of the activities of the respective named board, commission, authority or agency. Please designate the activities you want covered below. B. If the Governmental Body or Entity has purchased coverage elsewhere the City needs to evaluate their exposures and the coverage that they need. 1) Is the city named as an additional insured on the other policy and for what coverage? 2) Does the city want coverage from LMCIT for these activities? PLEASE CONTACT LMCIT FOR ASSISTANCE. ADDITIONAL PREMIUM MAY BE NECESSARY Municipal Liability Projected Projected Additional Governmental Body or Entity Coverage Desired Revenue Expenditures Information Gas Utilities Commission `Yes . .No Questionnaire Needed Electric Utilities Commission Yes No Questionnaire Needed Steam Utilities Commission _Yes No Questionnaire Needed Port Authority ,Yes X No Need Full Details Housing&Redevelopment Authority Yes ,..No Need Full Details Economic Development Authority X Yes No Need Full a` Details 1446Y Area or Municipal Redevelopment Yes X No Need FuII Authority Details Municipal Power Agency Yes 4. No Need Full Details Municipal Gas Agency Yes ,�No Need Full Details • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 3. A. Damages arising out of the following activities are excluded unless the agency or board is specifically named in the Declarations. Please designate the activities you want covered below. B. If the Governmental Body or Entity has purchased coverage elsewhere the City needs to evaluate their exposures and the coverage that they need. 1) Is the city named as an additional insured on the other policy and for what coverage? 2) Does the city want coverage from LMCIT for these activities? Municipal Liability Projected Projected Additional Governmental Body or Coverage Desired Revenue Expenditures Information Entity Welfare or Public Relief _Yes X No Need Full Agency Details School Board _Yes No Need Full Details 4. Does the city operate a dump or landfill? v What type of material is deposited there? Is the area fenced to keep out the public when closed? Is the area attended during open hours? 5. Does the city own or operate a ski jump, ski lift or tow rope? hd If operated by others, please indicate and advise if the city is named as an additional insured on their policy and the policy limits provided. Is coverage desired? Yes No If coverage is desired full details must be submitted. S LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 6. Does the city own or operate a marina? h 0 If operated by others, please indicate and advise if the city is named as an additional insured on their policy and the policy limits provided. Is coverage desired? Yes No If coverage is desired, full details must be submitted. 7. Dams classified as Class I or Class II by the Commissioner of the Department of Natural Resources or any dike, levee or similar structure - (Failure or bursting is excluded.) n(c` A. Age of Dams: Inspected regularly: Yes No By Whom: Height of dam above reservoir: Height of dam above the bottom of spillway: Width: Is the dam fenced to keep the public off? Acre feet of water dam has been designed to retain: acre feet B. Age of Dike or Levee: Height of Dike or Levee: Construction Material of Dike or Levee: Acre feet of water Dike or Levee has been designed to retain: acre feet Who built the Dike or Levee: Is the Dike or Levee inspected regularly: By Whom: LMCITAPP.02(11/97) PAGE 11 OF 19 • S LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 8. Describe any large construction projects anticipated for this coming year. c++ J rc rar., �., 0 12-c ,,-�- 2 L cuv r, 9. Parks and Playgrounds A. Description (including area) of each park or playground: Sauw-e f n 6 t B. Description of playground equipment on each: SG-'� � � '�'ir r'c! C. Description of other special features and sponsored activities: (i.e., ski, toboggan, tubing, water slides, skate board or BMX facilities). viovuz.. 10. Does the city operate any aeration devices in the winter to keep an area of local ponds, lakes or rivers ice free? no If so, please give full details and precautions taken. LMCITAPP.02(11/97) PAGE 12 OF 19 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 11. Firefighters C Cerv\-, Ya.c.0 ✓ .e 5-Or vt-c -fa""• C1 •'Payroll of paid firefighters: Ou Number of volunteers: nO'v■t► Number of fire trucks: ►''o Describe any fund raising activities or celebrations by the firefighters or relief associations: 12. EM 's and Paramedics v\(), Number of rescue trucks: Number of ambulances Number of emergency runs: Number of convalescent runs: Number of EMT's: Number of EMT-A's: Number of paramedics: Is there radio contact with hospital doctors? Describe any EMT type losses: 13. Law Enforcement Total law enforcement payroll: • 8'G DSO Number of law enforcement vehicles: 7 Number of Class A (Full-time): 9 ✓ /- (Part-Time): Number of Class B: Class C: Number of Class D: © Class E: C� Number of Class F: O See next page for description of classes. LMCITAPP.02(11/97) PAGE 13 OF 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST A = Armed with arrest power B = Unarmed, no arrest power C = Non-officer employees D = Auxiliary police E = Voluntary unarmed F = Voluntary armed Describe any law enforcement type losses: Describe any jail or detention facilities maintained: W1Q- Go 0 .` Maximum holding period: ao 0 Q.Qoc...re,cQ 646 .Qc 14. Grandstands and Stadiums A. Number and location of each: — 3'rdc ?c.d. L. (g24JrWC.J)_S_Fb.* B. Seating capacity: 1(o O C. Type of construction: mil'-2.Q� D. Permanent or temporary: vna . 15. Festivals. Parades. Exhibitions or other special events sponsored by city. Describe: Vnov..9- 16. Fireworks' Exhibitions - Excluded. (Refer for consideration.) kNow: 17. Wharf or Docks - Describe: 1A0r.12_ 18. Street or Road Construction or Maintenance Annual expenditures: / J./ (o di-r? exul 5<- b c ra How much work is sublet to others? caL r-�. -017) -•: - Q.e_ c • - Are Certificates of Insurance obtained indicating adequate limits? 14- ,4-c) tO ' ^c‘, 0 Is any blasting done? +46' LMCITAPP.02(11/97) PAGE 14 OF 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 19 Please describe any contractual agreements the city has entered into such as: A. Mutual aid: (.).-, Pe -crys. Co B. Police or fire protection: act, t E-w� L • C. Other. Describe: u- ^r 20. Joint Powers Boards are not covered. However, they may be considered for coverage by submitting full details in a separate application. IMPORTANT! Coverage is not bound or in effect until you receive written acceptance from LMCIT. 21. Do you routinely get Certificates of Insurance from all independent contractors? Ltr2P' 22. Does the city provide a fire alarm or burglar alarm protection system? no If so, please give full details. 23. Any other pertinent information not covered above: 24. City was created in: 1 c11 (Year) LMCITAPP.02(11/97) PAGE 15 OF 19 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 25. Names and official titles of the Members of the Board of the City: (City Council) Name Official i7cw ; d S c kac(f \cwljov c .Q Tw�v hc t �t Co t.. - c J v�vv*J" r lc Su) La,t, < 26. Fiscal Year *Revenue *Expenditure Fund Balance At Year End -t9-200°Projected Year .d , 11JT G5?77U [ L 7C� I d 5� 19 95 Current Budget 5i 1034 C,S"9 C75 7 /49 3.5".16y3 ' , 19 9g 1st Prior Actual , -tf `1i°tO'4 414 '7 1 F5 1 —17(0 19 91 2nd Prior Actual - ,SAP. 4 2,10 Z 19 °I(P 3rd Prior Actual 318g 141g g 31 gO(0 41('. 5 (0g0� 514 *These figures should include all funds including governmental, enterprise, miscellaneous special revenue and debt service funds. If desired, you may send photocopies of appropriate sheets from annual financial report. 27. a. Total amount of outstanding bonds: 3 23 d UC a/4 Ss,`5 O?8,( .7 LrCS-1- b. Latest Moody's and/or Standard and Poors' bond rating: fl2 —Mo 4� LMCITAPP.02(11/97) PAGE 16 OF 19 • i LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 28. Have any of the following situations occurred within the last five years? Yes No a. Appropriation or condemnation for which agreed settlements have not been achieved. b. Improper or alleged wrongful granting of variances, building permits or similar grants or zoning disputes. c. Wrongful or alleged wrongful approval of building plans, designs or specifications. d. Wrongful or alleged wrongful approval of building construction. e. Allegation of unfair or improper treatment regarding employee hiring, renumeration, advancement or termination of employment. f. Disputes involving integration, segregation, discrimination or violation of civil rights. g. Any grand jury indictments of any public officials. h. Assault and battery claims made against the municipality or its officials. I. Any riot or civil commotion in the past five years. X j. Any losses or claims occurred involving contractual disputes. 29. Land Use Liability Number of building permits issued: Number of variances: Granted Denied Number of conditional use permits: Granted Denied 30. Does the city want to exclude Medical Payments? Yes No X LMCITAPP.02(11/97) PAf1F 17 CIF 10 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 31. Please list the additional covered parties required. hpryut. COPY OF CONTRACT MAY BE REQUIRED BY LMCIT FOR ANY/OR ALL ADDITIONAL COVERED PARTIES LISTED BELOW ADDITIONAL COVERED NAME ADDRESS PARTIES INTEREST 32. Contracts with a railroad and contracts with the contractor performing the actual railroad construction project needs special attention. Please provide a copy of the contract to LMCIT. This does not apply to easement or side track agreements. Please contact LMCIT before you sign a construction agreement with a railroad or Jr a rt ar i s • fir in i .1 r.il 1 . 1 a. '1 33. Does the City own or operate any trampolines? Describe 116' LMCITAPP.15(11/97) PAGE 18 OF 19 • • A sal 42 77 O O 770 O � V A r� A Ot .k. 10 n CO Z 8 Cl 0 t-o: C...s...: C...\%! (------ '4"-- ........ I, F. sib 0 0 a O a m 171 vt m V V V .r e„ 2 m m et e7 e1. of n Cl Cl Cl 71 11 m 41 11 71 •1 VI n of Cl n' 4 a < A A' A A A A A a a a a a a a a 1 .1 i a < < < < < < < < v v v v v v v v < < < ri -n 1. 70 < ro v v 12 v v 1 2 v < < < < < < < < 0 0 0 0 m M N M M .1 M 1. N 1. 1. M et CI CO et C4 net MI M 1. - IV g 5 2922 n f } y f 7. r- P1 VI try VI yyVT� (VT O. Os O. .v011 ppV� pVVV V V N 1.4 140 smb 1..6 146 140 VT p0 pOS O1 {p O. (<� 4) O tb OI (IA Ot O. N N H VT (0 t0 (0 10 V V V V O O a O 1- % m s N r. •••• Cl g v ni m N to c a O m m m m 4 r- C y a O a O O O a O S 1m' Cl W CO S 8 6f Tel Cl i n t~9 n n n n n n n n n 10 70 m 17 r- 7* CI N N N N N a N VT N N u µ r. ... VT H t. 1.O la CD 02 CO N + N N N N N N PT + • 1. H V �00 <m a a a O V V V V V .+ N u y Z a a a O O O O V OS N WV es t V t t1 p p p b C r- s aO aO a aO aO aO aO aO a aO as a a aO as S a °o $ S S r a m 1 7* r i Z 7O N ■ m f 2'O mor N 7► et 2 2 2 2 2 2 2 Z 2 Z 2 2 2 Z x z z X Z Z P A Al ■ e1 Z O O N M 4 m es C3 77 r 4 VT r Vi r r 1. r r 12 VT r 14 Cl ? 1 A m U w 61 m M CO ENDORSEMENT #5 • AS 6-5-00 CITY OF OAK PARK HEIGHTS I CMC 19785 I 3-15-00 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages 2000 FORD EXPEDITION #6653 ALL LIABILITY COVERAGES A° ACV $500. DED. COMP. '10;1; $500. DED. COLL. **aF 470; b , 41, ++APE tVg Total Endorsement Premium: $ 167. AP (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR X DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged PR .3123 Executive Director, LMCIT LMCIT ME020(1/95) Page 1 of 1 S ENDORSEMENT #4 AS 6-5-00 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK HEIGHTS I CMC 19785 1-1-00 IT IS HEREBY UNDERSTOOD AND AGREED THAT SCHEDULE OF COVERED PROPERTY FORM PM-100(11-97) IS AMENDED AS FOLLOWS: TYPE OF SEC. IV-WATER& COVERED SUPPLEMENTAL LOC. # LOCATION OCCUPANCY PROPERTY VALUE FLOOD COVERAGE CHANGE: 1 14168 OAK PARK BLVD. CITY HALL/GARAGE B CODE C LOCATION IS CHANGED PER ABOVE IN LIEU OF 14168 57TH STREET N. Total Endorsement Premium: $ NO CHANGE (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. Of, All other terms and conditions remain unchanged Executive Director, LMCIT LMCIT ME044(1/95) Page 1 of 1 e • R N a S N m 1 v a A+ AA A N A P N CI V V s CO w N �pp � O ` O NS pO O T -4 T N H N N H N N 1.J ).+ H N N N N N N N N N N N i g 3 g g 3 g g g g i 3" i i Ut Ut Ut Ut 3 3 1 A� CS IDI N 93 53 -n g cs ef el CI Cf CS CP 11 11 11 11 a a a a a a a < < < < < < < < v a a cs UP ~ O131 U1 LTI Ul O O O O O O O pg T C C > > v y y O I. 1 77 gym..{1 O O v v O A > N A N H F A 70 a g A Z 2 �' F *' m M N N N r ra z x E x 'a' �e �v fie" e, cs ci c. 33 3d 33 to r r r -� r r 11 f�"' m T N N N > N. s o O o O $ $ $ $ r . I C1 to N N W W W W W co 4.7 W N N 1.+ ■.+ A A A A Ir 171 O A O -4 V W W W W In N NI UI I(Vy N((JJ FI1,1t N t71 UI Ni U1 0 0 0 A N + o o 1st W W W V V V V 01 01 01 N N N F�.1 m O 17 < O p 1t 2 N - N f1 1 $ O in N r c-i N N 0 ? O O = _= _= a O a a O O O O O O O m so C C M CS r r r r r r r r co or co al co co NCNN n m ei Cs ci Cs e7 ci cs p in v r a Cs N N W W W 14 N N N N 1.+ V N N 1.+ 1..1 N 1... N N N CO Cl 0 0 O +O 0 01 O1 O1 W 1 4 O O O RI V Sio Oyy C C 4 p8S C• C O O O O O O O O O O J CO O O O f••O pO O O O O O O O O pr O O O O O O O O O rn g i ✓ 1 g t Z 73 - Z0 H O o. ci or x 2 Z 2 Z 2 2 2 z W A3 R ■ Cs z O O N 1 N to T CC CC CC C{'�7 CC C1'�1 CC C� A O 3 3 H O 3 3 N O 2 M N O 3 S N O Z 3 1/1 0� I— r r w r r r r 17 N r r 17 N r O f! s < m in U ►W.I in to 1 • • so ■ . N O O A 1 I A b CS V i � r 1 S A O S ►+ w M+ m 1 r m A ron 0 a a 0 n ai I N Gaf r !Q! 4Q.� _ m 0'''' y ^ r t' if H - m C .. o m tn N r N C r = v v m 0 0 I NI AS `" ^ 0O Oo r %r., ... a sk. °o c4i 1 r -11 31 rfi r, II z II m 1 mo ,- X H n Am T- A CS c+ G., o n 4 Ly; - ; MI m g A g w A o ENDORSEMENT #D • AS 6-5-00 CITY OF OAK PARK HEIGHTS I CMC 19785 1 3-15-00 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages 2000 FORD EXPEDITION #6653 ALL UABIUTY COVERAGES ACV $500. DED. COMP. $500. DED.. COLL. € re Total Endorsement Premium: $ 167. AP (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR X DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged PR .3123 Executive Director, LMCIT LMCIT ME020(1/95) Page 1 of 1 • S ENDORSEMENT #4 AS 6-5-00 • COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK HEIGHTS CMC 19785 IT IS HEREBY UNDERSTOOD AND AGREED THAT SCHEDULE OF COVERED PROPERTY FORM PM-100(11-97) IS AMENDED AS FOLLOWS: TYPE OF SEC.IV-WATER& COVERED SUPPLEMENTAL LOC.# LOCATION OCCUPANCY PROPERTY VALUE FLOOD COVERAGE CHANGE: 1 14168 OAK PARK BLVD. CITY HALL/GARAGE B CODE li LOCATION IS CHANGED PER ABOVE IN UEU OF 14168 57"STREET N. C • Total Endorsement Premium: $ NO CHANGE (See Below for Billina Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged Executive Director, LMCIT LMCIT ME044(1/95) Page 1 of 1 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST AUTOMOBILE LIABILITY AND PHYSICAL DAMAGE CITY OF 0 cJ -- ?00/(G 44 2A.oett 1. Limit of Liability: Physical Damage: $750,000. Combined Single Limit on Bodily I. Comprehensive Deductible: (Standard) Injury and Property Damage II. Collision Deductible: (Standard) $ 50,000. Uninsured and Underinsured III. Please provide color of fire trucks $750,000. Uninsured and Underinsured 1=Lime Yellow; 2 =Red; 3=All Others Motorist Limit * The standard limit is $50,000. Cities may increase if they choose. 2. Cities have the option to make their LMCIT Liability Coverage primary for vehicles used by specified individuals or groups in specified circumstances. Please indicate if you want this optional coverage and provide additional information requested. Yes ?X No If yes, please indicate type of individuals or groups: If yes, please indicate number of individuals: HICLE SCHE ULE (The attached computer printout provides the most current Schedule. However, recent changes may not show on the Schedule.) Dept III- Unit Description of Vehicle Serial Used Bldg. Current Comp Coil. Fire No. # By Garaged GVW Value Ded Ded Trucks 2 3 4 5 6 7 8 9 l0 OPTIONAL: Replacement cost on Fire Trucks aged 10 years or less(Indicate unit number and replacement value). Replacement cost can also be considered on other high valued vehicles. Please contact your agent. LMCITAPP.I5(11/97) PAGE 19 OF 19 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST EXCESS LIABILITY APPLICATION s . Administered By: BERKLEY RISK SERVICES, INC. \ 145 University Avenue West St. Paul, MN 55103 `` (612) 281-1200 • City of OA k Pao Date 7 /2.00)0 Limit of excess coverage desired: $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 Do you want the Excess to apply to the Uninsured and Underinsured coverage provided by the primary PPY g P Y F rY covenant? X Yes No If yes, the automobile UM/UIM limits must be $750,000. The Excess Covenant does not automatically apply to liquor liability. Do you want the excess to apply to liquor liability? Yes )( No Special Note: The liquor liability primary limits must be $1,000,000. Employers Liability: Carrier: i..-MG I I Limits: V 000 000 Policy Number: Policy Period: —1/-7 / 2000 — 0 Does applicant now have or contemplate any exposure under: (If yes, attach sheet with payroll figures.) (a) Jones Act or Admiralty Jurisdiction Yes X No (b) Federal Railroad Employees Act Yes X No (c) Federal Longshoremen's & Harbor Workers Act Yes k No To what extent does applicant have primary insurance to cover these exposures? h�a IF THIS IS A RENEWAL, PLEASE INDICATE IF RENEWAL IS TO BE BOUND: YES NO LMCITAPP.12(11/97) PAGE 1 OF 1 LE1PUE OF MINNESOTA CITIES INSE TRUST Administered By: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103-2044 (612) 281-1200 SUBMITTED BY: LG ivd.n. .cw k I h S J r anr> J e.ru c e S PRODUCER: e ►CJY, f I W\ ADDRESS PO 'Uok 1 8 Cores ZIP: 5 5 0 25 APPLICATION FOR MINNESOTA PETROFUND 14,0 Coue/v - SUPPLEMENTAL REIMBURSEMENT AGREEMENT APPLICANT'S INSTRUCTIONS: 1. Answer all questions. If the answer is NONE, please state NONE. 2. If space is insufficient to provide a complete response, attach a separate sheet. 3. The application must be signed and dated by an authorized representative of the City. 4. PLEASE READ CAREFULLY THE STATEMENTS AT THE END OF THIS APPLICATION. APPLICANT 1. Name of City or other public entities to be covered under the Agreement. Ci o-C ocdt- k +4.,.a r).- LMCITAPP.MPRAAP(11/97) Page 1 of 6 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 2. Principal Address: Oc.k Bark QotAl2v t AO 14 1 to — 4-- bol Pcw IC N fs j /14 io 55o Z2-2 oo? 3. If Joint Powers entity, identify participants: r 4. Designate the public official primarily responsible for environmental protection: NAME: TITLE ADDRESS: TELEPHONE TANK SITE INFORMATION 1. Please list and describe all active and inactive underground and above ground storage tanks on the attached storage tank schedule. This list must include all tanks acquired through the Housing and Redevelopment Authority and the Economic Development Authority or any similar department/agency. 2. Are all tanks registered with the Minnesota Pollution Control Agency? ` YES NO If NO, please explain below: LMCITAPP.MPRAAP(11/97) Page 2 of 6 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 3. Do all tanks including piping meet all local storage tank regulations?_YES NO If NO please explain below: , . 4. Do all tanks including piping meet all state storage tank regulations? YES NO If NO, please explain below: 5. Do all tanks including piping meet all Federal storage tank regulations? _YES NO If NO please explain below: 6. Have you received any complaint or notice that any of your tanks including piping are leaking or have you any other indication that any of your tanks including piping are leaking? YES NO If YES, please explain below: LMCITAPP.MPRAAP(11/97) Page 3 of 6 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST CLAIM HISTORY 1. List individual petroleum tank release incidents or claims and damages/expenses: Date of Describe Injury Amounts Paid Incident or Damage or Reserved Location 2. Identify your tank sites that have been the subject of environmental litigation, claim or administrative prosecution or complaint. Please give details: 3. Are you aware of any other incidents or conditions which may result in a claim against you? _YES,NO If YES, give details: 4. Have you ever performed any remedial clean-up actions at any of your tank sites? YES NO If YES, give details: LMCITAPP.MPRAAP(11/97) Page 4 of 6 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST The undersigned authorized representatives of the Applicant represents to the best of his/her knowledge the statements herein are true, and it is agreed that this application shall become incorporated as a pan o � PP rpo p of the Minnesota Petrofund Supplemental 1 Reimbursement Agreement accepted eement tf a c e b Y LMCIT. � LMCIT is hereby authorized to make any investigation and inquiry in connection with this application as it deems necessary. Dated at this day of ,19 (Name of Applicant) BY: (Signature and Title of Authorized Representative) LMCITAPP.MPRAAP(11/97) PAGE 5 OF 6 • • z c 4 7 < mC7 0 0 i- 0 u MI � Y / G 4 v G O U .4 • C C o Y t . v Q 0 N_ d vi a. ys v � w a o o o y E Q • @ U ..l • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST ADMINISTERED BY: Berkley Risk Services, Inc. 145 University Avenue West St. Paul, MN 55103-2044 SUBMITTED BY: 10.4.4 k. 1 ✓l su.d a.. - SexU PRODUCER: vvl ADDRESS: Po c)O)C l g d PaJ42 ' Ca..f2EA-/ "i 5 5 0 2,5 APPLICATION FOR OPEN MEETING LAW DEFENSE COST REIMBURSEMENT AGREEMENT APPLICANT'S INSTRUCTIONS: 1. Please answer all questions. If the answer is NONE, please state NONE. 2. If space is insufficient to provide a complete response, attach a separate sheet. 3. The application must be signed by an authorized representative of the City. Special Note: Please answer all questions. These questions are intended to provide general information only. The information provided will also be used for a proactive loss control procedure if needed. APPLICANT 1. Name of city or other public entity whose city officials are to be covered under the Agreement. C,4.6 Y now(4_ 1-1. .i-A. 2. Principal Address: Qc.Y\( 130.1 )orrk ._ .u,. c _ _ I _ \ ,r°,-- ©a-Q4. a / k 1-Le,04/A,- / 47"11.J 550g2.- 2 00-i 3. If Joint Powers entity, identify participants: IC" LMCITAPP.OML(11/97) PAGE I OF 3 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST CLAIM HISTORY List incidents of threatened or actual open meeting law litigation involving city related individuals in the last five years. For each incident give its approximate date and its resolution,including the penalty imposed,if any,and the amount of attorneys fees incurred in defending the incident. Date of Penalty Imposed, Incident Describe Incident If Any,And Location Attorneys Fees Incurred VIC11'‘-R.. 2. Are you presently aware of any other incidents or situations which may result in an open meeting law claim or litigation against city related individuals? YES /1 NO If YES,give details: 3. What action has been taken to prevent future incidents or claims? V\fa. LMCITAPP.OML(11/97) PAGE 2 OF 3 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST OPEN MEETING LAW QUESTIONNAIRE 1. Description of orientations and/or training provided for All elected officials (GTS programs, League programs, Handbook for Minnesota Cities, oss control seminars ...)on the subject of the open meeting law: 5.011-1iy.eex_CI 6\.24-A-41 4 ri 2. Have all new members attended the League Conference for Newly Elected Officials? k YES NO 3. Do all officials understand the Open Meeting Law and the Cities' compliance procedures? ) YES NO 4. Description of method of documenting official meetings (written, audio, video, ...): Gar 41.42A.A ;Cho -44t f u 5. Does legal council attend all official meetings? y YES NO If no, describe service relationship with city attorney. 6. Is education provided for the elected officials in the proper policy and procedures? a) Land use decision making: YES NO b) Employment practices: k YES NO 7. Please indicate the percentage of reimbursement of defense costs. 80% 100% V BY: (Signature and Title of Authorized Representative) LMCITAPP.OML(11/97) PAGE 3 OF 3 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST PUBLIC EMPLOYEE DISHONESTY OR PUBLIC EMPLOYEE FAITHFUL PERFORMANCE COVERAGE APPLICATION ADMLNISTERED BY: Berkley Risk Services, Inc. 145 University Avenue West St. Paul, MN 55103-2044 Limit of Coverage Per Loss: (Deductibiel • Public Employee Dishonesty Coverage: $ 100000 (Standard) • Public Employee Faithful Performance Coverage: $ 10000 Q - (Standard' • Public Employee Dishonesty Coverage with Faithful Performance of Duty for Specified Positions or Obligee: ,. Specified Position $ 260000 * (Standard) Specified Position $ * (Standard) Specified Obligee, $ * (Standard) Specified Obligee $ * (Standard) *The specified limit of coverage is part of,not in addition to,the limit of coverage per loss. AUDITS: V FREQUENCY: BY WHOM?: CPA X STAFF AUDITOR OTHER(Explain Fully) DATE OF LAST AUDIT: DISCREPANCIES?: YES _ NO (If YES submit copy of audit or auditors comments.) LOSS HISTORY(LAST 5 YEARS): EMPLOYEES POSITION WHICH CAUSED LOSS: CORRECTIVE MEASURES TAKEN: WILL THERE BE A SUBSTANTIAL INCREASE IN THE NUMBER OF EMPLOYEES DURING THE TERM OF THIS BOND? INTERNAL CONTROLS: I. ARE BANK ACCOUNTS RECONCILED AT LEAST MONTHLY? YES 2c. NO_ 2. IS THE PERSON WHO RECONCILES PROHIBITED FROM MAINTAINING BANK ACCOUNT RECORDS? YES NO_ 3. ARE ALL PERSONS HAVING AUTHORITY TO MAKE BANK DEPOSITS OR WITHDRAWALS. PROHIBITED FROM EITHER MAINTAINING RECORDS OR RECONCILING THE BANK ACCOUNT? YES � NO_ 4. IS COUNTERSIGNATURE OF ALL CHECKS REQUIRED? YES � NO ADDITIONAL COMMENTS: LMCITAPP.PEB(11197) PAGE I OF 2 LETE OF MINNESOTA CITIES INSURANSRUST DICI CLASSIFICATION OF EMPLOYEES BY DUTIES OR RESPONSIBILITIES This classification under Class A, B and C constitutes the cities personnel as of the date of this application and should include Mayor and Council members. CLASS A EMPLOYEES All Executive Administrative Judicial and Supervisory officials.Department and Division Heads and Assistant Department and.Division Heads. All Police Officers*and- - all officials and employees whose principal duties require them to - - --- 1.) Handle,receipt for,or have custody of money,checks or securities.or account for supplies or other property.authorize for make appropriations for) expenditures;approve.certify.sign or countersign checks drafts,warrants,vouchers,orders or other documents providing for the paying over or delivery of money,securities,supplies or other property,or serve process,or, 2.) Maintain or audit accounts of money,checks„securities,time records,supplies or other property,or take physical inventories of money,checks.securities, supplies or other property. *Patrolmen are classified as"A"Employees under'Faithful Performance"Coverage but are classified as"C"Employees under"Dishonesty"Coverage. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF Q,uv..rr r.c�LA.WTOV- 1 OCCUPANTS COWNeR 1...44..0 .0r exec o o.,� Z, w.ca"•�ar o. 1.;... S4• N 1 c.; po Old �wbA�e, oke W. v + .._. ),t - C� 3 G P vc`� Total Class A CLASS B EMPLOYEES All personnel whose principal duties consist of: 1. Inside or outside clerical activities; 2. Office work such as stenography,typing,filing,switchboard operation,business machine operation etc.; 3. Operation of vehicles transporting passengers for cash fare or tickets. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF .;..m.*s/rh OCCUPANTS '�r InOJ� 1 • Total Class B CLASS C EMPLOYEES All personnel whose principal duties consist of: I. Skilled or unskilled labor and craftsmanship; 4. Any teaching capacity in the field of education; • 2. Solely the mechanical operation of automotive equipment; 5. Outside or field work of a non-clerical nature; 3. Non-clerical activities of the medical or nursing profession; 6. Patrolmen under the"Dishonesty"Coverage. � OslTI #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF w� OO OCCUPANTS Total Class C l O LMCITAPP.PEB(11/97) PAGE 2 OF 2 LIJE OF MINNESOTA CITIES INSURAN RUST CLASSIFICATION OF EMPLOYEES BY DUTIES OR RESPONSIBILITIES This classification under Class A, B and C constitutes the cities personnel as of the date of this application and should include Mayor and Council members. CLASS A EMPLOYEES All Executive Administrative Judicial and Supervisory officials.Department and Division Heads and Assistant Department and Division Heads. All Police Officers*and all officials and employees whose principal duties require them to: 1.) Handle,receipt for,or have custody of money,checks or securities,or account for supplies or other property,authorize(or make appropriations for) expenditures;approve,certify,sign or countersign checks drafts,warrants,vouchers,orders or other documents providing for the paying over or delivery of money,securities,supplies or other property.or serve process,or; 2.) Maintain or audit accounts of money,checks„securities,time records,supplies or other property,or take physical inventories of money,checks,securities, supplies or other property. *Patrolmen are classified as"A"Employees under"Faithful Performance"Coverage but are classified as"C"Employees under"Dishonesty"Coverage. POSITION //OF OCCUPANTS POSITION #OF OCCUPANTS POSITION N OF OCCUPANTS t^iry f4dw,I'niyr-a.rrue' 1 (0014 vs,Nnrti Per. Oft. Ofrecro✓ M Co,..0(.(:I Ya e„.,),4•Y" PC.coHAm-C4 a. ✓''tayor AI•,�^;s�•mtre Ass bower l 114m M L5rn.-rtie 5e4• Po1.tte Chi ft4nc Work.$ P eorw (Swi 7d 715 1 ifki4,1 I Cellin w^w^147 eV. Total Class A (6 CLASS B EMPLOYEES All personnel whose principal duties consist of: 1. Inside or outside clerical activities; 2. Office work such as stenography,typing,filing,switchboard operation,business machine operation etc.; 3. Operation of vehicles transporting passengers for cash fare or tickets. POSITION N OF OCCUPANTS POSITION N OF OCCUPANTS POSITION #OF 5cc fvrrein/Lo6'16cvi ! OCCUPANTS ttolice tie/ Total Class B CLASS C EMPLOYEES All personnel whose principal duties consist of: 1. Skilled or unskilled labor and craftsmanship; 4. Any teaching capacity in the field of education; 2. Solely the mechanical operation of automotive equipment; 5. Outside or field work of a non-clerical nature; 3. Non-clerical activities of the medical or nursing profession; 6. Patrolmen under the"Dishonesty"Coverage. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF P0(,�e O ' i' OCCUPANTS f∎nbtic 1.416,145 erlot7eeS .2 Total Class C (f7 LMC1TAPP.PEB(11/97) PAGE 2 OF 2 7 • • LMCIT LIABILITY COVERAGE - WAIVER FORM Cities obtaining liability coverage from the League of Minnesota Cities Insurance Trust must decide whether or not to waive the statutory tort liability limits to the extent of the coverage purchased. The decision to waive or not to waive the statutory limits has the following effects: • If the city does not waive the statutory tort limits, an individual claimant would be able to recover no more than$300,000 on any claim to which the statutory tort limits apply. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would be limited to $750,000. These statutory tort limits would apply regardless of whether or not the city purchases the optional excess liability coverage. • If the city waives the statutory tort limits and does not purchase excess liability coverage, a single claimant could potentially recover up to $750,000 on a single occurrence. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to $750,000,regardless of the number of claimants. • If the city waives the statutory tort limits and purchases excess liability coverage, a single claimant could potentially recover an amount up to the limit of the coverage purchased. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to the amount of coverage purchased, regardless of the number of claimants. Claims to which the statutory municipal tort limits do not apply are not affected by this detision. This decision must be made by the city council. Cities purchasing coverage must complete and return this form to LMCIT before the effective date of the coverage. For further information, contact LMCIT. You may also wish to discuss these issues with your city attorney. The City of accepts liability coverage limits of$ from the League of Minnesota Cities Insurance Trust(LMCIT). Check one: The city DOES NOT WAIVE the monetary limits on municipal tort liability established by Minnesota Statutes 466.04. X The city WAIVES the monetary limits on tort liability established by Minnesota Statutes 466.04,to the extent of the limits of the liability coverage obtained from LMCIT. Date of city council meeting June 27, 2000 Signature kik Position City Administrator Return this completed form to LMCIT, 145 University Ave. W., St. Paul, MN. 55103-2044 Page 1 of 1 • 110 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 1-5 BOILER AND MACHINERY APPLICATION ADMINISTERED BY: BERKLEY RISK SERVICES,INC. 145 University Avenue West St.Paul,MN 55103-2044 APPLICANT: INSPECTION CONTACT AT CITY: TELEPHONE#: AGENT'S NAME: TELEPHONE# COMPREHENSIVE(INCLUDING PRODUCTION MACHINES) NON-REFERRAL OCCUPANCIES ONLY LIMITS: $ 5,000,000 Per Any"One Accident"Combined Property Damage,Business Interruption and Extra Expense $ 25,000 Expediting Expenses $ 25,000 Ammonia Contamination $ 25,000 Water Damage $ 50,000 Ice Rink Buried Piping I. Does the applicant currently have Boiler&Machinery coverage? Yes Na 2. Name of current Boiler&Machinery carrier Expiration Date: 3. Has the applicant had any boiler and machinery breakdowns in the past 3 years? Yes No If yes,please provide description and amount: 4. 100%Replacement Cost Values of Building,Municipal Personal Property,Personal Property of Others: $ * 5. Non-Referral Occupancies Deductible: $ * Does not include values for referral. LMCITAPP.BOILER(11/97) PAGE 1 OF 2 LSUE OF MINNESOTA CITIES INSURAN•RUST REFERRAL OCCUPANCIES(Limited Coverage) Important: If the applicant has an exposure to any of the following,further analysis may be required by LMCIT. A representative of Hartford Steam Boiler(the reinsurer of LMCIT)may contact you for further information or inspection appointment. Each exposure must indicate a yes or no response. Special conditions,endorsements,limits and deductibles-may apply per occupancy. *]it *MPp *PP() at A. Refuse burning facility ty(boiler garbage burning systems-HBB) _Yes No B. Diesel electrical generating equipment(boiler diesel utility-HBD) Yes !No — — t(boiler electrical production Yes No C. Electrical generating equipmen (bo p _ � — _ utilities-HBE) D. Co-generation facility(boiler co-generation facilities-HBF) Yes _No — (*Does not include emergency back-up generators that serve only a single building or function and are not part of a municipal utility.) E. Equipment for recovering methane or other gases from a sewage treatment plant or landfill,or any other system for producing industrial gases(boiler industry gas production-HBG) —Yes i No F. Hospital/Clinic equipment listed below(boiler hospital-HBH) _Yes No 1. CT Scanner Yes No 2. MRI Unit Yes _No 3. PET Yes No 4. Linear Accelerator Yes No 5. Lithotripter Yes _No G. Steam or hot water district heating system(boiler municipal steam — Yes i No _ hot water-HBM) H. *100%Replacement Cost Values of Buildings, Municipal Personal Property,Personal Property of Others and 100%of Business Interruption Values. NOTE: Coverage for the above referral occupancies can not be bound unless approved by LMCIT. LMCITAPP.BOILER(1 I/97) PAGE 2 OF 2 LEAGUEOF MINNESOTACITIESINSURANCETRUST LIQUOR LIABILITY APPLICAT• ADMINISTERED BY: BERKLEY RISK SERVICES,LLC 145 University Avenue West St.Paul,MN 55103-2044 APPLICANT: AGENTS NAME: TELEPHONE# 1. Effective Date: Name of Licensee: License# 2. Limits of Liability: $ Per Claim $ Annual Aggregate (Past 12 months) (Estimated next 12 months) Receipts: Alcoholic Beverages$ ( ) $ ( nths) 4. List of location covered and their operations Location: Operation: Location: Operation: 5. Underwriting: (A) Has the applicant or any employee, officer or licensee incurred any claim for liquor liability in the past 5 years? [ ] Yes [ ]No If yes,explain: Is the applicant aware of any incidents which may lead to a claim? [ ]Yes [ ]No f yes, explain: (B) Have there been any fights or assaults inside or outside the locations among patrons in the past year? [ ] Yes [ ]No If yes, give details: Have there been any incidents of any employee, officer or licensee using reasonable force to remove patrons? [ ] Yes [ ]No If yes, explain: (C) Does the applicant provide for their employees to receive formal training in the following areas: Operations? [ ] Yes [ ]No Handling of minors? [ ] Yes [ ]No Handling of intoxicated customers? [ ] Yes [ ]No How often is the training done? By whom? Does the applicant provide any additional training? [ ]Yes [ ]No If yes. explain: Page 1 of 2 tub nasmeapplicant, oranyowner,partner, orricer, memoeror licensee everhada licenserevoked,refused or suspended? Ws [ ] No If yes,give details: (E) Previous Carrier: Exp. Date: Premium Policy Number: Limit of Liability Has insurance coverage ever been canceled or non-renewed? [ ] Yes [ ] No If yes, explain: . (F) Years in business at this location under.current ownership If under 2 years,give previous experience (G) Has applicant or employee ever been fined or cited for violations of a law or ordinance relating to sales of alcohol? (After hours,minor, etc) [ ]Yes [ ]No If yes, explain: (H) Normal Open/Closing hours: Mon-Thurs Fri Sat Sun (I) Does applicant have entertainment: [ ] Yes [ ] No If yes,type: (J) What is the turnover of bartenders? (K) Is there a documentation procedure in place for incidents? If yes,explain: 6. Do you have any special events sponsored and controlled by the liquor store? [ ]Yes [ ]No if yes, describe Coverage is excluded. An endorsement is necessary. Please let us know if you want coverage. .7. Do you have any other special events that is not sponsored or controlled by the liquor store?... If yes,explain: Coverage is excluded. An endorsement is necessary. Please let us know if you want coverage. 8. Receipts On-Sale Receipts Off-Sale Receipts Special Events #of Days By: (Signature and Title of Authorized Representative) Page 2 of 2 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST WATER AND SUPPLEMENTAL FLOOD COVERAGE APPLICATION ADMINISTERED BY: BERKLEY RISK SERVICES,INC. 145 University Avenue West St.Paul,MN 55103-2044 APPLICANT: AGENTS NAME: TELEPHONE#: I. Please indicate below by listing the location you want NFIP supplemental coverage. 2. NFIP flood insurance coverage must be at the maximum amount of insurance available for the LMC1T Water Supplemental Coverage to be available. Please contact your Berkley Risk Services Underwriter for further information. Loc# Bldg Name/Description Street Address NFIP NFIP Policy# Premium PAGE 1 OF . , • • LMCIT EXPENDITURES WORKSHEET City 0 tij(P u r 1 . 1-1..e_1'S,aS Budget Year o"?O O 0 I. All Expenditures G r '-f '(o.,3 315' 0. 725- r II. Transfers -1S o u° "203169 /G, -2 S v III. E&0 Deductions 7 RP ii-) - a) HRA 30,q/0 000 b) EDA ;a.r•. c...-----, a), 000 ti3,06o c) Port Authority .2,n nv TA r; ms`s S---- t_. d) Nursing Homes /,7 Su e) Hospitals /a:7S-0 T✓''}' , e,,,,'1e,".7 /71 n f) Airports i 4.4.iro g) Clinics L..ee . - iPO 5 , s--JO h) Utilities (Water, Electric, Gas d Steam) C,,,,pwf-zrMls /[1/Ob) I) Liquor Store Operations (Cost of goods sold) gulf Ck«-... C.So v IV. Adjust Total Expenditures t d S 5 Joe d O tJ c.. V. GL Deductions ��"� �v oo v a) Contracted Services �.z;,-�i2,,, `,, 43, l G 3 D 3'5'0 , ,r.„.t,E,-„.�.,of it ra /5,0047 b) Debt Service i` v.^ I 9G, ,j 3 (31 —1 O O c) Water Department '� ” �a v l S O 4 i...._.., 3 ) ooL) d) Electric 3 v,oa.) e) Steam 4 44., � ,?o 00 Q.,,(.4: -" !S o 00 0 Gas Q.a � r 7, oov g) Liquor (Operating Expenses Only,iv q,,t,/,,,....��4- y, ,d n -Do Not Include cost of goods soak,' / X30, ��O h) Recreation Buildings (Arenas, Sr. Citizens Centers, Ice Arenas) I) Swimming Pools j) Golf Courses k) Individual Purchases which exceed 5% of the adjusted total expenditures(E& 0) (List& Describe) 1) Operations or departments that have E&O Coverage with LMCIT, but have their own General Liability with another insurance company. m) Special Deductions (List and Describe) ,2 2 0 O 4.9 0 O &‘D..<. c.i`f-'Envt` ronrn 1 ..0cS - 5-00.1er VI. Operating Expenditures (GL) 02 U/� /' ' '2 LMCITAPP.13(11/97) PAGE 4 OF 19 • INSTRUCTIONS • I. All expenditures - include all operating expenses, capital outlay, capital projects, debt service (principal and interest) for the following: General Fund 22.0 /�1 S� Debt Service L.6-" q 7 O v Enterprise Fund q0/ / :300 Port Authority Special Revenue Funds q 000 Nursing Homes v Capital Improvement Funds 1 , � Zi91v Hospitals Airports O Clinics p HRA 0 Other-Gon%-}'ru_a-fr'a X777, ooa EDA a .2 0 II. Transfers III. Please list the expenditures for the categories shown in Item III. a - I). These expenditures may be deducted if LMCIT is NOT providing E & 0 Coverage for these operations. IV. Adjusted total expenditures is the total expenditures for those departments and operations that have E & 0 Coverage with LMCIT V. GL Deductions: A. Please list expenditures for the categories shown in Item V. a - m). These deductions are necessary to subtract expenditures for operations or departments where the exposures are individually rated. B. Work performed by contractors which includes capital projects or services are also subtracted For Your Information a) Contracted Services - All Operations: Expenditures should be deducted if the services are provided by others and they provide a Certificate of Insurance. b) Debt Service (principal and interest) c -j) Please indicate expenditures for these operations (minus contracted services and debt services) m) Special Deductions: There may be some special deductions that are appropriate. Please list these special deductions or list them with your underwriter. VI. The operating expenditures are the expenditures that will be used to develop a portion of the liability premium. Individually rated exposures are used to develop the remainder of the final premium. LMCITAPP.13(l l/97)(Rev.2199) PAGE 5 OF 19 • , • T1 c°3 f • _.41" (23 ) DI avd P /G 8 G%sOv. 0-7 “�J 4/oc - , i- � llsC17 �� ()do - sw-c 1 /0,, 16 / Dom X51 _ Tll= 0 /e OoJ 9,q27-7.29 003 b,i-s-?1-(Ex- ,?,lb 6,, 4( 000 .671- L �LL /3 / 06° 7;c-opf . a7. s"0 — ' to-bit, )015,50 — 7a q ✓55/4 690e. °=!!'' a ec- 000 81-75O / lc( 3, 1 21 Z� 1 5- 1 3 <9 T7042JJ ?Lta33 l G� 2-0`t_ca 3— G 49,. -r - • ex.vvJ 40( - a l s `f-O 1 LMCIT EXPENDITURES WORKSHEET City Oak Park Heights Budget Year 1999 All Expenditures 6 ,206 , 735 II. Transfers 276 ,655 III. E&0 Deductions a) HRA b) EDA 24,000 c) Port Authority d) Nursing Homes e) Hospitals fl Airports g) Clinics h) Utilities (Water, Electric, Gas and Steam) I) Liquor Store Operations (Cost of goods sold) IV. Adjust Total Expenditures (E & 0) 24,000 V. GL Deductions a) Contracted Services 2,963,950 b) Debt Service 553 ,500 c) Water Department 177,830 d) Electric e) Steam fl Gas g) Liquor(Operating Expenses Only -Do Not Include cost of goods sold) h) Recreation Buildings (Arenas, Sr. Citizens Centers, Ice Arenas) • 15 000 I) Swimming Pools o j) Golf Courses k) Individual Purchases which exceed 5% of the adjusted total expenditures(E&0) (List& Describe) I) Operations or departments that have E&O Coverage with LMCIT, but have their own General Liability with another insurance company. m) Special Deductions (List and Describe) 230 ,000 Met Council-Environmental Svcs . -Sewer VI. Operating Expenditures(GL) 1,965 ,800 LMCITAPP.13(11/97) PAGE 4 OF 19 . • INSTRUCTIONS All expenditures - include all operating expenses. capital outlay. capital projects. debt service (principal and interest) for the following: General Fund 2 ,175 ,215 Debt Service 553 ,500 Enterprise Fund 768,020 Port Authority Special Revenue Funds 6 ,000 Nursing Homes Capital Improvement Funds 530 ,000 Hospitals Airports Clinics HRA Other Construction 2, 150 ,000 EDA 24,000 II. Transfers III. Please list the expenditures for the categories shown in Item III. a - I). These expenditures may be deducted if LMCIT is NOT providing E & 0 Coverage for these operations. IV. Adjusted total expenditures is the total expenditures for those departments and Operations that have E & 0 Coverage with LMCIT V. GL Deductions: A. Please list expenditures for the categories shown in Item V. a - m). These deductions are necessary to subtract expenditures for operations or departments where the exposures are individually rated. B. Work performed by contractors which includes capital projects or services are also subtracted For Your Information a) Contracted Services - All Operations: Expenditures should be deducted if the services are provided by others and they provide a Certificate of Insurance. b) Debt Service (principal and interest) c -j) Please indicate expenditures for these operations (minus contracted services and debt services) m) Special Deductions: There may be some special deductions that are appropriate. Please list these special deductions or list them with your underwriter. VI: The operating expenditures are the expenditures that will be used to develop a portion of the liability premium. Individually rated exposures are used to develop the remainder of the final premium. LMCITAPP.13(11/97)(Rev.2/99) PAGE 5 OF 19 • 0 KKa� er 'c w , , i ', � ` } From: jjohnson (jjohnson @cityofoakparkheights.com] Sent: Monday, June 26, 2000 3:52 PM To: 'kkamper @cityofoakparkheights.com'; 'Dennis Postler'; 'Dave Hanson' Subject: RE: Street miles That is really old information. We are over 20 miles. I need BRAA to update me on our road mileage. Dennis or Dave. Could you double check our mileage. Also, note that we no longer have the roads in the area owned by MNDOT. Jay Original Message From: Kim Kam per`fSMTP:kkamper @cityofoakparkheighfs.com( Sent: Monday, June 26, 2000 1:30 PM To: Jay Johnson' Subject: Street miles Jay, I am working on our insurance renewal form. Last year June 1999 we reported that we have 15 miles of street. Has this changed with us adding Oak Park Blvd. And 58t Street? How many miles of street do we presently have? I need to send this information in on Tuesday. Thanks, Kim JUN-23-2000 14 59 LEAGUE OF MN CITIES 612 281 1298 P.01/07 ' t . r\---.'—‘'ss7 • • . L MC 145 University Avenue West, St. Pau), MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 t«.9we of Minnesota Cities LMC Fax: (651) 281-1299 • LMCJT Fax: (651) 281-1298 Cities promoting Qmlkn� 'Web Site: nttp://www.]mmnc.org Fax Name: /clef C.,.4,90A Organization: Cir y of Aix &AK *Z(ryiS Fax: &SY — 4/39— 05 741 Phone: From: IAN bfA4t___.. Date: 66a 6000 Subject: 1#47-116-e-/4/°A1—G.v1/ 912 + ei4 c-s5 G elaexr.f Pages: 7 RC5(Z- 04 opexinvI ode-,teO fo c-t-d w5 r . ldizA I (-1>?j_,_ 0114 ice v:i- CW ed-h ONo v),ci e.4. N AN EQUAL OPPORTUNITY/AFFIRMA11VE ACTION EMPLOYER JUN-23-2000 14:59 LEAGUE OF MN CITIES 612 281 1298 P.02/87 O LIVILI Risk Miliggeffient Information 145 University Avenue West, St. Paul,MN 55103-2044 LiM‘/%71P,.. Phone: (651) 281-1200 -- (800) 925-1122 Cp"° '` mi Fax: (651)281-1298--TDB (651) 281-1290 Web Site: http://www.lmnc.org LMCIT Liability Coverage Options Liability Limits, Coverage Limits, and Waivers LMCIT gives cities several options for structuring their liability coverage. The city can choose either to waive or not to waive the monetary limits which the statutes provide; and the city can select from among several optional liability coverage limits. This memo discusses these options and identifies some of the issues to consider in deciding which of the options best meets the city's needs. What are the statutory limits on municipal tort liability? The statutes currently limit municipal tort liability to $300,000 per claimant and$750,000 per occurrence. These limits apply whether the claim is against the city,against the individual officer or employee,or against both. The per-occurrence limit increases to $1,000,000 on January 1, 2000. What are the coverage limits for LMCIT's basic primary liability coverage? LMCIT's liability coverage provides a limit of$750,000 per occurrence,matching the per- occurrence part of the statutory municipal tort liability limit. Unlike LMCIT's previous practice, the$300,000 per claimant part of the statutory Iiability limit is no longer automatically waived. Thus under the basic coverage form,LMCIT and the city would be able to use the$300,000 per claimant limit as a defense where it applies. Beside the overall coverage limit of$750,000 per occurrence,there are also annual aggregate limits (that is, limits on the total amount of coverage for the year regardless of the number of claims)for certain specific risks. Aggregate limits apply to the following: Products/Completed Operations $750,000 annually Limited pollution claims* $750,000 annually Lead or asbestos liability* $200,000 annually Failure to supply utility service $750,000 annually EMP or stray voltage claims $1,500,000 annually Land use regulation and development litigation** $1,000,000 annually "Y2k"claims* $25,000 annually * The limit applies to both damages and defense costs. ** Coverage is on a sliding scale percentage basis. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER JUN-23-2000 15:00 LEAGUE OF MN CITIES 612 281 1298 P.03/07 • • If the statute limits our liability to $750,000 per occurrence,why would the city purchase higher coverage limits than that? There are several different reasons why cities should strongly consider carrying higher limits of liability coverage. I. The statutory tort limits either do not or may not apply to several types of claims. Some examples include: • Claims under federal civil rights laws. These include Section 1983,the Americans with Disabilities Act,etc. • Claims for tort liability that the city has assumed by contract. This occurs when a city agrees in a contract to defend and indemnify a private party. • Claims for actions in another state. This might occur in border cities that have mutual aid agreements with adjoining states, or when a city official attends a national conference or goes to Washington to lobby, etc. • Claims based on liquor sales. This mostly affects cities with municipal liquor stores, but it could also arise in connection with beer sales at a fire relief association fund-raiser, for example. • Claims based on a "taking"theory. Suits challenging land use regulations frequently include an`inverse condemnation"claim,alleging that the regulation amounts to a "taking" of the property. 2. LMCIT's primary liability coverage has annual limits on coverage for a few specific risks. These are outlined in the table on page 1. If the city has a loss or claim in one of these areas, there might not be enough limits remaining to cover the city's full exposure if there is a second loss of the same sort during the year. Excess liability coverage gives the city additional protection against this risk as well. But it's important to note that the excess coverage does not apply to three risks, lead and asbestos,failure to supply utilities, and Y2k; and that the excess coverage does not automatically apply to liquor liability unless the city specifically requests it. 3. The city may be required by contract to carry higher coverage limits. Contracts often include a requirement that the city carry,for example,at least$1,000,000 of liability coverage. Carrying excess coverage is a way to meet these requirements. (There's also another option for cities in this situation. LMCIT can issue an endorsement to increase the city's coverage e g limit only for claims relating to that particular contract. There's a small charge for these "laser"endorsements.) 4. There may be more than one political subdivision covered under the city's coverage. An HRA, EDA,or port authority is itself a separate political subdivision. If the city EDA,for example, is named as a covered party on the city's coverage and a claim were made that involved both the city and the EDA,theoretically the claimant might be able to recover up to $750,000 from the city and another$750,000 from the EDA, since there are two political subdivisions involved. Excess coverage is one way to provide enough coverage limits to JUN-23-2000 15:00 LEAGUE OF MN CITIES 612 281 1298 P.04/07 • • Address this situation. Another solution is for the HRA,EDA, or port authority to carry separate liability coverage in its own name. This issue of multiple covered parties can also arise is if the city has agreed by contract to name another entity as a covered party,or to defend and indemnify another entity. 5. Cities sometimes choose to carry higher coverage limits because of a concern that the courts might overturn the statutory liability limits. However, those limits have now been tested and upheld several times in Minnesota. While it's always possible that a future court might decide to throw out the statutory limits,this is now less of a concern. What excess liability coverage limits are available? Excess coverage is available in$1 million increments,up to a maximum of$5 million. We're just a small city. Isn't excess liability coverage really just something that big cities might need? Absolutely not. In fact if anything, excess liability coverage is even more important to a small city. If any city ends up with more liability than it has coverage,the city will have to either draw on existing funds or go to its taxpayers to pay that judgment. A large city faced with, say,a million dollars of liability over and above what its LMCIT coverage pays might be able to spread that$1 million cost over several thousand taxpayers. The small city by contrast might be dividing that same$1 million cost among only a couple hundred taxpayers. $1 million divided among 5000 taxpayers is$200 apiece—annoying but probably at least manageable for most taxpayers. $1 million divided among 200 taxpayers is$5000 apiece—enough to be a real problem for many. LMCIT now gives the cities who participate in the primary liability coverage the option to waive the $300,000 per claimant statutory liability limit. What's the effect if we do this? If the city chooses the"waiver"option, the city and LMCIT no longer can use the statutory limit of$300,000 per claimant as a defense. Because the waiver increases the exposure, the premium is roughly 3%higher for coverage under the waiver option. If the city waives the statutory limit, an individual claimant could therefor recover up to $750,000 in damages on a claim. Of course,the individual would still have to prove to the court or jury that s/he really does have that amount of damages. Also, the statutory limit of$750,000 per occurrence would still apply; that would limit the individual's recovery to a lesser amount if there were multiple claimants. Why would the city choose to pay more in order to get the waiver-option coverage? Does it give the city better protection? No. Buying coverage under the"waiver"option doesn't protect the city any better. The benefit :. ♦n�i.e:..:,..e.1 •••,.••. JUN-23-2000 15:00 LEAGUE OF MN CITIES 612 281 1298 P.05/0? • • The statutory liability limit only comes into play in a case where 1)the city is in fact liable;and 2) the injured party's actual proven damages are greater than the statutory limit. Very literally, applying the statutory liability limit means that an injured party won't be fully compensated for his/her damages caused by city negligence. Some cities as a matter of public policy want to have more assets available to compensate their citizens for injuries caused by the city's negligence. Waiving the statutory liability limits is a way to do that Other cities, of course, feel that the appropriate policy is to minimize the expenditure of the taxpayers' funds by taking full advantage of every protection the legislature has decided to provide. There's no right or wrong answer on this point. It's really a discretionary question of city policy that each city council needs to decide for itself. How would the waiver affect our city's coverage or risk on those claims that the statutory tort liability limits don't apply to? It doesn't. Waiving the statutory tort limits has no effect on claims that the statutory limits don't apply to. What's the effect of waiving the statutory limits if we have excess coverage? If the city has$I million of excess coverage and chooses to waive the statutory tort limits, the claimants(whether it's one claimant or several)could then potentially recover up to$1.75 million in damages in a single occurrence. If the city carries higher excess coverage limits,the potential maximum recovery per occurrence is correspondingly higher. Carrying excess coverage under the waiver option is a way to address an issue that some cities find troubling: the case where many people are injured in a single occurrence caused by city negligence. Suppose, for example,that a city vehicle negligently runs into a school bus full of kids,causing multiple serious injuries. S750,000 divided 50 ways may not go far toward compensating for those injuries. Excess coverage under the waiver option makes more funds available to compensate the victims in that kind of situation. The cost of the excess liability coverage is about 25%greater if the city waives the statutory tort limits. The cost difference is proportionally greater than the cost difference at the primary level because for a city that carries excess coverage, waiving the statutory tort limits increases both the per-claimant exposure and the per-occurrence exposure. If we waive the statutory tort liability limits,does it increase the risk that the city will end up with liability that LMCIT doesn't cover? No. The waiver form specifically says that the city is waiving the statutory tort liability limits only to the extent of the city's coverage. Of course, that's not to say that there is no risk that the city's liability could exceed its coverage limits. We listed earlier a number of ways that could happen to any city. But the waiver doesn't ••rP9N0,h.,. 14 A. JUN-23-2000 15:01 LEAGUE OF MN CITIES 612 281 1298 P.06/07 • • Can we waive the statutory tort limits for the primary covers g a but not for the excess coverage? No. If the city decides to waive the statutory tort limits, that waiver applies to the full extent of the coverage limits the city has. The city cannot partially waive the statutory limits. I'm confused. Is there a simple way to summarize the options? It's not necessarily simple,but here's a short-hand summary of what happens with and without excess coverage under both the waiver and the non-waiver options: 1. If the city does not waive the statutory tort limits and does not carry excess coverage: • An individual claimant would be able to recover no more than$300,000 on any claim to which the statutory tort limits apply. • The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would be limited to$750,000. • The city's LMCIT coverage would pay up to $750,000 of the damages awarded against the city on a claim to which the statutory tort limits don't apply. 2. If the city does not waive the statutory tort limits and carries excess coverage: • An individual claimant would be able to recover no more than$300,000 on any claim to which the statutory tort limits apply. • The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would be limited to$750,000. • On a claim to which the statutory tort limits don't apply, the maximum damages LMCIT would pay on the city's behalf would be$750,000 plus the amount of excess coverage the city purchased. 3. If the city waives the statutory tort limits and does not carry excess liability coverage: • A single claimant could potentially recover up to $750,000 on a single occurrence to which the statutory tort apply. • The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to $750,000, regardless of the number of claimants. • The city's LMCIT coverage would up to $750 000 of the damages awarded against ty g pay P � g g the city on a claim to which the statutory tort limits don't apply. JUN-23-2000 15:01 LEAGUE OF MN CITIES 612 281 1298 P.07/07 • • 4. If the city waives the statutory tort limits and purchases excess liability coverage: • A single claimant could potentially recover up to the limit of the coverage purchased on a single occurrence to which the statutory tort limits would apply. • occurrence to which the The total which all claimants would be able to recover for a single o urren T 81 statutory tort limits apply would also be limited to the amount of coverage purchased, regardless of the number of claimants. • On a claim to which the statutory tort limits don't apply,the maximum damages LMCIT would pay on the city's behalf would be$750,000 plus the amount of excess coverage the city purchased. I'm still confused. Who can I talk to? Give us a call at the League office. Pete Tritz,Tom Grundhoefer, Doug Gronli, or any of LMCIT's property/casualty underwriters will be glad to talk with you. PST—3/1/1999 -fax 66110 TOTAL P.07 • • r\--„7 LMCIT LMCRisk Management Information League of Minnesota Cities 145 University Avenue West, St. Paul, MN 55103-2044 Cities promoting excellence Phone: (651) 281-1200 • (800) 925-1122 Fax: (651) 281-1298 • TDD (651) 281-1290 Web Site: http://www.lmnc.org THINGS TO THINK ABOUT WHEN RENEWING YOUR CITY'S PROPERTY/CASUALTY COVERAGE LMCIT tries to make buying coverage for the city's property and liability exposures as simple and straightforward as possible, but it can still be a complicated and confusing business. Unfortunately, overlooking or misunderstanding some of these points can result in an unpleasant surprise at claim time. For renewals after November 15, 1999, we've revised the LMCIT property and liability coverage. The "Property and Liability Coverage Changes" memo that was sent to all agents and cities explains these specific changes in more detail. This memo is intended to provide a list of all issues or points that should be considered when renewing your coverage. In most cases, the need for the city to take a specific action is described. Property Coverage Issues What to Schedule At renewal, a schedule of building/contents, and property in the open will be attached to the renewal application. Please review this schedule for accuracy. It may not include some recent changes, or there may be a need to delete, add or modify items on the schedule. Essentially, the city needs to provide three lists of property to be covered: • Each building for which you want coverage. Any building you list on the schedule is covered for replacement cost, along with the building's contents. • Each piece of mobile equipment with a replacement cost of more than $25,000. "Mobile equipment" means property other than vehicles that's not part of a building or the building's contents. It's basically the kind of stuff that would traditionally have been covered by an "inland marine" form. (It also includes police dogs.) Items of mobile equipment with a replacement cost of less than $25,000 can be covered automatically without having to be specifically scheduled if the city wishes. The city needs to indicate on the application whether or not they want coverage for under-$25,000 items. • • • Property in the open. This is a"catch-all" category of property. It's essentially stuff that isn't a building and that doesn't move around. Hydrants, signs, streetlights, flagpoles, fences, CD sirens, tennis nets,picnic shelters, etc. are typical examples. You need to identify the property in the open that you want to cover. This can be done either by listing individual items(e.g., "the `Welcome to Mosquito Heights' sign on Main Street"), by location (e.g., `.property in the open at Mosquito Heights City Park" or"property in the park except picnic benches"), or by some other general description (e.g., "all street lights in the city"). Crime Coverage All cities automatically receive a $100,000 of coverage for crime losses, as part of the property coverage. This should be sufficient for most cities, but higher limits are available if needed. Flood and Water Damage The city needs to identify whether or not each building is in a "flood hazard area". A "flood hazard area" is an area that is either within the 500-year floodplain as mapped by NFIP, or is in an unmapped area. On a case by case basis, buildings in unmapped areas can be treated as not being in a flood hazard area if you can provide information to the underwriter showing that it's not at significant risk of flooding. Buildings not in a flood hazard area are covered for water damage, including floods. Buildings in a flood hazard area are covered for water damage except for flood. For any building in a flood hazard area, the city must decide whether to add the supplemental flood coverage which LMCIT makes available as an option. The supplemental flood coverage "wraps around"the NFIP flood insurance, picking up flood damages that the NFIP policy doesn't cover. The supplemental flood coverage is available only if the city has purchased NFIP flood insurance for the building at the maximum limit available. If your city has received FEMA disaster assistance for a flood in the past, it's especially important to consider NFIP flood insurance and the LMCIT supplemental flood coverage. For any future flood disaster in a city that's received FEMA aid in the past, FEMA assistance would be reduced by the amount that could have been covered by NFIP flood insurance—whether you have the NFIP flood insurance or not. Golf Courses A golf course will now need to be listed on the schedule of "property in the open" in order for this type of property to be covered. The coverage limit for this golf course property is $100,000, including costs of debris removal. Coverage for loss of revenue, extra expense, and expediting expense is not subject to the $100,000 limit on golf courses, but is subject to the $5,000,000 per occurrence limit. Property in the City's Care, Custody and Control Personal property of others in the city's care, custody and control is included in the definitions of "building/contents" and "mobile property" for purposes of coverage. However, there are two 2 • types of property in the city's care, custody and control that must be specifically scheduled in order to have coverage: • Mobile property valued at greater than $25,000 replacement cost; and • Automobiles, which must be scheduled on a garage-keepers legal liability endorsement. Coverage provided will be comprehensive and collision. Trees and Shrubs Trees and shrubs within 100 feet of a covered building are covered as part of the building. If it wishes, the city can cover other trees and shrubs by identifying the trees and shrubs to be covered on the schedule of"property in the open". The trees or shrubs to be covered must be identified specifically (e.g., "trees in Mosquito Heights Memorial Park"). The city also needs to provide a reasonable estimate of the number of trees or shrubs to be covered. Utility Poles and Wires LMCIT's standard property coverage excludes coverage for damage to city utility poles and lines. In the past, this has left cities with electric utilities with a significant uncovered loss in the event of a widespread ice or windstorm that downed city lines. To help avoid this potential problem, LMCIT offers optional property coverage for city utility poles and transmission and distribution lines. The coverage is subject to a$50,000 deductible per occurrence and a $500,000 limit. The rates for the coverage are based on the number of miles of transmission and distribution lines in the city. Limits The LMCIT property coverage includes sub-limits or additional limits on certain types of properties, damages, or exposures. These limits are summarized below. These standard sub- limits or additional limits should be sufficient for most cities, but they can be increased by endorsement if necessary. The city should review whether any of these sub-limits or additional limits need to be increased in order to meet its particular needs. The following are sub-Iimits that apply to specific exposures. These are limits on the amount that LMCIT will pay for particular types of damage, within the overall blanket limit. Coverage Limit Computer equipment data and media $1,000,000 per occurrence Fine arts $500,000 per occurrence Covered property in transit $250,000 per occurrence Unscheduled locations $500,000 per occurrence Personal Effects $25,000 per occurrence / $2,500 per employee Water and flood damage $500,000 annual aggregate Golf course property $100,000 per occurrence Business personal effects $25,000 per occurrence / $5,000 per employee 3 • For most losses, the following limits are in addition to the overall blanket limit. However, if the particular loss falls under the "water and supplemental flood coverage", coverage for these damages is within the $500,000 limit that applies to that coverage. Coverage Limit Newly acquired covered property $5.000,000 per occurrence Buildings under construction $2.000.000 per occurrence Asbestos clean up $250,000 per location Loss of revenue/extra expense/expediting $5,000,000 per occurrence expense Debris removal/physical damage to $1,000,000 per occurrence covered property Debris removal/no physical damage to $50,000 per occurrence covered property Leasehold interest $500,000 per location Pollutant clean-up and removal $10,000 per location Errors $500,000 per occurrence Rental reimbursement $25,000 annual aggregate Arson reward $5,000 per occurrence Accounts receivable $500,000 per location Valuable papers and records $500,000 per location Year 2000 extra expense $5,000 per occurrence/annual aggregate Independent Administrative Boards Administrative boards, commissions, agencies and authorities and their properties are not covered automatically under the city's LMCIT Property, Inland Marine, or Auto Physical Damage coverages. LMCIT can provide these coverages for these entities and their properties, but only if the city specifically indicates which boards or commissions are to be covered and under what type of coverage. • Liability Coverage Issues Fireworks Displays Cities sometimes put on fireworks displays for Independence Day or other celebrations. The city's LMCIT liability coverage document excludes coverage for any liability arising out of the city's ownership, sponsorship, or operation of fireworks displays. This exclusion applies both if city employees or volunteers are setting off the fireworks, and if the city itself sponsors or contracts for a fireworks display. (The exclusion does not apply to a fireworks display that is sponsored and operated by someone else. Where the city's only role is in regulating, licensing, or providing public safety services, the city's LMCIT coverage will cover liability the city incurs because of those activities.) 4 • • If the city is involved in a fireworks display as an operator or as a sponsor, the city won't automatically have coverage for liability for any damages arising out of the display, unless the city takes special steps to put fireworks display coverage in effect. There are a couple possible solutions to this problem. The preferred approach is for the city to contract with an experienced, reputable contractor to handle the fireworks display. The city should make sure that the contractor has adequate insurance limits, and that the city is named as an"additional insured" under the contractor's insurance. At the city's request, LMCIT can then also delete the fireworks exclusion from the city's coverage for a small cost. The city's LMCIT coverage would then apply as excess over the contractor's coverage; this would give the city additional protection in case of a very large claim, or if the contractor's insurance company went broke, etc. Unfortunately, it's not always possible for cities to hire a private contractor to handle the fireworks display. Sometimes the only feasible option is for the city to put on the display itself, using city staff and volunteers to handle the display. In this situation, LMCIT can by endorsement provide the needed liability coverage to the city, provided that the city has adequately trained staff and a safe location for the display. Cities considering putting on a fireworks display themselves should contact LMCIT as early as possible. This will give LMCIT's loss control consultants time to work with the city to help make the display as safe as possible; and it will give LMCIT's underwriters time to evaluate the risk properly to determine whether LMCIT will be able to provide the requested coverage. Joint Powers Contracts The city's LMCIT liability coverage does not apply to "liability arising out of the activities of a joint powers entity." Unless the joint powers entity has arranged for coverage in its own name, neither the city and its officers and employees, nor the joint entity and its officers and employees will have coverage for a liability claim or suit arising out of the joint powers entity's activities. To avoid this problem, if the city is involved in a joint powers contract that creates a separate joint powers entity, make sure that the entity has liability coverage. When LMCIT issues liability coverage to a joint powers entity, that coverage protects not only the joint powers entity and its officers, employees, and volunteers, but also the constituent political subdivisions and their respective officers, employees, and volunteers, for claims arising out of the joint entity's activities. Keep in mind that not every joint powers contract creates a joint powers entity. Most mutual aid contracts do not, for example. Often too, cities enter contracts under which one political subdivision provides certain services to another in return for a fee; again,this kind of contract typically won't create a new joint entity, though there are exceptions. Cities should review all of the joint powers contracts they are involved in, including mutual aid agreements, service contracts, etc. Remember: the name given to a contract doesn't necessarily tell you what's in the contract. We've seen examples of contracts that were called mutual aid 5 • • agreements. but which very clearly had the effect of creating a new joint operating entity. You need to look at what the contract actually does, not just what ifs called. In very general terms, the joint powers coverage exclusion will come into play if the joint powers contract creates a separate board with power to do any of the following: • receive and expend funds; • enter contracts; • hire employees; • purchase or acquire real or personal property; or • sue or be sued. If you're not sure about a particular contract, send LMCIT a copy. We'll be glad to review it and give you a definite answer as to whether the city's own coverage will apply or if the contract creates a joint entity that needs its own coverage. Independent Administrative Boards Statutes and some charters allow cities to create independent administrative boards to manage certain city operations; utility commissions and hospital boards are common examples. Other statutes allow cities to create separate public corporations for certain purposes; Port Authorities, HRA's, and EDA's are examples. The statutes generally give these boards and authorities full power to manage the activities for which they are responsible, including the authority to purchase the appropriate liability, property, and other coverages needed for those activities. If your city has any of the following, you need to make sure there is adequate coverage for its activities: • gas, electrical, or steam utilities commission; • port authority, housing and redevelopment authority, economic development authority, municipal redevelopment authority, or similar agency; • municipal power agency; • municipal gas agency; • airport board or commission; or • hospital, nursing home, and medical clinic board or commission. There are some particular coverage issues to be aware of for certain specific types of boards, commissions, and entities, as described below: • Airport, Hospital, Nursing Home, and Medical Clinic Boards or Commissions These boards or commissions require specialty coverages. LMCIT cannot provide all the coverages that the city and the board or commission require. LMCIT provides coverage to the city and the board or commission for Municipal Liability, except for "Bodily Injury", "Property Damage", or "Personal Injury". You will need to purchase coverage for the other unique exposures from specialty insurance companies. Contact LMCIT for any assistance. 6 • • • HRAs,EDAs,and Port Authorities These entities are legally separate political subdivisions and are not covered automatically under the city's LMCIT liability coverage. (This is true even if the council members themselves also make up the board of the political subdivision). Unless the city has specifically indicated that these entities are to be covered, a claim against one of these political subdivisions would not be covered. Nor would the city be covered for claims arising from the activities of these entities. These entities' status as separate political subdivisions creates a coverage limits issue that the city needs to consider. Since the city and the EDA (for example) are each separate political subdivisions, each could potentially be liable for up to the statutory liability limit. If the EDA is added as an additional covered party on the city's LMCIT liability coverage, and if both the city and the EDA were sued for the same occurrence, you conceivably could have a total of$1.5 million of liability. However, you'd have only $750,000 of coverage limits available for that occurrence. One solution is for the EDA, HRA, or port authority to purchase separate coverage in its own name. If this is done, the city would then have primary coverage under the political subdivision covenant and excess coverage for these activities under their own covenant. Another option is to name the political subdivision as a covered party on the city's covenant and then also purchase excess liability coverage. This would also eliminate the potential limits problem. If the political subdivision purchases private insurance elsewhere, the city and the board or commission need to review the following questions to assure adequate coverage. (Remember, LMCIT does not automatically cover the city for claims arising from the EDA's, HRA's or port authority's activities.) • What type of coverage is provided to the city and the board? Is the coverage as broad as provided by the LMCIT covenant? Does it cover employment-related liability, land use or development litigation, etc.? • Is the city named as an additional insured on the board or commission's policy? If the city needs coverage for a gap left by private insurance that the EDA, HRA, or port authority has purchased, please contact LMCIT—an additional premium may be required. • Gas, Electrical or Steam Utilities Commissions These boards and commissions are not covered automatically under the city's LMCIT liability coverage. Unless the city has specifically indicated that these entities are to be covered, a claim against one of these boards or authorities would not be covered. Nor would the city be covered for claims arising from the activities of these boards or commissions. In most cases, LMCIT can provide the needed coverage in either of two ways: by adding the board or authority onto the city's policy, or by issuing separate coverage to the board or authority itself. If the coverage is added to the city's policy, both the city and the board or 7 • authority are covered. If the board or authority purchase separate coverage from LMCIT, the city will be added as a covered party under the board's coverage and both would share coverage and limits. Unlike the EDAs, HRAs, and port authorities, a utilities commission is usually not legally a separate political subdivision. (There may be a few exceptions where city charters make the utilities commission a separate legal entity.) Generally though, covering the utilities commission under the city's general coverage doesn't create the same coverage limits problem that you can encounter with EDAs, HRAs or port authorities. If the utilities commission purchases coverage elsewhere, the city and the commission need to review the following questions to assure adequate coverage. Remember that LMCIT does not automatically provide coverage to the city for the utilities commission's activities. If the utilities commission purchases separate private insurance, the city can't just assume that the city's LMCIT liability coverage will protect the city and fill any gaps that the utilities commission's insurance leaves. Again, cities should look at a couple of issues: • What t yp e of coverage is provided the city and the board or commission? Is the coverage as broad as that provided by the LMCIT covenant? Does it cover employment liability, EMF, failure to supply utilities services, etc.? • Does the utilities commission's insurance company understand that the city and the utilities commission are not separate entities? That is, do they understand that they must handle a claim arising from the utilities operations that names the "City of Mosquito Heights" as the defendant? (One possible way to clarify this might be to have the utilities commission's insurance issued to "City of Mosquito Heights DBA Mosquito Heights Utilities Commission") If the city needs to cover a gap in coverage that's left by the utilities commission's private insurance, please contact your LMCIT underwriter. Additional premium may be necessary. • Municipal power agencies and gas municipal agencies P g g Under the statutes, a municipal power agency or municipal gas agency is legally a separate political subdivision, even though it's created by contract among two or more cities. Thus these organizations have some characteristics of both political subdivisions and joint powers entities. The city's LMCIT liability coverage excludes claims arising from the activities of a municipal power or gas agency. If your city participates in a municipal power or gas agency, you need to make sure that the agency has appropriate liability coverage. You need to look at the same kinds of coverage questions that arise with covering EDA's, etc. 8 • S Medical Payments Coverage The "Medical and Related Payments Coverage" is part of LMCIT's general liability coverage agreement. This coverage provides a limited amount ($1,000) of"no-fault" medical payment coverage for those injured on city property because of a condition in the property. Some have questioned whether there is a valid purpose for cities to pay these funds in situations when the city is not legally liable. Others have argued that the payments provide a simple and inexpensive way to possibly head off what might turn into a more expensive liability claim. Cities have the option to delete the medical payments coverage from their LMCIT liability coverage. Uninsured/Underinsured Motorist Coverage Cities need to decide what limits of uninsured/underinsured motorist (UM/UIM) coverage to provide. The statutes require a minimum limit of$50,000. We believe it makes sense for most cities to carry the minimum limit, rather than providing higher limits. The UM/UIM coverages are designed to help assure that an injured driver will be compensated if s/he is injured in an accident caused by an uninsured or underinsured driver. The UM/UIM coverage steps into the place of the liability insurance that the driver should have had. In the case of city vehicles though, an injury to the driver while operating a city vehicle would in most cases be covered by workers' compensation. The amounts the individual would be able to recover from UM/UIM would be in addition to the medical, indemnity, and other benefits paid under work comp, and in many cases would amount to a double recovery for the individual's injuries. A city might decide to carry a higher limit for a couple reasons: if they believe the workers' compensation benefits are insufficient to compensate their injured employees; or if they want to make sure that non-employees riding in city vehicles are fully compensated in the event of an accident with an uninsured or underinsured vehicle. (Note that in most cases the passenger's own UM/UIM would also respond.) In any case, it is an issue that your city should consider. Whether to waive the statutory per-person limit for liability coverage For renewals after November 15 ,1999, coverage is issued with a $1,000,000 per occurrence limit. The new coverage form does not automatically waive the statutory provisions that limit the city's liability to $300,000 per claimant. However, the city has the option to waive the statutory per-person limit. Each city needs to consider whether or not to waive the statutory per-person limit. Here's a shorthand summary of the practical effects of that decision. • lithe city does not waive the statutory tort limits, an individual claimant would be able to recover no more than $300,000 on any claim to which the statutory tort limits apply. The total which all claimants would be able to recover for a single occurrence to which the 9 • 0 statutory tort limits apply would be limited to $1,000.000. These statutory tort limits would apply regardless of whether or not the city purchases the optional excess liability coverage. • If the city waives the statutory tort limits and does not purchase excess liability coverage, a single claimant could potentially recover up to $1,000,000 on a single occurrence. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to $1,000,000, regardless of the number of claimants. • If the city waives the statutory tort limits and purchases excess liability coverage, a single claimant could potentially recover an amount up to the limit of the coverage purchased. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to the amount of coverage purchased, regardless of the number of claimants. Contact LMCIT if you have questions or need more information on this issue. Excess Liability Coverage LMCIT provides a standard $1,000,000 liability coverage limit to match the statutory limit. However, there are a number of ways in which that coverage could turn out not to be enough: federal civil rights suits, liability assumed by contract, liability for actions in another state, inverse condemnation liability for land use claims, the possibility of the caps being found invalid, and exhaustion of annual aggregate limits on products liability, limited pollution and land use claims are some examples. In light of these various ways cities can be exposed to liability beyond the statutory limits, the city should consider purchasing higher limits of liability coverage. LMCIT makes available up to $5,000,000 of additional limits at the city's option. Sometimes city officials reason that "we're only a small city, so we don't need high liability coverage limits." But arguably the opposite is true: A big city has much more tax base and many more taxpayers over which to spread, say, a $1,000,000 excess judgment; in a small city, the burden per taxpayer could be enormous. If your city has considered excess coverage in the past, but decided against it for cost reasons, you may want to reconsider. Rate reductions in recent years have reduced the cost substantially, and the rate is decreased further for 1999-2000. We have prepared a separate memo discussing the various issues that cities ought to think about when deciding whether to buy excess coverage. Contact us at the League office for a copy. Contractual Liability/Additional Covered Parties The LMCIT covenant provides coverage for most contracts. The covenant can also be endorsed to provide coverage for additional covered parties when requested. It is important to review all contracts and requests for additional insureds, and to consider the following points: 10 • • • many requests for an additional insured endorsement are really a request for a Certificate of Insurance; • the contract and the hold harmless provisions should be reviewed by legal counsel; and • contracts with railroads or involving work on railroad property need special attention— contact LMCIT for assistance. Automobile Liability Coverage Member cities have the option to make LMCIT auto liability coverage primary for privately owned vehicles used on city business by specified individuals or groups in specified circumstances (e.g., firefighters responding to calls). There is a premium charge per vehicle for this optional coverage. Liquor Liability Coverage If the city is involved in any way in selling liquor or beer, the city should have adequate amounts of liquor liability coverage. This includes not just cities with a municipal liquor store. Fire relief associations, for example, sometimes are involved in special-event beer sales as a fundraiser and may need liquor liability coverage. LMCIT now offers this coverage as part of the LMCIT property/casualty program, both for municipal liquor stores and for special-event sales by city-related entities, like a fire relief association. Standard coverage limit options are $500,000 or$1,000,000. Higher limits are also available upon request. Cities should be especially careful to make sure the liquor liability coverage limits are adequate, since there are no statutory limits on liability for illegal liquor sales. A typical liquor liability claim involves a car accident. If a breadwinner with several dependents is killed or disabled in an accident, damages can easily reach or exceed the half-million dollar mark. If the city's coverage limits aren't sufficient, the city can still be liable for the excess. We suggest that as a minimum any city involved in liquor or beer sales should have at least $500,000 of coverage, whether from LMCIT or from a private insurer. Other Issues Bond Limits and Forms For renewals after November 15, 1999, the minimum limit available for LMCIT fidelity and faithful performance bonds is $25,000. The limits have been changed because a number of cities carried very low limits on their bond coverage; some smaller cities carried a limit of $5,000 or $10,000, which really wouldn't provide much protection if a loss were to occur. Another key point to take into consideration is that the statutes call for certain officers to be covered by a "faithful performance" bond. A faithful performance bond guarantees that the 11 • • officer will faithfully perform the duties of his or her office, and it is required for a statutory city clerk or treasurer, for example. An ordinary fidelity bond protects the city only against losses caused by the individual's dishonesty. If the city suffers a loss because of the officer's mistake. or because the officer simply didn't perform his or her duties properly, an ordinary fidelity bond won't help; a "faithful performance" bond, however, might. To avoid these problems we suggest the following: • Review the limits on the city's current bond coverage. The Government Finance Officers' Association several years ago developed a formula for suggested bond limits based on the city's annual revenues and the amount of negotiable securities on hand. It's not an absolute or infallible rule, but this formula can give the city a starting point for thinking about what bond limits to carry. We would be happy to provide information on this formula. • Make sure that you have `faithful performance- bond coverage on those positions where the statutes require it. Some of the most common examples are statutory city clerks and treasurers and their deputies, and relief association treasurers. Most bond companies will provide this coverage on request for an additional premium for positions where the statutes require it, though they may be reluctant to extend "faithful performance" coverage to other positions. Petroleum Tank Leaks or Spills Minnesota's Petrofund provides reimbursement for 90% of the first $250,000 and 75% of the next $750,000 of clean up and liability costs from a petroleum products storage tank leak or spill. But to be eligible for this reimbursement,'the tank owner must be in compliance with applicable PCA and EPA regulations and requirements. The Petrofund reimbursement can be reduced or refused if the owner is not in compliance. In any event the city will be responsible for at least 10% of the cleanup and liability costs, as well as all legal defense costs associated with the leak or spill. If your city has any tanks,the first priority is make sure you comply with the applicable regulations, so that you'll be eligible for Petrofund reimbursement if you ever have a problem. It's an oversimplification, but key points are: • make sure the tank is registered with MPCA; • make sure you meet EPA's requirements and timetable for technical improvements to the tank, for leak monitoring, corrosion resistance, spill prevention, etc.; and • make sure you report any known leaks or spills to MPCA immediately. Cities with tanks also need to think about how best to handle the costs that Petrofund won't reimburse; i.e., the defense costs and 10% of the first $250,000 and 25% of the next $750,000 of liability and cleanup costs. For most cities, there are two choices: either retain these risks, or purchase LMCIT's optional Petrofund Supplement coverage. 12 • • EPA financial responsibility compliance is really no longer an issue in Minnesota. EPA now says that Minnesota's Petrofund by itself will satisfy the financial responsibility requirements —a separate plan to demonstrate financial responsibility to the EPA is no longer necessary. Thus, most cities can approach this as a straightforward financial risk management issue: Does it make more financial sense to pay the premium to LMCIT to assume these risks for the city, or for the city to simply retain these risks itself? Machinery Breakdown ("Boiler and machinery") Coverage LMCIT offers Machinery Breakdown Coverage to protect cities from the unexpected cost and expense associated with equipment and machinery breakdowns. The Machinery Breakdown Coverage, which we used to call '`boiler and machinery" coverage, was originally developed by the insurance industry to cover the risks of steam boiler explosions. As the coverage has developed, besides explosion risks from steam boilers or other pressure vessels, the coverage now provides protection against the risks of breakdowns of a wide variety of machinery and equipment, such as: • wastewater system equipment (e.g., pumps, agitators, air systems, electronic controls, motors, etc.); • air conditioning, refrigeration, and heating equipment; • water system pumps, motors, etc.; • electrical wiring, breakers, transformers, switches, etc.; • telephone switchboard and related equipment; and • compressors for filling fire department air packs. Cities may also have other types of equipment (such as steam or diesel generators, equipment for municipal gas or district heating systems, or medical equipment such as MRIs) which can also be covered but must be evaluated separately. Coverage for certain large municipal utilities will now be provided directly by Hartford Steam Boiler. Coverage terms, limits, deductibles, and exclusions are typically highly individualized for these type of risks. It was determined that these types of accounts should be handled directly by Hartford Stream Boiler in order to provide better service and underwriting expertise. Two types of costs are covered: • The actual cost of repairing or replacing the equipment as quickly as possible; and • Lost income or extra expense incurred to continue operations while the equipment is down. 4, In considering whether to purchase machinery breakdown coverage, a city should look at how much it would cost to replace various pieces of machinery, what extra expenses you might incur to continue operation while a key piece of equipment is being repaired, how long it might take to get repairs or replacement equipment, and so on. If your city's budget can handle these kinds of expenses, it probably doesn't make sense to carry the coverage. On the other hand, if the possible cost to repair or replace a particular piece of machinery is more than what your budget can comfortably absorb, machinery breakdown coverage is worth considering. 13 • • Open Meeting Law Defense Cost Reimbursement From time to time, city council members may get sued for alleged violations of Minnesota's Open Meeting Law. The LMCIT liability coverage does not cover these suits unless there is some other covered claim included as part of the complaint. Consequently, the cost of defending these suits for individual council members can often be fairly expensive. To avoid this uncovered exposure to the council member or to the city, LMCIT has made available Open Meeting Law Defense Cost Reimbursement Coverage. The coverage reimburses individual council members for up to $50,000 of their Open Meeting Law defense costs per person. The city now has the option to select either of two forms, which reimburse these costs at 80% and 100% respectively. Specialty Coverages You Probably Don't Need LMCIT provides liability coverage under one coverage document, which provides most of the coverages that a city or its independent boards or commissions need. If you are still purchasing any of the following coverages from another insurance company, you should review closely for duplication of coverages: • Police Liability • Employment Liability • Employee Benefit Liability • Firefighters Professional Liability • Public Officials Liability • Fiduciary Liability for Relief Associations • Ambulance Professional Liability Revised LS 11/99—fax 66060 14 • LMCIT L14.0 Risk Management Information League of Minnesota Cities 145 University Avenue West, St. Paul, MN 55103-2044 Cities promoting excellence Phone: (651) 281-1200 • (800) 925-1122 Fax: (651) 281-1298 • TDD (651) 281-1290 Web Site: http://www.lmnc.org COMPARING CITY LIABILITY, PROPERTY, CRIME AND BOND COVERAGE QUOTES Some Questions to Ask The commercial insurance market has become very competitive, with lots of insurance companies that want to sell insurance to cities. Obviously, cities will want to compare what the commercial companies offer with the coverage available from LMCIT. But it's important to compare not only cost but coverage as well. The LMCIT coverage was designed specifically to meet cities' needs. Consequently, LMCIT's coverage is broader than any we have seen offered to a city by any commercial insurance carrier. If you are looking at a commercial insurance company's policy or policies as an alternative to LMCIT, this list of questions may help identify some of the differences in coverage. LMCIT can answer "yes" to all of these questions. If a private carrier can't, their coverage isn't as good as LMCIT's. (Note that some of these coverages are optional in LMCIT.) Ask the agent or insurance company offering the coverage to answer these questions in writing. If you buy their insurance, keep a copy of the response with your policy. It will be useful when you have a claim. Some questions to ask about liability coverage 1. Does it cover the liability exposures of ambulance attendants, paramedics, and"First Responders"? 2. Does it cover the professional malpractice exposure of an engineer, surveyor, or accountant who is a city employee? 3. Does it cover libel, slander, defamation, and invasion of privacy arising out of the operation of a public access or city government cable TV channel, or a cable broadcast of council meetings? 4. Suppose a police officer acting in good faith misjudges the amount of force that is reasonable to use in making an arrest; that is, the officer in good faith thought that the force • • he used was reasonable, but a court later disagrees. Does the policy cover both the city's and the officer's liability for assault and battery or for using unreasonable force? 5. Suppose an officer acts in bad faith and intentionally uses an unreasonable amount of force on a suspect, who then sues both the city and the officer. Is the city's liability covered? 6. Are each of the following "named insureds" under the policy? a) City council members b) Members of boards or commissions c) City volunteers, whether individuals or organizations d) Other elected or appointed city officials e) City employees, whether full-time, part-time, or temporary f) Relief associations and their officers, employees, and members g) The ambulance service medical adviser or medical adviser h) Former city officers, employees, and volunteers 7. Does it provide at least $1,000,000 of coverage for each occurrence, regardless of the number of occurrences, the number of defendants, or the number of claimants? (Many policies have a"general aggregate" limit, which limits the total amount the insurance company will pay under the policy, regardless of the number of claims. LMCIT's coverage has no general aggregate limit, although there are aggregate limits on coverage for products and completed operations, "limited pollution", land use liability, EMF and stray voltage claims, claims for failure to supply utilities, and lead and asbestos claims.) 8. Do es it co ver liability for ore m employment actions such as hirin g, firing, disciplining or promoting? 9. Does it cover liability for claims of sexual or racial harassment? 10. Does it cover punitive damages to the extent permitted by statute? 11. Does it cover violations of civil rights? 12. Does it cover the city's statutory duty to indemnify volunteer firefighters for automobile liability incurred while responding to a fire? 2 • • 13. For any "claims-made" policy (most public officials "errors and omissions"policies are claims-made): a) Does it guarantee you the right to purchase an unlimited extended reporting period, even if you cancel the policy or decide not to renew it? b) Is the price of the extended reporting period specified in the policy itself? 14. Does it cover city liability arising from a city officer's or employee's malfeasance? 15. Does it pay for the defense of an officer or employee accused of malfeasance? 16. Does the errors and omissions policy cover property damage or bodily injury resulting from a"wrongful act"? (Don't confuse this with coverage for property damage or bodily injury caused by an "occurrence.") 17. Does it cover suits by one city employee against another employee or against the city? 18. Are general liability, police liability, ambulance liability, firefighters' liability, errors and omissions, and employment liability coverage provided in a single form by a single carrier? (If not, there is a possibility for coverage disputes among the insurers.) 19. Are special events covered? (LMCIT does not exclude coverage for special events per se, though certain activities sometimes associated with special events are excluded; motor vehicle races, fireworks, and mechanical rides are examples.) 20. Does the coverage preserve all of the city's statutory and common-law defenses? (Some policies explicitly waive all "governmental immunity" defenses.) 21. Does it cover liability arising out of strikes, riots, or civil commotion? 22. Does it pay on behalf of the insured, rather than reimbursing you after you have paid the loss and defense costs? 23. Does it provide "overlap" coverage? ("Overlap" coverage provides that if there is a dispute between two or more of the city's insurers as to which is liable for a particular claim, the insurers and not the city bear the cost of resolving that dispute.) 24. Is the carrier willing to provide coverage for joint powers entities such as watershed management organizations, cable TV commissions, sewer boards, and so on? 25. Does it cover the liability of the ambulance services medical adviser or medical director for his/her administrative actions? (The medical director's own malpractice coverage might not apply to administrative actions, as distinguished from professional medical activities.) 3 • 26. Does it cover liability for inverse condemnation when a court determines that a zoning or other land use regulation has resulted in a temporary taking of private property? 27. Does it cover claims for attorneys' fees that are claimed as part of a civil rights suit seeking an injunction but not seeking monetary damages? 28. Does it cover automotive liability the city has assumed by contract—through a defense and indemnification agreement, for example? 29. Does it cover the liability arising out of operating an employee benefit plan or advising employees regarding such a plan? 30. Does it cover the fiduciary liability of board members of a fire relief association? 31. Does it cover accidental, aboveground spills of pollutants? 32. Does it let you buy higher liability coverage limits where needed, without waiving the statutory liability limits where they apply? 33. Does it cover liability for lead contamination? 34. Does it cover liability for asbestos contamination? 35. Does it defend employment-related charges against the city that are filed with the EEOC or Human Rights Commission, even if those charges don't explicitly claim money damages? 36. Is coverage available to defend open meeting law charges against city officials? 37. Is coverage available for those liability, clean-up, and defense costs for an underground tank leak or spill which are not reimbursed by the state Petrofund? 38. If back wages are awarded as damages for wrongful termination of an employee, are those damages covered? 39. Is there coverage for the city's liability for loss of or damage to property belonging to others that's in the city's care, custody and control? 40. Are claims for damages caused by electromagnetic fields covered? 41. Are claims for damages caused by stray voltage covered? 42. Does it cover damages from the failure to supply utilities? 43. Is there coverage available for the professional activities of an attorney who is a city employee? 4 • • 44. Does it cover legal costs for litigation relating to land use regulation or development, even if that litigation doesn't involve a claim for damages? 45. Suppose a city employee is sued because of some action he took as a member a joint powers board that he sits on as the city's representative. The joint powers board doesn't have insurance itself, and isn't a"named insured" on the city's insurance. Does the employee or the city have any protection? 46. Does it cover liability for bodily injury, property damage, or other damages caused by "Y2k"problems in computers or other equipment? Some questions to ask about property coverage 1. Is the coverage on a"blanket limits" basis? If not,you need to make sure that each specific limit on each piece of property is adequate, for both the building and the building's contents. 2. Is the coverage written without a coinsurance clause? If not, the insurance company may penalize you on a claim if they determine that you didn't purchase and pay for adequate coverage limits. 3. Does the insurance company provide appraisals for your property? If not, you'll need to either come up with the values yourself or pay for a professional appraiser. If the values you come up with aren't adequate, you may not have enough coverage if a loss occurs and you might be subject to a coinsurance penalty. 4. Does the insurance company cover your buildings and their contents for replacement cost? 5. Does the insurance company cover your mobile equipment—i.e., "inland marine" property— at replacement cost? 6. Is property coverage automatic for minor pieces of equipment, or do you have to specifically schedule each one in order to have coverage? 7. Does it cover water damage to city property, including damage caused by sewer back-ups, flooding, mudslides, etc.? 8. Is loss of income and extra expense coverage included? 9. Are police dogs covered, including the cost of training a replacement dog? 10. Do you have any protection if you forget to schedule property coverage for a particular building or other piece of property? 11. Is coverage available for damage to city utility poles and lines? 5 • • 12. Does it cover earthquake damage? - 13. Is property in transit covered? 14. Does it cover vandalism damage to golf course greens, tees, signs, etc.? 15. Does it cover damage to city property caused by an off-premises power failure? (Note: This LMCIT coverage doesn't apply to municipal utilities property.) 16. Does it cover accounts receivable? 17. Does it cover computer equipment and media, including the cost to recover or reconstruct data and programs? 18. Does it cover damage caused by a computer virus? 19. Does it cover art objects? 20. Does it cover the cost to replace valuable papers? 21. If a building is damaged or destroyed, does the coverage pay the additional costs to clean up asbestos and other pollutants? 22. Does it cover extra expenses the city might incur to respond to Y2k problems? 23. Does it cover the cost to remove storm debris from a city park? 24. Does is cover property belonging to others that's in the city's care, custody, and control? 25. Does it cover your employees' personal tools or equipment used on city business? Some questions to ask about crime coverage 1. Does it provide a $100,000 limit for crime losses of money and securities? 2. Does it provide a blanket limit for crime losses, regardless of which"premises"the funds were stolen from? (If the coverage is based on a particular"premises" and funds were stolen by means of computer fraud or electronic funds transfer, you might have trouble proving that the theft was from a covered premises, or showing which specific covered premises the theft was from.) 3. Does it cover theft of city funds by computer fraud? 4. Does it cover theft of city funds by fraud or swindle? (Many crime policies exclude coverage if you were"induced by a dishonest act to voluntarily part with"the money or securities.) 6 i ` • 5. Would it cover a burglary loss from a building following an unexpected event that impaired the security of the building? 6. Does it cover theft by extortion or threat of violence? 7. Does it cover losses from forgeries or alterations? 8. Does it cover thefts from vending machines? (Many crime forms cover only vending machines that have a"continuous recording device".) 9. Are relief association funds covered? Some questions to ask about municipal bond coverage 1. Does the "faithful performance" bond cover all losses resulting from the official's failure to faithfully perform his/her duties? (Many "faithful performance" bond forms exclude various claims. A bond form that excludes certain losses wouldn't seem to meet the statutory requirements for those officials who are required by law to have a faithful performance bond.) 2. Are the bond limits realistic? (A $5,000 or $10,000 bond might comply with the statute, but doesn't give the city much real protection.) 3. Would it cover a third party's loss caused by the officer's dishonesty or other malfeasance? (Some bond forms have a"sole benefit" clause, which means it would only cover a loss of city funds.) 4. Would the faithful performance bond cover a tort claim or a civil rights claim against the officer based on the officer's malfeasance? (These exclusions are often found in bond forms. Again, a faithful performance that excludes these losses would not appear to meet statutory requirements.) 5. Does the faithful performance bond cover investment losses caused by the officer's malfeasance? 6. Would the bond cover a loss that isn't "tangible property"? 7. Does it cover relief association funds? 8. Does it cover relief association officers? 7 • i Do These Things Really Matter? Some people might suggest that these items are merely unimportant"frills"that aren't worth worrying about. But remember: Every "no"answer represents a claim which LMCIT would cover but the private insurance company wouldn't. It's easy to make insurance cheap by excluding coverage of certain items. But if coverage is excluded for a particular kind of claim, it means the city retains the risk of loss in those areas. From the city's standpoint, retaining risk is a great way to reduce premiums. But coverage exclusions are an unpredictable way of retaining risk. You might not have a claim that falls into one of the exclusions—but then you might have a$1,000,000 claim that falls into the exclusion. A better and more predictable way to reduce costs by retaining risk is to use deductibles. This could be a per-occurrence deductible, or an"annual" deductible under which the city keeps the financial responsibility for claims up to a certain dollar amount each year, or a combination of the two. By retaining risk this way, you know how much you're retaining and can budget for it. PST—2/7/2000-fax-66150 8 • 145 University Avenue West, St. Paul, MN 55103-2044 L MC Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence Web Site: http://www.lmnc.org J November 22, 1999 To: LMCIT member cities and agents From: Pete Tritz Re: Coverage changes for 1999-2000 The LMCIT Board has approved a number of changes in LMCIT's liability,property, workers compensation, and other coverages for the coming year. Many of these changes are relatively minor tweaks and clarifications,but there are also a number of important substantive changes. The changes summarized below affect property/casualty coverage written or renewed on or after November 15, 1999, and workers compensation coverage written or renewed on or after January 1, 2000. A major issue for cities this year is the increase in the statutory tort liability limit which takes effect January 1, 2000. A separate enclosed memo explains how LMCIT will handle that change. Liability coverage changes 1. Land use regulation, development, and franchise litigation—late reporting. The LMCIT liability coverage includes coverage for costs of litigation relating to land use regulation, development or redevelopment, or franchising, even if that litigation doesn't include a claim for damages. The change provides that any litigation costs which the city incurs prior to reporting the litigation to LMCIT will be reimbursed at only 50%. Prompt reporting of this type of litigation is therefor now even more important. 2. Joint powers exclusion. The recommended change clarifies that the "joint powers" exclusion only applies to claims arising from the activities of a joint powers entity of which the city is a member. 3. Nurses'professional liability—vaccinations. Some city fire departments, ambulance services, or first responder teams have registered nurses who are members of the department and who administer the hepatitis and other vaccinations that are required by OSHA. The LMCIT liability coverage will now pick up any professional liability arising from these kinds of services by nurses who are city volunteers. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • 4. ERISA exclusion. The exclusion for fiduciary claims under ERISA has been eliminated. (This really doesn't have much practical effect since ERISA doesn't apply to governmental benefit programs anyway.) 5. Personal injury definition. The definition of"personal injury" is amended to include "advertising injury", bringing it into conformance with the way that term is defined in CGL policies. The purpose of this change is to better coordinate with the specialty liability insurance the city may purchase from a private insurer for airports, hospitals, nursing homes, or clinics. 6. Coverage duplication. In certain rare circumstances, claims from a single event arguably could be covered under each of two successive policies. (It's possible to imagine a circumstance in which a police chase, for example, conceivably could lead to both an auto liability claim and a general liability claim.) The change clarifies that if a particular event results in claims that arguably are covered under each of two successive city policies, the later policy excludes those claims and coverage is provided only under the earlier policy. Property coverage changes 1. Property loss valuation. Several changes clarify how property losses will be adjusted in specific circumstances: • Property is deemed to be "destroyed" if the cost to repair it plus the reduction in appraised value of the repaired property would be greater than the cost to replace it. • If property is damaged but not destroyed and the city chooses to raze the property rather than repairing it, LMCIT will pay the city an amount equal to the estimated cost to repair the property on a "replacement cost"basis. • If the city and LMCIT cannot agree on a figure for the estimated cost to repair property in that situation, the issue will be resolved by arbitration. (The coverage already provides that disagreements over the property's appraised value would be resolved by arbitration.) • Increased costs to comply with building codes are considered part of "replacement cost". This has always been both the intent and LMCIT's actual practice, but the revision makes this clear, explicit, and unambiguous. 2. Police dogs. The changes clarify that LMCIT will cover the cost of veterinary treatment of a police dog for injuries but not for disease; that for purposes of coverage; a police dog is considered to be "destroyed" if because of injury or disease the dog can no longer perform the dog's normal functions; and clarify that the • • • replacement cost coverage for police dogs is subject to the same limit of 200% of appraised value which applies to other"mobile property". 3. Business personal effects. The change clarifies that LMCIT's coverage for"business personal effects"—i.e., employees' tools or other personal property used in performing their city duties—is primary. 4. Limits for golf course property and for business personal effects. The change clarifies that these limits are sub-limits within the blanket limit, rather than additional limits. 5. Computer virus damage. This change clarifies that damages caused by a computer virus are covered. Such damages might include, for example, the cost to reconstruct or replace data or programming that's been damaged or destroyed by a virus, or loss of income from business interruption, etc. Crime coverage changes The coverage for crime losses has been completely re-written to be broader, clearer, and easier to understand. All coverage for theft of city funds by persons other than city officers and employees is now combined into a single broad coverage part within the property coverage form. The separate coverage forms for"theft, disappearance, and destruction" and "forgery and alterations" are eliminated. There are also some important substantive changes: 1. All cities will automatically receive a$100,000 coverage limit for crime losses, with no additional premium charge. Higher limits are available if needed. The coverage and the coverage limit are now on a blanket basis, rather than being tied to specific locations. 2. Theft of city funds by computer fraud is now clearly covered. 3. Several exclusions are eliminated, broadening the coverage: • Theft from coin-operated devices • Transfer or surrender of property by threat or by unauthorized instruction (extortion, in other words) • "Exchanges or purchases" and "voluntary parting" (tricks or swindles, in other words) The old form also excluded coverage for theft from an armored car unless the city had first tried and failed to recover from the armored car company or their insurer. That restriction is now eliminated as well. • • Public employee fidelity and faithful performance bond changes Limits. The most significant change in the bond coverage is that LMCIT will no longer offer bond limits of less than $25,000. Some cities have historically carried very low bond coverage limits - $5,000 or $10,000 or even less. However, the Trustees concluded that it just didn't make sense for LMCIT to offer bond limits that are so low that they really don't give the city any significant protection. Bond form changes. LMCIT's "public employee fidelity bond"and "public employee faithful performance bond" forms have also been completely re-written to be easier to use and to understand. A second goal in revising the faithful performance bond form was to make it more specifically fit the statutory requirements for these bonds in Minnesota. The faithful performance bond actually serves three distinct purposes: • Like a fidelity bond, it would reimburse the city for losses resulting from an officer's or employee's dishonesty. • It would also reimburse the city for losses resulting from other types of"malfeasance, willful neglect of duty, or bad faith" by the employee, besides dishonesty. • It would reimburse a member of the public for losses caused by the employee's malfeasance, willful neglect of duty, or bad faith for which the employee is liable. The revised form now makes it clear and explicit that if LMCIT pays any loss resulting from the employee's malfeasance, willful neglect of duty, or bad faith in any of these three situations, LMCIT can and will recover that loss if possible from the employee who is responsible. The revision also addresses a quirk in the statutes that arguably requires a faithful performance bond to respond to other liability claims as well; i.e., claims based on ordinary negligence, rather than malfeasance, willful neglect of duty or bad faith. In most cases this is irrelevant, since the city's LMCIT liability coverage covers those claims. For those few"ordinary negligence" claims excluded by the LMCIT liability coverage, the bond form now provides a very limited amount of coverage— 10% of the bond limit. Unlike the "malfeasance" situation, LMCIT would not and could not seek reimbursement from the employee in these cases. (We'd stress that the purpose of this new provision of the bond coverage is to provide strict compliance with what the statute seems to require. It should not be viewed as providing any real substantive protection to the city or to anyone else.) • • Open Meeting Law Defense Coverage changes The coverage limit for the Open Meeting Law Defense Coverage is increased to $50,000 per official per year, up from the current limit of$20,000. There's no additional premium charge for the increased limit. Workers compensation coverage changes Peace officers'post-traumatic stress benefits. A 1999 law(Chapter 216, Article 5, Section 3 of the 1999 Laws, codified as M.S. 299A.411)requires cities to provide up to a year's paid leave and to pay the costs of any necessary psychological, psychiatric, or other medical care for a peace officer suffering from post-traumatic stress syndrome as a result of a use of force which resulted in death or great bodily harm. If there is no physical injury to the officer in these situations, workers compensation would not apply, but the new law would still require the city to provide these benefits. For 2000, coverage for these benefits will be included as a standard feature of the LMCIT workers compensation coverage. The new coverage will reimburse the city for the direct costs the city incurs to provide the required benefits. "No-fault sewer back-up coverage" option The LMCIT Board is continuing to review the possibility of adding a"no-fault sewer back-up coverage" option, and is interested in comments and feedback from cities on the concept. Currently,the LMCIT liability coverage covers claims for damages caused by sewer back-ups. Those claims are handled like any other liability claim. The law on liability for sewer back-up damages in Minnesota is clear and well-established. The key question is whether the sewer back-up damages were caused by some negligence on the city's part. If so, the city is legally liable for those damages, and LMCIT pays those damages on behalf of the city. If the damages aren't attributable to city negligence, the city is not legally liable, and LMCIT then denies the claim. Unfortunately,that legal analysis may not satisfy the homeowner who has suffered a back-up. City councils and staff often hear very emotional complaints in these situations, to the effect that "It's the city's sewer, I didn't do anything wrong, so the city should pay for cleaning it up and repairing the damage." The idea of the"no-fault sewer back-up coverage" would work like this. The city would have the option to pay an additional premium to LMCIT, in return for which LMCIT would agree to reimburse any property owner for damages from a sewer back-up, irrespective of whether the city had been negligent and was legally liable for those damages. The no-fault coverage would be subject to a relatively low limit—perhaps • • $5,000-$10,000 per claimant per occurrence. A possible variation would be to provide no-fault coverage only for clean-up costs. The additional cost to the city is estimated to be in the range of 5-10% of the city's liability premiums. It would likely be a requirement that the city have a regular sewer inspection and maintenance program in place in order to qualify for the coverage. If you have any suggestions or comments on whether it would make sense for LMCIT to develop this option, how it might best be structured, or whether it's something your city might be interested in, please let us know by phone, fax, or e-mail to ptritz @lmnc.org, • LMCIT LMC Risk Management Information League of Minnesota Cities 145 University Avenue West, St. Paul, MN 55103-2044 Cities promoting excellence Phone: (651) 281-1200 • (800) 925-1122 Fax: (651) 281-1298 • TDD (651) 281-1290 Web Site: http://www.lmnc.org LMCIT LIABILITY COVERAGE OPTIONS LIABILITY LIMITS, COVERAGE LIMITS, AND WAIVERS LMCIT gives cities several options for structuring their liability coverage. The city can choose either to waive or not to waive the monetary limits that the statutes provide; and the city can select from among several liability coverage limits. This memo discusses these options and identifies some issues to consider in deciding which of the options best meets the city's needs. What are the statutory limits on municipal tort liability? The statutes limit a city's tort liability to a maximum of$300,000 per claimant and $1,000,000 per occurrence. These limits apply whether the claim is against the city, against the individual officer or employee, or against both. What are the coverage limits for LMCIT's basic primary liability coverage? LMCIT's liability coverage provides a limit of$1,000,000 per occurrence, matching the per- occurrence part of the statutory municipal tort liability limit. Under the basic coverage form the $300,000 per claimant part of the statutory liability limit is not waived, so if the statutory limit applies to the particular claim, LMCIT and the city would be able to use that limit as a defense. Beside the overall coverage limit of$1,000,000 per occurrence,there are also annual aggregate limits (that is, limits on the total amount of coverage for the year regardless of the number of claims), for certain specific risks. Aggregate limits apply to the following: Products/completed operations $1,000,000 annually Failure to supply utilities $1,000,000 annually EMF $1,500,000 annually Limited pollution* $1,000,000 annually Lead and asbestos* $200,000 annually Land use litigation** $1,000,000 annually Y2k—basic* $25,000 annually Y2k—expanded* $750,000 annually Employers liability (work comp) $1,000,000 annually * The limit applies to both damages and defense costs. ** Coverage is on a sliding scale percentage basis. r S If the statute limits our liability to $1,000,000 per occurrence,why would the city purchase higher coverage limits than that? There are several different reasons why cities should strongly consider carrying higher limits of liability coverage. 1. The statutory tort limits either do not or may not apply to several types of claims. Some examples include: • Claims under federal civil rights laws. These include Section 1983, the Americans with Disabilities Act, etc. • Claims for tort liability that the city has assumed by contract. This occurs when a city agrees in a contract to defend and indemnify a private party. • Claims for actions in another state. This might occur in border cities that have mutual aid agreements with adjoining states, or when a city official attends a national conference or goes to Washington to lobby, etc. • Claims based on liquor sales. This mostly affects cities with municipal liquor stores, but it could also arise in connection with beer sales at a fire relief association fund-raiser, for example. • Claims based on a "taking" theory. Suits challenging land use regulations frequently include an"inverse condemnation"claim, alleging that the regulation amounts to a "taking"of the property. 2. LMCIT's primary liability coverage has annual limits on coverage for a few specific risks. The table on page 1 lists the liability risks to which aggregate coverage limits apply. If the city has a loss or claim in one of these areas,there might not be enough limits remaining to cover the city's full exposure if there is a second loss of the same sort during the year. Excess liability coverage gives the city additional protection against this risk as well. However there are a couple of important restrictions on how the excess coverage applies to risks that are subject to aggregate limits: • The excess coverage does not apply to three risks: lead and asbestos;failure to supply utilities; and Y2k, and • The excess coverage does not automatically apply to liquor liability unless the city specifically requests it. 3. The city may be required by contract to carry higher coverage limits. Occasionally, a contract might include a requirement that the city carry more than $1,000,000 of coverage limits. Carrying excess coverage,is a way to meet these requirements. (There's 2 • S also another option for cities in this situation. LMCIT can issue an endorsement to increase the city's coverage limit only for claims relating to that particular contract. There's a small charge for these "laser" endorsements.) 4. There may be more than one political subdivision covered under the city's coverage. An HRA, EDA, or port authority is itself a separate political subdivision. If the city EDA, for example, is named as a covered party on the city's coverage and a claim were made that involved both the city and the EDA, theoretically the claimant might be able to recover up to $1,000,000 from the city and another$1,000,000 from the EDA, since there are two political subdivisions involved. Excess coverage is one way to provide enough coverage limits to address this situation. Another solution is for the HRA, EDA, or port authority to carry separate liability coverage in its own name. This issue of multiple covered parties can also arise is if the city has agreed by contract to name another entity as a covered party, or to defend and indemnify another entity. 5. Cities sometimes choose to carry higher coverage limits because of a concern that the courts might overturn the statutory liability limits. However, those limits have now been tested and upheld several times in Minnesota. While it's always possible that a future court might decide to throw out the statutory limits, this is now less of a concern. What excess liability coverage limits are available? Excess coverage is available in $1 million increments, up to a maximum of$5 million. We're just a small city. Isn't excess liability coverage really just something that big cities might need? Absolutely not. If anything, excess liability coverage is even more important to a small city. If a city ends up with more liability than it has coverage, the city will have to either draw on existing funds or go to its taxpayers to pay that judgment. A large city faced with, say, a million dollars of liability over and above what its LMCIT coverage pays might be able to spread that $1 million cost over several thousand taxpayers. The small city by contrast might be dividing that same $1 million cost among only a couple hundred taxpayers. $1 million divided among 5000 taxpayers is $200 apiece—annoying but probably at least manageable for most taxpayers. $1 million divided among 200 taxpayers is $5000 apiece—enough to be a real problem for many. How does excess coverage apply to uninsured/underinsured motorist coverage? If the city carries excess liability coverage, the city has the option to have the excess coverage also apply to uninsured or underinsured motorist(UM/UIM) claims. To do so, the city must first increase its primary UM/UIM limit from the basic $50,000 to $1,000,000. There are additional 3 • • premium charges both to increase the primary UM/UIM limit and to apply the excess coverage to the UM/UIM exposure. The city needs to consider whether the benefit from having higher UM/UIM limits is worth that cost. The UM/UIM coverages are intended to assure that an injured driver will be compensated if s/he is injured in an accident caused by an uninsured or underinsured driver. The UM/UIM coverage steps into the place of the liability insurance that the driver should have had. Keep in mind that in the case of city vehicles, an injury to the driver while operating a city vehicle would in most cases be covered by workers' compensation. The amounts the individual would be able to recover from UM/UIM would be in addition to the medical, indemnity, and other benefits paid under work comp. In many cases, it would amount to a double recovery for the individual's injuries. A city might decide to carry a higher limit for a couple reasons: if they believe the workers' compensation benefits are insufficient to compensate their injured employees; or if they want to make sure that non-employees riding in city vehicles are fully compensated in the event of an accident with an uninsured or underinsured vehicle. (Note that in most cases the passenger's own UM/UIM would also respond.) LMCIT now gives the cities who participate in the primary liability coverage the option to waive the $300,000 per claimant statutory liability limit. What's the effect if we do this? If the city chooses the "waiver" option, the city and LMCIT no longer can use the statutory limit of$300,000 per claimant as a defense. Because the waiver increases the exposure, the premium is roughly 3%higher for coverage under the waiver option. If the city waives the statutory limit, an individual claimant could therefor recover up to $1,000,000 in damages on a claim. Of course, the individual would still have to prove to the court or jury that s/he really does have that amount of damages. Also, the statutory limit of $1,000,000 per occurrence would still apply; that would limit the individual's recovery to a lesser amount if there were multiple claimants. Why would the city choose to pay more in order to get the waiver-option coverage? Does it give the city better protection? No. Buying coverage under the"waiver"option doesn't protect the city any better. The benefit is to the injured party. The statutory liability limit only comes into play in a case where 1) the city is in fact liable; and 2) the injured party's actual proven damages are greater than the statutory limit. 4 • Very literally, applying the statutory liability limit means that an injured party won't be fully compensated for his/her actual,proven damages that were caused by city negligence. Some cities as a matter of public policy may want to have more assets available to compensate their citizens for injuries caused by the city's negligence. Waiving the statutory liability limits is a way to do that. Other cities may feel that the appropriate policy is to minimize the expenditure of the taxpayers' funds by taking full advantage of every protection the legislature has decided to provide. There's no right or wrong answer on this point. It's a discretionary question of city policy that each city council needs to decide for itself. How would the waiver affect our city's coverage or risk on those claims that the statutory tort liability limits don't apply to? It doesn't. Waiving the statutory tort limits has no effect on claims that the statutory limits don't apply to. What's the effect of waiving the statutory limits if we have excess coverage? If the city has $1 million of excess coverage and chooses to waive the statutory tort limits, the claimants (whether it's one claimant or several) could then potentially recover up to $2 million in damages in a single occurrence. If the city carries higher excess coverage limits, the potential maximum recovery per occurrence is correspondingly higher. Carrying excess coverage under the waiver option is a way to address an issue that some cities find troubling: the case where many people are injured in a single occurrence caused by city negligence. Suppose, for example, that a city vehicle negligently runs into a school bus full of kids, causing multiple serious injuries. $1,000,000 divided 50 ways may not go far toward compensating for those injuries. Excess coverage under the waiver option makes more funds available to compensate the victims in that kind of situation. The cost of the excess liability coverage is about 25% greater if the city waives the statutory tort limits. The cost difference is proportionally greater than the cost difference at the primary level because for a city that carries excess coverage, waiving the statutory tort limits increases both the per-claimant exposure and the per-occurrence exposure. If we waive the statutory tort liability limits, does it increase the risk that the city will end up with liability that LMCIT doesn't cover? No. The waiver form specifically says that the city is waiving the statutory tort liability limits only to the extent of the city's coverage. 5 S . Of course,that's not to say that there is no risk that the city's liability could exceed its coverage limits. We listed earlier a number of ways that could happen to any city. But the waiver doesn't increase that risk. Can we waive the statutory tort limits for the primary coverage but not for the excess coverage? No. If the city decides to waive the statutory tort limits,that waiver applies to the full extent of the coverage limits the city has. The city cannot partially waive the statutory limits. I'm confused. Is there a simple way to summarize the options? It's not necessarily simple, but the table on the following page is a shorthand summary of what the effect would be of the various coverage structure options in different circumstances. I'm still confused. Who can I talk to? Give us a call at the League office. Pete Tritz, Tom Grundhoefer, Doug Gronli, or any of LMCIT's property/casualty underwriters will be glad to talk with you. 6 • U >.. 4.0 u ams ..G• L U a ° .0 e 4E a o „5 = "'O O • O •.∎n h C y O O O O RS -b+ O C-...) 6 O O O O - •MIL O 0 CD .41 O O O O + N E O U 1■1 •- N I.q ,t D 6' 69 69 69 69 r0+ E a 0 et= o g U c 3 0 Oar cn � ° g 0 i.• ) > O O U N .Vr k b cai O O O O CI) ,Sy"•, ry ed '5 7 U O O O O 1 y d y Z O COQ O O O O O al .-• .-. .--, > CD 0 CI = E• r.c9 ,c s9 s9 s9 EA V •— E 'er .- - •�. S U O '.- ... 0 cri CC U O 4. ed 04 O O p O o M.•4 - .0 E . > U p O C O V o 0 0 [ 2 1■1 en FA eN1 14 .▪4 ° 'B U et U O L 023 023 U U= 023 Q ••••, 0 E U y .g y 8. L• cA al > — > O OU rA cA V > O > „rN o O y am'. U Z UE o � 0E elis.1 y H ^ k := G y y CD FBI k .s k 0 o .� 0 0 b o > > > +cd o ? c• • qs 0 0 0 3 0 a c a ^. c r. CA c y 0 -8o A3 co x3 a S LMC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence Web Site: http://www.lmnc.org! November 18, 1998 To: LMCIT member cities and agents From: Pete Tritz Re: Coverage for risks related to Year 2000 problems The LMCIT Board has approved a program to provide coverage for liability and other risks related to Y2k problems. For coverage written or renewed on or after November 15, 1998, Y2k risks will be addressed as follows: Basic Coverage The basic coverage that each city will automatically receive provides only very limited coverage for Y2k-related risks: • There will be a$25,000 annual aggregate limit on liability coverage for claims relating to Y2k problems. Both damages and defense costs are included within this limit. • There will be a $5000 limit for Y2k-related extra expenses. • Both the liability and the extra expense coverage are subject to a 15% city co-pay. Expanded Y2k Coverage Cities will have the option to purchase Expanded Y2k Coverage if the city 1) Has made reasonable efforts to identify and correct Y2k problems; and 2) Has developed contingency plans for dealing with potential Y2k problems that were unanticipated, not able to be corrected, or outside the city's control. A city can meet these criteria by following and documenting the procedures recommended in the LMC/LMCIT"Year 2000 Action Guide". Each LMCIT member has received a copy of the Guide. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • 0 Under the Expanded Y2k Coverage: • There is a$750,000 annual aggregate coverage limit for Y2k-related liability claims. Both damages and defense costs are included within this limit. • There is a$25,000 limit of coverage for Y2k-related extra expenses. • Both the Y2k liability coverage and the Y2k extra expense coverage are subject to a 15% city co-pay. • The charge for the Expanded Y2k Coverage will equal 5% of the city's annual liability premium and 2% of the city's annual property premiums. The LMCIT's Y2k coverage program is a unique approach to a unique and unprecedented set of problems and risks that cities are faced with. Because it's different from anything we've done before (or anyone else has done, for that matter), there will probably be a lot of questions. We've tried to answer some of those questions on the following pages. What's the big deal with liability for Y2k problems? Even if our computers don't work right, how could that result in a liability claim against the city? Actually, "computers"per se probably aren't the biggest problem. The"embedded chip" electronic devices that may be found in a wide variety of city systems—like water, sewer, dispatching, etc. — are probably the bigger concern. Y2k failures in other parties' systems—electric utilities, for example— could also result in liability claims against the city. Here are a few examples of how Y2k problems might result in liability claims against the city: • An electronic control that monitors water levels in the water tower malfunctions because of a Y2k problem. The water level drops, leaving the fire department without sufficient water to fight a fire that has broken out. The burning building is destroyed, and the owner sues the city. • The electric utility that serves the city encounters a Y2k problem with its equipment, and the power goes off as a result. Because the lift stations aren't functioning, sewers back up into houses all over town. The homeowners sue the city for their damages. • Because of a Y2k problem,the paging system for the city's volunteer ambulance attendants doesn't work. That causes a delay in responding to an accident, and the delay in providing needed emergency treatment makes the injured person's injuries worse. The injured person sues the city. • • So if the power goes out and the sewers back-up,LMCIT would pay for the damages caused by the sewer back-ups? Yes, if the city is in fact legally liable for those damages. We need to distinguish between coverage and liability. The LMCIT liability coverage would cover this kind of claim against the city. That means LMCIT would defend the claim on behalf of the city, and pay the damages if the city is liable. But whether the city is actually liable for those damages is a legal issue that the courts would decide. Actually, for a city that has qualified for LMCIT's Expanded Y2k Coverage, this kind of claim should be pretty defensible. That city should be in pretty good shape to demonstrate that the city wasn't negligent, since the city had made a reasonable effort to identify and correct Y2k problems. What's covered under the "Y2k extra expense" coverage? This will cover additional costs the city incurs in responding to a Y2k-related problem that develops. Here are some examples of the kinds of costs that would be covered: • The extra cost to have an officer directing traffic at an intersection because the traffic lights aren't working because of a Y2k problem • The extra cost for personnel needed to operate the water system manually, because of a Y2k problem with the system's electronic controls • The cost to rent a generator to keep the lift station running while the power is out because the utility company has a Y2k problem. There are a couple kinds of costs that we'd emphasize are not covered by the Y2k extra expense coverage: • The cost to diagnose and fix the Y2k problem in the equipment, or to replace equipment that's been rendered unusable by a Y2k problem. • The extra overtime or other costs the city incurs to have necessary personnel standing by or on duty and prepared to respond in case a Y2k problem develops. You could think of the Y2k extra expense coverage as helping to pay for the cost of implementing your contingency plan in response to a Y2K problem that actually occurs. But it doesn't pay for the costs you incur just in getting ready and being ready; and it doesn't pay for the cost to fix or replace your equipment to eliminate the Y2k problem for the future. ! I What do we have to do to qualify for the Expanded Y2k Coverage? There are basically three things the city needs to do: • The city needs to make a reasonable, systematic effort to identify and correct potential Y2k problems in its various systems. • The city needs to do some contingency planning, so as to be ready to respond in case there are Y2k problems with city systems. • The city needs to document and keep good records of its efforts to identify and correct Y2k problems, and of its contingency planning. The "Year 2000 Action Guide"that we've sent to all cities outlines a practical approach cities can follow to get these tasks done. The Guide also contains model forms, reference materials, and a lot of other Y2k-related information as well. The Guide will be supplemented and updated throughout the year, and cities will also receive a monthly Y2k newsletter beginning in January. We anticipate that the most cities will be able to meet the requirements to qualify for coverage. We'd particularly emphasize the importance of the"Y2k Assessment Worksheet", found on page 33 in Chapter 4 of the Guide. These records will be one of the key pieces of documentation that we'll be asking you to send to LMCIT's underwriters,to evaluate whether the city will quality for the expanded Y2k coverage. Our city's coverage renews in January. We're working on Y2k, but there's no way we'll be able to qualify for the Expanded Y2k Coverage in time for our renewal. What do we do? Actually, we anticipate that relatively few of the cities with renewals in late 1998 or early 1999 will be far enough along in their Y2k efforts to qualify at the time of the renewal. We expect that for most cities we'll probably be issuing a mid-term endorsement to add the Expanded Y2k Coverage, as the city makes enough progress to qualify for the expanded coverage. If we add the Expanded Y2k Coverage mid-term,will the premium charge be pro- rated? No. The full amount will be charged, regardless of when the city adds the coverage. The charge will be applied for two years—both 1998-1999 and 1999-2000 coverage years. 4 We carry a deductible on our city's coverage. How does the deductible work with the Y2k coverage? The coverage for Y2k liability and Y2k extra expense coverages is part of the city's liability and property coverages,respectively. Whatever deductibles— either per- occurrence or annual—you have in place which apply to those coverages will apply to Y2k-related claims. The deductible applies to the 85% share of the Y2k loss which would otherwise be paid by LMCIT. For example, suppose your coverage has a$2,500 per-occurrence deductible, and you have a$10,000 Y2k loss. After the 15%co-pay, $8,500 of the loss would be payable without the deductible. Subtracting the deductible leaves $6,000 of that loss which LMCIT would pay. Is there an option to buy higher coverage limits for Y2k-related liability risks? No. It's conceivable that we might be able later to add an option for higher limits, but at this time it's not available. For LMCIT cities that carry the optional excess liability coverage, it's important to be aware that the excess coverage does not apply to Y2k- related liability claims. I can go to a private insurance company and buy a standard comprehensive general liability policy that doesn't have any special exclusions, limits, charges, or underwriting requirements for Y2k. Isn't that a better solution than all this rigmarole LMCIT would make us go through? Well, no, probably not. A standard comprehensive general liability (CGL)policy covers bodily injury or property damage caused by an"occurrence", which is defined as "an accident". Standard CGL policies also exclude damage that is"expected or intended from the standpoint of the insured". Here's what you might run into if you try to rely on a CGL policy to cover a liability claim resulting from a Y2k equipment problem. First, you'll face the issue of whether a Y2k problem with a piece of equipment is an"accident" (or"fortuitous",to use another insurance-speak term). After all, it's hard to call it an accident if the equipment is functioning exactly as it was designed to function; the problem is that it wasn't designed to handle the year 2000. If it's not an"accident", it's not covered. You'll then face the issue of whether the damage was "expected". The insurance company may very well argue that with all the publicity there has been about possible Y2k problems with equipment,you can hardly claim that the problem was unexpected. They may even point out that they sent you lots of information telling you about Y2k, warning you to expect problems with your equipment, and recommending that you do 410 It something about it. Quite a few insurance companies have been sending their insureds that kind of communication. Of course, if you've bought a CGL policy from an insurance company,you might also have bought a"public officials errors and omissions"policy too. But those policies almost universally exclude bodily injury and property damage, so that may not be much help either. In short,you can't just assume that a private CGL or other insurance policy covers these risks. If you plan to rely on private insurance, ask them to tell you unequivocally in writing that they will cover liability claims arising from Y2k-related equipment or software problems. d S } J J , ii„.„..7 L MC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 League of Minnesota Cities Fax: (651) 281-1298 •TDD (651) 281-1290 Cities promoting excellence www.lmcit.lmnc.org December 2, 2002 To: LMCIT member cities and agents , 9 From: LMCIT Re: Important changes in t. /___;e-t- ,4-j‘.1 _, -- 1 ;e - Scheduled vs. b; R� ('''' `� -Vacant building �-� 2 For several years,the LMCIT :down coverages have been on a"blanket limits"basis, uni perty limit is available for a loss at any one location. Unfo. .____...-,, ,mac win no longer be able to provide true "blanket limits" coverage in the future. Instead, we'll be returning to a system in which there's a specific dollar limit on the amount of coverage available for each specific building or location. In addition, there are also some new restrictions on coverage for vacant buildings. The implication for cities is that it will now be much more important that the city review the estimated replacement cost figures for each building to make sure the available coverage limit is adequate. The remainder of this memo provides more detail on how the new approach will work, and on some potential problems cities and agents will need to watch out for. When does this change in coverage take effect? The new coverage approach will apply to each city at their first LMCIT coverage renewal after November 15, 2002. What coverage limit will be available for each building? For each building,the limit is 150% of the estimated replacement cost shown on the coverage schedule for that building. The estimated replacement cost is the value figure that was used to establish the city's premiums. For example, if the estimated replacement cost of a building and its contents is $2,000,000, the city's premium for that building will be based on that value. If that building is destroyed,the most LMCIT would pay to repair or replace the building and its contents is $3,000,000-i.e., 150% of$2,000,000. r � What costs and damages does that 150% limit apply to? The limit applies to the cost to repair or replace the building and contents, including "builders risk"property while under construction. The 150% limit also applies to property in the open. There are several additional types of covered loss which are in addition to and outside of the 150% limit. These include loss of revenue, extra expense, and expediting expense; debris removal; leasehold interest; accounts receivable; valuable papers; utility services; asbestos and pollutant clean-up; rental reimbursement; and arson reward. The"errors and omissions" and "extraordinary expense"coverages are also outside the 150%limit. Where do those estimated replacement cost figures on the schedule come from? In most cases, the estimated replacement cost figures were established by the professional appraisals LMCIT has been conducting over the past four years,updated as necessary to reflect increased construction costs since the time of the appraisal. Appraisals have now been completed for virtually all LMCIT members' buildings. For recently constructed buildings, the estimated replacement cost may instead be based on the actual construction cost. Where can we find the property schedules and appraisal information? LMCIT will send a copy of the city's property schedule, showing the most current estimated replacement cost figures for each building, along with the renewal application. The city received a copy of the appraisal report on its buildings when the appraisal was completed. If you can't find it or need another copy, contact your LMCIT underwriter. What happens if the actual cost to repair or replace the property turns out to be more than the estimated replacement cost on the schedule? As long as the actual cost is not more than 150% of the estimated replacement cost shown on the schedule,the claim is paid in full. If the actual cost to replace the property is more than 150%of the estimated replacement cost shown on the schedule, the excess would not be covered by LMCIT. The city would need to either find a way to scale back the cost of the repair or replacement, or eat the additional cost itself. When might the 150% limitation not provide enough coverage for the city? For most city buildings it shouldn't be a problem. The appraisal figures for the estimated replacement cost should be reasonably accurate for most buildings, and the 150% provision allows a substantial margin for error. But there are some situations where it could be a problem: 2 • • Historically significant buildings. The estimated replacement cost figures reflect the cost to repair or rebuild the "typical" building,based on the size,use, type of construction, etc. In a historically significant building, repair or replacement may become much more expensive, because of the need to reproduce specific historical construction techniques used in the building, such as ornate stonework, decorative plaster, etc. In some cases, these considerations can increase the cost to repair or rebuild a structure by as much as five or ten times. • Unique architectural features. A building that incorporates unusual or unique architectural features—e.g., special woodwork, murals or other artwork, etc. —can pose similar issues. • Building code compliance. If an older building that doesn't meet current building codes suffers significant damage, the building code may require that the building be brought up to current code standards. In some cases, that can substantially increase the cost. Are these the only types of buildings we need to worry about? These types of buildings are most likely to be a problem under the new system, but they're not necessarily the only place where a problem could arise. Its a good idea to at least eyeball the estimated replacement costs for all of the city's buildings to make sure they seem reasonable,that there aren't any typos, etc. Remember: 150% of the estimated replacement cost figure shown on the schedule for that building is the absolute most that LMCIT would pay to repair or replace that building. What should we do if we have one of these buildings? Give your underwriter a call right away. As an interim measure,we can temporarily use a reasonable "best guess" estimate as the amount shown on the schedule. We'll then schedule an appraisal to develop an estimated replacement cost figure that will reflect the property's unique characteristics. How will it affect our premiums if we increase the estimated replacement cost for a particular building? If you decide mid-term to increase the scheduled estimated replacement cost for a building, it won't have any immediate effect on your premiums. In other words, there won't be any charge for the endorsement increasing the estimated replacement cost. However, that new, higher estimated replacement cost will be used in calculating the city's premiums at the next renewal. Your LMCIT underwriter can on request provide an estimate of how the increased values will affect the city's future premiums. 3 .N Since we have the 150% provision,can we save some premium by scheduling the building for an amount less than the estimated replacement cost? No. Premiums will always be based on the actual estimated replacement cost of the building. The 150% provision is intended only to provide a buffer or margin for error in those estimates. A primary consideration for LMCIT is to make sure we treat all members equitably. That means that we need to make sure we're figuring every member's premiums the same way —based on the best estimate we have of what it would cost to replace that building. Allowing one member to arbitrarily select a lower valuation figure would mean that that member wouldn't be paying their fair share relative to the actual risk they're contributing to the pool. How will coverage work for newly constructed buildings? Generally the same as it does now. If the city constructs a new building during the year, that new building is automatically covered. Until the new building is scheduled,the applicable coverage limit for the newly-constructed building will be 150% of the construction cost or$5,000,000, whichever is less. What if we acquire an existing building? A newly-acquired building is also automatically covered, subject to a limit of 150% of the purchase price, or$5,000,000, whichever is less. However, we'd suggest that as soon as possible the city should provide an estimated replacement cost figure to their LMCIT underwriter, since in some cases the cost to rebuild a building may be substantially more than the acquisition cost. LMCIT will then schedule a formal appraisal of that building as quickly as possible. Does this mean that there is no longer a blanket limit? No,not quite. The city's total amount of coverage is still subject to the same blanket limit just as it has been in the past. The difference is that that entire limit will no longer be available for a loss at a single building. The blanket limit is equal to the total scheduled values of its covered property. That is, it's the sum of the estimated replacement costs shown on the schedule for buildings and contents (including property under construction), property in the open, and mobile property,plus the market value of any vacant buildings. An example might help clarify how the schedule, the blanket limit, and the 150% provision fit together. Suppose the city's covered property consists of three buildings, each with an estimated replacement cost of$100,000. The blanket limit is therefor $300,000. If one building burns down, LMCIT will pay a maximum of$150,000 (150% 4 of$100,000)to repair or replace it. If all three burn down, LMCIT will pay a maximum of$300,000. How will vacant buildings be handled? After a building has been vacant for 60 consecutive days, it is no longer covered for replacement cost. Instead, it will be covered only for the building's actual fair market value. In other words, if the vacant building is damaged or destroyed,the most LMCIT would pay to repair or replace it is the fair market value of the building. Note: The limit for a vacant building is the fair market value—not 150% of the fair market value. When is a building considered "vacant"? A city-owned building is considered vacant if for a period of 60 consecutive days less than 31% of the building's total square footage is either being used by the city for customary operations or leased out. If the city is covering a building that the city rents but doesn't own,that building is considered vacant if for a period of 60 consecutive days it doesn't contain enough contents to conduct customary operations. A building under construction or renovation is not considered to be vacant. What should the city do if we have a vacant building? We suggest that you notify your LMCIT underwriter right away when a covered building becomes vacant, and provide the information on the building's market value at the same time. Keep in mind though that after 60 days the coverage on a vacant building is automatically limited to the building's market value, whether or not you've notified LMCIT that the building is vacant. At the city's next renewal, the renewal premiums for the vacant building will be based on the building's market value, rather than on the estimated replacement cost. A slightly higher rate per$100 value is used for vacant buildings. Do these changes this affect our LMCIT machinery breakdown coverage? Yes. The 150% limitation and the vacant building provisions also apply to the LMCIT machinery breakdown coverage. 5 Why is LMCIT making these changes? It means one more thing that the city now has to wor ry about,that we didn't used to have to think much about. Mostly it's because of new reinsurance restrictions. In the current very tight reinsurance market, our reinsurers basically told us they're no longer willing to support a"blanket limits"approach. This is very much the trend in the commercial insurance world. Very few private insurance companies still provide true blanket limits coverage. There's also an issue of fairness among members. Under the blanket limits system, a city might have, say, a historical building, where the cost to rebuild it would be much greater than the estimated replacement cost shown on the schedule. That city would be paying in less than other cities, relative to the actual amount of risk it's contributing to the pool; that is, that city is effectively getting the benefit of a higher limit but not really paying for it. The new system will help correct that kind of inequity among members. But the main reason for making the change is because of reinsurance restrictions. Who should we call if we have questions? Call your LMCIT underwriter, or talk with LMCIT Administrator Pete Tritz or Associate Administrator Ann Gergen. 6 t LMC 145 University Avenue West, St. Paul,MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 League of Minnesota Cities Fax: (651) 281-1298 •TDD (651) 281-1290 Cities promoting excellence www.lmcit.lmnc.org December 2, 2002 To: LMCIT member cities and agents From: LMCIT Re: Coverage changes for 2002-2003 Here's a summary of the changes LMCIT member cities will see in their property, liability, auto and machinery breakdown coverages for the coming year. These changes will be effective at the city's first renewal after November 15, 2002. Property coverage changes Coverage limits. LMCIT will no longer provide "blanket limits" coverage. Instead, there will be a specific coverage limit for each building or location. This change means it will now be very important that the city review and be comfortable with the estimated replacement cost and coverage limit for each of its buildings. Because this is a significant change, we've enclosed a separate memo that discusses this change and its implications for cities in more detail. Vacant property. After 60 days, vacant property will be covered only for its market value, rather than its replacement cost. (The accompanying memo discusses this change in more detail as well.) Terrorism coverage. Coverage for property damage caused by terrorism will now be limited to $1 million total, regardless of the number of occurrences or buildings affected. However, with the expected passage of the federal terrorism insurance legislation, it may be possible for LMCIT to increase the amount of terrorism coverage provided in the fairly near future. We'll keep you posted on how this develops. Market value. The replacement cost coverage for mobile property has been limited to 200% of the property's "appraised value". Also, in certain cases (i.e. where a building is damaged or destroyed but not repaired or replaced), claims are adjusted based on the change in the"appraised value"of the building. The coverage will now use the term "market value"rather than "appraised value". This is a clarification, rather than a substantive change. Mobile property/building contents. The definition of"building contents" is revised to exclude mobile property. This change clarifies that the 200% limitation applies even if the mobile property happened to be stored in a building at the time of the loss. Mold. The definition of"mold" is expanded and clarified. Y2k. The special "Y2k" provisions and limits are now eliminated. Flood. Beginning February 1, 2003, LMCIT will begin offering flood insurance under the National Flood Insurance Program (NFIP). We'll provide more information as the details are finalized. Liability coverage changes Land use coverage—cost-sharing provisions. The cost-sharing provisions of the land use coverage are revised. The city will now begin sharing in the costs earlier, and coverage for damages will be under the same sliding scale as applies to legal costs. Specifically, the land use coverage will now pay 100%of the first$25,000 of litigation costs, including both legal costs and damages; 85%of the next $225,000 of litigation costs; and 60%of litigation costs above $250,000. Currently,the coverage pays 100% of the first $50,000 of legal costs; 85% of the next$200,000 of legal costs; 60% of legal costs above $250,000; and a flat 85%of damages. The $1,000,000 annual aggregate limit on coverage for damages and defense costs remains unchanged. Plaintiff attorney fees. In the past, the LMCIT liability coverage has covered plaintiff attorney fees only when they're awarded under the federal civil rights or state human rights statutes. Plaintiff attorney fees awarded under other statutes in connection with a covered claim will now be covered as well. The coverage does not include attorney fees awarded against an individual officer or employee in cases of malfeasance,willful neglect of duty, or bad faith. The coverage for attorney fees is subject to a$200,000 limit per occurrence. Mold liability. Coverage for liability claims relating to mold will now be subject to a $1.5 million annual aggregate limit. (Note also that the optional excess liability coverage will now exclude mold claims; see below.) Supplemental payments. This revision clarifies that"supplemental payments" are covered under the land use coverage as part of the litigation costs. Y2k provisions. The special Y2k provisions and limitations are eliminated from the liability coverage as well. No-fault sewer back-up coverage. The no-fault sewer coverage endorsement is revised to clarify that only sewer back-up claims in which the city was not negligent and is not 2 legally liable are counted toward the no-fault coverage's $10,000 per building annual limit. Excess liability coverage The excess liability coverage document is completely revised and simplified, with much of the language which was redundant with that of the underlying primary coverage being eliminated. The only substantive change is that the excess liability coverage will now exclude coverage for liability claims relating to mold. Auto liability coverage A "professional services"exclusion is added to the auto liability coverage. This clarifies that the auto liability coverage is not intended to cover the professional medical services of a physician, etc., even if an auto (such as an ambulance) is involved. 3 ., v LMC 145 University Avenue West, St. Paul,MN 55103-2044 Phone: (651)281-1200• (800) 925-1122 League of Minnesota Cities Fax: (651) 281-1298 •TDD (651) 281-1290 Cities promoting excellence www.lmcit.lmnc.org December 2, 2002 To: LMCIT members From: LMCIT RE: 2003 Property/Casualty and Workers' Compensation rates and dividend Here's what LMCIT members will see at their next renewal: Premium rate changes • Municipal liability rates will decrease 8%. • Auto liability rates will decrease 3%. • Property rates will increase 10%. • Excess liability rates will increase 7%. • Work comp rates will increase 10%. Rates for all other coverages will be unchanged. This includes the machinery breakdown, liquor liability, airport liability, bond, open meeting law defense, Petrofund supplement, and volunteer accident coverages. The property/casualty rate changes apply to renewals on or after November 15, 2002. The work comp rate changes apply to renewals in 2003. The property/casualty rate changes will pretty much offset each other, so most cities should see not much change in their total property/casualty premium cost. Dividends • Property/casualty program members will share a $9 million dividend, to be distributed in mid-December. • The workers compensation program will not return a dividend this year. S What's behind the rate changes? Property/casualty In the liability side, loss costs have generally been good for the past few years. Auto liability losses have also been exceptionally low in the past few years. This year's actuarial projections are lower than what our actuaries had projected a year ago. That means that the loss projections we use to set rates are also lower than the projections we used a year ago, which in turn means lower rates. While liability loss costs have overall been good, the cost of litigation relating to land use regulation and to development and redevelopment is significant and continues to be a concern. We'll be focusing more loss control efforts on this area in the coming year. The increases in the property premium rates reflect some significant increases in LMCIT's reinsurance costs. Property losses have generally been in line with projections. Had reinsurance costs not increased, we would have been able to hold these rates unchanged. The excess liability premium rate increase is also driven by higher reinsurance costs. Work comp Several factors combine to make this year's 10% increase in work comp premiums necessary: • The state this summer increased the Special Compensation Fund(SCF)assessment rate from 20%to 30%. That assessment is applied to paid indemnity benefits. This factor alone accounts for about 3%of the 10% increase. • The rate of inflation in medical costs is increasing. In each of the past few years, medical costs for work comp injuries have exceeded what we'd projected when we set the premium rates for those years. We now estimate that medical costs to treat work comp injuries are increasing about 8%per year. • In 2000, the legislature approved increases in the maximum weekly indemnity benefit,permanent partial disability benefits, and dependents' benefits in fatality cases. This was part of the same legislation that transferred $325 million of surplus funds from the Assigned Risk Plan to the SCF, which allowed the state to then reduce the SCF assessment rate from 30%to 20%. The idea was that the 3-4% additional premium needed to pay for those higher benefits was more than offset by the savings from the SCF rate reduction. Those benefit increases remain in effect, even though the SCF savings are now gone. Again this year, in order to minimize the shock to city budgets we've tried to keep the rate increase as low as possible, while still making sure LMCIT remains financially 2 A strong. To help minimize the increase, the 2003 rates incorporate virtually no margin. If the 2003 injuries and claims should turn out to be greater than projected, the excess would be covered from the program's existing fund balance. Fortunately, that fund balance is very strong, so that it's feasible to take that risk. But it's likely we'll need to increase work comp rates further in the future, since we'll need eventually to get back to a point where there's some reasonable safety margin built into the rates. Dividend Property/casualty program members will share a $9 million dividend this year. This compares with the $8 million dividend returned in 2001. As in the past, we'll distribute the dividend in mid-December. The dividend formula will be the same as we've used in the past. That is, each city's share is proportionate to the difference between the city's total earned premiums and total incurred losses for all years the city has been a member, with large individual losses capped for purposes of the formula. This dividend is possible because the property/casualty program again shows very strong net income for the year. Several factors contributed to that income: • Our premium rates are designed to include a contingency margin, in case losses should turn out to be greater than projected. If losses are at or below projections, that margin isn't needed and can be returned as a dividend. • The actuaries this year reduced their estimates of what incurred losses from previous years will ultimately cost, compared to what they had estimated a year ago. • Losses incurred during the year were less than what the premium rates were designed to fund. Most of the difference is in municipal liability and auto liability. • Earned premiums were higher than we'd projected. • Capital gains on investments also contributed to this fiscal year's income. In addition to the dividend, the LMCIT Board also decided to use a part of the year's p income to further strengthen LMCIT's fund balance. While the property/casualty program is already very strong financially, we anticipate that the reinsurance market will continue to be difficult for at least the next few years. It may prove to be more economical in the future to retain a greater amount of risk rather than reinsuring it; and reinsurance for some risks might in the future not even be available at a reasonable cost. Having a very strong fund balance gives LMCIT more flexibility to retain greater amounts of risk in the future if it makes sense to do so. 3 gg • e • • ,. • • . , ;!!..fig.:..:?,s x . ..:,ix,,.: �:�s. 4ig'...4, ..'` w`°? ..a....giWa„x.k d�� ;. �. .-' d °3,W.: m...a§`a . .... c. ' � �' ::�s z :. ,rte Kn` v. Tr City of Oak Park Heights 14168 Oak Park Blvd. • Box 2007 Oak Park Heights,MN 55082 Phone(651)439-4439 Facsimile(651)439-0574 facsimile transmittal To: , Fax: a `d 1 a°l 7 (; r�C �, fh c From: 6” y Date: 7 _ 2 q _o Re: t,�)®, 14 C.o v.A Pages: L . CC: 0 Urgent ❑For Review ❑ Please Comment Please Reply 0 Please Recycle Notes: a v Y../ t v c le— G, J ''--'>11 S fi 1, �, `e ar r T t sy x 0 . ,9 ;33 ; a "'D�r f,,,,,,,,,,,4,ki 9 ,. r x�fl -0 g'..,Y `. P� i 4 Y3 n z 3 tk r L . v F 3,M,,`,rie : ,1 r k i NKi , , t �'#? ry,Y le A d k f0,a%.'15,.1'" X ,. ty #^ c r ,y . � s a rya a 4 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 r-L___„.7 LMC League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence J Web Site: http://www.lmnc.org March 2002 To: LMCIT Workers'Compensation member cities Re: Certification of non-smoking status for police and fire department members The League of Minnesota Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in the premium charged for workers' compensation coverage for police and fire departments,if the city can certify that at least 90 percent of the department's members are non-smokers. To certify non-smoking status,cities must ask police and fire department staff to fill out a form indicating that they do not smoke. This information is private employee data. LMCIT recommends that police and fire department members be provided with appropriate information about the request when it is made of them(Tennessen warning). It is the city's responsibility to provide appropriate information about why this private data is being requested from the employee,and also to maintain the information correctly. To help you with this process,LMCIT is providing a sample non-smoking certification that includes a Tennessen warning to the employee. This sample document is on the back of this page,and can be copied for city use. LMCIT will also accept other certification that the city might choose to submit from police or fire department staff. Please keep in mind the need to provide employees with information about why the request is being made,what the data will be used for,and who will have access to the data submitted. If you have any questions,please contact LMCIT at 651-281-1200 or 800-925-1122. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER 1 Notice to Police and Fire Department Members City of Fire Department or Police Department The League of Minnesota Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of department members are non-smokers. The information below is requested in order for your city to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status.You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If you provide false or misleading information,it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are: employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data,and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to by (employee) (city contact) on at (date) (time) EMPLOYEE COMPLETES THIS PORTION: I acknowledge receiving this advisory. I do not smoke and have not smoked within the past six months. (signature) (date) Notice to Police Members City of Oak Park Heights Police officers: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information,it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to David Kisch by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. I do not smoke and have not smoked within the past six months. Otg ITO (sig :ture)' (date) City of Oak Park Heights Police officers Notice to Police Members: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information,it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to Paul Hoppe by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. I dotnt tsm ke and h,ve not smoked within the past six months. j4 ,.-2.44a.2 (signa ';' (date) Notice to Police Members City of Oak Park Heights Police officers: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information, it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting, it will be available to members of the public. Advisory provided to Fred Kropidlowski by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. I do not smoke and have not smoked within the past six months. �r•-. Co- -0 a- (signati re) (date) Notice to Police Members City of Oak Park Heights Police officers: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information,it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to Brian DeRosier by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. I do not smoke and have not smoked within the past six months. (signature) (date) Notice to Police Members City of Oak Park Heights Police officers: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information,it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to Michael Hausken by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. I do not s ke and h not smoked within the past six months. Zjel 2 6�z (signature) (date) Notice to Police Members City of Oak Park Heights Police officers: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information, it may be used by the city to impose discipline against you,including dismissal; and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to Joseph Croft by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. I do not smoke and have not smoked within the past six months. *i&d:reac2,1- (72 (signature) (date) I _ _ Notice to Police Members City of Oak Park Heights Police officers: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments,if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information,it may be used by the city to impose discipline against you, including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to Kenneth Anderson by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. g I do not smoke and have not smoked within the past six months. (signature (date) Notice to Police Members City of Oak Park Heights Police officers: The League of MN Cities Insurance Trust(LMCIT)allows cities a 10 percent reduction in workers' compensation premium for police and fire departments, if the city can certify that at least 90 percent of the department members are non-smokers. The information below is requested in order for us to receive this discount. The information will be submitted by the city to LMCIT,where it will be used to determine premium discount status. You are not required to provide this information at this time. If you refuse to supply the information,you will face no disciplinary action as a result of the refusal. However, • If your provide false or misleading information,it may be used by the city to impose discipline against you,including dismissal;and • At some point in the future,the city may choose to require you to provide this information. At that time,you will be provided another advisory telling you of the requirement and the consequences for refusing. Other persons or entities who are authorized by law to receive this information are;employees,agents,and officials of the city who have need to know about the information in the course of their duties or responsibilities,the person who is the subject of the data about him or herself,people who have permission from the subject of the data and LMCIT. If it is reasonably necessary to discuss the information at a city council or board meeting,it will be available to members of the public. Advisory provided to Sandra Kruse-Roslin by Gary Brunckhorst on June 26,2002. EMPLOYEE COMPLETE THIS PORTION I acknowledge receiving this advisory. I do not smoke and have not smoked within the past six months. (signature) (date) LMCIT LMC Risk Management Information League of Minnesota Cities 145 University Avenue West,St.Paul,MN 55103-2044 Cities promoting excellence Phone: (651)281-1200• (800)925-1122 Fax: (651)281-1298 •TDD (651)281-1290 www.lmcit.lmnc.org THINGS TO THINK ABOUT WHEN RENEWING YOUR CITY'S WORKERS' COMPENSATION COVERAGE The LMCIT workers' compensation program is specially designed for Minnesota cities. LMCIT's coverage is unique because it picks up some related risks that standard workers' compensation insurance policies don't cover. This program also offers a number of coverage and premium options, deductibles and credits. LMCIT tries to make buying coverage for the city's workers' compensation exposures as simple and straightforward as possible, but there are still a number of decisions the city needs to make in renewing its work comp coverage. This memo is intended to serve as a guide for cities and agents when thinking about purchasing or renewing work comp coverage. BOARDS AND COMMISSIONS Elected officials Unlike city employees, elected officials are not automatically covered by the work comp law. Cities wishing to cover elected officials need to pass an ordinance or resolution to make the elected officials "employees"for purposes of work comp coverage. If the city does not pass the resolution, a city official that is injured while on city business wouldn't receive any work comp benefits from the city. This mostly affects mayors and council members,but it could also apply to clerk, treasurers, and other officers in cities where those are elected positions. The 2001 premium rate for mayors and council members is $.37 per$100 of payroll. This rate is applied to the greater of either the official's actual salary or an imputed salary of$70 per week. In case of injury, an elected official would receive the same work comp benefits as any other city employee. Indemnity benefits would be based on the sum of his/her earnings from his/her regular employment plus the actual salary (if any) s/he receives from the city. An alternative to work comp coverage for elected officials is to purchase LMCIT's board member accident coverage. Under this option, cities can provide more limited benefits to council members injured or killed in the course of performing their duties. Accident policy rates for 2001 are $12.75 per person per year. Benefits are paid for death or short-term disability. This program was originally developed a number of years ago as a low-cost alternative to work comp for elected officials. However, LMCIT has reduced the cost of work comp for elected officials very substantially since then, so the cost advantage of the accident coverage option is now minimal. Here's a summary comparison of the two ways cities can cover elected officials through LMCIT: LMCIT elected officials work LMCIT elected officials accident comp coverage coverage Premium cost $.37 per $100 of actual payroll or $12.75 per person per year imputed salary Coverage benefits • Death • Death • Short-term disability • Short-term disability • Loss of wages • Rehabilitation • Medical expenses • Permanent disability For more information about coverage for elected officials, refer to the "Coverage for Injuries to Elected and Appointed Officials" memo, fax number 66040. Members of separate administrative boards Members of administrative boards that the city creates pursuant to statute or charter can also be covered by workers compensation in the same way as elected officials if the city passes the appropriate ordinance or resolution. Common examples of these types of boards include planning commissions, housing and redevelopment authorities, port authority boards, EDA boards,utilities commissions,park boards, and hospital or nursing home boards. The accident coverage alternative is also available for these positions. For more information about coverage for members of separate boards, refer to the"Coordinating Coverages for Separate City Boards and Commissions"memo, fax number 66260. Employees of separate administrative boards In some cases,the city may prefer that entities which are managed by a separate administrative board have their own work comp coverage separate from the city. HRAs, EDAs, port authorities, utilities commissions, and hospital or nursing home boards are examples. Alternately, these employees can be included under the city's general coverage. Having separate coverage may make it easier to allocate costs appropriately between the two budgets. Another reason cities sometimes choose to use separate coverage is so each operation stands on its own for purposes of the experience modification calculation. I.e., with separate coverage, the utilities commission's employees losses won't affect the city's experience modification, and vice versa. On the other hand, by separating the two,the city may lose some benefit of the volume discount on premiums. 2 LMCIT can provide the coverage either way, but the important thing is to make sure that all parties involved are clear on what the intent is.Note that employees of an utilities commission, HRA, EDA,port authority, or hospital or nursing home board are not automatically covered by the city's LMCIT work comp coverage unless that board is specifically listed on the information page of the coverage document. Joint powers boards If a joint powers board has its own employees, it needs work comp coverage. Any joint powers board which has at least one city as a member is eligible for LMCIT work comp coverage. LMCIT can provide that coverage either by issuing separate coverage to the joint powers board, or by adding the joint powers board as a covered employer on the city's LMCIT work comp coverage. Advisory boards Unpaid members of advisory boards that do not have legal decision-making authority are not eligible to be covered by work comp. However, cities may obtain board accident coverage from LMCIT for members of advisory boards at the same rate as for administrative boards. VOLUNTEERS Volunteers considered employees Certain volunteers are defined by statute as employees for purposes of work comp coverage. These include volunteer firefighters, ambulance attendants, first responders, law enforcement assistance volunteers, and civil defense volunteers. These volunteers are entitled to receive work comp benefits if they are injured while performing volunteer services for the,city, and are covered under the city's regular work comp policy. Volunteers in an Emergency City volunteers at work during an emergency are entitled by statute to work comp benefits under a city's policy. Emergency city volunteers must be registered with the city and work under the direction and control of the city. LMCIT does not charge any additional premium for this work comp exposure. (Like other city volunteers, emergency volunteers are also automatically "covered parties" under the city's LMCIT liability coverage.) For more information, refer to the "Providing Assistance in Emergencies: Coverage and Liability Issues" memo, fax number 66840. Other city volunteers Other city volunteers are not considered employees and are therefor not covered by workers' compensation. For these volunteers, LMCIT offers an optional volunteer accident coverage, which provides some limited "no-fault" benefits for volunteers injured while working for the city. Volunteers under this program receive limited death, disability and impairment benefits. 3 The city can also add coverage for up to $1,000 of medical costs for an additional charge. This coverage could help avoid litigation in cases where the city may be at fault, and it also provides some protection for people donating their time and effort to city projects. Volunteer accident coverage provides blanket coverage for all city volunteers working under city direction and control, such as coaches and instructors in recreation programs, or volunteers working on city-sponsored festivals or celebrations. The cost of volunteer work comp coverage is based on the city's population, with a basic annual charge of$.10 per capita subject to a minimum premium of$150 and a maximum premium of$1,500 annually. The charge to add volunteers working on a construction project is $300 per project. For more information, refer to the "Accident Coverage for City Volunteers"memo, fax number 66050; and the "Covering the City's Volunteers"memo, fax number 66030. PREMIUM OPTIONS LMCIT work comp members have a number of retrospective rating and deductible options as well as an option to close-out retro coverage from previous years. Members also have the option of using a managed care provider for the medical management of employees injured while at work. Retrospective rating Under LMCIT's retro-rating plan, a city's final premium costs reflects its own, actual loss experience for the year. Cities with standard premiums of$25,000 or more are given the choice of three retrospective options, so that each city may select the amount of risk it wishes to retain. Retrospective rating gives cities the closest option to self-insurance. Since the final premium will be a function of the city's own losses, a good safety and loss control program can save the city money over the long run. On the other hand, the city would also be subject to premium increases if it experiences a big loss. Cities that select a retrospective rating option pay a deposit premium to LMCIT at the beginning of the agreement period. Six months after the end of the agreement year, the city's premiums are adjusted up or down based on the city's actual incurred losses for that year. That adjustment is repeated annually until all claims from the agreement period are closed. Before selecting retro rating, a city may wish to do a"what if' calculation of what the city's premiums would have been for each of the past few years if the city had had a retrospective rating plan in place. This can be a useful tool for cities evaluating retrospective rating options. For more information about the retrospective rating options, refer to the"Workers' Compensation Retrospective Rating Options" memo, fax number 66360. 4 Retro close-out option After five years participation in a retro program, cities have the option to close out retro-rated coverage from previous years. If a city closes out the retro, no further adjustments are then made to the city's premiums under the retro-rated formula,regardless of what future changes there may be in the city's paid or incurred losses. The charge for the close-out is a percentage of the city's incurred losses for the coverage year in question. You may call Barb Meyer at 651-215- 4173 to calculate your city's close-out charges. For more information about the retro close-out option, refer to the "Workers' Compensation Retro Close-Out Option"memo, fax number 66320. Deductible options Under a deductible option, the city pays lower premium in return for agreeing to reimburse LMCIT for paid medical losses up to a set deductible. If the city selects a deductible option,the deductible applies per occurrence to medical costs only. There are six deductible options ranging from a $250 deductible with a 3 percent premium credit to a$1 0,000 deductible with an 18 percent premium credit. Deductibles do not affect the experience modification calculation. Even though under a deductible option the city reimburses LMCIT for certain medical costs,those costs are still included in calculating the experience modification. For more information on deductible options, refer to the "Workers' Compensation Deductible Options"memo, fax number 66350. Managed care option Cities that enroll with a state-certified managed care organization(MCO)receive a 5%premium credit on their work comp coverage. MCOs attempt to reduce the total costs of work comp claims by providing care in a network setting, establishing cost effective treatment protocols, and working to return the employee to work as soon as possible.If the MCO is successful in reducing loss costs, the city would see additional savings in the form of an improved experience modification. LMCIT has been monitoring cities' experience with MCOs for several years. The results are not clearcut, though the most recent review suggests that managed care may be producing at least some overall savings for some cities. There are a number of certified MCOs in Minnesota, but the two that cities have most often used to date are CMC (a Blue Cross subsidiary) and Corvel. Some factors to look at in selecting an MCO are whether the MCO has network providers in their area; the MCO's fees and charges; and whether the MCO's overall approach and philosophy matches the city's. For a list of certified MCOs, contact the Department of Labor and Industry at 800-342-5354 or www.doli.state.mn.us. 5 Non-smoker credit for police and firefighters LMCIT offers member cities a 10 percent rate credit for non-smoking police and firefighters. To qualify for the credit,the city must obtain written statements of non-smoking from at least 90 percent of the members of the department. The statement must be signed and dated, and must state that the individual does not smoke and has not smoked within the previous six months. LMCIT gives this discount because several of the diseases presumed by statute to be job-related for firefighters and police officers—various heart diseases, lung diseases, and cancers—are also related to smoking. Fire or police departments with very few smokers represent a lower risk for claims for heart disease, lung disease, or cancer. For more information on how this credit works,refer to the "Workers' Compensation for Volunteer Firefighters"memo, fax number 66020. July 2001 6 • • w � 41t, .. City of Oak Park Heights 14168 Oak Park Blvd. Box 2007 Oak Park Heights,MN 55082 Phone(651)439-4439 Facsimile(651)439-0574 facsimile transmittal 1 �r Fax: 65-/ -Y6 � To: K' T e r p ^ y� From: K1 m � Date: / //��Gv Re: t Pages: 3 CC: El Urgent ❑For Review ❑ Please Comment ❑ Please Reply 0 Please Recycle Notes: Kc. FYI) 1/1-€ 1 r d('(n h 1'-5 ?o„\ t m e yes 7e cf/ (4/-e G k rYPn Thy 0,`^7n 1 � J/Ulti//v, / + tis$ '^fix t 7 14;x^x w, :a£ I M x 11/07/2000 TUE 13:31 FAX 6514647596 LANDMARK INSURANCE 81001/001 i ---- --- _ MEMO _._.._.. y Page 1 Landmark Insurance Services PO Box 188 ACCOUNT NO. OP DATE Forest Lake,MN 55025 OAKPA-1 KT 11/07/00 Phone: 651-464-3333 POLICY INFORMATION POLICY N CMC20796 TYPE EFFECTIVE EXPIAATION CAU 07/07/00 07/07/01 City of Oak Park Heights 14168 Oak Park Blvd. Oak Park Heights,MN 55082-6476 Kim Re: Insured Autos In reviewing the city' s auto coverage I find I have some questions on the vehicles to be covered. Please look at the following list and advise if the city still owns any of the following units: 1990 Olds #--1936 1990 Olds Cierra #--0610 1993 Chev Caprice #--0238 - 6 ,Ford Crbwn Vic #--6000 [17 S Chev_ Caprice #--4521--tr'�lk" - .6: Chev P,a-e=- #--12 3 6-sr+11 6 we- Let me know - thank you! . . .Then I can deliver your renewal policy and get the auto ID cards issued. /9e --- ., . 04.4p..-63-----?( Kate Tipping MEMO Page Landmark Insurance Services — — ACCOUNT NO. OP DATE Box 188 OAKPA-1 KT ' 02/03/00 Forest Lake,MN 55025 Phone: 651-464-3333 Support: 651-464-7596 POLICY INFORMATION POLICY# CMC19785 TYPE EFFECTIVE EXPIRATION CP 07/07/99 07/07/00 City of Oak Park Heights Thomas M.Melena,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 Judy Re: Limits endorsement Since the statutory limits changed 1-1-2000 to $1, 000, 000 . here is the city' s endorsement accomplishing that limit amendment - no additional premium. Thank you. Kate Tipping FEB - 4 2000 ENDORSEMENT # 3 1/20/00 CP COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK CMC 19785 01/01/00 HEIGHTS IT IS HEREBY UNDERSTOOD AND AGREED THAT THE FOLLOWING FORMS ARE ADDED PER THE ATTACHED: Comprehensive Municipal Coverage - Change of Limits Endorsement - Municipal Liability ME044(01/00)-A Comprehensive Municipal Coverage - Change of Limits Endorsement - Automobile Liability - ME044(01/00)-C Total Endorsement Premium: $ No Change (See Below for Billing Information), PREMIUM DUE NOW: $ No Change (See Invoice Attached) OR DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged / / //` //' /(/ Executive Director, LMCIT LMCIT ME044(01/95) Page 1 of 1 COMPREHENSIVE MUNICIPAL COVERAGE CHANGE OF LIMITS ENDORSEMENTS MUNICIPAL LIABILITY IT IS HEREBY UNDERSTOOD AND AGREED THAT FOR ANY CLAIM ARISING FROM AN OCCURRENCE THAT TOOK PLACE ON OR AFTER JANUARY 1 , 2000 THE LIMITS OF COVERAGE STATED IN ITEM 4 ON LMCIT DEC-013(11/98) ARE AS FOLLOWS: EACH OCCURRENCE LIMIT $ 1,000,000 PRODUCTS & COMPLETED OPERATIONS ANNUAL AGGREGATE LIMIT $ 1,000,000 FAILURE TO SUPPLY ANNUAL AGGREGATE LIMIT $ 1,000,000 EMF ANNUAL AGGREGATE LIMIT $ 1,500,000 FIRE DAMAGE LIMIT $ 50,000 MEDICAL EXPENSE LIMIT $1,000/10,000 Occurrence /Aggregate LIMITED POLLUTION LIABILITY *$ 1,000,000 Per "Sudden Occurrence"/ $ 1,000,000 Annual Aggregate LEAD OR ASBESTOS CLAIM LIMIT *$ 200,000 Per Claim/ $ 200,000 Annual Aggregate LAND USE, DEVELOPMENT or *$ 1,000,000 Annual Aggregate FRANCHISE LITIGATION YEAR 2000 CLAIM *$ 25,000 Per Claim/ $ 25,000 Annual Aggregate *Limit includes loss, loss adjustment expense, and legal defense costs. ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. ME044(01/00)-A COMPREHENSIVE MUNICIPAL COVERAGE CHANGE OF LIMITS ENDORSEMENT AUTOMOBILE LIABILITY IT IS HEREBY UNDERSTOOD AND AGREED THAT FOR ANY CLAIM ARISING FROM AN OCCURRENCE THAT TOOK PLACE ON OR AFTER JANUARY 1 , 2000 THE LIMITS OF COVERAGE STATED IN ITEM 4 ON LMCIT DEC-016(11/97) ARE AS FOLLOWS: LIABILITY $ 1,000,000 Per Occurrence PERSONAL INJURY PROTECTION Basic Minnesota Statutory Coverage UNINSURED AND UNDERINSURED MOTORIST INSURANCE $ 1,000,000 PER OCCURRENCE ALL OTHER TERMS AND CONDITIONS REMAIN UNCHANGED. ME044(01/00)-C L :?ci23Ltiud 145 University Avenue West, St. Paul, MN 55103-2044 League of Minnesota Cities Fax: (651) 281-1297 • TDD (651) 281-1290 Cities promoting excellence October 20, 2000 Attn: Judy Hoist City of Oak Park Heights PO Box 2007 Oak Park Heights,MN 55082 Dear Ms. Hoist, Here is a copy of the audit worksheets per your request. Thanks, Barb Meyer Policy Service Tech (651) 215-4173 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER INSURED CLIENT: CITY OF OAK PARK HEIGHTS #135 PO BOX 2007 Berkley Administrators OAK PARK HEIGHTS, MN 55082 AUDITOR NAME: PAT HANNA POLICY NUMBER: POLICY PERIOD: AUDIT PERIOD: FILE ID: DATE: 02-000729-13 07/07/99 To 07/07/00 07/01/99 To 07/01/00 131497D 10/12/2000 1141050VE,RSION " t r .fa r�� xi a ,. # nd��A., ty ,� 3, wfY I� .ca', =.y Page 2 of 7 Description of operations--Provide detailed description of all operations/services. Include all locations,products or services,distribution or delivery methods,and materials handled etc. List all officers partners or Owners-Their duties,remuneration and class codes. Corporation Individual Closely Held Corporation po Y Po Partnership Other Limited Liability Corporation Ni io Audit Notes Key Questions Y N e 1. Premium overtime excluded?If no explain. X 2. Are relatives employed?If yes list on audit j X 3. Did the condition or type of records cause X additional audit time? 4. is there a"125"Cafe Plan or 401 1(Plan? X 5. Hoard or Lodging provided? X 6. Are commissions or bonuses paid? X Audit Records: Use Policyholder Terminology 7. Did the insured request a division of any X IER'S employees payroll? P/R JOURNALS 8. If yes to 7 did records reflect proper division? ■ MDES 9. Casual or contract labor? 10. Aircraft operation? 11. Any sub-contractors used? iX 12. Are certificates on file for all subs?(if no ;A provide complete details) 13. All classifications of policy accounted for? X Next Audit: 14. Was an owner or officer interviewed? JUDY HOLST FINANCE DIRECTOR Federal Tax ID#: 14168 OAK PARK BLVD N i41-0941681 ;OAK PARK HEIGHTS State Unemployment Account#: 651-439-4439S 7983042-000 i I i 1 131497D.WK4 10/12/2000 BJM :■• s,° INSURED CLIENT: CITY OF OAK PARK HEIGHTS #135 PO BOX 2007 Berkley Administrators OAK PARK HEIGHTS,MN 55082 AUDITOR NAME: PAT HANNA POLICY NUMBER: POLICY PERIOD: AUDIT PERIOD: FILE ID: DATE: 02-000729-13 07/07/99 To 07/07/00 07101/99 To 07/01/00 131497D 10/12/2000 SUMMARY PAGE KEY= A-AREA B-FRONTAGE C-REMUNERATION D-SALES/RECEIPTS E-COST F-ADMISSIONS -G-PER CAPITA/EACH K BASIS OF A CLASSIFICATION E T CODES PREMIUM T PREMIUM Y E V I E Workers Compensation Summary STREETS&MAINTENANCE C MN 5506 122,848 POLICE OFFICERS&D C MN 7720 522,375 CLERICAL OFFICE EMPLOYEES&NOC C MN 8810 400,548 PARK NOC-ALL EMPLOYEES&D C MN 9102 71,245 MUNICIPAL,TOWNSHIP,COUNTY OR STATE EMPLOYEE C MN 9410 123,789 ELECTED OFFICIALS: MAYOR&COUNCIL C MN 9411 26,000 RINK OPERATIONS C MN 9016 2,51$ 1,269,383 General Liability Summary 1 LESS AMOUNT PREVIOUSLY BILLED EARNED PREMIUM LESS PREVIOUS BILLING LESS DEPOSIT PREMIUM [j AP OR (RP DIVIDEND BALANCE DUE O INSURED I j COMPANY 1 131497D.WK4 10112/2000 BJM - ill 000OIt P- N st " MOO Yr (DO) 0e- 000Is OD NCO Ps (0 U) 0000000) 000 Oa0Oe- 000NU) NOtC) NnOOOCDOU) Od' NCDMe- 0000 000a0to `f Or0N V_0CDe- P- P- Ise- N- 00 CO CV CD 01 La) N- 000 ON- N- N� J J U)P-vOT' OfOM00e-P ONOD(Do 66.61:4-66.4766c6 U)M M OHN- U) (OMU) M (OU) (0U) U) O et00 OD e- C4 et CO CD 0 0 aI O ca O a' CO 0 O O 0 0 ZI N W O N I° d O o 10 } F_ " I O � O. ° ID O I0 f;'/ 0 ii ic IL Z Mc') 9Fb 1 0 Zd) f _10 N ■C'') O .1- Ps CO et CO ) O0C OD - 0NN d' N0P- 00001 00 d' N M I 0 U) CD 00 P- OD e- (O CO V) C) N- - 0 (0 - (O CO M U) Tr M 0 0 d• CO M V ~Q F.. 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OP DATE Forest Lake,MN 55025 OAKPA-1 KT O1/17/00 Phone: 651-464-3333 Support: 651-464-7596 POLICY INFORMATION POLICY# CMC19785 TYPE EFFECTIVE EXPIRATION CP 07/07/99 07/07/00 City of Oak Park Heights Thomas M.Melena,City Admin. r 14168 N 57th St, Box 2007 ,1 Stillwater,MN 55082 JAN 2 0 2000 ; Judy Re: Endorseme Enclosed please find endorsements #1 & #2 for this year' s policy. #1 is merely a result of a typo on the original renewal and does not change your coverage. #2 is a result of a recent appraisal, please see the attached cover letter. If you have any questions about this endorsement please let me know - it does not effect your 1999-2000 premium. Glad to see that the city received such a nice dividend from the League and I hope your Holidays were good! II Kate Tipping i ENDORSEMENT # 1 11/18/99 CP COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK CMC 19785 7/07/99 HEIGHTS IT IS HEREBY UNDERSTOOD AND AGREED THAT MUNICIPAL PROPERTY and CRIME and BOILER AND MACHINERY DECLARATIONS FORM DEC-012 (11-98), ITEM 8. COVERAGE PARTS, FORMS SCHEDULES AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE, MPC(11-98) - PROPERTY AND CRIME COVERAGE FORM IS DELETED AND REPLACED WITH THE PROPERTY AND CRIME COVERAGE FORM MPC(11/97)(REV. 11/98;12/98;7/99) AS PER THE ATTACHED. Total Endorsement Premium: $ NO CHANGE (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged Executive Director, LMCIT LMCIT ME044(1/95) Page 1 of 1 11111 11110 145 University Avenue West, St. Paul, MN 55103-2044 L Phone: (612)281-1200 • (800) 925-1122 Cities promoting excellence Fax: (612)281-1299 • TDD (612) 281-1290 November, 1999 To: LMCIT member cities and agents From: LMCIT Re:Revised Coverage Form(s) Revised Municipal Property and Crime Coverage Form,LMCIT MPC (11/97) (REV. 11/98:12/98:7/99) Enclosed you will find an endorsement replacing the Municipal Property and Crime Coverage Form attached to your covenant with the Revised Municipal Property and Crime Coverage Form,LMCIT MPC (11/97)(REV. 11/98;12/98;7/99). This revision was necessary due to some typographical errors on the previous form; specifically: Page 5 of 19,Section III,3. Year 2000 Claims is amended to read: 4. Year 2000 Claims. Any year 2000 problem. But if loss or damage by a "specified cause of loss"results, we will pay for the resulting loss or damage. This exclusion does not apply to Year 2000 Extra Expense as provided in Section II. 11. Revised Specific Location Endorsement,PM111(11-97)(7199) Please note that this form is not mandatory on all covenants and may not apply to your covenant. This revision was necessary due to a typographical error on the previous form; specifically: Paragraph B. 1.4. Power Failure, is corrected to read B. 1. 5. Power Failure. If you have any questions, please feel free to contact your underwriter. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • - League of Minnesota Cities PROPERTY AND CRIME COVERAGE LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) • • • PROPERTY AND CRIME COVERAGE WHAT IT IS AND WHERE YOU CAN FIND IT INDEX PROPERTY COVERAGE - PART ONE League of Minnesota Cities SECTION I - PROPERTY COVERAGE Page A. Covered Property 1 B. Property Not Covered 1 -2 SECTION II - ADDITIONAL COVERED LOSS OR DAMAGE 1. Asbestos Clean Up, Abatement and Removal 2 2. Loss of Revenue, Extra Expense and Expediting Expense 2 3. Debris Removal 2 -3 4. Leasehold Interest 3 5. Pollutant Clean Up and Removal 3 6. Errors 3 -4 7. Rental Reimbursement 4 8. Arson Reward 4 9. Accounts Receivable 4 10. Valuable Papers and Records 4 11. Year 2000 Extra Expense 4 SECTION III - CAUSES OF LOSS AND DAMAGES NOT COVERED 4-6 SECTION IV - WATER AND SUPPLEMENTAL FLOOD COVERAGE 6-7 SECTION V - LIMITS OF COVERAGE AND VALUATION 7 - 11 SECTION VI - DEFINITIONS 11 - 16 SECTION VII - CONDITIONS 16 - 19 LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) • • PROPERTY AND CRIME COVERAGE WHAT IT IS AND WHERE YOU CAN FIND IT INDEX MIL' II CRIME COVERAGE - PART TWO League of Minnesota Cities Page SECTION I - CRIME COVERAGE 1 SECTION II - EXCLUSIONS 1 SECTION III - LIMITS OF COVERAGE AND VALUATION 2 SECTION IV - CONDITIONS 2-5 SECTION V - DEFINITIONS 5 -6 LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) • • League of Minnesota Cities MUNICIPAL PROPERTY COVERAGE PART ONE LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) S • MUNICIPAL PROPERTY COVERAGE PART ONE Various provisions in this covenant restrict coverage. Insurance Trust. The word you and your refer to the Read the entire covenant carefully to determine city shown in the Declarations. The words we, us, rights, duties and what is or is not covered. and our refer to LMCIT providing this covenant. Throughout this covenant, the word city refers to the Other words and phrases that appear in italics have first city shown in the Declarations. The word special meaning, as given in SECTION VI - LMCIT refers to the League of Minnesota Cities DEFINITIONS. SECTION I - PROPERTY COVERAGE I. COVERAGE AGREEMENT 2. We will pay for loss to Newly Acquired Covered Property as described in SECTION We will pay for direct physical loss of or damage V - LIMITS OF COVERAGE AND to your Covered Property unless the cause of loss VALUATION. or damage is not covered, as described under SECTION III - CAUSES OF LOSS AND 3. We will pay for loss to your Buildings in the DAMAGES NOT COVERED. The amount we Course of Construction, Alteration, or will pay for loss or damage is limited as described Repair as described in SECTION V- in SECTION V- LIMITS OF COVERAGE AND LIMITS OF COVERAGE AND VALUATION. VALUATION A. Covered Property 4. We will pay for loss to Covered Property in Transit as described in SECTION V - 1. We will cover the following types of LIMITS OF COVERAGE AND property. VALUATION. a. Building/contents described in the 5. We will pay for loss to Covered Property Schedule of Covered Property. that is temporarily at an Unscheduled Location that you do not own, lease or b. Property in the open described in the operate, as described in SECTION V- Schedule of Covered Property. LIMITS OF COVERAGE AND VALUA- TION. c. Mobile property valued at $25,000 replacement cost or less if identified as B. Property Not Covered covered on the Schedule of Covered Mobile Property; and Mobile property 1. We will not cover the following types of valued at greater than $25,000 property: replacement cost and is listed on the Schedule of Covered Mobile Property. a. Aircraft; LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 1 of 19 • b. Animals (except for police dogs); j. Underground and buried pipes, flues or drains; c. Automobiles, vehicles, or self-propelled machines that are licensed for use on k. Foundations of buildings, structures, public roads; or machinery or boilers if their foundations are below: d. Bills,currency,deeds,evidences of debt, money, notes or securities; (1) The lowest basement floor; or e. Bridges, roadways, walks, patios or (2) The surface of the ground, if there is other paved surfaces, except golf course no basement; property; 1. Retaining walls that are not part of the f. Contraband or property in the course of Covered Property; illegal transportation or trade; m. Transmission and distribution lines and g. Cost of excavations, grading,backfilling poles and equipment that are usual to or filling; the transmission of electricity. This does not include substations and h. Land, subsoil, crops or lawns, except transformers. golf course property; n. Trees and shrubs that are not within 100 i. Pilings, piers, wharves or docks; feet of a building. SECTION II - ADDITIONAL COVERED LOSS OR DAMAGE We will provide coverage for the following loss or 2. LOSS OF REVENUE, EXTRA EXPENSE damage unless the cause of loss or damage is not AND EXPEDITING EXPENSE covered, as described under SECTION III- CAUSES OF LOSS AND DAMAGES NOT We will pay for the actual loss of revenue, extra COVERED. The amount we will pay for loss or expense or expediting expense sustained by you damage is limited as described in SECTION V - due to the necessary suspension of your LIMITS OF COVERAGE AND VALUATION operations during the period of recovery caused by direct physical loss or damage to any 1. ASBESTOS CLEANUP,ABATEMENT AND Covered Property. REMOVAL 3. DEBRIS REMOVAL a. We will pay for your expense to clean up, abate or remove from Covered Property We will cover the following debris removal asbestos particles that are discharged, expenses: dispersed, or released. a. The cost of removal of debris of Covered b. The expenses to clean up, abate or remove Property and non-Covered Property from a asbestos particles will be paid only if such covered location resulting from direct expenses are incurred within 90 days of the physical loss or damage to Covered date of direct physical loss or damage. Property; or LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 2 of 19 410 • b. The cost of removal of debris of non- d. We will cover your leasehold interest when Covered Property from your covered your Covered Property is rendered wholly or location which results from a specified cause partially untenantable and the lease is canceled of loss. by the lessor in accordance with the conditions of the lease or by statutory requirements of the 4. LEASEHOLD INTEREST state in which the damaged or destroyed Covered Property is located. a. We will provide coverage for leasehold interest resulting from direct physical loss or e. We will cover your leasehold interest for the damage to Covered Property. first three months succeeding the date of the loss and the net lease interest for the remaining b. Leasehold interest means: months of the unexpired lease. We will not be liable for any increase of loss that may be (1) The excess of the fair rental value of occasioned by the suspension, lapse, or similar premises over the actual rent cancellation of any license,or by the exercising payable by you as lessee (including any of any option to cancel the lease. maintenance or operating charges paid by the lessee) during the unexpired term of 5. POLLUTANT CLEANUP AND REMOVAL the lease; and a. We will provide coverage for pollutant cleanup (2) The rental income that would have been and removal resulting from direct physical loss earned by you from sublease agreements, or damage to Covered Property. We will cover over and above the rental expense the expense to extract pollutants from land or specified in the lease between you and the water on a covered location if the discharge, lessor. dispersal, seepage, migration, release, or escape of the pollutants is caused by any c. When Covered Property is rendered wholly or covered cause of loss. partially untenantable by a direct physical loss or damage and the lease is canceled by the b. We will cover the costs of testing that are lessor in accordance with the conditions of the incurred in the course of extracting pollutants lease or by statutory requirements of the state from land or water and any expense incurred to in which the damaged or destroyed Covered test for, monitor, or assess the existence, Property is located, we will cover the pro rata concentration, or effects of pollutants. proportion from the date of loss to expiration date of the lease (to be paid without discount) 6. ERRORS on your interest in: a. We will pay for loss to any Covered Property (1) Improvements and betterments to Covered if the loss is not covered solely because of: Property during the unexpired term of the lease that is not covered under any other (1) Any inadvertent error in the description or section of Part One of the covenant; or location of the building and contents, property in the open or mobile property (2) The amount of advance rental paid by covered by the covenant,which inadvertent you and not recoverable under the terms error existed at the inception date of the of the lease for the unexpired term of the covenant; or lease. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 3 of 19 i • (2) Any inadvertent error in the description or 8. ARSON REWARD location of the building/contents,property in the open or mobile property in In the event that a covered fire loss was the result endorsements to the covenant; or of an act of arson, we will reimburse you for rewards you pay for information leading to (3) Failing through an inadvertent error to convictions for that act of arson. schedule (a) any building/contents, property in the open, or mobile property 9. ACCOUNTS RECEIVABLE owned by the city at the inception of the covenant, or (b) any newly acquired We will pay for loss or damage to your accounts building/contents, property in the open or receivable caused by direct physical loss or mobile property during the term of the damage to your accounts receivable. coverage document. 10. VALUABLE PAPERS AND RECORDS (4) It is a condition of this coverage that such inadvertent error shall be reported and We will pay for loss or damage to valuable corrected when discovered. papers and records caused by direct physical loss or damage to valuable papers and records. 7. RENTAL REIMBURSEMENT 11. YEAR 2000 EXTRA EXPENSE We will pay for rental reimbursement expenses incurred by you for the rental of mobile property. We will pay for your expenses that are necessarily incurred: a. No deductibles apply to this coverage. a. To mitigate loss that is directly or indirectly b. This coverage does not apply while there is caused by a year 2000 problem; and spare or reserve equipment available to you for your operations. b. To implement any contingency plan to maintain your operations if any of your operations are impaired by a year 2000 problem. We will not pay any of your expenses to determine or to correct a year 2000 problem. SECTION III - CAUSES OF LOSS AND DAMAGES NOT COVERED I. CAUSES OF LOSS NOT COVERED: a. Flood,surface water,waves,tides,tidal waves, overflow of any body of water, A. We will not pay for loss or damage caused or their spray, all whether driven by directly or indirectly by any of the following. wind or not; Such loss or damage is excluded regardless of any other cause or event that contributes b. Mudslide or mudflow; concurrently or in any sequence to the loss. c. Water that backs up or overflows from 1. Water a sewer, drain or sump; or LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 4 of 19 S • d. Water under the ground surface c. Insurrection, rebellion, revolution, pressing on, or flowing or seeping usurped power, or action taken by through: governmental authority in hindering or defending against any of these. (1) Foundations, walls, floors or paved surfaces; 4. Year 2000 Claims (2) Basements, whether paved or not; Any year 2000 problem. or But if loss or damage by a "specified cause (3) Door, windows or other openings, of loss" results, we will pay for the except for coverage that is provided resulting loss or damage. by Water and Supplemental Flood Coverage as described in SECTION This exclusion does not apply to Year 2000 IV - WATER AND SUPPLE- Extra Expense as provided in Section MENTAL FLOOD COVERAGE. II.11. But if loss or damage by fire, explosion or II. DAMAGES NOT COVERED: sprinkler leakage results, we will pay for that resulting loss or damage. A. We will not pay for the following damages. This exclusion does not apply to: 1. Damage to your electrical devices, appliances or wires caused by artificially a. Mobile property generated electric current including electric arcing. 2. Nuclear Hazard This exclusion does not apply to: Nuclear reaction or radiation, or radioactive contamination, however a. Computer equipment data and media. caused. 2. Damage from the discharge, dispersal, But if loss or damage by fire results, we seepage, migration, release or escape of will pay for that resulting loss or damage. pollutants. 3. War This exclusion does not apply if the discharge, dispersal, seepage ,migration, a. War, including undeclared or civil war; release of pollutants is itself caused by a specified cause of loss. b. Warlike action by a military force, including action in hindering or 3. Damages caused by dishonest or criminal defending against an actual or expected acts by you, or your employees, attack, by any government, sovereign or other authority using military a. Acting alone or in collusion with others; personnel or other agents; or or b. Whether or not occurring during the hours of employment. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 5 of 19 • This exclusion does not apply to acts of This exclusion does not apply to: destruction by your employees; but theft by employees is not covered. a. Computer equipment data and media. 4. Damages caused by explosion of steam 7. Damages caused by: boilers,steam pipes,steam engines or steam turbines owned or leased by you, or a. Rust, corrosion, fungus, decay, operated under your control. deterioration, hidden or latent defect, mold or disease; But if loss or damage by fire or combustion explosion results, we will pay for that b. Settling, shrinking or expanding; or resulting loss or damage. c. Wear and tear. We will also pay for loss or damage caused by or resulting from the explosion of gases This exclusion does not apply if the above or fuel within the flues or passages through damage results from a specified cause of which the gases of combustion pass. loss. 5. The cost to repair or replace faulty 8. Unexplained loss, mysterious workmanship, materials, construction or disappearance, or shortage disclosed upon design. taking inventory. This exclusion does not apply to: 9. Seizure or destruction of property by order of governmental authority. a. Computer equipment data and media. But we also will pay for acts of destruction 6. The cost to repair or replace mechanical ordered by governmental authority and breakdown, including rupture or bursting taken at the time of a fire to prevent its caused by centrifugal force. spread, if the fire would be covered under this Coverage Part. SECTION IV - WATER AND SUPPLEMENTAL FLOOD COVERAGE I. COVERAGE AGREEMENTS COVERED LOSS OR DAMAGE as a result of direct physical loss of or damage A. For your building/contents or property in the to your building/ contents or property in open, subject to the exclusions and limitations the open; in Paragraph B below, we will pay for: which are caused by: 1. Direct physical loss of or damage to your buildings/contents or property in the open 1. Flood, surface water, waves, tides, described in the Schedule of Covered tidal waves, overflow of any body of Property; and water, or their spray, all weather driven by wind or not; 2. Any additional covered losses or damages as described in SECTION II - ADDITIONAL 2. Mudslide or mudflow; LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 6 of 19 • • 3. Water that backs up or overflows from a 3. For any building/contents or property sewer, drain or sump; or in the open for which Code C is shown on the Schedule of Covered Property, 4. Water under the ground surface pressing on, we will not pay for any loss or any or flowing or seeping through: damage resulting from any occurrence for which a National Flood Insurance (a) Foundations, walls, floors or paved Program Coverage would cover any surfaces; loss or any damage. (b) Basements, whether paved or not; or 4. For any Newly Acquired Covered Property, Buildings in the Course of (c) Doors, windows or other openings. Construction, Alterations or Repair, Covered Property in Transit or But if loss or damage by fire, explosion or Covered Property that is temporarily at sprinkler leakage results,we will not pay for an Unscheduled Location as provided that resulting loss or damage under this by SECTION I, IA Covered Property SECTION IV. that are not shown on the Schedule of will pay Property;w e p y an y loss B. 1. For any building/contents or property in the or any damage as if the WATER and open for which Code A is shown on the SUPPLEMENTAL FLOOD COVER- Schedule of Covered Property,no additional AGE was shown as Code C on the exclusions apply to the coverage provided Schedule of Covered Property. under this section. II. LIMITS OF COVERAGE 2. For any building/contents or property in the open for which Code B is shown on the The maximum amount we will pay for all Schedule of Covered Property,the coverage losses or damages covered under this provided by this section is specifically in SECTION IV is limited as described in addition to and in excess of the applicable SECTION V-LIMITS OF COVERAGE AND National Flood Insurance Program VALUATION. Coverage. SECTION V - LIMITS OF COVERAGE AND VALUATION A. LIMITS OF COVERAGE b. Fine Arts: $ 500,000 1. We will not pay for more than the blanket limit per occurrence specified in Item 5 of the c. Covered Property in Transit: Declaration. $250,000 2. The sublimits stated below are per occurrence d. Unscheduled Locations: and are part of and not in addition to the $500,000 blanket limit of occurrence: e. Personal Effects: a. Computer Equipment Data and Media: $25,000 per occurrence, but not to $1,000,000 exceed $2,500 per employee LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 7 of 19 • • 3. The sublimits stated below are in addition to i. Accounts Receivable: the blanket limit of occurrence. $500,000 Per Location a. Newly Acquired Covered Property: j. Valuable Papers and Records: $5,000,000 $500,000 Per Location b. Buildings in the Course of Construction, k. Year 2000 Extra Expense: Alterations or Repair: 85% of the expense, up to a limit of $2,000,000 $5,000 per occurrence and a $5,000 Annual Aggregate 4. The limits for the Additional Covered Loss or Damage are specified in Item 5 of the 5. The limits for Water and Supplemental Flood Declaration and are listed below. The limits Coverage are specified in Item 5 of the are in addition to the blanket limit of Declarations and are stated below. occurrence. a. $500,000 per occurrence a. Asbestos Clean Up, Abatement and Removal: b. The Water and Supplemental Flood $250,000 Per Location Coverage Annual Aggregate is the most we will pay for Water and Supplemental Flood b. Loss of Revenue, Extra Expense and Coverage loss during the annual coverage Expediting Expense: period. $5,000,000 Per Occurrence c. The sublimits stated below are per c. Debris Removal: occurrence and are part of and not in $1,000,000 Per Occurrence addition to the per occurrence limit: However, if there is no direct physical loss (1) Golf Course Property: $100,000 or damage to Covered Property, the most we will pay is $50,000 per occurrence. (2) Property In Transit: $250,000 These limits do not apply to golf course 6. Golf Course Property property. The most we will pay for direct damage to d. Leasehold Interest: Golf Course Property and Debris Removal of $500,000 Per Location Covered Property and non-Covered Property is $100,000 per occurrence. e. Pollutant Cleanup and Removal: $10,000 Per Location 7. Business Personal Effects f. Errors: The most we will pay for direct physical loss 90% of the loss, subject to $500,000 or damage to business personal effects is Per Occurrence $25,000 per occurrence but not to exceed $5,000 per employee. g. Rental Reimbursement: $25,000 Per Annual Aggregate B. LOSS VALUATION h. Arson Reward: 1. General Provisions $5,000 Per Fire Loss LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 8 of 19 • • a. Except as provided in 2. below, in the LMCIT will pay the cost to replace event of direct physical loss of or damage destroyed equipment with equipment of to your Covered Property, the basis of greater processing ability; the cost to adjustment will be as follows: reproduce or restore the data; and the cost to repair or replace media with the same (1) If the Covered Property is destroyed kind and quality of material. Any and is replaced or rebuilt,LMCIT will replacement equipment must be able to pay the cost to rebuild or replace the perform the same function as the destroyed Covered Property with new materials equipment. of equivalent size, kind and quality. If the Covered Property is replaced at a c. Accounts receivable. For accounts different site, the cost cannot be receivable,LMCIT will pay for all amounts greater than if you would have rebuilt due from your customers that you are at the same site. unable to collect; interest charges on any loan required to offset amounts you are (2) If the Covered Property is destroyed unable to collect pending our payment of and is not replaced or rebuilt, LMCIT these amounts; collection expenses in your of our normal collection expenses pay the appraised value of the excess P property at the time of the loss. that are made necessary by the loss; and other reasonable expenses you incur to re- (3) If the Covered Property is damaged establish your accounts receivable. If you but not destroyed and is repaired, are unable to establish the amount of LMCIT will pay the actual cost to accounts receivable outstanding at the time repair the property. of the loss, we will use the average monthly amounts of account receivable for (4) If the Covered Property is damaged the 12 months immediately preceding the but not destroyed and remains in month in which the loss occurs, adjusting service without being repaired,LMCIT to reflect the normal business during the will pay the amount of the reduction if loss month. any in the appraised value of the damaged property. d. Fine arts. For fine arts which are destroyed, LMCIT will pay the appraised In any event, LMCIT will not pay you more value, regardless of whether the Covered than your financial interest in the Covered Property is replaced or not. Property. e. Mobile property. For mobile property that 2. Special Provisions is damaged or destroyed, LMCIT will not pay for more than the amount you actually a. Valuable papers. For valuable papers and spent to repair or replace the damaged records, LMCIT will pay the cost of blank mobile property; or 200% of the appraised materials for reproducing the records,plus value of the damaged property, whichever the cost of labor to transcribe or copy the is less. records when there is a duplicate, or to reproduce the data of records. f. Police Dogs. For police dogs that are destroyed LMCIT will pay for the b. Computer equipment, data and media. For replacement cost of the dog and the cost of computer equipment, data, or media, any necessary training. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 9 of 19 o g. Trees and shrubs and (1) For a tree or shrub which is destroyed, (c) Deeds, liens or contracts. LMCIT will pay the actual cost to replace it with a tree or shrub of b. The amount of extra expense loss LMCIT similar type and of a size that is will pay, will be determined based on: normally considered to be reasonable and practical to transplant, regardless (1) All expenses that exceed the normal of whether the tree or shrub is replaced operating expenses that would have or not. been incurred by operations during the period of recovery if no direct physical (2) For a tree or shrub that is damaged but loss or damage had occurred. We will not destroyed, LMCIT will pay the deduct from the total of such expenses: actual cost of any service, treatment, or repair that is actually performed. (a) The salvage value that remains of any property bought for temporary But, we will not pay more than the use during the period of recovery actual cost to replace it with a tree or once operations are resumed; and shrub of similar type and of a size that is normally considered to be (b) Any extra expense that is paid for reasonable and practical to transplant. by other insurance, except for insurance that is written subject to 3. Loss of Revenue, Extra Expense and the same plan, terms and Expediting Expense Provisions conditions and provisions as this insurance; and a. The amount of loss of revenue loss LMCIT will pay, will be determined based on: (2) All necessary expenses that reduce the business income loss that otherwise (1) The gross revenue of the city before would have been incurred. the direct physical loss or damage occurred; We will reduce the amount of your: (2) The likely gross revenue of the city if a. Loss of revenue loss, other than extra no physical loss or damage had expense or expediting expense to the extent occurred; you can resume your operations, in whole or in part, by using damaged or (3) The operating expenses, including undamaged property (including merchan- payroll expenses, necessary to resume dise or stock) at the described location or operations with the same quality of elsewhere. service that existed just before the direct physical loss or damage, and b. Extra expense or expediting expense loss to the extent you can return your operations (4) Other relevant sources of information, to normal and discontinue such extra including: expense or expediting expense. (a) Your financial records and However, if you do not resume operations,or accounting procedures; do not resume operations as quickly as possible, we will pay based on the length of (b) Bills, invoices and other vouchers; time it would have taken to resume operations as quickly as possible. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 10 of 19 • 4. Appraisal be made by a judge of a court having juris- diction. The appraisers will state separately If the city and LMCIT disagree on the the value of the property. If they fail to appraised value of covered property either agree,they will submit their differences to the prior to the loss or damage, after the loss or umpire. A decision agreed to by any two will damage, or after repair, either party may be binding. Each party will: make a written demand for an appraisal of the loss. In this event, each party will select a a. Pay the cost of its own appraiser; and competent and impartial appraiser. The two appraisers will select an umpire. If they b. Bear the other expenses of the appraisal cannot agree,either may request that selection and umpire equally. SECTION VI - DEFINITIONS Accounts Receivable means: 3. Any covered property in the open at each location; or 1. All amounts due from your customers that you are unable to collect and there is a loss; 4. Any covered mobile property. 2. Interest charges on any loan required to offset Building means the building or structure including; amounts you are unable to collect pending our payment of these accounts; 1. Completed additions; 3. Collection expenses in excess of your normal 2. Permanently installed fixtures, machinery and collection expenses that are made necessary by the equipment; loss; and 3. Outdoor fixtures; 4. Other reasonable expenses that you incur to re- establish your records of accounts receivable. 4. Contents owned by you that is used to maintain or service the building or structure or its premises, 5. Accounts receivable does not include: including: a. The amount of the accounts that you are able to a. Fire extinguishing equipment; re-establish or collect; b. Outdoor furniture; b. An amount to allow for probable bad debts that you are normally unable to collect; and c. Floor coverings; and c. All unearned interest and service charges. d. Appliances used for refrigerating, ventilating, cooking, dishwashing or laundering; or Automobile means a land motor vehicle, trailer or semi-trailer designed for travel on public roads. 5. If not covered by other insurance: Blanket means the limit of coverage can be applied to a. Additions under construction, alterations and any of the following: repairs to the building or structure; 1. Any covered building at each location; b. Materials, equipment, supplies and temporary structures, on or within 100 feet of the 2. Any covered contents at each location; described building, used for making additions, LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 11 of 19 . . alterations or repairs to the building or 2. Facts,concepts or instructions in a form usable for structure. communications; Building/Contents as described in the Schedule of 3. Interpretation or processing by automatic means; Covered Property, means the following: or 1. Building; or 4. Computer programs and materials on which the data is recorded. 2. Contents. Contents means property located in or on the building Business Personal Effects means personal property of described in the Declarations or in the open (or in a your employees that is used to maintain the operations vehicle) within 100 feet of the described building, of the city. consisting of the following: City means governmental body or entity first named 1. Furniture and fixtures; in the Declarations. For purposes of this coverage city includes relief associations. Unless specifically 2. Machinery and equipment; named in the Declarations, city shall not include: 1. Gas, electrical, or steam utilities commission; 3. Stock; 2. Port authority, housing and redevelopment 4. All other contents owned by you and used in your authority, economic development authority, area municipal operations; or municipal redevelopment authority, or similar 5. Labor,materials or services furnished or arranged agency; by you on contents of others; 3. Municipal power agency; 6. Your use interest as tenant in improvements and betterments are fixtures, alterations, installations 4. Municipal gas agency; or additions: 5. Hospital or nursing home board or commission; a. Made a part of the building or structure you 6. Airport commission; occupy but do not own; and 7. Welfare or public relief agency; b. You acquired or made at your expense but cannot legally remove; or 8. School board; or 7. Contents of others that is in your care, custody 9. Joint powers entity. and control. Computer Equipment, Data and Media means a However, our payment for loss or damage to network of machine components capable of accepting contents will be for the account of the owner of information, processing it according to plan and the property. producing the desired results. It includes: 8. Trees and shrubs; 1. Air conditioning, fire protection equipment and electrical equipment used exclusively in your 9. Accounts receivable; computer operations; 10. Computer equipment data or media; or LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 12 of 19 M • 11. Valuable papers and records; or Extra expense means the excess total cost necessarily incurred to continue your operations as reasonably as 12. Personal Effects practicable during the period of recovery that is over and above the cost that would normally have been 13. Fine Arts incurred to conduct the operations during the same period had no loss or damage occurred. It includes: Employee means: 1. Extra expense to avoid or minimize the suspension 1. A person whom you compensate directly by of business and to continue operations: salary, wages or commissions and who you have the right to direct or control while performing a. At the described location; or duties for you; b. At a replacement location or at temporary 2. Member of the city council; locations, including: 3. Member of a city board, commission, or (i) Relocation expenses; and committee which is not excluded by the definition of city; (ii) Costs to equip and operate the replacement or temporary locations. 4. Elected or appointed official of the city; 2. Extra expense to minimize the suspension of 5. Volunteer person or organization while acting on business if you cannot continue operations. behalf of the city and subject to the city's direction and control; 3. Extra expense to: 6. Other authorized person or agent of the city while a. Repair or replace any Covered Property; or acting on behalf of the city, but excludes independent contractors; b. Research, replace or restore to the lost information on damaged valuable papers and 7. City relief association members, officers, and records; - employees; or to the extent it reduces the amount of loss that 8. Any natural person employed by an employment otherwise would have been payable under this contractor while that person is subject to your covenant. direction and control and performing services for you excluding, however, any such person while Fine Arts means property or articles of artistic or having care and custody of property outside the historical value including paintings, etchings, premises. pictures, tapestries, statuary, marbles, bronzes, porcelain,rare glass,antique silver,china,books and But employee does not mean any agent, broker, manuscripts, rugs and similar articles. factor,commission merchant,consignee,independent contractor or representative of the same general Golf Course Property means bridges, paved character. roadways,paved cart paths and other paved surfaces, shelters, restrooms, ball washers, screens, flags, Expediting expenses means the reasonable extra cost markers, signs, tees, fairways and greens. of temporary repair and expediting the repair of damaged Covered Property, overtime and express freight or other rapid means of transportation. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 13 of 19 • Joint Powers Entity means an operating entity created 7. Mobile Property in your care, custody and by two or more governmental units entering into an control. agreement as provided by statute for the joint exercise of governmental powers. An intergovern- Occurrence means an accident or event that causes a mental agreement will be deemed to create a joint direct physical loss or damage to covered property. powers entity if the agreement establishes a board Any continuous accident or event that causes more with the effective power to do any of the following, than one direct physical loss or damage to covered regardless of whether the specific consent of the property during a seventy-two (72) hour period constituent governmental units may also be required: constitutes an accident or event as a single occurrence. 1. To receive and expend funds; Operations means: 2. To enter into contracts; 1. Your city activities occurring at the described 3. To hire employees; location; or 4. To purchase or otherwise acquire or hold real or 2. The tenantability of the described location. personal property; or Period of Recovery means the period of time that: 5. To sue or be sued. 1. Begins immediately after the time of direct Location means the site of any building/contents or physical loss or damage to Covered Property. property in the open listed in the Declarations or attached schedules. 2. Ends on the earlier of: Loss of Revenue means gross revenue, including a. The date Covered Property is actually repaired, rental value, less charges and expenses that do not rebuilt or replaced and operations are resumed; necessarily continue. and your operations would generate the loss of revenue amount that would have existed if no Mobile property means: direct physical or damage had occurred; or 1. Machinery or equipment designed for use b. Sixty (60) consecutive days after the date, principally off public roads; when the Covered Property is actually repaired,rebuilt or replaced and operations are 2. Police Dogs resumed. 3. Vehicles maintained for use solely on or next to However, the expiration date of the covenant will locations owned or rented by you and not licensed not cut short the period of recovery. for highway use; Personal Effects means personal property of your 4. Vehicles and its equipment whether self-propelled employees. or not,maintained primarily to provide mobility to permanently mounted equipment; or Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, 5. Tools. vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, 6. Business Personal Effects; or reconditioned or reclaimed. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 14 of 19 • • Property in the Open means: 3. Water Damage means accidental discharge or leakage of water or steam from any part of a 1. Equipment such as, but not limited to, benches, system or appliance containing water or steam. fences,light poles,playground equipment,statues, scoreboards, traffic signals or signs that are in the Stock means merchandise held in storage or for sale, open and are not part of a building; or raw materials and in-process or finished goods, including supplies used in their packing or shipping. 2. Golf Course Property. System or system component means any of the following: Rental Value means the sum of: 1. Computer hardware, including microprocessors; 1. The total anticipated gross rental income from tenant occupancy of the Covered Property as 2. Computer application software; furnished and equipped by you; and 3. Computer operating systems and related software; 2. The amount of all continuing charges that are the legal obligation of the tenant and that would 4. Computer networks; otherwise be your obligation; and 5. Microprocessors or other computer chips not part 3. The fair rental value of any portion of the of any computer system; or Covered Property that you occupy. 6. Any other computerized or electronic equipment Specified Causes of Loss means fire; lightning; or components. explosion; windstorm or hail; smoke; aircraft or vehicles; riot or civil commotion;vandalism; leakage Valuable Papers and Records means inscribed, discharge from fire extinguishing equipment;sinkhole printed or written documents,manuscripts or records, collapse; volcanic action; falling objects; weight of including abstracts, books, deeds, drawings, films, snow, ice or sleet; or water damage. maps and mortgages. 1. Sinkhole collapse means the sudden sinking or But valuable papers and records does not mean collapse of land into underground empty spaces money or securities, converted data, programs or created by the action of water on limestone or instructions used in your data processing operations, dolomite. This cause of loss does not include: including the materials on which the data is recorded. a. The cost of filling sinkholes; or Year 2000 claim means any claim for damages arising directly or indirectly out of: b. Sinking or collapse of land into man-made underground cavities. 1. Any actual or alleged failure, malfunction, or inadequacy of any system or system component, 2. Falling Object does not include loss or damage to: whether belonging to the city or to others, which is due to any year 2000 problem; a. Property in the open; or 2. Any actual or alleged failure, malfunction, or b. The interior of a building or structure, or inadequacy of any product, service, data, or property inside a building or structure, unless function that directly or indirectly uses or relies on the roof or an outside wall of the building or any system or system component, which is due to structure is first damaged by a falling object. any year 2000 problem; or LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 15 of 19 • • 3. Any advice, consultation, design, evaluation, Year 2000 problem means the inability of any system inspection, installation, maintenance, repair, or system component to correctly recognize,process, replacement, or supervision done by a covered distinguish, interpret, or accept the year 2000 and party to determine, rectify, or test for any beyond. potential or actual year 2000 problem. SECTION VII - CONDITIONS A. CONTROL OF PROPERTY E. COVERAGE PERIOD, COVERAGE TERRITORY Any act or neglect of any person other than you beyond your direction or control will not affect Under this Coverage Part: this coverage. 1. We cover loss or damage commencing: The breach of any condition of this Coverage Part at any one or more locations will not affect a. During the coverage period shown in the coverage at any location where, at the time of Declarations; and loss or damage, the breach of condition does not exist. b. Within the coverage territory. B. COVERAGE UNDER TWO OR MORE 2. The coverage territory is: COVERAGES a. The United States of America(including its If two or more of this covenants coverages apply territories and possessions); to the same loss or damage, we will not pay more than the actual amount of the loss or damage. b. Puerto Rico; and C. LEGAL ACTION AGAINST US c. Canada No one may bring legal action against us under F. LOSS CONDITIONS this Coverage Part unless: 1. Abandonment. 1. There has been full compliance with all of the terms of the Coverage Part; and You cannot abandon your property to us. 2. The action is brought within 2 years after the 2. Duties In The Event of Loss or Damage. date on which the direct physical loss or damage occurred. You must see that the following are done in the event of loss or damage to Covered D. NO BENEFIT TO BAILEE Property: No person or organization, other than you, a. Notify the police if a law may have been having custody of Covered Property will benefit broken. from this coverage. b. Give us prompt notice of the loss or damage. Include a description of the property involved. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 16 of 19 S • c. As soon as possible, give us a description 4. Recovered Property. of how, when and where the loss or damage occurred. If either you or we recover any property after loss settlement, that party must give the other d. Take all reasonable steps to protect the prompt notice. At your option, the property Covered Property from further damage. If will be returned to you. You must then return feasible, set the damaged property aside to us the amount we paid to you for the and in the best possible order for property. We will pay recovery expenses and examination. Also keep record of your the expenses to repair the recovered Property, expenses, for consideration in the subject to the amount applying under this settlement of the claim. Covenant. e. At our request, give us complete G. PREMIUMS AND PREMIUM ADJUST- inventories of the damaged and undamaged MENTS property. Include quantities, costs, values, and amount claim of loss demand. 1. You agree to furnish us with a Schedule of Locations and Buildings, Schedule of Mobile f. Permit us to inspect the property and Property and Schedule and Location of records proving the loss or damage. Property in the Open prior to the beginning of each covenant period. The initial annual g. If requested, permit us to question you premiums will be based upon these Schedules under oath at such times as may be and the appropriate replacement cost values. reasonably required about any matter relating to this Covenant or your claim, 2. You will pay us additional premium if: including your books and records. In such event, your answers must be signed. a. Building/contents, mobile equipment or property in the open is added during the h. Send us a signed, sworn statement of loss covenant period. containing the information we request to settle the claim. You must do this within b. Additional Covered Loss or Damage 60 days after our request. We will supply limits, or property sublimits are increased you with the necessary forms. during the covenant period. i. Cooperate with us in the investigation, or c. Buildings in the Course of Construction, settlement of the claim. Alteration or Repair is added during the covenant period. 3. Loss Payment d. Newly acquired Covered Property is added a. We will give notice of our intentions within during the covenant period. 30 days after we receive the sworn statement of loss. 3. We will return premium to you if: b. We may adjust losses with the owners of a. Building/contents, mobile equipment or lost or damaged property if other than you. property in the open are deleted during the If we pay the owners, such payments will covenant period. satisfy your claims against us for the owners' property. We will not pay the b. Additional Covered Loss or Damage limits owners more than their financial interest in or property sublimits are reduced during the Covered Property. the covenant period. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 17 of 19 • • H. CANCELLATION J. MORTGAGE HOLDERS 1. You may cancel Part One of this covenant. 1. The term mortgage holder includes trustee. You must mail or deliver not fewer than thirty (30) days advance written notice to us stating 2. We will pay for covered loss of or damage to when the cancellation is to take effect. buildings or structures to each mortgage holder shown in the Declarations in their 2. We may cancel Part One of this covenant. We order of precedence, as interests may appear. must mail or deliver to you not fewer than thirty(30)days advance written notice stating 3. The mortgage holder has the right to receive when the cancellation is to take effect. loss payment even if the mortgage holder has Mailing that notice to you at your mailing started foreclosure or similar action on the address shown in the Declaration will be building or structure. sufficient to prove notice. However, we may cancel with ten (10) days written notice for 4. If we deny your claim because of your acts or nonpayment of premium. because you have failed to comply with the terms of this Coverage Part, the mortgage 3. The covenant period will end on the day and holder will still have the right to receive loss hour stated in the cancellation notice. payment if the mortgage holder; 4. If Part One of this covenant is canceled, we a. Pays any premium due under this will send you any premium refund due. If we Coverage Part at our request if you have cancel, the refund will be pro rata. If you failed to do so; cancel, the refund may be less than pro rata, computed in accordance with our current b. Submits a signed, sworn proof of loss cancellation rules. The cancellation will be within 60 days after receiving notice from effective even if we have not made or offered us of your failure to do so; and a refund. c. Has notified us of any change in I. DEDUCTIBLE ownership, occupancy or substantial change in risk known to the mortgage All losses, damages, or expenses arising out of holder. any one occurrence will be adjusted (net of salvage, subrogation, recoveries, and any other All of the terms of this Coverage Part will recoveries) as one loss, and from the amount of then apply to the mortgage holder. this adjusted loss will be deducted the sum that you selected as a deductible as shown in Item 7 5. If we pay the mortgage holder for any loss or of the Declarations for property coverage. damage and deny payment to you because of your acts or because you have failed to The deductible applies against the total loss comply with the terms of this Coverage Part: incurred by you from any one occurrence, regardless of the number of locations involved. a. The mortgage holder's rights under the mortgage will be transferred to us to the If two or more deductibles in Item 7 of the extent of the amount we pay; and Declarations for property coverage apply to one occurrence for you, the total to be deducted will b. The mortgage holder's right to recover the not exceed the largest deductible applicable. full amount of the mortgage holder's claim LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 18 of 19 • • will not be impaired. At our option, we K. TRANSFER OF RIGHTS OF RECOVERY may pay to the mortgage holder the whole AGAINST OTHERS TO US principal on the mortgage plus any accrued interest. In this event, your mortgage and If any person or organization to or for whom we note will be transferred to us and you will make payment under this Coverage Part has pay your remaining mortgage debt to us. rights to recover damages from another, those rights are transferred to us to the extent of our 6. If we cancel this covenant, we will give payment. That person or organization must do written notice to the mortgage holder at least: everything necessary to secure our rights and must do nothing after loss to impair them. But a. Ten (10) days before the effective date of you may waive your rights against another party cancellation if we cancel for your non- in writing: payment of premium; or 1. Prior to a loss to your Covered Property or b. Thirty (30) days before the effective date Covered Income. of cancellation if we cancel for any other reason. 2. After a loss to your Covered Property or Covered Income only if, at time of loss, that 7. If we do not renew this covenant we will give party is one of the following: written notice to the mortgage holder at least ten(10)days before the expiration date of this a. Someone insured by this Covenant; covenant. b. A business firm: (1) Owned or controlled by you; or (2) That owns or controls you; or (3) Your tenant. This will not restrict your Covenant. LMCIT MPC(11/97)(REV. 11/98;12/98;7/99) Page 19 of 19 • League of Minnesota Cities CRIME COVERAGE PART TWO • S S MUNICIPA L CRIME COVERAGE PART TWO Various provisions in this covenant restrict coverage. The word LMCIT refers to League of Minnesota Read the entire covenant carefully to determine Cities Insurance Trust. The word you and your rights, duties and what is or is not covered. refer to the city shown in the Declarations. The words we, us, and our refer to LMCIT providing this Throughout this covenant, the word city refers to the covenant. first ci ty shown in the DECLARATIONS. SECTION I - CRIME COVERAGE 1. COVERAGE AGREEMENT and Valuation, General Conditions and General Definitions apply to all Crime Coverage Forms We will pay for loss as provided by each coverage forming part of this covenant. form that is designated in the DECLARATION. Other words and phrases that appear in italics Unless stated otherwise in any Crime Coverage have special meaning, as given in SECTION V - Form, DECLARATIONS or endorsement, the DEFINITIONS. following General Exclusions,Limits of Coverage SECTION II - EXCLUSIONS We will not pay for loss as specified below: a loss covered under this covenant. 1. Governmental Action: Loss resulting from seizure C. Payment of costs, fees or other expenses you or destruction of property by order of incur in establishing either the existence or the governmental authority. amount of loss under this covenant. 2. Indirect Loss: Loss that is an indirect result of 3. Legal Expenses: Expenses related to any legal any act or occurrence covered by this covenant action. including, but not limited to, loss resulting from: 4. Nuclear: Loss resulting from nuclear reaction, A. Your inability to realize income that you nuclear radiation or radioactive contamination,or would have realized had there been no loss of, any related act or incident. or loss from damage to, Covered Property. 5. War and Similar Actions: Loss resulting from B. Payment of damages of any type for which war, whether or not declared, warlike action, you are legally liable. But, we will pay insurrection, rebellion or revolution, or any compensatory damages arising directly from related act or incident. LMCIT MPC(11/97)(Rev. 11/98;12/98;7/99) Page 1 of 6 • • SECTION III - LIMITS OF COVERAGE AND VALUATION 1. LIMITS OF COVERAGE occurrence is the applicable Limit of Coverage shown in the DECLARATION. The most we will pay for loss in any one SECTION IV - CONDITIONS 1. Consolidation- Merger: C. Give us a detailed, sworn proof of loss within 120 days. If through consolidation or merger with, or purchase of assets of, some other entity: D. Cooperate with us in the investigation and settlement of any claim. A. Any additional persons become employees; or 5. Joint Parties B. You acquire the use and control of any additional premises; A. If more than one city is named in the DECLARATIONS, the first named city will any coverage afforded for employees or premises act for itself and for every other city for all also applies to those additional employees and purposes of this covenant. If the first named premises, but only if you: city ceases to be covered, then the next will become the first named city. A. Give us written notice within 30 days thereafter; and B. If any city or employee or officer of that city has knowledge of any information relevant to B. Pay us an additional premium. this covenant, that knowledge is considered knowledge of every city. 2. Coverage Extensions: Unless stated otherwise in the Coverage Form, our liability under any C. An employee of any city is considered to be Coverage Extension is part of, not in addition to, an employee of every city named in the the limit applying to the Coverage or Coverage Declarations. Section. D. If this covenant is cancelled or terminated 3. Discovery Period for Loss: We will pay only for as to any city, loss sustained by that city is covered loss discovered no later than one year covered only if discovered no later that one from the end of the covenant period. year from the date of that cancellation or termination. 4. Duties in the Event of Loss: After you discover a loss or a situation that may result in loss of, or E. We will not pay more for loss sustained by loss from damage to, Covered Property you more than one city than the amount we would must: pay if all the loss had been sustained by one city. A. Notify us as soon as possible. 6. Legal Action Against Us: You may not bring B. Submit to examination under oath at our any legal action against us involving loss: request and give us a signed statement of your answers. A. Unless you have complied with all the terms of this covenant; and LMCIT MPC(11/97)(Rev. 11/98;12/98;7/99) Page 2 of 6 I B. Until 90 days after you have filed proof of If any loss is covered: loss with us; and A. Partly by this covenant, and C. Unless brought within 2 years from the date you discover the loss. B. Partly by the prior cancelled or terminated covenant that we or any affiliate had issued to 7. Loss Covered Under More Than One you or any predecessor in interest, the most Coverage of This Covenant: If two or more we will pay is the larger of the amount coverages of this covenant apply to the same loss, recoverable under this covenant or the prior we will pay the lesser of: covenant. A. The actual amount of loss; or 10. Non-Cumulation of Limit of Coverage: B. The sum of the limits of coverage applicable Regardless of the number of years this covenant to that loss. remains in force or the number of premiums paid, no Limit of Coverage cumulates from year 8. Loss Sustained During Prior Insurance to year or period to period. A. If you or any predecessor in interest 11. Other Insurance: sustained loss during the period of any prior insurance that you or the predecessor in This covenant does not apply to loss recoverable interest could have recovered under that or recovered under other insurance or indemnity. insurance except that the time within which to However, if the limit of the other insurance or discover loss had expired, we will pay for it indemnity is insufficient to cover the entire under this covenant provided: amount of the loss, this covenant will apply to that part of the loss, other than that falling (1) This covenant became effective at the within any deductible amount, not recoverable time of cancellation or termination of the or recovered under the other insurance or prior insurance; and indemnity. However, this covenant will not apply to the amount of loss that is more than (2) The loss would have been covered by the applicable Limit of Coverage shown in the this covenant had it been in effect when DECLARATIONS. the acts or events causing the loss were committed or occurred. 12. Ownership of Property; Interests Covered: B. The coverage under this Condition is part of, The property covered under this covenant is not in addition to, the Limits of Coverage limited to property: applying to this covenant and is limited to the lesser of the amount recoverable under: A. That you own or hold; or (1) This covenant as of its effective date; or B. For which you are legally liable. (2) The proper covenant had it remained in However,this covenant is for your benefit only. effect. It provides no rights or benefits to any other person or organization. 9. Loss Covered Under This Covenant and Prior Covenant Issued by Us or Any Affiliate: LMCIT MPC(11/97)(Rev. 11/98;12/98;7/99) Page 3 of 6 • . 13. Covenant Period: Canal Zone, or Canada. A. The covenant period is shown in the 17. Transfer of Your Rights of Recovery Against DECLARATIONS. Others to Us: B. Subject to the Loss Sustained During Prior You must transfer to us all your rights of Insurance condition, we will pay only for recovery against any person or organization for loss that you sustain through acts committed any loss you sustained and for which we have or events occurring during the coverage paid or settled. You must also do everything period. necessary to secure those rights and do nothing after loss to impair them. 14. Records: 18. Valuation-Settlement You must keep records of all Covered Property so we can verify the amount of any loss. A. Subject to the applicable Limit of Coverage provision we will pay for: 15. Recoveries: (1) Loss of money but only up to and A. Any recoveries, less the cost of obtaining including its face value. We may, at our them, made after settlement of loss covered option, pay for loss of money issued by by this covenant, will be distributed as any country other than the United States follows: of America: (1) To you, until you are reimbursed for any (a) At face value in the money issued loss that you sustain that exceeds the by that country; or Limit of Coverage and the Deductible Amount, if any; (b) In the United States of America dollar equivalent determined by the (2) Then to us until we are reimbursed for rate of exchange on the day the loss the settlement made; was discovered. (3) Then to you until you are reimbursed (2) Loss of securities but only up to and for that part of the loss equal to the including their value at the close of Deductible Amount, if any. business on the day the loss was discovered. we may, at our option: B. Recoveries do not include any recovery: (a) Pay the value of such securities or (1) From insurance,suretyship,reinsurance, replace them in kind, in which event security or indemnity taken for our you must assign to us all your rights, benefit; or title and interest in and to those securities; (2) Of original securities after duplicates of them have been issued. (b) Pay the cost of any Lost Securities Bond required in connection with 16. Territory: issuing duplicates of the securities. However, we will be liable only for This covenant covers only acts committed or the payment of so much of the cost events occurring within the United States of of the bond as would be charged for America, U.S. Virgin Islands, Puerto Rico, a bond having a penalty not LMCIT MPC(11/97)(Rev. 11/98;12/98;7/99) Page 4 of 6 • • exceeding the lesser of the: cash value of the property or repair or replace it. i. Value of the securities at the close of business on the day the loss If we cannot agree with you upon the actual was discovered; or cash value or the cost of repair or replacement, the value or cost will be ii. Limit of Coverage. determined by arbitration. (3) Loss of, or loss from damage to property B. We may, at our option, pay for loss of, or other than money and securities or loss loss from damage to property other than from damage to the premises for not money: more than the: (1) In the money of the country in which the (a) Actual cash value of the property on loss occurred; or the day the loss was discovered; (2) In the United States of America dollar (b) Cost of repairing the property or equivalent of the money of the country in premises; or which the loss occurred determined by the rate of exchange on the day the loss (c) Cost of replacing the property with was discovered. property of like kind and quality. C. Any property that we pay for or replace We may, at our option, pay the actual becomes our property. SECTION V - DEFINITIONS . City means the governmental body or entity first 7. School board; , named in the Declarations. For purposes of this coverage city includes relief associations. Unless 8. Airport commission; or specifically named in the Declarations, city shall not include; 9. Joint powers entity. 1. Gas, electrical, or steam utilities commission; Crime Coverage Form means the following crime forms: 2. Port Authority, housing and redevelopment authority, economic development authority,area 1. Theft, Disappearance and Destruction Coverage or municipal redevelopment authority, or Form MPC 201; similar agency; 2. Forgery or Alteration Coverage Form MPC 202; 3. Municipal power agency; 3. Public Employee Dishonesty Coverage Form 4. Municipal gas agency; MPC 203; 5. Hospital or nursing home board or commission; 4. Public Employee Faithful Performance Coverage Form MPC 204; or 6. Welfare or public relief agency; LMCIT MPC(11/97)(Rev. 11/98;12/98;7/99) Page 5 of 6 S 5. Public Employee Dishonesty Coverage with intergovernmental agreement will be deemed to Faithful Performance of Duty for Specified create a joint powers entity if the agreement Position or Obligee Form MPC 205. establishes a board with the effective power to do any of the following, regardless of whether the Employee means: specific consent of the constituent governmental units may also be required: 1. A person whom you compensate directly by salary, wages or commissions and who you have 1. To receive and expend funds; the right to direct or control while performing duties for you; 2. To enter into contracts; 2. Member of the city council; 3. To hire employees; 3. Member of a city board, commission, or 4. To purchase or otherwise acquire and hold real or committee which is not excluded by the definition personal property; or of city; 5. To sue or be sued. 4. Elected or appointed official of the city; Money means: 5. Volunteer person or organization while acting on behalf of the city and subject to the city's direction 1. Currency, coins, and bank notes in current use and control; and having a face value; and 6. Other authorized person or agent of the city while 2. Travelers checks, register checks and money acting on behalf of the city, but excludes orders held for sale to the public. independent contractors; Property Other Than Money and Securities means 7. City relief association members, officers, and any tangible property other than money and securities employees; or that has intrinsic value but does not include any property listed in any Crime Coverage Form as 8. Any natural person employed by an employment Property Not Covered. contractor while that person is subject to your direction and control and performing services for Securities means negotiable and non-negotiable you excluding, however, any such person while instruments or contracts representing either money or having care and custody of property outside the other property and includes: premises. 1. Tokens, tickets, revenue and other stamps But employee does not mean any agent, broker, (whether represented by actual stamps or unused factor,commission merchant,consignee,independent value in a meter) in current use; and contractor or representative of the same general character. 2. Evidences of debt issued in connection with credit or charge cards, which cards are not issued by Joint powers entity means an operating entity created you; by two or more governmental units entering into an agreement as provided by statute for the joint but does not include money. exercise of governmental powers. An LMCIT MPC(11/97)(Rev. 11/98;12/98;7/99) Page 6 of 6 • • ENDORSEMENT # 2 12-14-99 JH COVERED PARTY COVENANT NUMBER EFFECTIVE DATE r CITY OF OAK PARK CMC 19785 7-07-99 HEIGHTS IT IS HEREBY UNDERSTOOD AND AGREED THAT MUNICIPAL PROPERTY AND CRIME AND BOILER AND MACHINERY FORM DEC-012(11-97) ITEM 5. COVERAGE PART ONE - PROPERTY, SECTION 1 - PROPERTY BLANKET LIMIT OF COVERAGE PER OCCURRENCE IS INCREASED TO $5,846,532. IN LIEU OF $5,719,718. Total Endorsement Premium: $NO CHANGE (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged Executive Director, LMCIT LMCIT ME044(1/95) Page 1 of 1 i • , r 1_,_,_._s,.,7 L MC • 145 University Avenue West, St. Paul, MN 55103-2044 ~ Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence J Web Site: http:JJwww.lmnc.or� ii 1 1 r - TO: Brian Alm Landmark Insurance Service ', n F C 1 5 1999 FROM: LMCIT 1 r I. Re: Appraisals Date:November 30, 1999 LMCIT provides these appraisals as standard service to LMCIT members. This service should eliminate the need for further professional appraisals of your buildings, contents and mobile property. Your property in the open has not been appraised. These reports will also provide you a method to review your current blanket limit of coverage that is stated on the Declarations of your covenant and compare this total to the appraised total replacement cost values of your property as shown on the Appraisal Summary Form. The attached LMCIT memo "Changes in Property Coverage 1997-98" will also provide an additional overview of the new property coverages and appraisal system. We should emphasize two points about these appraisal figures: * The value shown for a particular building or item is not a limit on the coverage for that building or item. The values shown are reasonable estimates of the replacement cost. But if a loss occurs, the loss payment would be the actual cost to repair or replace the building or item, as specified in the coverage document. The amount could turn out to be greater or less than the specific amount we've estimated for that item. * These appraisals are not intended to serve as a premium audit, and we will not increase your city's premium this year. Attached you will find your Appraisal Summary Form, Schedule of Individual Valuations, and a letter from Valuation Resource Management, Inc. that outlines their method of value development. 1. The Appraisal Summary Form provides a broad overview of your values and compares the total per occurrence values that are currently on your covenant to the estimated appraised values that have been established. 2. The Schedule of Individual Valuations provides detail on each building/contents, mobile property, and property in the open. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • a. The report shows the current LMCIT replacement cost value and the VRMI appraised value for each building/contents. 1. Buildings with replacement cost values of less than$500,000. have been appraised using a desk-top appraisal system. 2. Buildings with replacement cost values of greater than $500,000. have been appraised using an on site detailed appraisal. b. The report shows the current LMCIT replacement cost values and the VRMI appraised value for each mobile property greater than$25,000. replacement cost values. c. The property in the open replacement cost values has been provided by each member. d. Mobile property replacement cost values less than$25,000. Were established by LMCIT using the following method: 1. The cities actual values for items less than$5,000. were developed several years ago. These values have been adjusted 2%per year. 2. The city's actual values for items greater than$5,000. were added to the total limit for less than$5,000. 3. This final total was increased to an estimated replacement cost value using a replacement cost conversion factor. The attached endorsement amends the per occurrence limit on your covenant. The new limit is based on the appraisals. Additional premium will be waived this year and any return premium will be returned. If you have any questions,please contact your LMCIT underwriter 1 • 40 a • Valuation Resource Management, Inc. 2817 Anthony Lane South, Suite 107 • Minneapolis, MN 55418 • 612-788-2335 • FAX 612-788-2354 0 November 30, 1999 Mr. Michael J. Wozniak, CPCU Assistant Vice President—Underwriting Berkley Risk Services 145 University Avenue West St. Paul, MN 55103-2044 Dear Mr. Wozniak: We have made an appraisal and/or valuation of certain designated property of the City of Oak Park Heights, a member of the League of Minnesota Cities Insurance Trust, and submit our findings in this report and are in the Schedule of Individual Valuations. The purpose of our investigation was to express our opinion of the cost of reproduction new for insurance purposes. Cost of Reproduction New, an appraisal term synonymous with"new replacement cost" in the insurance industry, is defined as follows: Cost of Reproduction New is the amount required to reproduce property in like kind and materials at one time in accordance with current market prices for materials, labor and manufactured equipment, contractor's overhead, profit, and fees, but without provisions for overtime or bonuses for labor and premiums for materials. In estimating the cost of reproduction new,we did not consider costs associated with conforming with local ordinances or other legal restrictions, the cost of demolition in connection with reconstruction, or the cost to remove destroyed property. In the event of a partial loss, the amount of loss may be based upon the repair cost, which is usually proportionately higher than the cost of reproduction new for the entire property as defined and included in this report. Atlanta • Beverly Hills • Boston • Chicago • Columbus • Dallas • Denver • Indianapolis • Jacksonville • Los Angeles Miami • Milwaukee • Minneapolis • Philadelphia • Pittsburgh • Richmond • San Diego • San Francisco • Seattle • • Mr. Michael J. Wozniak, CPCU Assistant Vice President Berkley Risk Services Page 2 Our investigation included buildings and their related service systems, contents and mobile equipment with a replacement cost exceeding $25,000. On-site appraisal investigations were completed for those buildings with a replacement cost exceeding $500,000. For those structures VRMI did not physically inspect, value estimations were calculated using information provided by member City employees. Excluded from our investigation were land, land improvements, licensed vehicles, infrastructure, assets of an intangible nature, personal property of city employees and leased property. Contents, consumable supplies, spare parts and inventory items were valued utilizing a modeling concept which matched each building's contents value with a similar model in our database of previously appraised buildings, or by a physical tally of a building's contents in the field. The values generated by the system not only reflect the cost of all standard furniture and equipment found within a particular building, but also included all computer equipment, machinery, business machines, consumables, spare parts, supplies, software and books. Based upon our appraisal investigation and analysis, and the premises outlined above, it is our opinion that as of November 30, 1999 the Cost of Reproduction New is as stated on the Schedule of Individual Valuations. Respectfully submitted, VALUATION RESOURCE MANAGEMENT, INC. William N. Jaeger, ASA President William A. Kiewel Responsible Appraiser /4z/\ • • Appraisal Summary Form City: OAK PARK HEIGHTS Date: 7-7-99 LMCIT EST. VALUES VRMI VALUES BUILDINGS $ 5,028,786 $ 5,135,100 CONTENTS $ 257,500 $ 278,000 PROPERTY IN THE OPEN $ 363,173 $ 363,173 (Used LMCIT Values For VRMI) TOTAL BUILDING/CONTENTS/ $ 5,649,459 5,776,273 PIO VALUES MOBILE PROPERTY <$25,000 $ 70,259 $ 70,259 (Used LMCIT Values For VRMI) MOBILE PROPERTY >$25,000 $ - $ - TOTAL PER OCCURRENCE $ 5,719,718 TOTAL PER OCCURRENCE $ 5,846,532 VALUES BASED ON COVENANT VALUES BASED ON APPRAISALS 4. • r CO 0 , J O U A CO N 0 CO Co r 0) N A CO N -9 O • � C 0 m .1 D3) -13 n x cn m cn c co * * n m n d a) N ,. R R- x ic- 0 0 cn m m m v a) m m = -. 1=+ NN 5. d o' 2 d -I -1 d •0 ;�•co co O O_ O O O O_ F ..3 O 7 7 CD W• N N h O ill co OO C, * S2+ 94. Ca IA N' W I D co CD 7C 1 MI CO CO MI X I I 4 4 I , I N W N O CO Wd * co T N F 4" it D O CO A m C O - N a j N ...<G N Cb O (D W CO CD CT R O Z O) 0 rn N CD co - - W N m CD 111 -0 0) QI -.4 CD M = x F A- N a m g f A w 5 5 m z — y "i - x co co w r- w R- CO co "' m (N) 0.. Cr) x Z w 8 Z CC @ 1 , , I I 1 . 1- • m CD CD m er CA CA CD D D D 2 m 2 m CD CD N D D N N co CD C O 0 v CD CD CD v CD v CD CD 0 0 0 0 0 0 0 $ CD Cl) N CD cNCn CD (0 CO CD CO CO Cl) N CO CO CO (0 CO C) O C) C) O 0 0 0 0 0 0 O 0 C) C) C) C) O I I - -4 1 1 T It 0 O 2. co 1 , , I I l T r r 4 ' , I co CO W N W o T N O N T 1 1 I O I , 0 747 .'3 Z1 k m T .Z1 7:1 7+ 9. g N ' 1 1 1 / ' I , , 1 1 1 - I CA -< n 1 1 , I I I 1 r CD 44; ‹ f C m o n a CD 1 1 I f 1 `° 0 N c W N 0- ', CI. _ ( F . , I I • Cl) G• 1 1 T 1 C Q.TI 3 SD p Cw� C C CD W N (n c , I I 1 - 0 C I 1 { CD (D N co co CO N 0 CD El O 0.CO 5CO O , 1 1 , , I I I T . 1 1 O °) N D J CT co o O CA N co A 5..T4 MI Z O O O 0 'coma obi),CT O O C) m 0 0 0 0 0 0 0 0 0 0 0 0 1 -' 1 + I r f ( -4 . .N.. = M o m 0 C) o O O co 1. 9 f I 1 1- 1 V al M. ZCI O a $ N N N 0 -• O O A la CT A CO CO _CAT CO A 0 -i O V V N W C.) 01 N co O 00 N 0 0 A CO v 0 0 CO 0 0 O 1 1 , 0 r tn cn rn 0_ 0 o Oo C) -I A r N M N 0 O o I N 0 C CT CO ✓ I- N 3. w 0 O ':74 0 O -v -0 I-' C 0 0) N 0) W O W '""I -CO is "v -co '0 O N co (00 00) C0O 0 ENDORSEMENT # � 411kS 41R/-g-� {E OWE COVERED PARTY COVENANT NUMBER EFI=: APR23I°99 CITY OF OAK PARK CMC 18745 25/99 HEIGHTS It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages 1999 FORD F350 4X4 W/PLOW ALL LIABILITY COVERAGES A #3507 ACV $500. DED. COMP. O $500. DED. COLL. r' Q 0 l {r3�te9)LP DiD(X‘ \A161f+ La r \— nn,cot lica-fi , df Q �n Oev- -to z.itcupoh�-� id 3 E : /�n��YYti �1 VSCIAA Total Endorsement Premium: $ 134. AP (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR X DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged si/A Executive Director, LMCIT LMCIT Page 1 of 1 ME020(1/95) ENDORSEMENT # 6' ES 41'99 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK CMC 18745 3/8/99 HEIGHTS It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages 1999 FORD F550 DUMP TRUCK ALL LIABILITY COVERAGES A W/PLOW #3333 ACV $500. DED. COMP. $500. DED. COLL. D O .! N ! S ! . D. L.. Ei 0 N ' S_ ? Total Endorsement Premium: $ 167. AP (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR X DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION All other terms and conditions remain unchanged Executive Director, LMCIT LMCIT Page 1 of 1 ME020(1/95) r I 411* M 0 Page+,1 Landmark Insurance ervices PO Box 188 ACCOUNT NO. OP DATE Forest Lake,MN 55025 OAKPA-1 HJ 04/17/98 Phone• 612-464-3333 Support: 612-464-7596 POLICY INFORMATION POLICY# CMC17704 TYPE, EFFECTIVE EXPIRATION CP 07/07/97 07/07/98 City of Oak Park Heights Mike Robertson,City Admin. 14168 N 57th St, Box 2007 1 0 ,� Stillwater,MN 55082 J �� APR 2 0 1998 Mr.Robertson, Re: Endorsement Enclosed please find an endorsement which adds the 1990 Chev Pickup for liability only. The additional premium for this endorsement is $51 . 00 . Please contact us with any further questions . Thank you! .: . ... .,..x:,14.4.. . F ENDORSEMENT '�7V//L `)��t�i � eather Jonaso THE SUM OF $ ...��, 1;17 IN THE SUM O $ JATU• , av-\ /4 /-47v00O—"/' ) , • f 4 ENDORSEMENT # • KT 4/14/98 IP lCITY OF OAK PARK HEIGHTS CMC 17704 3/24/98 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages "' 1990 CHEV. PICKUP 15936 LIABILITY COVERAGES ONLY ilt >N ::0E D >EE<< litil 1'"..0 dmgmarwall :::!:.::.::: I APR 17 1998 ;;o0 .• N ON Toil Endorsement Premium: $ 51• AP (See Below for Billing information) PREMIUM DUE NOW: $ (See Invoice Attached) OR X DO NOT PAY NOW PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged. if/101 Executive Director, LMCIT LMCIT ME020(1/95) Page 1 of 1 Pr- ENDORSEMENT # 3 • • 7/11/97 JMS ICITY OF OAK PARK HEIGHTS , CMC 16674 ' 6/28/97 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages JUL 1 51997 :10 MN 1994 CHEVY CAPRICE #9481 ALL COVERAGES • 4 • Total Endorsement Premium: $11. RP (See Below for Billing information) PREMIUM DUE NOW: $ (See Invoice Attached) OR X DO NOT PAY NOW PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged. Executive Director, LMCIT • LMCIT EC�n JUL 21991 ME020(1/95) Page 1 of 1 ACORD I NS U RA I E BINDER • OP ID TL D DATE(MM/DDIYY) 07/03/97 THIS BINDER IS A TEMPORARY INSURANCE CONTRACT,SUBJECT TO THE CONDITIONS SHOWN ON THE REVERSE SIDE OF THIS FORM. PRODUCER PHONE (No, 612-464-3333 _ COMPANY BINDER# 833 k�(( Ko,ESt): 612-464-7596 LMCIT-Berkley Risk Services, I Landmark Insurance Szervlces EFFECTIVE EXPIRATION 232 South Lake Street DATE TIME DATE TIME PO Box 188 X AM X 12:01 AM — Forest Lake MN 55025 07/07/97 12:01 PM 08/07/97 NOON Tracey Lund THIS BINDER IS ISSUED TO EXTEND COVERAGE IN THE ABOVE NAMED COMPANY CODE: SUB CODE: X PER EXPIRING POLICY#: CMC16674 AGENCY CUSTOMER ID: OAKPA-1 DESCRIPTION OF OPERATIONSNEHICLES/PROPERTY(Including Location) INSURED - City of Oak Park Heights , \2 L.: ii '.°. Mike Robertson, City Admin. i — _-"_""__" 14168 N 57th St, Box 2007 Stillwater MN 55082 JUL -- 7 s COVERAGES__, L. 4IITS TYPE OF INSURANCE COVERAGE/FORMS AMOUNT DEDUCTIBLE COINS X PROPERTY CAUSES OF LOSS BASIC BROAD SPEC GENERAL LIABILITY GENERAL AGGREGATE _ $ COMMERCIAL GENERAL LIABILITY PRODUCTS-COMP/OP AGG_ $ CLAIMS MADE OCCUR PERSONAL&ADV INJURY _ $ OWNER'S&CONTRACTOR'S PROT EACH OCCURRENCE __ $ FIRE DAMAGE(Any one tire) $ RETRO DATE FOR CLAIMS MADE: MED EXP(Any one person) $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED AUTOS BODILY INJURY(Per accident) $ SCHEDULED AUTOS PROPERTY DAMAGE $ HIRED AUTOS MEDICAL PAYMENTS $ NON-OWNED AUTOS PERSONAL INJURY PROT $ UNINSURED MOTORIST $ $ AUTO PHYSICAL DAMAGE DEDUCTIBLE ALL VEHICLES SCHEDULED VEHICLES ACTUAL CASH VALUE COLLISION: STATED AMOUNT $ OTHER THAN COL: OTHER GARAGE LIABILITY AUTO ONLY-EA ACCIDENT $ ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EXCESS LIABILITY EACH OCCURRENCE $ UMBRELLA FORM AGGREGATE _ $ OTHER THAN UMBRELLA FORM RETRO DATE FOR CLAIMS MADE: SELF-INSURED RETENTION $ STATUTORY LIMITS WORKER'S COMPENSATION EACH ACCIDENT $ AND EMPLOYER'S LIABILITY DISEASE-POLICY LIMIT $ DISEASE-EACH EMPLOYEE $ SPECIAL BINDER ISSUED AS PER EXPIRING POLICIES UNTIL RENEWAL APPLICATION IS CONDITIONS/ RECEIVED AT THE COMPANY INDICATING ANY CHANGES. OTHER COVERAGES NAME&ADDRESS MORTGAGEE ADDITIONAL INSURED — — LOSS PAYEE LOAN# AUTHORIZED REPRESENTA Tracey Lund If ACORD 75-S(12/93) NOTE:IMPORTANT STATE INFORMATION ON ATT ED PAGE ©ACORD CORPORATION 1993 • • Variances- 14 7/24/95 McCullum, Jim and Julie 14269 57th Street Variance from side and rear setbacks; approved on presence of mature trees and their location as well as proposed shed location. 9/11/95 Brown, Jeremy and Sharon 6365 Peacan Avenue Variance for a new garage; approved on hardship that homeowner had a small site and was forced to use main entrance to property. 9/11/95 Carlson, Douglas and Jody 6218 Peabody Avenue Variance for addition to home; approved on hardship that small lot did not provide enough room for expansion. 11/27/95 Bonse, James 14775 Upper 55th Street North Variance for a garage 208 feet larger than allowed; approved for reasons of home improvement. 1996 1/22/96 Jerry's Auto Detail (Joe and Jerry Schoenecker) 13601 North 60th Street Variance and Conditional Use Permit requested subject to the conditions listed on the planning report. 5/13/96 Kelly, Casey and Michelle 14954 North 60th Street Variance for additional utility shed; approved on grounds of constraints of lot topography and location of power lines. 5/13/96 Wood, Robert and Lydia 15075 65th Street Variance for construction of an additional outbuilding; approved on hardship due to the size of the parcel and the manner in which the building will be designed and maintained. • Variances- 15 6/10/96 Torgerson, Robert and Pearl 15242 64th Street Variance for front yard setback from 30 to 26 feet 6/10/96 Young, Dale 5420 Ojib Way Street Variance for reduction f i e back from 10 to 3 feet; opposition from of side yard setback pp neighbor; variance approved at 5 feet. 8/13/96 Amoco (Don Zimmerman & Ray Remmeck) 14738 North 60th Street Variance from 10 foot setback from frontage road for sign; approved on hardship that there was no other place to locate. 8/13/96 Gramenz, William and Sandra 13965 55th Street North Variance for second accessory building, from total square footage restrictions on access buildings, and from setback requirements between principal and accessory buildings; approved because it will meet future requirements and property already has an existing concrete pad. 1997 2/25/97 Simonet, William & Deborah 5976 Stagecoach Trail Variance requested; approved on the hardship conditions listed in the staff report. 4/22/97 Fredrickson, Terry & Susan (Northwest corner of 56th Street and Newell Circle North) 1.09 foot variance requested for a 2,800 square foot home; approved on the hardship that the Fredrickson's are caring for a visually-impaired family member and the variance is a reasonable accommodation under the American with Disabilities Act (ADA). • • Conditional and Special Use Permits Action Rentals (Swager Bros. Inc.) 5740 Osgood Avenue North 12/18/73 SUP requested to erect a chain link fence; granted Albertson, Bonnie 7/27/83: CUP requested for a Home Occupation License; granted A Network Answering Systems 6396 North Lookout Trail 4/8/85: CUP requested for a Home Occupation license; granted S Arby's/Sbarro, Doug Kennedy, 10/22/96: CUP granted with conditions based on information from 9/26/96 and 10/14/96 memos and contingent with compliance with staff recommendations. Beyer, James 5802 Olene Avenue North 11/28/88: CUP requested for a Home Occupation License; granted Auto Max store (Breckenridge Development Corporation) 14773 60th Street North 5/27/86 CUP requested for a minor auto repair and loading in front of building; granted 6/12/89 CUP requested; granted contingent on recommendations from City Planner's 6/7/89 report. Brown, Jerry 1/11/93 CUP requested to allow woodworking, mail order, retail sales, and light manufacturing of musical instruments in a B-2 zone; granted. Champion Auto, (John Morley) 14621 60th Street North 10/22/84 CUP requested for construction of a commercial building; granted contingent • 6969 Omaha Avenue North 7/13/81 CUP requested for an office condominium project; granted Oak Park Plaza building 2/26/90 CUP requested for a drive-thru teller station and window at; granted subject to conditions in City Planner's report dated 1/31/90 (stipulating that facility be open until 5:00 PM on Friday's and have a night depository). Hauge, Lawrence & James Sowle, 9/12/83 CUP granted for a combination of residential and nonresidential use in one building CUP granted to allow a building in excess of 35 feet CUP granted for an apartment density bonus 8/26/85 CUP requested for an elderly housing project in a R-B Zoning District; granted 10/15/85 CUP requested; granted Haynes, Sharon 2/18/92 CUP requested for Home Occupational license; granted. Holiday Stationstores, Inc. 14773 North 60th Street 11/23/87 CUP requested ; granted contingent upon City Planner's recommendations from 11/20/87 being met. Jerry's Auto Detail (Joe and Jerry Schoenecker) sQ ) 13601 North 60th Street 1/22/96 CUP granted subject to conditions listed on planning report. J & R Rental (Jay Bellargeon) 13481 North 60th Street, 9/25/95 CUP to conduct outdoor sales and storage contingent on maintenance conditions mentioned in City Planner's report. Johnson, Dennis P. • i McDonald's 14545 60th Street North 5/22/79 CUP requested for a drive thru window; granted. Menard's (Gary Colby and Tim Erkilla) 3/27/95: CUP requested for operating hours; granted. CUP requested for open and outdoor storage; granted. Metropolitan Waste Control Commission 6163 North St. Croix Trail 3/12/90 CUP requested; granted. Mil!road Inn (Timothy Marlow & Mark Tueugi) 15506 North 59th Street 7/23/84 CUP requested for construction of outdoor non-enclosed deck on east side of building; granted. Jon Nelson 5845 Stagecoach Trail 11/14/94: CUP requested to allow limited warehousing associated with a lawn care/snow removal business; granted conditioned upon compliance with recommendations from City Planner. NSP Gov. Lots 2 & 3, Section 2, T29N R20W, Washington County 4/11/77 SUP requested at Allan S. King Generating Plant; granted (Elmer Haase land), 700' W of Oakgreen & 300' S of Highway 36 8/27/90 CUP requested for a substation; granted contingent on conditions being met as outlined in City Planner's letter from 8/23/90 (with the exclusion of#4). (Mike Thomas), 10/22/96: CUP to allow mining and land reclamation in excess of 400 cubic yards contingent on complying with conditions in staff report. 12/26/84 CUP requested; granted • • UNTIED FIRE &CASUALTY COMPANY CEDAR RAPIDS,IOWA Team 1 PUBLIC SCHOOL SYSTEM EMPLOYEES OR PUBUC EMPLYOYEE'S BLANKET BOND APPLICATION Bond Number. 51-62482 Executed: Yes g1 No❑ Premium: GENERAL !NI ORMALION $ COMPLETE NAME OF OBLIGEE CLASSIFICATION: STATE ❑ COUNTY ❑ City of Oak Park Heights, MN an X TowN ❑ VILLAGE ❑ SCHOOL ,Q ❑ ADDRESS 7 T77 71 �L41(Q� u. 5 a. eX 20010x1- 4�1_44e g s Minnesota STREET '1 CITY c , /'�i f ei,4/-5 STATE ZIP TYPE OF COVERAGE AMOUNT INSURING AGREEMENT 1 ❑ HONESTY BLANKET BOND COVERAGE $ INSURING AGREEMENT 2 ❑ HONESTY BLANKET POSITION COVERAGE $ INSURING AGREEMENT 3 ❑ FAITHFUL PERFORMANCE BLANKET BOND COVERAGE $ INSURING AGREEMENT 4 ❑ FAITHFUL PERFORMANCE BLANKET POSITION BOND COVERAGE $ MM PUBUC EMPLOYEES BLANKET BOND PUBLIC SCHOOL SYSTEM EMPLOYEES BLANKET BOND ❑ * t b,WD ALDITS �d CJ �j FREQUENCY BY WHOM? STAFF AUDITOR �r{U✓ �S, �� e`� �(.' y f/ ❑OTHER(EXPLAIN FULLY) DATE OF LAST AUDIT DSCREPANCIES? ❑YES / Z-3/-76 (IF YES,SUBMIT COPY OF AUDIT OR AUDITORS COMMENTS) LOSS HISTORY(LAST 5 YEARS) EMPLOYEES POSITION WHICH CAUSED LOSS( CORRECTIVE MEASURES TAKEN: WILL THERE BE A SUBSTANTIAL INCREASE IN THE NUMBER OF EMPLOYEES DURING THE TERM OF THIS BOND? PRESENT COVERAGE IN FORCE—CHECK IF NONE❑ FORM OF BOND EFFECTIVE DATE AMOUNT NAME OF COMPANY p.E. buck . k. 1/D-11 4( imam LL - i .&1 USE SEPARATE SHEET IF NECESSARY. COMPLETE THE CLASSIFICATION OF EMPLOYEES ON REVERSE SIDE. POSITION IF ADDITIONAL INDEMNITY UNDER ANY INSURING AGREEMENT IS DESIRED ON ANY POSITION,COMPLETE THE FOLLOWING INSURING TOTAL NUMBER OF EMPLOYEES AMOUNT OF ADDITIONAL POSMON LOCATION AGREEMENT IN EACH POSITION INDEMNITY ON EACH EMPLOYEE Date 6/1/ 7 Agaxycode as- Obligee . i�I• Add,. P•o. fox 'GIVa.TURE Aiw TrTI E1 Lp.K2 m N 6� 5 l�/)1/. /III/S CITY STATE UND-20$2b(5-93)page 1 of 2 CLASSIFICATICCF EMPLOYEES BY DUTIES OR RESPONJTIES This classification under Class A, B and C, together with supplemental classification required in the event coverage under the bond applied for is to be given under more than one Insuring Agreement, constitutes the Insured's entire personnel as of the date of this application-questionnaire and includes members of Boards and Commissions whether or not such personnel or the members of such Boards and Commissions are to be covered under the bond.If coverage is to be given under more than one Insuring Agreement,separate Classifications of Employees must be completed for each Insuring Agreement and in such event this classification applies to Insuring Agreement CLASS A L1tf'LOYLI S All Executive Administrative; Judicial and Supervisory officials, Department and Division Heads and Assistant Department and Division Heads, All Police Officers*and all officials and employees whose principal duties are to 1. Handle,receipt for,or have custody of money,checks or securities,or account for supplies or other property;authorize(or make appropriations for)expenditures approve;certify,sign or countersign checks,drafts,warrants vouchers,orders or other documents providing for the paying over or delivery of money,securities,supplies or other property,or serve process;or 2 Maintain or audit accounts of money, checks, securities, time records, supplies or other property, or take physical inventories of money, checks,securities,supplies or other property. *Patrolmen are classified as"A"Employees under both"Faithful Performance"Coverages but are classified as"C"Employees under both"Honest" Coverages. POSITION #OCCUPANTS POSITION it OCCUPANTS POSITION #OCCUPANTS Administrator 1 Dep. Clk/Fin. Dir. 1 Clerical/Recept. 1 TOTAL CLASS A 3 CLASS II EMPLOYEES All personnel whose principal duties consist of 1. Inside or outside clerical activities 2. Office work such as stenography,typing.filing.switchboard operation,business machine operation,etc; 3. Operation of vehicles transporting passengers for cash fares or tickets. POS[IION i OCCUPANTS POSITION #OCCUPANTS POSITION #OCCUPANTS Police Disp/Recs. 1 • TOTAL CLASS B 1 CLASS C FMPLOYEFS All personnel whose principal duties consist of 1. Skilled or unskilled labor and craftsmanship; t Any teaching capacity in the field of education; 2. Solely the mechanical operation of automotive equipment 5. Outside or field work of a non-clerical nature; 3. Non-clerical activities of the medical or nursing profession; 6. Patrolmen under the"honesty"Coverages. N #OCc137PANES POSITION #OCCUPANTS POSITION #OCCUPANTS Public Works Building Inspect. 1 Police Chief 1 Patrolmen 7 P-T Patrolmen 2 TOTAL CLASS C 14 AGENT'S REC )MMENl)A LION U11D-20026(5-93)page 2 of 2 TO • FROM SPE1112 MESSAGE Tracy Lund Judy Hoist Landmark Insurance Services C•i t-v of Oak Pakk Heir;hts Here' s the insurance application for. the City. If there is anything else you need, please call me 039-4439) . I also enclosed a list of assets for the City. SIGNED L DATE 7-9'97 WilsonJones•Carbonises e WileonJones,1989 MADE IN USA.•44.889 Oupllcete Landmark Insur nce rvi 411k M O Page 1 a � ces PO Box 188 ACCOUNT NO. OP DATE Forest Lake,MN 55025 OAKPA-1 TL 06/03/97 Phone: 612-464-3333 Support:612-464-7596 POLICY I N F O R M A T I O N POLICY# CMC16674 TYPE EFFECTIVE EXPIRATION CP 07/07/96 07/07/97 City of Oak Park Heights Mike Robertson,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 Mike, Re: Renewal Application Per our phone conversation, attached please find the renewal application from the League for the 7/07/97 Package renewal . Please review the entire application, complete the highlighted questions and return to our office at your earliest convenience . Thanks, Mike and please call me if you have any questions . Sincerely, D U (�JUN - !�. 97 Tr cey Luni 4 G ; , D K LEAQ OF MINNESOTA CITIES INSNCE TRUST Administered by: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103 (612) 281-1200 APPLICATION FOR THE CITY OF: Oat Pax l_ (i4Et Q htS County: WaSh I rysprn Mailing Address: P. 0. box. 2 cU1 Phone: l.alZ— 14 ' l 9%439 City, State, Zip: twater, Y`fN 55-N2 - 2C7 City Contact: I'M/e �ohe(€5c1\ Title: l l lla t-tt! • 1990 Census Population: .. 114c6 0 Current Estimated Population: 3 g 7� Total Expenditures All Operations: c� 55;27$ P P Is the City a Member of The League of Minnesota Cities? ✓ Yes No Submitting Agency: L-0.-' d a 15 -■ (v►CeZ Address: P•D• .7c4)` i 0 City, State, Zip: Vor€M LoJu mks 5-0Z.6 Telephone: OIL') '4(.D4 - 3332 Facsimile: ( LoIZ') y&o4 —115%) Agency Contact: 77-CI C D it O( ,02)1( Date of Council Resolution or Contract Appointing the Agency: AGENT COMPENSATION: V 10% City Will Compensate the Agent Directly Other Please specify: Standard Deductible: 4520 (Applies to All Lines. Optional All Lines Deductibles are Available.) Current Information on Coverage You Are Applying For: Carrier Policy Type Expiration Date Premium urYT. -T PaL.9v 111191 35,Lica' It LOD(I .Comp• 111111 1-1,(,03 u • -111 q� -i, 1-76, LMCITAPP.TBL(I/96) Page 1 of 20 LEAGU•MINNESOTA CITIES INSURANCE TRIO PROPERTY Causes of Loss: Basic Form ✓ Special Form Deductible: $ (Standard) Coverage Format: _ Actual Cash Value ✓ Replacement Cost Risk Sharing: qv If either of the following is desired,the amount of coverage must be at least 90%to value. Agreed Amount Blanket Per Schedule Blanket Limit$ �SO� Q� } Q�> When indicating building construction, please use one of the following classifications: Frame - (F)wood, brick veneer, or Modified Fire Resistive - (MR) exterior walls, wood combined with other materials. floors and ceilings are constructed of masonry Joisted Masonry - (JM) concrete or fire resistive material with a fire resistive block, concrete or other non-combustible rating of one hour or more. walls with floors or ceilings that are Fire Resistive - (R) same as modified fire combustible. resistive except it must have a fire resistive Non-Combustible - (NC) same as joisted rating of two hours or more. masonry except floors and ceilings are constructed of non-combustible materials. EXTRA EXPENSE, LOSS OF INCOME IF COVERAGE IS DESIRED, PLEASE SUBMIT DETAILS ON A SEPARATE SHEET AND BUILDERS RISK * * PERS. * PERS. LOC. BLDG ADDRESS OF #OF BLDG. OCCUPANCY YEAR BLDG. PROP. PROP.OF PROPERTY NO. NO. PROPERTY STORIES CONST. BUILT AMOUNT AMOUNT OTHERS IN OPEN *PLEASE PROVIDE 100%VALUES. THE AMOUNT OF COVERAGE PROVIDED WILL BE THE 100%VALUES. IF YOU WANT A DIFFERENT%USED TO ARRIVE AT THE AMOUNT OF COVERAGE PLEASE INDICATE %. LMCITAPP.30(1-96) Page 2 of 20 City of Oak Park Heights 20-May-97 • uw std -lo Louk STATEMENT OF VALUES ALLIES 290 LOC- COV 'TOY "11 1't¢'"'W U ITEM DESCRIPTION LIMIT TYPE 1-1 - ...z-ftwomea ..>IDLortzip Water Tower,Tower, Well &Pump $543,843.09 B 1-2 Cement Block Garage & Municipal Bldg $1,114,660.80 B Well, Motor pump, Auto corn & Contents $157,605.73 C Property in the open $3,154.29 PIO 1-3 Pump house #2 (18 x 24 block& brick, ste $21,318.65 B Contents of the above? $21,318.65 C 2-1 k 16 x 20 frame shelter $8,396.94 B Property in the Open $16,554.58 PIO Cement Block Recreation Building, concre $12,507.30 B Property in the open $54,842.22 PIO 4-1 im .T° ;i. t 28 x 44 Cement& Brick building, wood ro $59,107.04 B Property in the open $35,869.71 PIO 5-1 4iitoret kskfts*,, ' Lift Station& Pump equipment, steel $45,138.98 PIO 6-1 Lift Station& Pump equipment, steel $49,924.80 PIO 7-1 D .. .m s4 ,, s e a � Cement Block Building, wood roof $177,996.58 B Property in the open $74,782.78 PIO Page 1 City of Oak Park Heights • 20-May-97 40 STATEMENT OF VALUES LOC- COV ITEM DESCRIPTION LIMIT TYPE 8-1 ° *'t R $34,479.65 PIO Z7L- 1U4: Lift Station& Pump Equipment $73,527.59 PIO 10-1 Water Tower& Well (500,000 gallon) $672,407.60 PIO 11-1 °` , , ' , Lift Station&Force Main $105,060.00 PIO Page 2 City of Oak Park Heights 20-May-97 • STATEMENT OF VALUES LOC- COV ITEM DESCRIPTION LIMIT TYPE t o a � i All Replacement Cost Buildings $1,937,830.40 All Replacement Cost Contents $178,924.38 All Replacement Cost Property In The Open $1,165,742.20 Sub-total $3,282,496.97 90% of Sub-Total $2,954,247.27 Values for this "Statement of Values" consisting of 2 pages attached hereto were prepared for City of Oak Park Heights, 14168 57th Street North, Oak Park Heights, MN All values submitted are correct to the best of my knowledge and belief. Signed Title Date Building Inflation Factor 1.08768618 Contents Inflation Factor 1.08768618 Property In the Open Inflation Factor 1.08768618 Page 3 LEAGUE OF MIOESOTA CITIES INSURANCE TV PROPERTY, INLAND MARINE, and AUTOMOBILE PHYSICAL DAMAGE I The new covenant provides Errors and Omissions coverage for Property, Inland Marine and Automobile Physical Damage. The following information is needed to designate the entities that are to be covered. Please indicate if you want the following entities to have coverage for Property, Inland Marine or Automobile Physical Damage. AUTOMOBILE PROPERTY INLAND MARINE PHYSICAL DAMAGE HOSPITALS YES NO N/A )( YES NO N/A )C YES NO_ N/A )C NURSING HOME YES NO N/A X YES NO N/A x YES NO N/A u HEALTH CLINICS YES NO_ N/A_g YES NO_ N/A x YES NO _ N/A AIRPORTS YES NO_ N/A YES NO_ N/A j( YES NO_ N/A X ELECTRIC UTILITY YES NO_ N/A )( YES NO_ N/A X YES NO _ N/A X- GAS UTILITY YES NO_ N/A x YES NO _ N/A )( YES NO _ N/A ?C STEAM UTILITY YES NO_ N/A }C YES NO_ N/A y YES NO_ N/A X HRA YES NO x N/A_ YES NO K N/A_ YES NO )( N/A_ EDA YES NO_ N/A X YES NO N/A )t YES NO_ N/A X PORT AUTHORITY YES NO_ N/A X YES NO_ N/A X YES NO_ N/AiX ADDITIONAL INFORMATION: LMCITAPP.11 (1/96) PAGE 4 OF 20 ■ LEAGUE OF MINNESOTA CITIES INSU CE TRUST • INLAND MARINE COVERAGES Mobile equipment and miscellaneous equipment valued at $5,000 or less can be cover d with no Schedule needed. There is a flat premium. Do you want this coverage? YES V NO _ PLEASE ATTACH A COMPLETE SCHEDULE & ADVISE WHERE EQUIPMENT IS STORED _ Limit w ° ' y lr e x 'ir.' Mobile Equipment (Items greater than$5,000 in value) Deductible (Standard) Miscellaneous Equipment(Items greater than$5,000 in value) Deductible (Standard) Valuable Papers Location Deductible (Standard) Sign Type Location Deductible (Standard) yi-e,r e��`ri'� EDP Equipment (100% Values) � I Deductible (Standard) Combined Data &Media (100% Values) Deductible (Standard) Other(Describe) / Deductible (Standard) Does your city loan out equipment to the public? Yes No ✓ Cities sometimes have equipment that is loaned out for use by members of the public; equipment for video production is an example. Normally, if such equipment is damaged or lost while loaned out, LMCIT would be able to "subrogate"; that is, recover the amount of those damages from the person who borrowed it. If the city wants to waive the right to subrogate against the borrowers of particular equipment, please contact your agent. Under the covenant, the city may not waive these subrogation rights without LMCIT approval. An additional premium charge will be made for this Inland Marine coverage amendment. PERSONAL PROPERTY OF OTHERS COVERAGE Your covenant already provides legal liability coverage for personal property of others in the possession of a police, fire or ambulance service in the course of performing public safety duties. In addition, your covenant also provides limited coverage for personal property of others that is not in the possession of a police, fire or ambulance service in the course of performing public safety duties. Additional coverage is available by using the following options. 1. If you want personal property of others to be specifically covered as property, please declare on page 2 and 3 of the application. 2. If you want personal property of others to be covered by the care, custody and control endorsement, please complete the following. This is a legal liability endorsement Type of Property Location Value CRIME COVERAGE Form Location Limit Deductible Forgery & Alteration (Standard) Theft, Disappearance &Destruction (Standard) Please describe Safe and Vault GLASS COVERAGE PLEASE ATTACH COMPLETE SCHEDULE If other than plain plate, the value of each pane is needed. LMCITAPP.13(1/97) PAGE 5 OF 20 LEAGUE OINNESOTA CITIES INSURANCE TRU 1 EXPENDITURES CITY: O� PGA. 'NQ i f►h1S POPULATION 3 873 BUDGET YEAR 161611 GOVERNMENTAL FUNDS GENERAL GOVERNMENT AISG 4-65 POLICE 72 FIRE 5-7 .2.2 5 OTHER PUBLIC SAFETY 7D 6, 747 STREETS &HIGHWAYS 9 7,7)$ SANITATION (GARBAGE) I 6,00 LIBRARY PARKS &RECREATION „20 3 GS O i ALL OTHER(DESCRIBE) TOTAL CAPITAL OUTLAY* 547' OO O TOTAL GOVERNMENTAL FUNDS: ) CI4 120 ENTERPRISE FUNDS WATER ) 04/ 575� SEWER ELECTRIC REFUSE LIQUOR ALL OTHER(DESCRIBE) TOTAL CAPITAL OUTLAY* /i/ 00d TOTAL ENTERPRISE FUNDS: X14,3, x'75 DEBT SERVICE TOTAL DEBT SERVICE: c3/.2, 2/90 ALL OTHER FUNDS MISCELLANEOUS ((ons`fr'uc" 4 /�<<uu a7 S) 36 8: 750 TOTAL CAPITAL OUTLAY*LArk Tr O.:/3 'f'S 1 .5`/ ODO ` : ,-„P;OV-tom T AL ALL OTHER FUNDS: q2•oZ 7 JU •CAPITAL OUTLAY:LIST INDIVIDUAL ITEMS OR PROJECTS AND THEIR DOLLAR VALUE WHICH EXCEED 5%OF TOTAL CITY BUDGET TOTAL CAPITAL OUTLAY: 02, GOO CONTRACTUAL SERVICES: TOTAL CONTRACTUAL SERVICES: '4/3% 2 25 (WORK PERFORMED BY INDEPENDENT CONTRACTORS WHO CARRY ADEQUATE INSURANCE AND FURNISH CERTIFICATES TO THE CITY.) TOTAL EXPENDITURES: 3 /EC�275 LMCITAPP.29(1/93) PAGE 6 OF 20 •GUE OF MINNESOTA CITIES INSURIPE TRUST MUNICIPAL LIABILITY-SEPARATELY RATED EXPOSURES DO NOT LEAVE ANY SPACES BLANK IF NO EXPOSURE PLEASE INDICATE N/A OR NONE City of oaAL Pa„{{L I Date -7-/-Q7 1. Golf course annual receipts: UL. t Number of golf carts: 2. Street mileage: 12.. (Round to nearest mile, i.e. 4.2 miles should be 4) 3. Area (square feet) of Exhibition Buildings, Recreation Centers, Arenas, Auditoriums or Community Centers: AJ 4. Water Department payroll: /�� /D U (yll ud 'r� -c c�s �� fo /1 /c4.1 7 w'`9" Total gallons of water used annually: /C, y 000 (Round to nearest million, i.e. 2,500,000 should be 3,000,000) 5. Electric Department payroll: 6. Gas Department payroll: 7. Steam Department payroll: 8. Number of powered boats: Horsepower and usage of each: 9. Number of boats and canoes not powered: Explain how they are used: 10. Municipal liquor store receipts: IA Pt Store 1 Store 2 Store 3 On Sale Off Sale LMCITAPP.01 (1/96) PAGE 7 OF 20 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 11. Number of seasonal swimming pools: 0 Height of diving boards: 12. Number of inside swimming pools: 0 Height of diving boards: 13. Number of swimming beaches: 0 Height of diving boards: Number of docks and rafts: 0 14. Number of water slides: d Height: Length: Location: Seasonal: Year Round: 15. Number of staff attorneys: C' — C c .Jfrad fo o?-7/c4-e-- 2.4 Do you want coverage to be excluded? Yes No Or%s Additional Information May Be Necessary �/ cr/��l LMCITAPP.01 (1/96) PAGE 8 OF 20 (*AGUE OF MINNESOTA CITIES INSUICE TRUST MUNICIPALITY QUESTIONNAIRE DO NOT LEAVE ANY SPACES BLANK IF NO EXPOSURE PLEASE INDICATE N/A OR NONE City of Ooic ' Date 7'/-q 7 1. Does the city own or operate any of the following? *Municipal **Limits of **Type of ** Is the city named Liability Coverage Provided Coverage provided by as an additional Governmental Coverage Desired Projected by the other insurance the other insurance insured on the other Body or Entity (Must See Below) Expenditures company company insurance company's (If Applicable) (If Applicable) policy? (If Applicable) Hospitals _Yes ✓ No _Yes No Nursing _Yes ✓ No _Yes No Homes Health _Yes ✓ No _Yes No Clinics _ Airports _Yes / No _Yes No Comments: * Municipal Liability, except for bodily injury. property damage or personal injury, is automatically provided for the City and the other Governmental Body or Entity. If you do not want coverage please notify L:\ICIT. ** These questions are intended to analyze the coverages provided by the other insurance companies. These other policies must provide bodily injury, property damage or personal injury coverage to the City and the other Governmental Body or Entity. LMCITAPP.02(1/97) PAGE 9 OF 20 LEAGUE OF MINNESOTA CITIES INSURANCEtUST 2. A. Damages arising out of the following activities are excluded unless such board, commission, authority, or agency is named in the Declarations, in which case the "city" will also be covered to the extent of coverage provided under this covenant to the named board, commission, authority or agency for damages arising out of the activities of the respective named board, commission, authority or agency. Please designate the activities you want covered below. B. If the Governmental Body or Entity has purchased coverage elsewhere the City needs . to evaluate their exposures and the coverage that they need. 1) Is the city named as an additional insured on the other policy and for what coverage? 2) Does the city want coverage from LMCIT for these activities? PLEASE CONTACT LMCIT FOR ASSISTANCE. ADDITIONAL PREMIUM MAY BE NECESSARY Municipal Liability Projected Projected Additional Governmental Body or Entity Coverage Desired Revenue Expenditures Information Gas Utilities Commission —Yes X No Questionnaire Needed Electric Utilities Commission —Yes ( No Questionnaire Needed Steam Utilities Commission —Yes ?S No Questionnaire Needed Port Authority No Need Full � — Yes Details Housing &Redevelopment Authority _Yes . ,No Need Full Details Economic Development Authority —Yes No Need Full Details Area or Municipal Redevelopment —Yes _X-No Need Full Authority Details Municipal Power Agency —Yes X No Need Full Details Municipal Gas Agency Yes x No Need Full Details LMCITAPP.02(1/97) PAGE 10 OF 20 LEAGUE OF MINNESOTA CITIES INSURANETRUST • 3. A. Damages arising out of the following activities are excluded unless the agency or board is specifically named in the Declarations. Please designate the activities you want covered below. B. If the Governmental Body or Entity has purchased coverage elsewhere the City needs to evaluate their exposures and the coverage that they need. 1) Is the city named as an additional insured on the other policy and for what coverage? 2) Does the city want coverage from LMCIT for these activities? Municipal Liability Projected Projected Additional Governmental Body or Coverage Desired Revenue Expenditures Information Entity Welfare or Public Relief Yes No Need Full Agency Details School Board _Yes k No Need Full Details 4. Does the city operate a dump or landfill? A- What type of material is deposited there? ►.�A Is the area fenced to keep out the public when closed? ►CIA Is the area attended during open hours? 5. Does the city own or operate a ski jump, ski lift or tow rope? VGA If operated by others, please indicate and advise if the city is named as an additional insured on their policy and the policy limits provided. LA A- Is coverage desired? Yes No If coverage is desired full details must be submitted. LMCITAPP.02( 1/97) PAGE 11 OF 20 LEAGUE OF MINNESOTA CITIES INSURANCE TRRT 6. Does the city own or operate a marina? ' kO If operated by others, please indicate and advise if the city is named as an additional insured on their policy and the policy limits provided. L A Is coverage desired? Yes No If coverage is desired, full details must be submitted. 7. Dams or Dikes or Levees - (Failure or bursting is excluded.) I Pr A. Age of Dams: Inspected regularly: Yes No By Whom: Height of dam above reservoir: Height of dam above the bottom of spillway: Width: Is the dam fenced to keep the public off? Acre feet of water dam has been designed to retain: acre feet B. Age of Dike or Levee: L, Height of Dike or Levee: Construction Material of Dike or Levee: Acre feet of water Dike or Levee has been designed to retain: acre feet Who built the Dike or Levee: Is the Dike or Levee inspected regularly: By Whom: LMCITAPP.02( 1/96) PAGE 12 OF 20 • SLUE OF MINNESOTA CITIES INSURANCE TRUST 8. Describe any large construction projects anticipated for this coming year. O k 'iocu/< To4dS (St rr' ry14(< y Iatrnkow yoaccS) 9. Parks and Playgrounds A. Description (including area) of each park or playground: t.,iU C(L_&Qd B. Description of playground equipment on each: 'i C. Description of other special features and sponsored activities: (i.e., ski, toboggan, tubing, water slides, skate board or BMX facilities). Does the city operate any aeration devices in the winter to keep an area of local ponds, lakes or rivers ice free? lA If so, please give full details and precautions taken. LMCITAPP.02(1/96) PAGE 13 OF 20 • PARK DESCRIPTIONS : Valley View - 5575 Ozark Avenue 62 acres ,• Partially fenced. 28 x 44 cement block building cn premises 5winc sets ; Slide ; 20 picnic tables ; 15 charcoal Critic ; wood play structure Erekke - 5500 Omar • 10 acres, fenced cn three sides 30 x 50 cement block buildinc _ T i cht�ng; hockev-ice r?nk; 2-swing sets ; slide, 2 softball fields ; 4 sets of alLT47lu1 and steel bleachers (40 vectl e eac: ; C micni c tables ; 2 c arcoai cri 1 1 c ; wccd t aV structure; Kid Euilder metal structure (decks at 3 levels and 7 t!av events) ; 50 x 0 a l 12 benches; i cudspeaker; Various playground equipment, ie: swing sets, spring animals and other toddler equipment_ cwacer - =,79a Ole.e -venue 'I .& acres , fenced 16 x 20 shelter building swing set; 2 tennis courts; wccd clay set; 50 x 50 asphalt basketball pad and ecu wtnent; tables; charcoal grill . Cover - =el lar Avenue be.1te_en Seth & 59th 1 acre, fenced • • Cement block buildinc . hockey-ice rink with l i ch ts ; swing set; wccd play set, bench; table; i aker . 50 x 30 asphalt basketball tad & ecuimme nt; ,., CL'CS_e _ . swinging seat. • • • 1 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST • 11. irefighters C -k0.cA±.tk � \ l QO(t Payroll of paid firefighters: 0 Number of volunteers: 0 Number of fire trucks: 0 Describe any fund raising activities or celebrations by the firefighters or relief associations: Km 12. EMT's and Paramedics OA' Number of rescue trucks: Number of ambulances Number of emergency runs: Number of convalescent runs: Number of EMT's: Number of EMT-A's: Number of paramedics: Is there radio contact with hospital doctors? Describe any EMT type losses: 13. Law Enforcement Total law enforcement payroll: / 0 Number of law enforcement vehicles: Number of Class A (Full-time): (Part-Time): Number of Class B: Class C: O Number of Class D: 0 Class E: 0 Number of Class F: O See next page for description of classes. LMCITAPP.02(4/93) PAGE 14 OF 20 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST A = Armed with arrest power B = Unarmed, no arrest power C = Non-officer employees D = Auxiliary police E = Voluntary unarmed F = Voluntary armed Describe any law enforcement type losses: k- -, Describe any jail or detention facilities maintained: •s-t-L1Q. COLLI'14. itieS Maximum holding period: CIS OJtouUf-i t&LL) 14. Grandstands and Stadiums A. Number and location of each: CO) exeloce Plc. has pe,olution blta rs B. Seating capacity: LP O �hleklC -t Id C. Type of construction: See-l. D. Permanent or temporary: 15. Festivals. Parades. Exhibitions or other special events sponsored by city. Describe: 16. Fireworks' Exhibitions - Excluded. (Refer for consideration.) �l.tlk.A.- 17. Wharf or Docks - Describe: 18. Street or Road Construction or Maintenance Annual expenditures: (.O� 7 a How much work is sublet to others? (Pp(ki(S oeepi ny � &A-Leer-0-1N r-0-1 if Are Certificates of Insurance obtained indicating adequate limits? y2S 3 Is any blasting done? LMCITAPP.02(1/96) PAGE 15 OF 20 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 19 Please describe any contractual agreements the city has entered into such as: A. Mutual aid: LUnhln�-- Cour*c- B. Police or fire protection: Ja Ve TQPt- C. Other. Describe: 20. Joint Powers Boards are not covered. However, they may be considered for coverage by submitting full details in a separate application. IMPORTANT! Coverage is not bound or in effect until you receive written acceptance from LMCIT. 21. Do you routinely get Certificates of Insurance from all independent contractors? Aol)C1) 22. Does the city provide a fire alarm or burglar alarm protection system? L J3 If so, please give full details. 23. Any other pertinent information not covered above: 24. City was created in: 1a1 L1 (Year) LMCITAPP.02(4/93) PAGE 16 OF 20 • LEAGUE OF MINNESOTA CITIES INSURANCE OST 25. Names and official titles of the Members of the Board of the City: (City Council) Name �M Official d�u ✓i'e( 1D. Sc A ct c�F." 6( 3 ct n-t r '-"Wo b�rf U.(�Ctl r'lu.r ( SW-ens o,1 " Tu Li; d t,,i-ct '( PLL,1 �. I u r rl t u is 1' ‘1 26. Fiscal Year *Revenue *Expenditure Fund Balance At Year End 19 q Projected Year c 3,Sf. 3„/ 1 �7� ( S3 7 .2 SY 19 14 Current Budget 3 F5//,7? 38ay S 6 SO ,57 �( 19 45 1st Prior Actual 5 35,2,1/4 t301-1, 172 SO� 5 y/ 19 qq 2nd Prior Actual 2,1t;in 21447, lou) 5, $JO Loth 5 19 q3 3rd Prior Actual 3,OZ4,343 3:117, 105 5)151'40(o *These figures should include all funds including governmental, enterprise, miscellaneous special revenue and debt service funds. If desired, you may send photocopies of appropriate sheets from annual financial report. 27. a. Total amount of outstanding bonds: 2 2 /S 00 0 b. Latest Moody's and/or Standard and Poors' bond rating: LMCITAPP.02(4/93) PAGE 17 OF 20 LEAo OF MINNESOTA CITIES INS CE TRUST 28. Have any of the following situations occurred within the last five years? Yes No a. Appropriation ro riation or condemnation for which agreed settlements have not been achieved. b. Improper or alleged wrongful granting of variances, building permits or similar grants or zoning disputes. _ X c. Wrongful or alleged wrongful approval of building plans, designs or specifications. d. Wrongful or alleged wrongful approval of building construction. e. Allegation of unfair or improper treatment regarding employee hiring, renumeration, advancement or termination of employment. X f. , Disputes involving integration, segregation, discrimination or violation of civil rights. �G g. Any grand jury indictments of any public officials. h. Assault and battery claims made against the municipality or its officials. X i. Any riot or civil commotion in the past five years. �C j. Any losses or claims occurred involving contractual disputes. X 29. Land Use Liability Number of building permits issued: /37 Number of variances: Granted -7 Denied D Number of conditional use permits: Granted , 4/ Denied d 30. Does the city want to exclude Medical Payments? Yes No ✓ LMCITAPP.02(4/93) PAGE 18 OF 20 LEAGUE OINNESOTA CITIES INSURANC UST 31. Please list the additional covered parties required. COPY OF CONTRACT MAY BE REQUIRED BY LMCIT FOR ANY/OR ALL ADDITIONAL COVERED PARTIES LISTED BELOW. ADDITIONAL COVERED NAME ADDRESS PARTIES INTEREST 32. Contracts with a railroad and contracts with the contractor performing the actual railroad construction project needs special attention. Please provide a copy of the contract to LMCIT. This does not apply to easement or side track agreements. Please contact LMCIT before you sign a construction agreement with a railroad or the contractor that is performing the actual railroad construction project. LMCITAPP.15(1/96) PAGE 19 OF 20 L GUE OF MINNESOTA CITIES INSU E TRUST OMOBILE LIABILITY AND PHYSICAZDAMAGE CITY OF O(�( Pcu tAo r\fQ 1. Limit of Liability: Physical Damage_ $600,000. Combined Single Limit on Bodily I. Comprehensive Deductible: (Standard) Injury and Property Damage II. Collision Deductible: (Standard) $ 50,000. Uninsured and Underinsured / III. Please provide color of fire trucks ✓ $600,000. Uninsured and Underinsured 1=Lime Yellow; 2 =Red; 3=All Others Motorist Limit * The standard limit is $50,000: Cities may increase if they choose. Please review the memo`_`Things to Think About When Renewing Your Property/Casualty coverage" from LMCIT for additional information 2. Cities have the option to make their LMCIT Liability Coverage primary for vehicles used by specified individuals or groups in specified circumstances. Please indicate if you want this optional coverage and provide additional information requested. Yes No / 5 r. ka- 't*-t CG If yes, please indicate type of individuals or groups: 0P�.`enu-f CoV-.7��,--r— If yes, please indicate number of individuals: VEHICLE SCHEDULE (The attached computer printout provides the most current Schedule. However, recent changes may not show on the Schedule.) Dept 111- Unit Description of Vehicle Serial Used Bldg. Current Comp Coll Fire No. # By Garaged GVW Value Ded Ded Trucks 1 2 3 4 5 6 7 8 9 10 OPTIONAL: Replacement cost on Fire Trucks aged 10 years or less(Indicate unit number and replacement value). Replacement cost can alsobe considered on other high valued vehicles. Please contact your agent. LMCITAPP.15(1196) PAGE 20 OF 20 • • r-1 W aa cm N 6 • W W >. LI f0.) O. J J O. J J H Q J J O. J J H O. J J O. 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J W • a > ‘,0.% �O _ J �r ,/� W �J • 2 W_ 0 0 0 0 0 0 0 0 0 0 C. 0 0 0 `r-t J 0 0 0 0 0 Co 0 0 0 0 0 0 0 0 > 2 0) • e.) �) C. t.1 0 0 0 0 0 0 0 0 N a J U) O co co co aO a a a a a a a O 0 WC N rti N) en eh CO O O O O U) U) in U W U> 4 O IN N. IN IN N. A 1s. N. 01 01 at 0) Z La N N N N rI rI r1 1-1 v-1 N N N WWs 0. V W U1 0 /� ta.) N O O O O O O O O O O O O O O 0'� �/ a 0 0. 0. 0. 0. a O. O. 0. d O. 0. a 0. d 2 W - - 0 Cr LO VI 41 , J= 9{/N W a Q a a J H U W Y W U • a > H N N H N N. N. N. n O O O O 1-1 = 4 4 N N N N 1■1 rl r t. r1 O O O O �/ r"1 f- W I 131 It1 ll CO CO CO CO O O O O a H > a 1 a 1 a R a a '-1 ti N rti )O b )O )0 3.3 GGG a ~ U ~ U U ~ ~ U ' t tI t) L.) /. W W W W W W > > > > > > > 3-) U U H U J H H 2 2 2 22 2 2 2 2 O W a a a a a a A 3 O 5 6. 0. O O O )' 0 . U U 4 0. U U U a a a a U U U U a a a a U U U U �. • W v` a LL W a F.. H O a > > > > > > a O O a O a a O U O<G W W S 2 W W W W S = S S a a a a O O O O a a a a O O 0 0 I- U U U U U U Li- U. U. U. U. U. U. LL W J r. W U a4 ce 4 a IA a ttl 1[1 in 1f1 In 1/'1 O 10 a a )O J =Y a a 01 a 01 O1 O a as a 01 a 01 O) Cr a o IR it W J U O N. CO a a /� S O O O O ..I yl 0. c I ` ...s. O1 4 U b N J U 5 a U) FN (9 •) W a-) ettt I _LU N. Y( a a a W a e a 0. \ N 11 e+1 = 4 O H 0 l LEAGUE O•NNESOTA CITIES INSURANCE T T EXCESS LIABILITY APPLICATION Administered By: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103 (612) 281-1200 City of PO AL T`L O'f F► Date .7 — / --g 7 Limit of excess coverage desired: ✓ $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 Do you want the Excess to apply to the Uninsured and Underinsured coverage provided by the primary covenant? /Yes No If yes, the automobile UM/UIM limits must be $600,000. Please refer to memo "Things to Think About When You're Renewing Your Property/Casualty Coverage" for important issues to consider. Employers Liability: Carrier: LM..C.I.T Limits: 2..00I(D00J(oCQ Policy Number: czc00lZq--to Policy Period: 7)i(ii- r3 Does applicant now have or contemplate any exposure under: (If yes, attach sheet with payroll figures.) (a) Jones Act or Admiralty Jurisdiction Yes ✓ No (b) Federal Railroad Employees Act Yes ✓ No (c) Federal Longshoremen's & Harbor Workers Act Yes No To what extent does applicant have primary insurance to cover these exposures? IF THIS IS A RENEWAL, PLEASE INDICATE IF RENEWAL IS TO BE BOUND: YES NO LMCITAPP.12(1/96) PAGE 1 OF 2 0 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST LMCIT EXCESS LIABILITY COVERAGE Cities obtaining excess coverage from the League of Minnesota Cities Insurance Trust must decide whether or not to waive the statutory liability limits to the extent of the excess coverage purchased. This decision must be made by the city council. CITIES PURCHASING EXCESS COVERAGE MUST.COMPLETE AND RETURN THIS FORM TO LMCIT BEFORE THE EFFECTIVE DATE OF THE COVERAGE. For further information, refer to the accompanying memo. City officials may also want to discuss these issues with the city attorney. The City of boa. PY - Ff 1 �Saccepts excess liability coverage limits of $ I) ,, from the League of Minnesota ties Insurance Trust. Check one: The city DOES NOT WAIVE the monetary limits on tort liability established by Minnesota Statutes 466.04. - OR - X The city WAIVES the monetary limits on tort liability established by Minnesota Statutes 466.04, to the extent of the limits of the excess liability coverage obtained from the League of Minnesota Cities Insurance Trust. Date of city council meeting: July 8 , 1997 Signature 7 �j_,/" i .'"i„„- Position: Administrator Return this completed form to: Berkley Risk Services, Inc. 145 University Avenue West St. Paul, MN 55103-2044 LMCITAPP.31 (1/96) PAGE 2 OF 2 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST Administered By: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103-2044 (612) 281-1200 SUBMITTED BY: PRODUCER: ADDRESS ZIP: APPLICATION FOR MINNE I TA PETROFUND SUPPLEMENTAL REIMBU SEMENT AGREEMENT APPLICANT'S INSTRUCTIONS: 1. Answer all questions. If the answer •: NONE, please state NONE. 2. If space is insufficient to provide . complete response, attach a separate sheet. 3. The application must be signe• and dated by an authorized representative of the City. 4. PLEASE READ CAREFU Y THE STATEMENTS AT THE END OF THIS APPLICATION. APPLICANT 1. Name of Cit or other public entities to be covered under the Agreement. LMCITAPP.MPRAAP(1/96) Page 1 of 6 AGUE OF MINNESOTA CITIES INt RANCE TRUST 2. Principal Address: 3. If Joint Powers entity, identify participants: 4. Designate the public official primarily responsible for enviro -ntal protection: NAME: TITLE ADDRESS: TELEPHONE TANK SITE INFORMATION I. Please list and describe all active and active underground and above ground storage tanks on the attached storage tank schedule. T • list must include all tanks acquired through the Housing and Redevelopment Authority and t - Economic Development Authority or any similar department/agency. 2. Are all tanks register-• with the Minnesota Pollution Control Agency? YES NO If NO, please e slain below: LMCITAPP.MPRAAP(11/92) Page 2 of 6 LEAGIOF MINNESOTA CITIES INSURAN•FRUST 3. Do all tanks including piping meet all local storage tank regulations?_YES NO If NO, please explain below: 4. Do all tanks including piping meet all state storage tank regulations? YES NO If NO, please explain below: 5. Do all tanks including piping meet all Federal storage t. regulations? YES NO If NO, please explain below: 6. Have you received any complai or notice that any of your tanks including piping are leaking or have you any othe indication that any of your tanks including piping are leaking? YES NO If YES, please ex. ain below: LMCITAPP.MPRAAP(11/92) Page 3 of 6 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST CLAIM HISTORY I. List individual petroleum tank release incidents or claims and damages/expenses: Date of Describe Injury Amounts Paid Incident or Damage or Reserved Locati• 2. Identify your tank sites that have been the subject of environ, ental litigation, claim or administrative prosecution or complaint. Please give details: 3. Are you aware of any other incidents %r conditions which may result in a claim against you? YES NO If YES, give details: 4. Have you ever erformed any remedial clean-up actions at any of your tank sites? YES 0 If YES, give details: LMCITAPP.MPRAAP(11/92) Page 4 of 6 410 S LEAGUE OF MINNESOTA CITIES INSURANCE TRUST The undersigned authorized representatives of the Applicant represents to the best of his/her 'e wledge the statements herein are true,and it is agreed that this application shall become incorporated as a part of the ■ mnesota Petrofund Supplemental Reimbursement Agreement if accepted by LMCIT. LMCIT is hereby authorized to make any investigation and inquiry in connecti s with this application as it deems necessary. Dated at this day •' ,19 (Name of Applicant) BY: (Signature and Title of Authorized Representative) LMCITAPP.MPRAAP(11/92) PAGE 5 OF 6 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST OPEN MEETING LAW QUESTIONNAIRE 1. Description of orientations and/or training provided for all elected officials (GTS programs, League programs, Handbook for Minnesota Cities, loss control seminars ...) on the subject of the open meeting law: luny[ . Qrce rnrns LOSS eon-f/oL &.rxulcuS 2. Have all new members attended the League Conference for Newly Elected Officials? )( YES NO 3. Do all officials understand the Open Meeting Law and the Cities' compliance procedures? )( YES NO 4. Description of method of documenting official meetings (written, audio, video, ...): tor.t{en 4 ui dem- 5. Does legal council attend all official meetings? )( YES NO If no, describe service relationship with city attorney. 6. Is education provided for the elected officials in the proper policy and procedures? a) Land use decision making: X YES NO b) Employment practices: X YES NO BY: ( ignature and Title of Authorized •epresentative) LMCITAPP.OML(10/93) PAGE 3 OF 3 • 2 o co C7 O 0. t". c.) O y • C T O to H U o Y LU Q H W U E^ U W C4 0 o . U 'L C C N_ N C' a a ¢ c a o a v Q V Q O *AGUE OF MINNESOTA CITIES INIRANCE TRUST ADMINISTERED BY: Berkley Risk Services, Inc. 145 University Avenue West St. Paul, MN 55103-2044 ((�� SUBMITTED BY: (DAMai I in; • .Ser.LYLC Q� PRODUCER: ADDRESS: P.c. box Iii roY C.S ULU rnki 55DZ5 APPLICATION FOR OPEN MEETING LAW DEFENSE COST REIMBURSEMENT AGREEMENT APPLICANT'S INSTRUCTIONS: 1. Please answer all questions. If the answer is NONE, please state NONE. 2. If space is insufficient to provide a complete response, attach a separate sheet. 3. The application must be signed by an authorized representative of the City. Special Note: Please answer all questions. These questions are intended to provide general information only. The information provided will also be used for a proactive loss control procedure if needed. APPLICANT 1. Name of city o other ublic enti whose city officials are to be covered under the Agreement. ci.�t (�iLac vilt 411013h 2. Principal Address: 141 VA 5101 Sk. . Oax Paz L 4Ie,IC m� 55b?2, -2 n 7 3. If Joint Powers entity, identify participants: %--1R LMCITAPP.OML(1/96) PAGE 1 OF 3 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST CLAIM HISTORY List incidents of threatened or actual open meeting law litigation involving city related individuals in the last five years. For each incident give its approximate date and its resolution,including the penalty imposed, if any,and the amount of attorneys fees incurred in defending the incident. Date of Penalty Imposed, Incident Describe Incident If Any.And Location Attorneys Fees Incurred 2. Are you presently aware of any other incidents or situations which may result in an open meeting law claim or litigation against city related individuals? YES X NO If YES,give details: 3. What action has been taken to prevent future incidents or claims? �A- LMCITAPP.OML(10/93) PAGE 2 OF 3 LLUE OF MINNESOTA CITIES INSCE TRUST PUBLIC EMPLOYEE DISHONESTY OR PUBLIC EMPLOYEE FAITHFUL PERFORMANCE COVERAG APPLICATION ADMINISTERED BY: Berkley Risk Services, Inc. uJU: m 145 University Avenue West St. Paul, MN 55103-2044 Limit of Coverage Per Loss: ►r eductible) • Public Employee Dishonesty Coverage: $ (Standard) • Public Employee Faithful Performance Coverage: $ (Standard) • Public Employee Dishonesty Coverage with Faithful Performance of Duty for Specified Positions or Obligee: Specified Position $ * (Standard) Specified Position $ * (Standard) Specified Obligee $ * (Standard) Specified Obligee $ * (Standard) *The specified limit of coverage is part of, not in addition to,the limit of ,verage per loss. AUDITS: FREQUENCY: BY WHOM?: CPA STAF. AUDITOR OT R(Explain Fully) DATE OF LAST AUDIT: DISCREPANC S?: YES _ NO (If YES sub it copy of audit or auditors comments.) LOSS HISTORY(LAST 5 YEARS): EMPL• EES POSITION WHICH CAUSED LOSS: CORRECTIVE MEASURES TAKEN: • W L THERE BE A SUBSTANTIAL INCREASE IN THE NUMBER OF EMPLOYEES DURING THE RM OF THIS BOND? INTERNAL CONTROLS: 1. ARE BANK ACCOUNTS REC• CILED AT LEAST MONTHLY? YES _ NO_ 2. IS THE PERSON WHO RE •NCILES PROHIBITED FROM MAINTAINING BANK ACCOUNT RECORDS? YES _ NO 3. ARE ALL PERSONS H• ,ING AUTHORITY TO MAKE BANK DEPOSITS OR WITHDRAWALS. PROHIBITED FROM HER MAINTAINING RECORDS OR RECONCILING THE BANK ACCOUNT? - YES _ NO_ 4. IS COUNTERSIG •TURE OF ALL CHECKS REQUIRED? YES _ NO ADDITIONAL CO ENTS: • LMCITAPP.PEB(1/96) PAGE 1 OF 2 LEAGI1 MINNESOTA CITIES INSURANCE TRiali CLASSIFICATION OF EMPLOYEES BY DUTIES OR RESPONSIBILITIES This classification under Class A, B and C constitutes the cities personnel as of the date of this application and should include Mayor and Council members. CLASS A EMPLOYEES All Executive Administrative Judicial and Supervisory officials,Department and Division Heads and Assistant Department and Division Heads. All Police Officers* and all officials and employees whose principal duties require them to: 1.) Handle, receipt for,or have custody of money,checks or securities,or account for supplies or other property,authorize(or make appropriations for) expenditures;approve,certify,sign or countersign checks drafts,warrants,vouchers,orders or other documents providing for the paying over or delivery of money,securities,supplies or other property,or serve process,or; 2.) Maintain or audit accounts of money,checks„securities,time records,supplies or other property,or take physical inventories of money,checks,securities, supplies or other property. *Patrolmen are classified as"A"Employees under"Faithful Performance"Coverage but are classified as"C"Employees under"Dishonesty'Coverage. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS Total Class A CLASS B EMPLOYEES All personnel whose principal duties consist of: 1. Inside or outside clerical activities; 2. Office work such as stenography,typing,filing,switchboard operation,business machine operation etc.; 3. Operation of vehicles transporting passengers for cash fare or tickets. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS • Total Class B CLASS C EMPLOYEES All personnel whose principal duties consist of: 1. Skilled or unskilled labor and craftsmanship; 4. Any teaching capacity in the field of education; 2. Solely the mechanical operation of automotive equipment; 5. Outside or field work of a non-clerical nature; 3. Non-clerical activities of the medical or nursing profession; 6. Patrolmen under the"Dishonesty"Coverage. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS Total Class C • LMCITAPP.PEB(12/94) PAGE 2 OF 2 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST BOILER AND MACHINERY APPLICATION ADMINISTERED BY: BERKLEY RISK SERVICES,INC. 145 University Avenue West St.Paul,MN 55103-2044 APPLICANT: INSPECTION CONTACT AT CITY: TELEPHONE#: AGENT'S NAME: TELEPHONE# COMPREHENSIVE (INCLUDING PRODUCTION MA HINES) NON-REFERRAL OCCUPANCIES ON LIMITS: $ 5,000,000 Per Any"One Accident"Combined Pro. rty Damage,Business Interruption and Extra Expense $ 25,000 Expediting Expenses $ 25,000 Ammonia Contamination $ 25,000 Water Damage $ 50,000 Ice Rink Buried Piping 1. Does the applicant currently have Boiler&Machinery coy rage? Yes No 2. Name of current Boiler&Machinery carrier Expiration Date: 3. Has the applicant had any boiler and machinery eakdowns in the past 3 years? Yes No If yes,please provide description and amoun 4. 100%Replacement Cost Values .f Building,Municipal Personal Property,Personal Property of Others: 5. Non-Referral Occupancie Deductible: $ * Does not include values f'r referral. BOILER.APP(1/96) PAGE I OF 2 LEAGUES/MINNESOTA CITIES INSURANCE TR REFERRAL OCCUPANCIES(Limited Coverage) Important: If the applicant has an exposure to any of the following,further analysis may be required by LMCIT. A representative of Hartford Steam Boiler(the reinsurer of LMCIT)may contact you for further information or inspection appointment. Each exposure must indicate a yes or no response. Special conditions,endorsements,limits and dedu 'bles may apply per occupancy. *B *MPP *. . • *BI A. Refuse burning facility(boiler garbage burning systems-HBB) _Yes _No _ B. Diesel electrical generating equipment(boiler diesel utility-HBD) _Yes _No _ C. Electrical generating equipment(boiler electrical production _Yes _No _ utilities-HBE) D. Co-generation facility(boiler co-generation facilities-HBF) _ Yes _No (*Does not include emergency back-up generators that serve only a single .uilding or function and are not part of a municipal utility.) E. Equipment for recovering methane or other gases from a sewage treatment plant or landfill,or any other system for producing industrial gases(boiler industry gas production-HBG) _Yes _No F. Hospital/Clinic equipment listed below(boiler hospital-HB ) _Yes _No 1. CT Scanner _Yes o 2. MRI Unit _Yes No 3. PET _Yes _No 4: Linear Accelerator _Ye _No 5. Lithotripter _ -s _No G. Steam or hot water district heating syste boiler municipal steam _ Yes _No _ hot water-HBM) H. *100%Replacement Cost Values o' :uildings, Municipal Personal Property, Personal Property of Others and 100%of Business Interruption Values. NOTE: Coverage for the abo'e referral occupancies can not be bound unless approved by LMCIT. • BOILER.APP(4/95) PAGE 2 OF 2 *CFG ' ,IAN 3 1 2002 CFG INSURANCE SERVICES, INC. January 28, 2002 CFG EMPLOYERS SERVICES, INC. CFG FINANCIAL SERVICES, INC. Kim Kamper Oak Park Heights City Hall 1416857StN Oak Park Heights,MN 55082-6409 Dear Ms. Kamper: Thank you for speaking with me today. I appreciate the time you took out of your day to answer my questions. As we discussed,I will be in contact with you from time to time to share an idea or answer any questions you may have regarding the co-op you have joined or medical insurance in general. If you do have a question before my call,please don't hesitate to reach me by phone or email. Thank you again for your time this morning. Sincerely, Angie Benson Enclosure www.cfginsurance.com gem cFG CFG INSURANCE SERVICES, INC. ANGIE BENSON 9800 BREN ROAD EAST,THIRD FLOOR MINNETONKA, MN 55343-9610 PHONE 952.945.0200 FAx 952.945.9477 angie.benson @cfginsurance.com • 9800 BREN ROAD EAST MINNETONKA, MINNESOTA 55343-9610 PHONE 952.945.0200 FAx 952.945.9477 WEBSITE cfginsurance.com E-MAIL Info @cfginsurance.com CapeHa UNIVERSITY Distance learning— It's not what it used to be apatite' Education Company revolutionized t�� ducation with its results-focused, a i`-centered, online university Employee benefits Listening to employees pays big rewards for success-driven • Win the best recruits employers Pages 18-19 with a diverse benefits Listening environments benefit employers package Pages 22-23 and employees. T Voluntary benefits enhance the overall L benefits package without causing a big What employers need r1 blow to your company's bottom line to know about military leave Page 21 Since September 11th,many Americans have been called to military duty.Find out Cover story ' s .: what the rules are for employers. • Meet Capella s , University Pages 12-14 CFG news A N1 Steve Shank,chairman and CEO of Capella Education Company,has redefined higher IP. education by following his vision to create Seminar schedule . . . Page 9 a virtual university designed for today's adult learners. ■ Complete coverage prevents pitfalls—but some contracts Risk management Human resources go too far Page 15 A CFG account representative works to overturn the conditions of a client's con- II Making employment Accurate job descriptions struction contract. agreements work for can be an employer's best the employer Page 6 friend Pages 3-4 Understand the risks and rewards of Job descriptions are important to nearly employment agreements. every step of the employment process. How to resuscitate your HR tips from safety program Page 7 the courtroom Page 5 A look at two recent court rulings on Create a safety culture in your company employee misconduct and performance that works! concerns. �` Protect your company from a COBRA lawsuit Page 8 —0- The initial COBRA notice must be provided IP- to employees and spouses. Performance appraisals— A powerful productivity and retention tool for your business Pages 16-17 Take performance appraisals to the next level .,. for increased productivity. POSTMASTER send address changes to: Editors:Amy Quiram &Kristen Evenson CI CFG The CFG Update is published bimonthly and is intended solely as a report on developments in the area of insurance,financial services, human resources,and risk management.It is not intended as legal, 9800 Bren Road East insurance,or other professional advice nor does it attempt to offer Minnetonka, Minnesota solutions to individual or business problems.Readers of the CFG 55343-9610 Update are encouraged to call with any questions or comments. Phone 952.945.0200 • Fax 952.945 9477 Readers who are seeking legal advice should contact their attorney. Web site cfginsurance.com • E-Mail info @cfginsurance.com ©2002 CFG Insurance Services, Inc. ■ Page 2 www.cfginsurance.com 0 CFG UPDATE•January—February 2002 • Human resources Accurate job descriptions can be an employer's best friend by James Olney, Esq., CFG Employers Services, Inc. of the most dynamic employment tools,so let's take a look at some of the ways you should be using job descriptions. Identifying the ideal candidate It seems that everyone is searching for the ideal candidate, , : but only a few companies know where to start.What's their secret?Considering the focus of this article,it may not sur- prise you to learn that it all begins with the job description. Assuming that your job description is updated,it represents the single best summary of the position that exists. Under- standing the requirements and goals of the position will help tP you define its needs,and thus the qualifications of the person who would be ideally suited to succeed in the position. The ideal candidate should be able to perform each and every duty at the level, and under the conditions, identified t. *;.4 in the job description. Understanding what your ideal candi- date should be able to do will allow you to take the crucial next step of determining how well he or she should be able f" t to perform those functions, what skills or experience he or i she will need to succeed, and what personality traits are best \ i suited to the position. However,none of these determinations are possible without first knowing what the job requires.The job description is the place you should start. Avoiding disability discrimination t4 4, " The Americans with Disabilities Act(ADA),along with x related laws in most states,prohibits discrimination against IT. w individuals with disabilities who are able to do each of the essential functions of a job with(or without)reasonable accommodation.In other words,you can't fire or refuse to hire someone just because they have a disability. However, IN you can fire or refuse to hire someone who can't perform an essential function of the job with(or without)reasonable n the realm of human resources and employment law, accommodation. there are few things less glamorous than job descriptions. A job's"essential functions"are the duties it exists to However,there is probably no single exercise more accomplish that can't reasonably be performed by another important to nearly every step of the employment process position(for example,your receptionist must be able to than a thorough,accurate,and up-to-date job description, answer the phone).The job description is the best place to How important are job descriptions?Well, when drafted clearly identify essential functions,and should be provided and used properly,job descriptions can help you decide to applicants,job offerees,employees,and supervisors. whom to hire, when to coach or discipline, when to promote, Moreover,if you are ever sued for disability discrimination, _ and whether to fire. Moreover,job descriptions can help you the job description is the first document the court will exam- avoid discrimination and protect you in court. ine. If you have taken the time to properly identify the essen- Surprised?If so,don't feel bad,because you're not alone. tial functions,you can short-circuit a case before it even gets Fortunately,it's never too late to start taking advantage of one off the ground. ■ 0 CFG UPDATE•January—February 2002 www.cfginsurance.com Page 3 • Human resources Understanding when to Preparing a more effective commend, coach, or performance evaluation discipline employees There are few reasons A basic question underlying every The fundamental principles of manag- fl � r, performance evaluation is, "How well more ing are to recognize and encourage good is the employee performing the func- performance,improve mediocre per- terminating an employee tions of the job?"To answer this ques- formance,and discipline or discourage tion,you must understand what the job consistently poor performance. than the fact that they duties actually are. Commendation,coaching, and discipline The job description can essentially are most effective when both the super- were poorly performing operate as a checklist to confirm that visor and the employee know what is each of the job's tasks is being per- expected,and have a gauge by which to a duty clearly identifi ed formed. It can also help ensure that measure performance.The job descrip- each duty is properly considered, and tion should communicate expectations. or, a Job description. that overall performance is not over- Using a job description to determine looked because of recent good or bad when to commend,coach,or discipline performance on a few of the tasks.The can also help keep you out of court by providing an objective job description keeps the focus on performance, and pro- basis for your decisions.For instance, a disciplinary meeting vides a roadmap for future goal setting. is much more effective(and legally safer)if you can identify Much like the disciplinary example given above,an employee the function that is being performed poorly by pointing it out is less likely to claim unfairness or disagree with the review if on the job description. Doing so makes it much more difficult the expectations for the position(and thus whether the employee for an employee to argue that your performance expectations has met them)are clearly laid out in the job description. are arbitrary,or that, worse,they are discriminatory. Making terminations more safe Although terminations occur for a variety of reasons, Making sure your Job descriptions cover the majority of them result from performance problems. the important areas Performance invariably comes back to how successfully(or A properly constructed job description should be the poorly)the employee is performing the duties or require- product of careful planning and significant reflection. ments of the job.The duties and requirements of the job, of course, should be clearly laid out in the job description. Although all of the steps that go into drafting an effective Any termination for performance should be directly job description are beyond the scope of this article,your linkable to (and justified by)the individual's job description. final description should contain the following: There are few reasons more legally sound for terminating an 1. An accurate position identificationititle employee than the fact that the individual was poorly per- 2. A statement of the exempt/nonexempt status of forming a duty clearly identified on a job description. the position Remember,maintaining objectivity minimizes your risks of being hauled into court. 3. A creation/revision date Of course,termination for performance should typically be the 4. To whom the position reports final step in an on-going process of assessment,correction,and 5. A summary of the purpose and objectives of the position discipline.But as we've seen,the job description should provide the foundation for each of these steps.In the end,termination for 6. A complete list of the essential or primary responsibilities performance reasons should rarely come as a surprise. 7. A list of the secondary responsibilities Accurate and up-to-date job descriptions can be an 8. A statement that other duties may be assigned employer's (and an employee's)best friend. Drafted properly, as necessary and used effectively,job descriptions should be a fundamen- tal component for almost every step of the entire employment 9. An identification of the minimum required relationship. knowledge,skills,and abilities Don't let your job descriptions let you down just because 10.A statement of the education and/or experience you don't think they are glamorous.Review and revise them required today. If you have questions about your job descriptions,or 11.Whether the position has supervisory responsibility would like help reviewing,revising,or drafting them, 12.A complete list of the physical/mental requirements contact CFG Employers Services at 952.945.9191.Also, 12 II' watch in the near future for a new website hosted by CFG of the position Y called HRDeskside Advisor. See page 20 for more information 13.The working conditions to which the job is exposed about how you can get your user name and password.Within this site,you will find tools for drafting job descriptions. Y gJ ■ Page 4 www.cfginsurance.com 0 CFG UPDATE•January—February 2002 fil Human resources HR tips from the courtroom by James Olney, Esq., CFG Employers Services, Inc. personal purposes without first getting employee had"behaved badly and had his supervisor's approval. undermined his relationships with oth In deciding that the employee was ers within Farmland." disqualified from receiving benefits, Among other significant problems, `' the Court concluded that,because the the CEO was contacted directly by the ' employee understood he could be dis- company's second biggest customer, charged for using the Internet without a who complained that the employee was supervisor's prior approval,his doing not providing the service they needed. \ so amounted to misconduct. Demotion sounds like a no-brainer, B right?Too bad the employer made the ' following mistakes. In explaining the Practice tip: reasons for the decision, the employer Because your policies and proce- indicated that"relations wore down, accounts wanted a change, so those dares are important, it is essential kinds of things."The employee refused that you effectively communicate the demotion, and the employer then them to your employees. Once you replaced the employee with a younger \, have done so,you should make employee. sign The employee sued, claiming age sure your employees sgn a form acknowledging that they have discrimination—even though the evi- dence ultimately showed that age received, read,and will abide by played ed no role whatsoever in the deci- What kind of misconduct your policies/procedures. It may sion.Unfortunately,by beating around will disqualify a former also be helpful to have the the bush, the employer gave the employee from receiving impression that it had something to- acknowledgment indicate that unemployment benefits? hide and opened itself up for a lawsuit In a recent unemployment benefits violation of any of the policies/ that it could have prevented.Although appeal,the Minnesota Appellate Court procedures may result in discipline the employer ultimately won,it had to ` concluded that an employee was guilty up to and including termination, pay significant(and unnecessary) of misconduct(and therefore disquali- attorneys'fees to get there. fied from receiving benefits) because he accessed the Internet for personal Why honesty is better Practice tip: reasons during work time. than trying not to hurt In the case of Haywood v. Qwest , Always address performance con- Co oration,the employer had a policy someone s feelings. P y terns immediately. When doing so, that employees were not to use A recent case from the 8th Circuit employer-owned equipment for personal Court of Appeals provides a good identify the specific performance at use without a supervisor's prior example of how trying to sugarcoat a issue,why it has caused concern, approval. Employees were required to demotion can land you in court. In and what must be done to correct it. sign a statement acknowledging that Erickson v. Farmland Industries, Inc., Stay objective, include all necessary they'd read and been trained on the the employer began to get negative facts, and clearly tie the perform- employer's policies. feedback and have performance con- On 11 occasions over the course of a cerns about a long-term,49-year old ance to the remedy.Doing so will month,the employee accessed inoffen employee in a managerial position.In save you from numerous headaches sive commercial Internet sites for particular, on several occasions the down the road. IN 0 CFG UPDATE•January—February 2002 www.cfginsurance.com Page 5 U Risk management , Making employment agreements work for the employer by Jeanine Loomis, CFG Insurance Services, Inc. i employment contract.And,while some confidential information.Label I might consider an offer of employment appropriate documents"confiden- letter to be routine correspondence,once tial"and limit distribution.Have it's accepted,that letter can be a binding written policies regarding how con- employment agreement.Experts recom- fidential information should be filed , mend that the content of these docu- or kept secured. ments be carefully reviewed before 2.Noncompete agreements: j making them available to employees. Noncompete agreements help pro- tect valuable information,but they Sign here please hold up best when they are limited Formal employment agreements to a specific geographical location, should include a description of the indi- industry,and timeframe—typically vidual's job duties and responsibilities, six months to two years.Experts as well as the duration of the agreement estimate that up to 20 million U.S. or the at-will relationship.Compensation employees have noncompete agree- should be spelled out including base and ments to prevent unfair competition incentive pay.The agreement should also from former employees. include grounds for termination and sev- Noncompete laws vary from state to erance arrangements.And it should spec- state.In general,they must be con- ify any restrictions the employee may sidered reasonable to be enforced. raw face if he or she leaves the organization. For example,if the terms are too '''''',;!',"°' ""° Formal employment contracts can broad or the timeframe is too long, protect a company in many ways.They the agreement may not hold up in E mployment agreements are an g y p help safeguard confidential and propri- etary court.They also have a downside. integral part of most organza- information.They secure customer y organiza- tions today.Whether your com- y Noncompete agreements might dis- pany is large or small,it pays to be lists and other market resources.They suade exceptional job candidates knowledgeable about them and under- establish ownership of ideas and inven from joining your organization. stand their risks and rewards. tions.They preserve intellectual proper 3. Timing:Ideally,employment agree- ty and protect an employer from unfair ments should be presented before an What are employment competitive practices.And they can help employee accepts the job and starts agreements? prevent costly lawsuits. work.The best time to alter a con- Mention an employment agreement Taking the right steps tract is when a company is being and most managers immediately think of acquired or when the individual is Here are four ways you can a formally signed contract.But,in gen- being transferred or promoted. strengthen employment agreements eral,an employment agreement is much . Legal review: Review anything n your organization. broader than that. that constitutes an employment 1. Confidential information:In today's Employment agreements can be oral. high tech information age,many agreement with your company's That means an enthusiastic manager legal counsel.Done correctly, employees have access to a compa- who claims that employees"never need employment agreements protect all ny's most vital secrets.These knowl- to worry about their jobs as long as they parties.They help define the edgeable workers are one of an keep up the good work"may be creating organization's greatest strengths. expectations of both the employer a binding obligation on your company. and the employee and can help But,to protect your company over Other common forms of communica- the long-term,make sure employees prevent costly problems. tion, such as employee handbooks and For more information,call 952.945.0200 clearly understand what constitutes company policies,also can create an or e-mail info @cfginsurance.com. • i Page 6 www.cfginsurance.com 0 CFG UPDATE•January—February 2002 U Risk management How to resuscitate your safety program by Linda Lutgen, CFG Insurance Services, Inc. ccording to an old adage,noth- may have unique considerations, ing is certain except death and answers to the following questions may . taxes.But a close look at U.S. provide important benchmarking data. Labor Department statistics suggests a What is the level of awareness third certainty:Accidents.Without a among employees regarding the corn- doubt,accidents occur in the workplace. pany's safety policies?Are roles and In any given year, thousands of employ- responsibilities well understood?Are ees will be injured on the job. In fact, the safety rules and regulations relevant 15 to 20 employees die in work-related to the work site?How effective is the injuries every day. How to reduce acci- training?Do supervisors support a safe dents and work-related injuries is a work environment?What prevents challenge every business faces. employees from following safe proce- An effective safety program has a big dures?And,what can be done to payback.It reduces the direct and indirect improve work site safety? costs associated with an accident, Next, analyze your current safety improves employee morale,and helps record.What current work processes ensure compliance with government regu- cause accidents or illness?How fre- lations.Whether you are setting up a safe- quent are they?What measures have ty program for the first time or trying to you taken to prevent similar accidents resuscitate an existing one,these guide- and how successful were they? lines can point you in the right direction. Create a safety culture Save the slogans A safety culture reflects how an organi- "Safety first!"looks great on a zation values safety.Safety programs and banner,but it takes more than a well- systems are important,but what people orchestrated campaign to create an believe and how they act and behave are effective safety program. Like every the driving forces behind success.If a other essential business strategy, the manager adopts a"do as I say and not as I safety program must have management do"attitude,safety rules are bound to fail. sound decisions.Include safety training commitment,performance measure- If managers are rewarded for meeting pro- in new employee orientation.Most ments, and reporting mechanisms in duction goals at the expense of safety employees welcome training and feel place, as well as adequate funding for measures,it sends a clear message. good about the fact that their company training and communication, accounta- Closing the gap between philosophy and cares about their safety. bility, and consequences. practice creates a safety culture that works. Review your recognition and reward There are many ways to create a safe- programs to make sure that safety per- Get the facts ty culture.First and foremost,empower formance is included.Offer special Conduct a safety audit to get an objec- employees. Get them involved in setting incentives for accident-free time periods. tive assessment of the safety conditions safety goals, set up simple ways to Finally,celebrate your success.As your at your work site.The goal is to identify measure safety performance, and report accident record improves and employee those things that discourage or prevent the results on a regular basis.Post safe- injuries decline,make sure you take the safe behavior and practices.Interview ty and emergency information in promi- time to acknowledge the value of your management, supervisors,employees, nent places,including employee manu- safety program and applaud your and other key stakeholders, offering als. Provide training,arming both employees'contributions in ensuring a anonymity to the respondents.While the supervisors and employees with the safe work environment.For more infor- safety concerns will vary from one tools and information they need to sup- mation,call 952.945.0200 or e-mail industry to another and each work site port a safe work environment and make info @cfginsurance.com. -- - - — --- ---- ------------------- ■ CFG UPDATE•January—February 2002 www.cfginsurance.com Page 7 N Human resources , 1 Protect your company from a COBRA lawsuit by Roger Stelljes, Esq., CFG Employers Services, Inc. qualifying event occurring within 60 days.If notification is not made by the qualified beneficiary to the employer within 60 days,the individual loses COBRA eligibility.And as the employer, if you have not followed the COBRA laws,you 0 could be responsible for future medical bills. • So how do employees know they have to provide you notice?You have to tell them. An employer is obligated to provide covered employees and spouses (if enrolled in the employer health plan) an initial COBRA notice which outlines their COBRA rights. "'° 1 x This notice must be provided to employees when they enroll in an employer's health plan. 0 sg For example,most health plans have a waiting eriod ME 4 P P g P bvv v. y .� before employees become covered.A typical waiting period might be the"first of the month after 30 days of employ- ment."Under COBRA, an employer would need to issue an,r{ �� initial COBRA notice to the employees when they go on the �� BAR plan.In this case,the initial notice is issued on the first of the month following 30 days of employment. If the employees are married and want to cover their spouses, the spouses must B y now you are a seasoned COBRA administrator, receive a separate notice at that time as well.If the employees right?Well you may be surprised to know that many want to add their spouses at a later date,the spouses must COBRA administrators still don't know they are receive an initial notice at that time. Incidently,sending a required to provide employees and their covered spouses notice to the parents(employee and spouse)constitutes notice with an initial COBRA notice that outlines their COBRA to any dependent children who are covered under the plan. rights.Where do you fall? Your initial COBRA notice must disclose the various In short, COBRA provides employees and their depend- rights employees have under COBRA. In particular,the ents,otherwise known as"qualified beneficiaries"the notice must disclose the events that lead to COBRA entitle- opportunity to continue their health insurance, at their own ment,those events listed earlier in this article.The notice cost, should they experience a COBRA qualifying event. should inform the qualified beneficiaries of how long they Below are the seven COBRA qualifying events: will have coverage based on the qualifying event they may 1.Termination of employment. experience. Finally, the notice should indicate how coverage 2. Reduction of work hours. could be cut short. For example,coverage could be cut short 3.Death of the covered employee, due to failure to pay premium on time. 4. Divorce or legal separation of the covered employee If you haven't been issuing an initial COBRA notice, from the employee's spouse. correct the problem now. Provide all covered employees and 5. Covered employee becomes entitled to benefits under their spouses, if applicable, with an initial COBRA notice. Medicare. Failure to provide the initial notice is a violation of IRS 6. Dependent child ceases to be a dependent child under COBRA regulations.The potential penalty is up to$100 per the generally applicable provisions of the plan. day per violation. Consequently,make sure your employees 7.An employer's bankruptcy. receive this important notice.For more information, call As you may know, when a divorce, legal separation, or a 952.945.0200 or e-mail info @cfginsurance.com.Also visit child ceases to be a dependent child occurs,the employee or www.cfginsurance.com to learn how CFG can take the qualified beneficiary is required to notify the employer of the burden of COBRA administration off of your hands. • Page 8 www.cfginsurance.com 4,CFG UPDATE•January—February 2002 N Seminars . Seminar Schedule Seminar CFG Mainline Your Expert Fee* Client**fee Personnel Recordkeeping/Wage and Hour Rules Presenters Wednesday,January 16,2002 8:30 a.m. -4:00 p.m. $289 $144 Roger Thursday,April 11, 2002 8:30 a.m. -4:00 p.m. „, Stelljes, Handling Problem Employees I: Coaching Esq. Roger has Thursday, January 24, 2002 8:30 a.m. - 12:00 p.m. $179 $99 wide-ranging Wednesday,April 17, 2002 8:30 a.m. - 12:00 p.m. f experience in Employment Practices human Thursday,January 31,2002 8:30 a.m. -4:00 p.m. $289 $144 resources, Wednesday,April 24,2002 8:30 a.m. -4:00 p.m. employment law, and work- ers'compensation. He fre- Hire the Best: Successful Interviewing & Hiring quently presents seminars Thursday, February 7, 2002 8:30 a.m. -4:00 p.m. $289 $144 for employers on various Wednesday,May 1, 2002 8:30 a.m. 4:00 p.m. issues including sexual Effective Employee Evaluations harassment,performance Wednesday,February 20, 2002 8:30 a.m. - 12:00 p.m. $169 $$4 management, and COBRA. Thursday,May 16,2002 8:30 a.m. - 12:00 p.m. David Missing in Action: Managing Absenteeism,Tardiness Flotten, g g g Esq. and Leaves of Absence 41 David has Thursday,February 21, 2002 8:30 a.m. - 12:00 p.m. $169 $84 been advising Wednesday,May 29, 2002 8:30 a.m. - 12:00 p.m. employers for COBRA Administration—Getting it Right! many years Wednesday,March 13,2002 8:30 a.m. - 12:00 p.m. $169 FREE to CFG on employ- Thursday,June 20,2002 8:30 a.m. - 12:00 p.m Employee Benefit ment practices and human ■ clients/Reg.Fee$84 resource issues including wage&hour rules,employ- Harassment Investigation: Do it Right or Pay the Price ee coaching,and discipline. Thursday,March 14, 2002 8:30 a.m. - 12:00 p.m. $169 $ 84 David also spent two years Wednesday,June 12, 2002 8:30 a.m. - 12:00 p.m. working for judges in the Handling Problem Employees II: Minnesota state courts. Discipline &Termination James Wednesday,March 20, 2002 8:30 a.m. - 12:00 p.m. $169 $ 84 -” Olney, Esq. Thursday,June 27, 2002 8:30 a.m. - 12:00 p.m. ., As a former employee's Leading to Success: Leadership Skills for Supervisors trial attorney, Thursday,April 4, 2002 8:30 a.m. -4:00 p.m. $289 $144 James has Wednesday, September 11, 2002 8:30 a.m. -4:00 p.m. learned to Supervisor Skill Set (see page 11 for details) $999 $499 identify problems before Creating Effective Partnerships with they get out of such are.s a specializes in such areas as Executive Search Firms (see page 10 for details) FREE FREE discrimination, discipline, Introductory Briefings termination, and leaves of How to Identify and Retain Top Business Talent absence. Wednesday,January 23, 2002 8:30 a.m. - 11:00 a.m. FREE FREE Mary Joki Thursday,February 14,2002 8:30 a.m. - 11:00 a.m. #14 Ebb, Esq. M has Profiles Training for Profiles Clients over ight Wednesday,January 23,2002 1:30 p.m. - 3:30 p.m. FREE FREE years experi- Thursday,February 14, 2002 1:30 p.m. - 3:30 p.m. ence as a cor- 'I Developing Effective Leaders porate trainer, Wednesday,January 30,2002 8:30 a.m. - 11:00 a.m. FREE FREE an organizational develop- Wednesday,February 27, 2002 8:30 a.m. - 11:00 a.m. ment specialist, and a HR *Twin Cities Human Resource Association Members— *"A CFG Mainline Client is any company which consultant.Her areas of 15%discount on each seminar(TCHRA members who CFG handles the group medical plan,the expertise include preventing are CFG Mainline Clients can only use one discount.) property/liability program, or the 401(k)plan. workplace harassment,man- e CFG Employers Services has been reviewed and approved as an authorized provider of continuing edu-aging workplace diversity, ‘itiiiw cation and training programs by the International Association for Continuing Education and Training. and employee relations. NOTE:All seminars will be held at our Minnetonka facility unless otherwise noted. _ ■ 0 CFG UPDATE •January—February 2002 www.cfginsurance.com Page 9 II Seminars Special free briefing for clients and friends of CFG Creating Effective Partnerships with pro-actively managing the search process to a highly Executive Search Firms successful outcome. Thursday, February 28,2002•8:30 a.m.-10:00 a.m. Topics for this briefing include: Locating,hiring,and retaining the very best talent available •The hidden(and true)costs of mis-hires has always been a"needle in the haystack"process.Today's •Determining the needs of the organization(What are we challenging economic climate is only making the haystack REALLY looking for?) bigger and the need to find the"sharpest needles"more criti •Determining when you need a search firm and selecting cal than ever. the right one Cindy and Brad Chandler,principals of Chandler Group, •Negotiating search fees a retained executive search firm,have nearly 20 years of •Developing a successful search process executive search experience assisting clients with key tal •Establishing accountabilities and managing expectations ent acquisition and retention.They will lead a discussion •Creating appropriate lines of communications focused on how to avoid the staggering costs of mis-hires •Reviewing the candidates by establishing effective partnerships with search firms and •Negotiating the offer Introductory Briefings How to Identify and Retain Developing Effective Leaders Profiles Training for Top Business Talent: We'll show you how to build top Profiles Clients Maximizing Your Human leaders and managers in your organiza- As a client of CFG and the Profiles Capital tion.You will learn how to measure and Assessment System,you deserve the Find out how assessment systems actually know how your managers are results that our other clients are reaping can help you put the right people in progressing to your organizations goals. from these proven tools.We'll demon- the right jobs customized to your cul- Find out how to best build stronger strate how these tools can best work for ture.They can tell you who you have leaders,how to know if your managers you.We'll show you methods of assess- in your organization(their abilities and are really leading in the direction you ment use that helps you to reduce traits) and how to promote,hire, and need them to lead,and how to improve turnover,to hold onto your best per- coach the top"twenty percenters." your objective evaluations of managers' formers,and to improve performance and supervisors'performance. and productivity. Seminar Registration Form Due to limited space,cancellations that are received at least 48 hours before the seminar will receive a refund or the opportunity to reschedule for a later date.If a cancellation is not received within this time frame,payment is still required.If individuals using seminar vouchers do not comply with this policy,the Attendees seminar voucher will be forfeited. Name Position Method of Payment IMPORTANT:Tuition is due prior to seminar. Please Seminar title make checks payable to CFG Employers Services Date and return form to: CFG Employers Services, Inc. Name Position 9800 Bren Road East Minnetonka, MN 55343-9610 Seminar title Please check one(unless seminar is free): Date 1. Registration fee enclosed (Please list additional names on a separate sheet) 2. Our purchase order is attached. Your Organization P.O.# Address 3. Charge to: Mastercard _Visa I I City/St/Zip Exp.Date Phone Fax Acct. No. E-mail Signature CALL 952.945.9191 FAX your registration REGISTER ONLINE at MAIL the registration or 800.258.3190 to 952.945.9477 www.cfges.com form to above address • Page 10 www.cfginsurance.com 0 CFG UPDATE•January—February 2002 Seminars Supervisor Skill Set COBRA Administration: Missing in Action: Managing Seminars: Six Business Getting It Right! (0.3 CEU credits) Absenteeism,Tardiness Favorites Don't take chances when you admin- and Leaves of Absence The Supervisor Skill Set includes six of ister your own COBRA. Recent law (0.3 CEU credits) CFG's informative, in-depth seminars changes as well as those already in place Every employer has had employee packaged together at a discount price. make it crucial that you do each step of attendance problems at one time or It's an economical way to provide your this cumbersome law correctly—or another, whether it's excessive supervisors and managers with the suffer the consequences. absences,habitual tardiness,or those skills they need to be effective leaders A great refresher for those already who are gone due to leaves of absence. and also protect your organization from doing their own COBRA administration This seminar gives you tips on dealing legal pitfalls. or ideal for those who've never tackled with your employee attendance problems The six-part program includes the this burden. as well as valuable information about following training sessions: when you're required to grant employees Harassment Investigation: time off under the law and managing •Leading to success:Leadership skills Do it Right or Pay the Price g g g y for supervisors and managers your employees'leaves of absence. •Handling problem employees I: (0.3 CEU credits) Coaching Sexual and other unlawful harassment Hire the Best: Successful •Effective employee evaluation negatively impacts your workplace Interviewing and Hiring •Harassment investigations:Do it right through lost productivity,poor morale, (0.6 CEU credits) or pay the price and the loss of teamwork and trust.This To pick the best employees from the •Handling problem employees II: seminar helps employers to proactively very beginning, attend this seminar and Discipline&Termination create and maintain a workplace free find out how to set up the interview •Hire the best from harassment.The seminar also process to your advantage.Anyone in a These seminar sessions are scheduled teaches important investigative tech- position to make a hiring decision throughout the year(see page 9 for niques and procedures. should attend this full-day seminar. dates).You may attend them in any Business owners,operating managers, order. Handling Problem supervisors,and personnel staff all will Employees I: Coaching dramatically improve their interviewing Leading to Success: technique and success rate. Leadership Skills for (0.3 CEU credits) Today's supervisors and managers Effective Employee Supervisors (0.6 CEU credits) must be cheerleaders,motivators, Evaluations (0.3 CEU credits) This seminar will introduce supervi- teachers, and confronters, all rolled into Employee evaluations are a key ele- sors to the basic skills needed to lead one.This seminar helps you define ment to the success and productivity of employees and be a successful manag- your role as "coach"in the work group. your employees. er. Designed for new supervisors, this You'll see how the coaching role At this half-day seminar you will be seminar can also be a useful refresher requires a variety of skills to handle provided with the tools you need to course for experienced managers. different situations and come away with effectively review your employees. a better understanding of how to suc- From day to day performance manage- Employment Practices ceed as a coach. ment to a formal performance evalua- (0.6 CEU credits) tion, we'll teach you what to write and Attention all employers!Attend this Personnel Recordkeeping/ say when evaluating your employees. full-day seminar and get the information Wage and Hour Rules Handling Problem you need to meet your responsibilities (0.6 CEU credits) Employees II: Discipline & under the employment regulations that The employee/employer relationship exist for businesses.At this seminar generates countless records and reports, Termination (0.3 CEU credits) you'll gain a basic understanding of the especially when it comes to paying This seminar gives attendees pointers legal and practical steps an employer wages. This seminar covers state and on how to deal with supervisors'two g process, federal recordkeeping requirements, as most difficult tasks—disciplining should include in the hirin rocess, overtime and exempt/nonexempt status, well as best practices for keeping your employees and terminating unsuitable employer responsibilities for sexual employment records.We will also dis- staff.Find out how to take appropriate harassment,issues involved in disciplin- cuss the many wage and hour rules that action with problem employees. ing and terminating employees,and what govern how and when you must pay COBRA is and who is eligible for it. your employees. For more information, visit www.cfges.com ■ 0 CFG UPDATE •January—February 2002 www.cfginsurance.com Page 11 III Cover story . Capella University--Redefining higher education for adult learners by Kristen Evenson S riy I m Ilk S teve Shank, chairman and CEO of Capella Education As a lifetime learner himself, Shank understood that the Company and chancellor of Capella University, is the traditional model of higher education needed to be revolu- epitome of what Americans call an entrepreneur. His tionized for adult learners.What he saw was traditional vision of what people value in society and of what they need universities dabbling in distance learning, yet not truly to attain their personal and professional goals is flawless. respecting nor making it easy or effective for the learners to This is evident when you review Shank's professional achieve their educational and professional goals.There had to history.He spent 12 years leading Tonka Toys and its 4,000 be a better way.His vision was to use the power of the Internet employees around the world to success. When the company to remove institutional and logistical barriers to create expand- was sold to a larger competitor in 1992, Shank searched for ed opportunities for a high-quality university education. his next opportunity. He decided to create a for-profit virtual In 1993, Capella Education Company,parent company university designed for today's adult learners and employers. of Capella University,was born and the first year was an ■ Page 12 www.cfginsurance.com interesting one. Shank's first order of business was to con- them with an understanding of the educational value of life fvince the state of Minnesota that Capella University was in experience.When considering a prospective learner,Capella fact a real, operating university. Shank says, "The state told stays true to two values: 1)Capella seeks to broaden access us it liked our model because it realized the need for better to education; and 2) Capella wants people to leave the • higher education for adult learners."More importantly,it university having made significant strides toward realizing realized that traditional universities weren't about to change their full potential. So rather than relying on quantitative test their educational models unless they were forced to do so scores,Capella evaluates potential learners by requiring cer- by competition. tam educational requirements for each program. In addition Eight years later Capella University offers a rewarding to professional experience and grade point averages,it also educational experience with measurable results,immediate asks learners to describe their professional experience and impact, an efficient path to increased professional value, and personal goals. Shank says, "If these categories are fully a surprisingly intimate learning experience. articulated, there is a bias towards admission." Once a learner is committed to earning a degree from What does real growth look like? Capella University,the educational experience is markedly The model worked from the beginning.The university different from what a traditional university would offer. offers undergraduate and graduate programs in Business, IT, "Central to Capella's philosophy is the vital and direct Education,Human Services, and Psychology.Today,Capella connections between learners and faculty,"explains Shank. ,, (Left)Employees of Capella are 341;1111k excited about what they do, as they r „, , ° understand the impact they have .�.. ... on people's lives. The office envi- ,` ronment is well-suited for open t communication and is positioned .411100, for growth. are. (Bottom)Capella learners can access their study assignments and participate in threaded discussion groups from any Internet connected computer: .3' 7:AP 1 ,, ,,Z, 4 d Y A 4,i q,,.„...,-0.4+ W t k Betsy Bausch, vice president of human is,f resources, has helped Capella become an �, , '," 1`rtri employer of choice, growing from 75 to 255 il employees in only two years. P has more than 4,300 students,600 graduates,30 full-time "The learner/faculty ratio is 12:1."A strong learning commu- faculty members,250 adjunct faculty members,255 employees, nity is the result of a high degree of online interaction with and over 500 customized online courses. Now that's real expert faculty,achievement-oriented learners,and a university growth for a business that has only been around since 1993. staff passionate about each individual's success. Capella's approach Capella has customized programs, accessible faculty,resi- When learners apply to Capella, the university approaches dency requirements, and a dedicated support services net work. Expert faculty develop curriculum that is stimulating CFG UPDATE•January—February 2002 Page 13 i III Cover story and rigorous and has immediate value what they valued most.They told us in the marketplace. Learner support QUICK S TATS they wanted more natural light,"says 1 services are designed to aid success in Company Name Shank.So what Shank did was build program and degree completion. • Capella Education Company most of the offices in the interior parts Capella strives to address all the rele- •Capella University of the building so that no windows • vant needs any learner could possibly Type of Business would be blocked. Shank says,"It was have.These services are available 24/7 •Online,accredited university something that made the employees with staff required to respond within 12 focused on providing learners with happy and helped them get excited about hours if the question cannot be a rewarding educational experience the move."This is just one example of with measurable results. answered on the spot. how Shank understands that he must Location listen to his people to continue to move Capella:Working to revolu- •Minneapolis,MN Capella forward."We have a great group tionize the effectiveness of Employees •255 of people here and I'm really proud to higher education Web site work with them,"says Shank.Capella The Higher Learning Commission of •www.capella.edu will no doubt continue to revolutionize the North Central Association of higher education. Shank and his team Colleges and Schools—the regional will demand themselves to focus on the accrediting body—accredits Capella University.Traditional customer,make learning more effective,and offer their accreditation is achieved by measuring inputs versus out- services to people who understand the benefits of life-long comes or results of the education.Again staying true to its learning. Shank reflects,"We started down this path and we values,Capella is focused on measurable results. weren't always sure where we were going.But it's very real One year ago, Capella University became the first online now and the vision is only getting bigger." 1 university to participate in the Academic Quality Improvement Project, an alternative accreditation model that CFG supports vision of Capella with measures results versus inputs. "I'm really enthusiastic about broad-based, learner-focused services this. I think it will be a very positive trend in higher educa- I tion," says Shank.What this means is that Capella seeks to One principle successful entrepreneurs realize is that measure how well it's serving the needs of its learners. Is building an organization only begins with a vision.To Capella helping them in their professional careers?Is this succeed,entrepreneurs identify and partner with education benefiting the learners'employers?Capella will resources that can help them implement their visions. measure these elements in various ways. They already have a Betsy Rausch, vice president of human resources, says, strong alumni organization and within that group are ambas- "We chose CFG because its services are very helpful sadors. "These individuals are our strongest allies.This to a growing business.Besides getting our employee outstanding group of professionals are as vested in our benefits through CFG,we use the COBRA success and we are,"says Shank. Administration service,Flexible Spending Passion shared among the employees Administration service, and the Human Resource Of Capella Hotline because it would be very difficult for us to do Shank is most excited about the culture that is developing these things ourselves." CFG strives to be more than just a provider of at Capella. He says, "We transform people's lives.This is employee benefits and human resource expertise to meaningful and our employees share that vision."Many of Capella. Gene German,the CFG representative that the people that work at Capella came out of the education serves Capella,understands Capella's vision and does field and they are excited about what Capella is doing with what it takes to help them achieve it.He even helped higher education. Shank reminds his staff that Capella Rausch recruit Lee Willhite,Capella's new compensa- always maintains a passionate commitment to a profound tion and benefits manager. learning experience and everything that Capella does is "CFG offers a broad range of services and a very based on this vision.Whether it is the completion of a bachelor's degree, a corporate sponsored MBA program, or high level of customer service,"says Rausch.This is an advanced IT certification, Capella inspires learning. obviously critical when one considers that Capella grew from 75 employees to 255 employees in only two Continuous improvement years. Besides providing Capella with its employee Believing in a strong vision helps to create a positive culture, benefits package and human resource consulting but extreme growth can present its own set of challenges. services,CFG makes the commitment to understand Effective and open communication is taken seriously by Capella's ever-changing needs to continue to be its Shank. "We kept outgrowing tout rowin our facilities, so when we made provider of choice. the move to our current office space,we asked employees • Page 14 www.cfginsurance.com CFG UPDATE•January—February 2002 ■ CFG goes the extra mile Complete coverage prevents pitfalls—but some contracts go too far li by Amy Quiram commercial insurance client representative learned that the client of CFG's was thrilled when it was requesting the incredibly high re was given the contract for a insurance coverage she dove right into large construction project at a local action. The account representative o church. The church asked the contrac- contacted the client to find out why tor to sign a construction agreement such high limit insurance coverage was . �� contract before any work was done on being requested, and she discovered the site.The contractor signed the that the church was requiring the insur- contract, and later was surprised to ance coverage as part of the agreement find out that it included outrageous with the contractor. She explained to insurance requirements that were not the client that one of the insurance appropriate for the project. policies being requested would never . be approved by an insurance company Contract required because the amount was ridiculously Requiring contractors to sign a high,and the two types of coverage construction agreement contract were not appropriate types of insurance including insurance requirements is a for a contractor to even have in place. normal procedure in construction She then told the client that she would work. Contractors are usually required contact the church to explain the to have insurance in place to protect problems of the contract. themselves, and the property owner, The account representative contacted a 1 in case of damage to property or an representative from the church to individual. Normally the contractor discuss the outlandish insurance request reviews the requirements of the and found out that the church was contract,purchases any insurance requiring the insurance limits or was not coverage it doesn't already have to going to let the contractor's employees fulfill the requirements of the con- on the job.The account representative tract, and then provides the property explained to the church representative owner with an insurance certificate why the limits were not acceptable, showing the insurance requirements and why the types of coverage listed are in place. in the contract were not suitable.She The CFG client signed the contract was able to get the representative to from the church, which required a fire amend the terms of the contract,and damage legal liability limit(also allow the contractor's employees on know as fire damage for premises the job. rented or occupied by you) of The client was pleased with the $1,000,000 and a medical payments assistance CFG provided.Thanks to the limit of$1,000,000.The contractor CFG account representative going the did not have insurance coverage for extra mile, the insurance terms of the either policy in amounts that high, and agreement were overturned so the client therefore contacted CFG to request to was not held to an unacceptable agree- have its insurance policy modified. ment, it was able to keep the construe- Amending the contract tion project at the church, and the When a CFG commercial account client's employees didn't lose a day on the job. ■ 0 CFG UPDATE •January—February 2002 www.cfginsurance.com Page 15 NI Human resources Performance appraisals--A powerful productivity and retention tool for your business by Roger Stelljes, Esq., CFG Employers Services, Inc. • Give ample notice. Schedule an appointment with the � � employee at least one week in advance of the meeting. t A k . , Encourage the employee to prepare for the appraisal. i Provide a copy of the appraisal form and suggest that the employee make personal notes in every category to facil- itate discussion.This eliminates confusion about how the employee will be evaluated. .,, •Review the employee's job description. It never hurts to 3 refresh your memory even with those employees with ' ' whom you've worked closely during the year.This helps 0 . „= i .. managers take the entire year into consideration,instead , ''� + of the most recent timeframe, and also helps them find specific examples to discuss. •Determine the outcome of the appraisal. Determine whether the employee is working up to his or her poten- tial.What contributions has he or she made and how is that measured?Review the job expectations.Analyze what additional training an employee might need. •Evaluate your own performance. Think candidly about how you may have helped or hindered the employee's performance during the year. magine this:There's a powerful productivity and reten- Conducting the appraisal tion tool available to your organization.It's capable of performance, helps managers make The actual performance appraisal meeting is more of an art improving employee p p g wise decisions,and can make your business more competi- than a science.These guidelines can help a manager make tive. You'd want that tool,wouldn't you? this one-on-one communication more meaningful. Now imagine this:You have that tool right at your dispos •Allow sufficient time. Plan a minimum of one hour for the appraisal itself and allow an extra half-hour on your al. It's the often overlooked and underestimated annual employee performance appraisal. Done correctly,perform- calendar to respond to any unexpected issues that might ance appraisals motivate employees to do more and better require additional time. work,provide an accurate assessment of training needs, and •Make sure the employee understands the entire process help managers make sound decisions regarding job transfers, before you begin.At the beginning of the meeting, promotions,demotions,termination, and compensation.As explain the rating system,performance categories, and an added bonus,performance appraisals done correctly help any other aspects of the performance appraisal that might defend an organization against litigation. be confusing to an employee. •Focus on the work itself and on the employee's behavior, Unfortunately,many supervisors find conducting a perform explaining which behaviors are desirable and which ance appraisal to be a time-consuming,difficult,and awkward need correction. This helps the manager judge the per- task.But with advance planning and some helpful tips,perform- ance appraisals can become a positive and rewarding experience son s actions,not the person.Don t focus on the employ for employees,their supervisors,and the organization. ee's personality or characteristics that the manager likes or dislikes. Getting ready •Structure the appraisal around the employee's strengths, The most important part of a performance appraisal actual- not weaknesses. Be both honest and fair.The appraisal ly takes place before the event itself.This pre-work gives should focus on the positive,encouraging an employee to managers more confidence to conduct an effective appraisal. work towards his or her fullest potential. This means ■ Page 16 www.cfginsurance.com 0 CFG UPDATE•January—February 2002 I • Human resources building on strengths, talents, skills, and experience. Watch out for inflated appraisal ratings That's not to say that an employee's problems or poor performance should be ignored. Every organization has its share of exceptional,good, •Be specific and use examples. Specific feedback with fair, and—let's face it—lousy performers.Yet at perform- concrete examples makes performance feedback more ante appraisal time,many managers rate the vast majority credible and objective.Leave room for the employee to if not all of their employees"excellent"or"good."What explain by asking open questions. causes that?Experts say that these are some of the most •Listen. Give ample opportunity for the employee to express likely factors behind inflated performance ratings. concerns,ask questions,and describe his or her perform- ance.Keep in mind that this is a two-way conversation and `To avoid a confrontation that it is an opportunity for the manager to learn about the •To encourage an employee who has done marginal employee's work environment and critical barriers that work in the past but has seen recent improvement keep the employee from doing his or her best work. •To cover up a department failure or problem •To empathize with an employee who is suffering from Follow-up temporary personal problems The most effective performance appraisals are a two-part •To make the supervisor look good process.The first part,of course,is to research and to conduct while there may be many such reasons behind the prat- the meeting.The second part sets a course of action for the tice of artificially inflating performance ratings,the prac- coming year. tice is a poor one.It defeats the very process and opportu- •Provide a time-out. At the first part of the meeting, give nity for improving performance,for setting and reaching the employee a copy of the written performance apprais- goals important to the business,and for recognizing and al. Encourage them to read it carefully before signing it. rewarding the truly worthwhile contributions to the busi- The form should include space for the employee to pro- ness.It also haunts many businesses when continued per- vide personal comments as well. formance or reductions in force require the termination of •Focus on the future. The second part of the meeting employment.Those businesses may face the unenviable focuses on the future. It's an opportunity to set specific task of telling a judge or a jury that what they wrote and job-related goals for the coming year and determine the documented before was not true,but what they are saying employee's development plan. This is the most important now in response to a lawsuit is true. aspect of the performance appraisal process. While the first half highlights past performance,this sec- ond half re-energizes and challenges the employee. It pro- info @cfginsurance.com.Also,watch in the near future for a vides a mutual understanding of job expectations and how new website hosted by CFG called HRDeskside Advisor. See the employee's work will be evaluated.And,it lays the page 20 for more information about how you can get your groundwork for periodic follow-up and feedback. user name and password.Within this site,you will find tools [ For more information, call 952.945.0200 or e-mail for creating performance appraisals. Human resource dilemma Q. My company has a 90-day probationary period for all new employees. Can I fire an employee for any reason I want during this period, and what happens after the 90 days is up? . First off we suggest avoiding the term "probationary"and using "introductory" instead, as the opposite of"probationary" is "permanent," which is contrary to the at-will nature of employment. ' As to the first part of the question, assuming there is no contract of employment, the answer is that, yes, you generally can terminate an introductory employee for any reason you want—so long as it's not discriminatory(i.e., not based on race, age, disability,pregnancy status, etc.). Interestingly, ' because of the at-will nature,of employment, you have no greater legal right to terminate an employee during his introductory period than you would afterwards. The only thing an introductory period typically means is that, during this time, the employee will be subjected to heightened scrutiny and review to determine job fit. Thus, after the 90 days are up, you will still have the same right to termi- nate the employee, but you will most likely monitor his work less closely. ■ CFG UPDATE•January—February 2002 www.cfginsurance.com Page 17 II Human resources Listening to employees pays big rewards for success-driven employers by Kristie Greve Every organization makes a big investment in its employees.Yet 0. , that investment walks right out the door when an employees quits. Smart business leaders know they can't retain every employee,but they can "+ stem the tide by putting in an early- warning system that catches problems I " before they get out of hand. r �" 7 The solution?Create a"listening t - environment"that captures employees' ` ideas and concerns.It's an easy,but often overlooked, strategy.While most ,•w organizations expect employees to lis- ten to what management has to say, r many don't consider the importance of I x listening to their employees. A listening environment provides _ ., several different tools for employees to 70." ask questions,raise issues,offer sug `f gestions, and talk to management in a i"� meaningful way. But this is not a strate- �' rip gy for the faint hearted.To be success 117 ful, management must be willing to not only listen but provide timely, credible - »F °a; responses.And both managers and � ,"� , employees must realize that they may not always like what they hear,but they will understand what is happening the organization's needs. It ensures that the people closest to the within their organization and be better Second, listening also helps predict work have opportunities for input that able to do something about it. reactions. For example,if you are can result in an improved work prod- considering a reduction or change in uct. It also helps managers re-evaluate Five reasons why listening benefits, how much will employees established programs that could benefit to employees counts care?That knowledge may lead you to from a fresh perspective. There are five important reasons man- consider other options or you may find Fourth,listening increases manage- agers should listen to their employees. that it's simply not as important to ment's effectiveness. Hearing what , The first reason is to minimize unfore- employees as you thought.In either employees have to say helps managers seen consequences. Listening to cases, the information focuses manage- better identify potential problems in the employees helps predict behaviors that ment time and resources on what really work environment.Do employees,for could derail a new program.For exam- counts the most. example,feel safe and respected?Do ' ple,if you plan to introduce a new bene- Third, listening increases the quality they understand the company's goals? fit,such as flex-time,what options will of products and services. Employee Do they feel part of a team and are their employees choose?That advance insight feedback can clarify the strengths and contributions recognized and appreciat- can help managers design a new benefit weaknesses of new products and serv- ed?This information helps uncover that satisfies both the employees'and ices before a major investment is made. sources of dissatisfaction that can be ■ Page 18 www.cfginsurance.com CFG UPDATE•January—February 2002 1 ■ Human resources addressed before they lead to turnover. Host informal focus • senior manager may And,fifth,listening is a way to meas- groups to brainstorm a Senior the nagement give a brief presenta ure trends and gauge morale. Ongoing special topic.This tion,but his or her pri dialogue with employees helps man might be as simple as i' volvemelit mary role is to foster a agers assess whether opinions are inviting small groups of critics � OI"ttlne discussion and answer changing—for better or worse. For employees to extend questions.Forum partic example,if something was introduced their lunch hour by 15 S�Q firm invited email may get informa- to address a problem, did the solution minutes,on company tion or an assignment in work?If not, why not?This information time,to discuss a cer groups ells loyees advance of the meeting. helps managers determine if the pro fain topic.The modera They may,for example, to have lunch with grams they have in place are working. for remains impartial— be asked to interview How to listen his or her sole goal is to the CEO OVer the co-workers on a particu- gather information. lar topic and bring this There are many listening techniques another approach is Course additional feedback to and all of them work,if everyone to sponsor a group the meeting. involved makes a good faith effort.The of the year. forum.These sessions, Other organizations most effective communication occurs which can accommo sponsor large group when employees and managers are face- date up to 25 employees,have a senior meetings,sometimes called town meet- to-face.Set aside time in regularly manager who acts as a facilitator The ings.In these sessions,the audience pri scheduled meetings to solicit questions agenda is identified ahead of time an d manly listens and learns.But write in and comments.Let shy employees sub- employees are encouraged to share their questions,panel discussions,and a live mit write-in questions or comments in views.These forums differ from focus advance,anonymously if need be,to Q&o portion provide opportunities for groups because the moderator is actively employee involvement. make sure all voices are heard. involved in the discussion.In a forum,the Senior management involvement is also critical. One Fortune 500 firm,for The art of active listening example,invited small groups of employees to have lunch with the CEO Were all taught to speak and write.But is anyone really taught to listen?We over the course of the year. Employees rutty hear what a person is saying,but actual listening is much more.Active were invited according to their service listening is understanding what the other person is saying and feeling. anniversary dates; that is, employees Active listeners build an atmosphere of trust.They concentrate on the person who who were hired in the month of i ,.speakig,and they don't interrupt or daydream,Active listeners remain objective, " January gathered during that month, making atr effort to understand the speaker's frame of min or reference point.They ensuring a good cross section of take in the entire message,and pay attention to body language and nonverbal cues. employees attended each time. They`show interest and give feedback without dominating the dialogue. During times of corporate change and turmoil, these programs become Keep these simple tips iun mind to improve your'listening skills: even more important. It's a two-way I'Be attentive:Make dye contact,Iook and act interested, and don't try to street: Information from senior man- complete another task while listening. agement alleviates anxiety and uncer- tainty among employees, and senior 2 ,Hold your fire:Withhold judgment,using noncommittal words such as, management is better able to stay on "I see,""That's interesting'"or"Uh huh" top of rumors that can hurt productivity .Paraphrase and restate:Tell-'the person what you heard him or her say in and cause turnover. your ow words to show that you are listening anti grasp the facts. Listening—and responding- Suxnrturize the important points with phrases such as, "From what you've empowers employees to help shape " told me,your idea is..."or-In other words,you would like to..." their organization and resolve issues. It gets them involved in every aspect of 4.`Ask open-ended questions:Focus on questions that draw the speaker's the business that affects them,enhanc- ideas out(those that begin with How?What. Would?Or Tell me' ing productivity.Active listening '' snore about,:,). Closed questions(those that begin`with Is?Are?Do?Did?) enhances a company's reputation in the discourage conversation, marketplace and builds loyalty,creating 5.Give feedback: Share your perceptions of the speaker's ideas or feelings, the kind of culture that attracts and showing warmth and interest.Offer your own feelings or experiences when retains employees.For more Fyt to, CO vsre call 952.945.0200 or e-mail info @cfginsurance.com. ■ CFG UPDATE •January—February 2002 www.cfginsurance.com Page 19 . . . . . . . . . . . . . . . . IS . . • . . . . . . IN . . MIN . . . MIN . . . . . MIN . . . . . . . Comilla Soon tc p ccnTlPuter wear you . Immediate answers to your questions 24 hours a day, 7 days a week, right at your computer with ,; ,. � - _H.ortt Ryes, .. _ diet Muir = ddress: r,, a HUMAN RESOURCES HR E-TOOLS,FORMS,CHECKLISTS,AND w+uu.I n. c...i.,■• cr,h.'imi 1.4 ii,r c.r+.mr..... ❑—....i.,il r{.n,.r.. �, e.,.,.+ir+n,c.,.�m.- .,r,.,., :,.f.r.i RESOURCES AT YOUR FINGERTIPS Too;K1tS Oubson0bef�epee 0. Staffing welcome back What's NEW O Crisis Resources for HR Click here(undated 11112) Recruitment U Job Descriptiomcom New Hires ' O PerformanceReview.com CI HR News Retention v H Lev S Pteehcv.com O HR Ouir?Reduce risk of ' anthrax exposure la Legal Compliance _' . „ II And more.,, EEO/Diversity - Hundreds of FREE Tools! Legal Updates Sexual D Harassment O Email Tralninq;Becoming a O Check Federal Law Changes Discipline&Termination Better Moreover O Check State Law Changes II Federal Reco rdkeepinv Requirements E-mail if Training&Performance O Email+Internet Use Ouiz on;;oe poi; + Performance Managem nt O And more... Which is your favorite free Training&Development info@cfginsurance.com HRDesksideAdvisor feature? Discipline&Termination Q NewsTracker Benefits&Compensation s for, ; for your user name ®My HR Toolbox HR SOiLttions i 9 Employee Success Builder Benefits • • , 0 Cost of Conflict Calculator Cpmpensatipn and password today (�' Exemption Tester workers Compensation re HR Tooreou , (�jndupendant Contractor Testat Safe My HR Toolbox store is a 9 lir O news and legal updates place fr uen l your most email training tools,(Click on thesed Q forms&checklists icon to go to My HR Toolbox to ®'quizzes learn more. View Resuitf asa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . la 11.1 E IIII Human resources What employers need to know about military leave by James Olney, Esq., CFG Employers Services, Inc. he current war on terrorism, and What other rights are because of his or her absence,the the patriotism that has accompa- entitled tO? employee would be eligible to continue nied it,has lead to an increased Employees on military leave are enti- his or her coverage through COBRA. focus on what we as individuals can do tied to any seniority as though they had Finally,employees returning from to help defend our country.As a result, never been on leave, as well as pension service of more than 180 days cannot the likelihood of military duty, whether plan benefits that accrued during the be discharged without cause for a it is through call-ups of reservists, military service.For leaves of 90 or period of one year after the date of enlisting,or even possibly a draft, more days,the employee must be reemployment. Employees returning hasn't been this high since the Gulf placed into the position he or she from service of 31 to 180 days may not War.Therefore,employers must be be terminated without cause for six would have been in,had the employee aware of what will be expected of them remained continuously employed. months after reemployment. during this time of national crisis. Moreover,protected employees are America's response to terrorism may entitled to the most favorable rights and require that some of your employees be What is the law? away from work for long periods of Under the Uniformed Services benefits available for any other leaves Y g P Em to ment and Reem to ment such as jury duty or personal leave,and time.Making sure you respond properly p Y p Y service members cannot be forced to is essential.If you have any questions Rights Act(USERRA)employers are about military leave and you are a prohibited from discriminating(or use their vacation time during a leave. Y p g If, consistent with other employer Hotline client,or if you would like to retaliating)against covered employees find out how to become a Hotline (or covered prospective employees)in provided leaves, a service member's health coverage would terminate client, call us at 952.945.9191 or e-mail any of the following areas: hiring, info @cfges.com. promotion,reemployment,termination, or benefits. Time limits for returning to work depend upon the USERRA applies to all individuals who serve in the"uniformed services" duration of a person's military service.* (Army,Navy,etc.),including reservists. The types of"service"covered include 1 to 30 days The employee must return by the beginning of the first active duty, active duty training, inac- regularly scheduled work period occurring at least eight tive duty training,full-time National hours after returning home. Guard duty,and exams to determine fitness for duty. 31 to 180 days** Application for reemployment must be submitted no later than 14 days after completion of service.If this is What is military leave? impossible or unreasonable through no fault of the In short,everyone in the"uniformed employee then as soon as possible, services"is generally entitled to up to 181 days or more** Application for reemployment must be submitted no five years of time off to serve their country.During this protected period, later than 90 days after completion of service. employers are obligated to reemploy Service-connected Reporting or application deadlines are extended for up those who have left to serve(except injury or illness to two years for persons who are hospitalized or recov- those who have been dishonorably ering from an injury suffered while on military leave. discharged),unless doing so would present an"undue hardship,"would be *These guidelines exclude fitness-for-service examinations. unreasonable or impossible due to **For leaves of 31 or more days,employers can require the employee to submit documen- changed circumstances,or would be tation substantiating the timeliness of the reemployment application,the length of the contrary to the clearly temporary nature leave,and the honorable nature of discharge. of the original position. i G CFG UPDATE•January—February 2002 www.cfginsurance.com Page 21 III Employee benefits Win the best recruits with a diverse benefits package—Voluntary benefits work with your bottom line, not against it by Christine McKenzie, CFG Insurance Services, Inc. ecent developments affecting the U.S. economy require that employers select and retain the best workers.In an environment where companies must do more with less,having the right people on your team will mean the difference between sweet success and bitter failure. i' '°x`" At the same time, economic pressures on companies are 7,4 forcing employers to maximize the value of money spent in all areas,including employee benefits.Yet,employers must offer attractive compensation packages to recruit and retain } employees.What are employers to do? Because of these trends in the workforce,there is increas- ing demand for voluntary,employee-paid benefits.Voluntary benefits can enhance an overall benefits package without causing much impact on the company's bottom line.Just 0",.‘):„ what are"voluntary benefits"?Generally,they are consid- ered to be any employer-sponsored benefit paid for by the „ , •" participants through payroll deduction.A recent study shows significant growth in this area with employers offering vol- untary benefits increasing from 30 to 56 percent during 1994 to 1999.Thirty-six percent of those surveyed were consider- ing adding voluntary benefits in the next two years.' Outsource COBRA administration to CFG Insurance Services! Save Time. Save Money. Reduce Liability. r Get Back to Business! Save Money...Avoid unnecessary claims costs and administrative expenses! Save Time...You inform CFG when you have a COBRA qualifying event and CFG does the rest! Y q fY g Reduce Liability...It's simple,proper COBRA management helps keep your company out of court! Get Back to Business...It's smart business to outsource your COBRA administration to CFG! CFG Insurance Services provides hi-tech COBRA administration and payment collection for employers. As a COBRA client,you can be assured your human resource staff is using up-to-date notices,has direct access to expert COBRA technical advice,and has the best COBRA resources available to them as close as the touch of a button. E-mail info @cfginsurance.cotn to request a free brochure about CFG's COBRA administration service. is Page 22 www.cfginsurance.com CFG UPDATE•January—February 2002 II Employee benefits CFG small employer medical renewal rating increase index Renewal Month December 2001 January 2002 February 2002 140 Employers 178 Employers 130 Employers Blue Cross Blue Shield +15.03% +18.73% +17.79% HealthPartners +15.79% +10.89% +10.10% Medica +15.35% +12.75% +14.01% The CFG Index reports the actual,average rate increases our clients of 2-50 employees have experienced at renewal time.Our purpose for doing so is to keep you informed about trends in the insurance marketplace,so that you can make some preliminary decisions about how you will handle your benefits package for the year 2002.If you would like more information on our index,please visit our web site at www.cfginsurance.com or call 952.945.0200. Employees demand comprehensive to balance work and family demands are attractive to benefits plans today's workers. Employee demand is another factor in the growth of vol- The employer's role in offering voluntary benefits is to untary benefits.A ranking of benefits in order of importance select the products/services to be offered,choose the to employees placed"benefit choices" six out of fifteen. (See vendors, communicate and enroll employees,and finally, table below)Employees look to their employer to provide process payments from the participants.The voluntary access to products that relate to their personal financial secu- benefits communication process involves a multi-faceted rity.Voluntary group life, accidental death and dismember- approach including some or many of the following: ment, disability, long-term care,and financial planning give • Surveys employees control of their overall financial picture.Time •Written communication(Brochures,payroll stuffers,etc.) saving benefits such as pre-paid legal services,group •Enrollment meetings(1:1 meetings or group meetings) auto and homeowners insurance,child care assistance, •Phone access mortgage/personal loans, and even pet insurance that help •Internet access •Confirmation statements •On-going education Employees rank importance of benefits' •Re-enrollment 1.Medical plan The Internet makes administration easier 2.Employer-paid retirement plan With the advance of technology,particularly the Internet, the distribution and administration of employee 3.Employer match on retirement plan' benefits,including voluntary benefits,has changed dramat- 4.Vacation/holidays ically. Online administration of voluntary benefits pro- 5.Sick leave/short-term disability grams makes the benefits manager's job easier,removing 6.Benefit choices them from the paper enrollment headaches and day-to-day 7.Retiree medical administration hassles.The Internet gives workers access to all the information needed to learn the features of the 8.Prescription card benefits available to them 24 hours a day, seven days a 9.Preventive/wellness week. Enrollment in the voluntary benefits program is l0.Life insurance available to employees at any time. 11.Dental insurance In short,today's employees no longer view their jobs strictly in terms of salary.The overall compensation pack- 12.Long-term disability age including benefits that incorporate flexibility and 13.Flexible work schedule choice for workers is what separates one company from 14.Vision insurance another in the 21st century workplace.Voluntary benefits 15.Paid-time-off banks can be a critical"edge" when it comes to recruiting and retaining employees. For more information,call 952.945.0200 or e-mail 1 Source:LIMRA"Employer Perspective"Study,1999 info @cfginsurance.com. 2 Source:AON Consulting America @ Work,2000 ■ CFG UPDATE•January—February 2002 www.cfginsurance.com Page 23 oKy y � �' •'4. 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F t .'!' � t � d ��'y��yry�r v'a AWi�' a r�ra.� ,�,y�►.Y K X^ t r• 31 , {�,gp�' ,,{{'" 401. t {`,4ro T' # ;r ,,,I ',F" '+ tE I. f.t �" e. 9 .. . .� . a�.•�. . ' '.,,'• k 4.,..4:41.t-ti— } ,4,"4',..,'''44,.,' ', r" � a,d , ^, fi , x f k ' w H '" ,' s Ft A r tr u a,, s A. P , ..op.",,..„, e'` RF� , vy 4,5 -t„.ct .K..a= .k�ti .��.ut.. �_.�.YVin .c.w1 W:a3�.rF>«t.r,@°�nr�:M:.'. Y 1:rL .°,�.4:t s of�;r�`i i4:. For free a demonstration of CFG's Online Sexual Harassment Prevention Training program,go to www.cfges.com/onlinetraining. Click on "Demo”to see a section of the online training program. Click on the "Admin Demo"to see the administrative portion of the online training program. El MUNICIPAL POOL APR 2 Z :43c DATE: April 18, 2002 TO: Long Term Disability Group Administrators FROM: James H. Ochs OCHS,INC. RE: THE MUNICIPAL POOL Long Term Disability Plan Endorsement THE MUNICIPAL POOL has once again conducted an extensive review of the various Long Term Disability products now available to city and county employees in the State of Minnesota. The review consisted of analyzing each insurance company's contract, rates, claims paying ability and fmancial rating. Based on the quality of contract, claims administration and financial rating, THE MUNICIPAL POOL has again elected to endorse the Fortis Benefits Long Term Disability product. It has consistently provided the most comprehensive benefit level at the lowest cost. Enclosed you will find a summary of the contract features that were compared as part of our review. If you have specific questions regarding the plans that were reviewed, please feel free to contact me. To receive a proposal, complete and return the enclosed Coverage Profile. For your convenience, you can also send your request with census information via e-mail to ochs @ochsinc.com. Enclosures 400 ROBERT STREET NORTH, SUITE 1880, SAINT PAUL, MINNESOTA 55101 651-665-3789 800-392-7295 FAX: 651-665-3791 ® MUNICIPAL POOL Comparing Long Term Disability Quotes -Questions to Ask- Long-term disability (LTD) coverage can be a valuable benefit for cities and counties and their employees. When reviewing such coverage plans, however, it is important to compare not only cost, but also coverage provisions to assure that employer and employee needs are being adequately met. The Municipal Pool endorses a Fortis LTD plan which is broader than most others offered to cities and counties. If you are comparing LTD insurance, the following list of questions may help you identify some of the differences in coverage offered by The Municipal Pool. The Municipal Pool/Fortis LTD coverages answer"Yes" to all of these questions: 1. Will the insurance benefit be paid until the disabled employee reaches their Social Security Normal Retirement Age? 2. Is there a minimum monthly benefit of at least $100 per month? 3. Is there an "Own Occupation" definition of disability as follows: • 5 years for the city manager/county coordinator, city clerk and department heads making a minimum of$30,000 annually? • 3 years for all others? 4. Does it include a pre-existing clause limitation of 3-3-12 for new employees? 5. Does the plan not integrate with sick leave? 6. Does the plan pay a benefit if an employee is partially disabled? 7. Does the plan pay partial disability benefits without requiring a prior total disability? 8. Will the plan treat schizophrenia, dementia, organic brain syndromes, delirium, amnesia syndromes or organic delusional or hallucinogenic syndromes as any other illness, outside of any 2 year mental/nervous limitation? 9. Will the contract take the pre-disability earnings and index this amount 7.5% unlimited compounded so the claimant can still qualify over a time period for the 80% earnings test for partial disability? 10. Does the contract include a Family Care Expense Credit on partial disability that allows up to $350/mo. per family member to be subtracted from return to work earnings before the partial formula applies? 85 EAST SEVENTH PLACE, SUITE 275, SAINT PAUL, MINNESOTA 55101 651-665-3789 800-392-7295 FAX: 651-665-3791 11. Does the contract allow the claimant to qualify for the own occupation or the earnings test? (Either/or, not both.) 12. Does the plan offer a conversion privilege to employees leaving the plan? 13. Does the plan offer incentives for claimant to return to work such as: • Accommodation expense for employer up to $2,000? • Employer Rehab Incentive - 50% of first months' wages if claimant returns on a part-time basis? • 100% incentive -no offset in first year of partial disability benefits unless earnings and benefit exceed 100% of pre-disability earnings? • Employee Rehab Incentive- increased benefit by 5% if joining a rehab plan and returning to work? 14. Does the written policy specify payment of the cost of such services as: • Educational expenses for training in a new occupation? • Medical expenses for treatment, physical therapy and adaptive equipment in excess of the amounts paid by third parties or under a policy or medical coverage? • Moving expenses if, because of school or employment, the employee must move more than 35 miles? • Additional job search assistance and up to three months of additional benefits if the employee recovers while unemployed? • Vocational rehabilitation assistance to spouses of disabled employees who cannot be rehabilitated? 15. Will the plan match and pay the city's share of FICA taxes on payments made to disabled employees and prepare all long-term disability W-2 forms for the city? 16. Will the plan allow unlimited part-time work during the qualifying period and support brief returns to active full-time work(up to five days per month)if the employee is temporarily capable of doing the material duties of his or her occupation? For more information about The Municipal Pool's LTD coverage or any of the other employee benefits offered by The Municipal Pool, please contact: Jim Ochs Phone: (651) 665-3789 or 1-800-392-7295 OCHS, INC.. Fax: (651) 665-3791 85 East Seventh Place, Suite 275 E-mail: ochs @ochsinc.com St. Paul,MN 55101 THE MUNICIPAL POOL • Employer Name: Address: Contact Name: Title: Phone: FAX: E-mail: I am interested in a quote for: Group Term Life Short Term Disability Long Term Care Group Dental Long Term Disability Vision • List all benefit eligible employees or send/e-mail census to ochs @ochsinc.com. • Please enclose information regarding your present coverages. Age or Dental Only- Gender DOB Occupation Salary* Spouse/#Children 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. *Type of Salary: ANNUAL MONTHLY WEEKLY HOURLY ciD• "�• Fit".‘ C/� • w -• `C CS' y• p O ° ��t CJ' (PI) n r4S O -t � S w w l '. Q � rY 'y A '.S CD CD z G r4 -.0 ' (:) w -'S w r{ `� V, FTy y,.��;CI)Q p FS w r't .nt ,..i O w 1-,--, "t O rQ. rt -- `] . _ ' i Faq C7- p) ---1 7-' o•' a CD n .„1. w CD C C p 'r�-'�I • (p •L' Oet rt CD P-' . � C tri 5 ¢' _zt Lnn _ a �, •• '(3 p-. 0 e, " �J c,' . e- v- 1-' "' S w Z �- C CD OCD w In '"r "t . F w w . "t CD y "C? C " '> rr ¢' ° O rn '~ O O w rr Cr O O o '� F21-% 0 rn on c rn et ti' n w a O (u "t Q•'/0 w "� CD r Pj ter' n O CD CD ° o 'ws Q Q. rnU' on C rn O ✓� •fit C O w �- '7 ,�'., ►t c, ,171 O �. CD r, O C O a Q- C�i Cr O ep C� ..- _. , r" r-r C!) n rte-• .._, 3 -P C' CD cn ' 0 `C cn l 1 OQ p w to N > \�� CDo O rt N ,j CD t-- CL O . Q. 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OCHS,INC., specialists in municipal and public group insurance plans since 1943, is the exclusive administrator of THE MUNICIPAL POOL. The lines of coverage we can provide include Life Insurance, Short and Long Term Disability, and Dental Insurance. These benefits can be provided either on a Voluntary 100% employee paid basis or with the employer funding all or part of the premium. Please add THE MUNICIPAL POOL to your vendor list for the following: • Life and Accidental Death&Dismemberment Insurance • Short Term Disability • Long Term Disability • Dental Insurance Please call OCHS,INC. at 800-392-7295, FAX 651-665-3791, e-mail ochs @ochsinc.com or write to us when you request insurance proposals. Thank you for your consideration. THE MUNICIPAL POOL OCHS,INC. 400 Robert Street North, Suite 1880 St. Paul, MN 55101 MUNICIPAL POOL 2 , 200.) MAR March 18, 2002 City of Oak Park Heights Ms. Judy Holst PO Box 2007 14168 Oak Park Blvd Oak Park Heights,MN 55082-2007 A city saved$30,000 annually... A county cut yearly insurance premiums by$10,000... A municipality trimmed$17,000 in expenses... Dear Employee Benefits Manager: These are budget savings realized by just a few of the more than 250 municipal groups who participate in The Municipal Pool. The Pool gives small and medium-sized municipal organizations greater group insurance purchasing power. The Municipal Pool brings separate municipal groups together to form one large group able to command more attractive rates. By buying directly from the Pool, municipalities may pay significantly lower premiums than they could negotiate on their own. Your municipal organization may be eligible to receive a quote outlining your insurance costs through the Municipal Pool. To receive your proposal, complete and return the enclosed Coverage Profile. For your convenience,you can also send your request with census information via e-mail to ochsnu.ochsinc.com. I encourage you to request a quote to determine if your municipality could save by participating in the pool. There's no obligation, and of course there's no cost to receive a quote. Sincerely, James H. Ochs ■ P.S. I've yet to see a better approach to helping municipal groups reduce their group insurance cost. Call me at 1-800-392-7295 if you wish to discuss this now. 400 ROBERT STREET NORTH, SUITE 1880, SAINT PAUL, MINNESOTA 55101 651-665-3789 800-392-7295 FAX: 651-665-3791 THE MUNICIPAL POOL Employer Name: Address: Contact Name: Title: Phone: FAX: E-mail: I am interested in a quote for: Group Term Life Short Term Disability Long Term Care Group Dental Long Term Disability Vision • List all benefit eligible employees or send/e-mail census to ochs @ochsinc.com. • Please enclose information regarding your present coverages. Age or Dental Only- Gender DOB Occupation Salary* Spouse/#Children 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. *Type of Salary: ANNUAL MONTHLY WEEKLY HOURLY • \(Ls \ Ef� �1r �T }1 145 University Avenue West, St. Paul, MN 55103-2044 f,� NOV 2 41999 Phone: (651) 281-1200 •• (800) 925-1122 TDD (651) 281-1290 League ofM;nnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence Web Site: http://www.lmnc.org November 22, 1999 To: LMCIT member cities and agents From: LMCIT Re: Updates and information Enclosed are several memos which will update you on developments with LMCIT's workers compensation and property/casualty programs: • Workers compensation rates and dividends. Information on rates for work comp coverage for 2000, and on the dividend to be returned to members next spring. • Property/casualty rates and dividends. Information on premium rates for property, liability, auto, and related coverage for next year, and on the dividend you'll receive in December. • Coverage changes for 2000. Information on coverage changes for workers compensation and for property/casualty coverage. • Statutory tort liability limit increase. How LMCIT will adjust member cities' coverage limits in response to the 1/1/2000 increase in the statutory liability limit. • Vaccine program update. Information, order forms, and a revised price list for hepatitis and Lyme disease vaccines available from SmithKline Beecham through LMCIT. As always, if you need more information or have questions these materials don't answer, don't hesitate to give us a call at the League office. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER I P. • LMC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence Web Site: http://www.lmnc.org J November 22, 1999 To: LMCIT member cities and agents From: Pete Tritz Re: Workers compensation rates and dividends Here's what LMCIT work comp program members will see in 2000: • Rates. There will be no change in rates for 2000. • Dividend. Work comp program members will share a$4 million dividend, which will be distributed next spring. Rates LMCIT Work Comp Premiums A.erage Rate per$100 payroll Over the past several years, LMCIT has been able to bring workers $6.00 - compensation premium rates down dramatically. LMCIT's current rates are $4.00 m p - just about half of what they were in - I 1992. Several factors have combined to $2.00 make this possible: $0.00 • We're seeing fewer injuries that '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 '00 result in lost time. In 1991, nearly 28% of reported injuries resulted in lost time and payment of indemnity benefits. For 1996-1999,that figure is about 17%. • For claims that do result in lost time, the average cost of indemnity (i.e., wage replacement) benefits per claim is about the same for 1999 injuries as it was for 1992 injuries-even though average wages increased substantially over that time. • Average medical costs per claim for injuries in recent years are still actually less than our average costs for 1991 and 1992 injuries. Average medical costs dropped by nearly a third from 1992 to 1995 before beginning to increase somewhat for a couple years. Since 1997, our average medical cost per claim is virtually unchanged. That's a very surprising result, in light of what's happening with health care costs generally. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER - 1 • • Those very good trends in the frequency and cost of lost-time Lost Time Claims per$1 M Premium injuries are extremely important, because of the 30% assessment 60 - -" to the state Special 45 Compensation Fund that applies 30 pti to all indemnity benefits. In other words, every dollar of 15 0 i g kJ ndemnity benefits we can avoid actually saves member cities '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 $1.30. — --- Why are we seeing these improvements in loss costs? Undoubtedly,the 1992 and 1995 workers compensation reform legislation is one important reason. Cities' own loss control efforts are an important factor as well. One very important aspect of loss control in work comp is getting injured workers back to work as quickly as possible. Those figures on the cost and the frequency of indemnity claims indicate that cities are continuing to make real progress in this area. Another indication of cities' success is controlling losses is the experience modification factor which the Workers Compensation Reinsurance Association (WCRA) calculates for LMCIT each year. Just like an individual city's experience mod, the experience modification factor that WCRA calculates compares the LMCIT member cities' collective loss experience with what would be expected based on the cities' total payrolls. For 1999, LMCIT's experience mod is .86. That's 14%better than average-pretty good by any standard. In addition to the improved loss experience, investment income has also played an important role in reducing premiums. Investment income now provides about 35% of the LMCIT work comp program's total revenues. Premiums alone right now would actually not quite cover projected losses, let alone the state assessments, expenses, reinsurance costs, and safety margin. g The rates for 2000 In light of the continuing good claims trends, it might have been feasible to reduce work comp rates slightly for 2000. However,the LMCIT Board ultimately decided to hold rates unchanged because of concerns about a couple factors that potentially could mean higher loss costs: • The cost of medical care in general is rising faster than general inflation. It's prudent to anticipate that at some point that general trend will affect our work comp medical costs. • There seems a good chance that the state will need to increase the Special Compensation Fund assessment rate at some point. r - • • The dividend The LMCIT Board approved a $4 million LMCIT Workers Compensation Dividends dividend to be returned to cities in April. This will bring the total to nearly $27 $10,000,000 �� million LMCIT has returned to member $8,000,000 cities since 1993. (This includes $13.9 $6,000,000 million of refunds from the WCRA which - $4,000,000 E 4 a ed on to member cities in LMCIT ss P $2,000,000 �, ,; 1993 and 1997.) '93 '94 '95 '96 '97 '98 '99 '00 Where does the dividend come from? __ ' ave made the rate reductions ossible which also have It s really the same factors that h p resulted in the funds being available for these dividends. When LMCIT sets rates, the rates are designed so that when combined with investment income they'll produce enough revenue to cover projected losses and expenses plus a"safety margin"—a cushion in case losses should turn out to be greater than projected. The loss projections we use in setting rates are based on actual loss experience from preceding years. However, the cost of the losses from those earlier years is now turning out to be less than what we'd projected when we set those rates. That safety margin that's built into the rates therefor isn't needed; and not all of the loss funding that was built into those rates is needed for losses. Those are the funds that are now available to be returned as dividends. How and when will the dividend be distributed? The dividend will be returned to member cities in April, 2000. As in the past, each city's share will be proportionate to the difference between the city's total premiums and total losses for all of the years the city has been a member. For purposes of the dividend formula, large individual losses are capped at$50,000. The formula is designed so that cities that have been members the longest and that have been the most successful in controlling their losses receive a proportionately greater share of the surplus funds being distributed. The actual dividend calculations won't be done for several months. If you need a rough estimate of your city's share, figure 80% of what you received last spring. What can we ex ect for the future? P While reading the tea leaves, we spilled tea on our astrological charts, so we can't say for sure what the future will bring. But here are some things to look for in LMCIT's workers compensation program: • Future dividends are likely to be smaller and/or less frequent. Rates have been reduced substantially over several years, reflecting the lower projected losses; and the safety margin that's built into the rates is comparatively small. When and if future • dividends are possible will depend on whether cities can continue to reduce injuries and losses. Rising medical costs, an increase in the SCF assessment rate, or legislation to undo some of the work comp reforms are some possible factors that could push future loss costs higher. • Future rates are very difficult to predict. Barring a major change in loss patterns,big rate changes in either direction seem unlikely. If medical costs rise,the SCF assessment rate increases, etc., it could put some pressure on rates, though as noted earlier the LMCIT Board hedged this year's rates a bit in anticipation of those possibilities. For 2001, we'll also be adjusting the relative levels of the rates for the individual payroll classes, as we do every three years. Even if the overall rate levels don't change, individual cities could be affected differently, depending on how much of the city's payrolls fall into which classes. • We're continuing to study and monitor the effect of managed care on workers compensation costs. While managed care appears to be producing some savings, the data are still rather equivocal. There also seem to be some differences in results among the different managed care organizations (MCOs). Some possibilities for 2001 are that the managed care premium credit (currently 5%) could be changed or even eliminated; or that different credits could be allowed for different MCOs based on the MCO's past results. are capped at$150,000 for purposes of the formula. The first ss$10,000 of • Individual losses into pp each loss goes into the formula at 100%. The discount 0a.r00 With the size of the city. e percentage formula at a discounted rate. The city's exposure applying an"expected loss rate" to the city p • Expected losses are calculated by , enditures; for auto liability, it's the number of base. For general liability,that base is crt exp vehicles. • The expected loss rates will be adjusted each year. (These are the same expected loss rates used to set premiums.)es of claims will continue to be weighted more heavily in franchising claims.te formula: employment- related • ulation/developmen claims and land use regulation/development/franchising eg In some cities,the revised formula could have a significant effect on th e perid overly rating. abrupt Where that occurs, the changes will be phased in over a 4-5 year period premium changes in a single year. The schedule of credits for deductibles has also been revvis d e vised credits more accurately reflect the actual value of the various levels types What's ahead? Here are some things to look for: ds are likely to be smaller and/or less frequent s discussed above,have v e become• Future dividends /casualty program. years ago. accustomed to seeing from the property " that's built into the rates is now smaller compared to what it returned years ago. — All em equal,that will mean less surplus funds All else being q unless, of course,cities can continue to reduce losses. • surprises in how losses develop,we wouldn't anticipate major inc hough rexpect Barring any sure decreases either way in property/casualty p remiums generally. Cities should, to continue to see each year the same kind of relatively minor adjustments as are being implemented this year. • practices relating and reviewing LMCIT's policies and p to o d diva d LMCIT Board will be studying ends and surplus. Some issues include whether LMCIT rates; and larger amounts of surplus in order to generate increased investment income to further is might be one possible whether LMCIT should consider other ways to assist citiemen ask g fated activities. exampl role e helping finance needed bleacher improve suggestions from example of the latter.) The Trustees would welcome any comments and cities on these issues. • • cover the year's losses and expenses, even if the losses turn out to be more than projected. If losses turn out to be at or below what we projected when we set rates, that cushion isn't needed for funding losses, so it can either be returned to the member cities as dividend or used to strengthen LMCIT's fund balance. • Current estimates are that losses from several previous years will be less than what we'd previously estimated. Most of the change is in auto and general liability from 1994 through 1998. As more of the claims from the 1996 underwriting year are being closed, liability costs from that year in particular are now shaping up to be well below earlier estimates and well below what the rates for that year were designed to fund. This positive development in liability claims was partly offset though by property losses. The LMCIT Board also took a couple other factors into account in determining how much of a dividend could be returned to member cities this year: • Y2k is the big unknown. From what we know about Y2k preparations both by cities and by the electricity, gas, and telephone service providers, we're much more optimistic than we were a year ago. However, it's still crucial to maintain adequate funds to be able to handle things if it were to turn out that Y2k problems generate an exceptional level of claims. • Investment income is another consideration. As noted above, we're seeing some good patterns in how losses from previous years are developing. However, that also means that we're holding less funds as reserves for those losses, which in turn affects investment income. In deciding on this year's dividend,the LMCIT Trustees also had to make sure that the invested loss reserves and fund balances after the dividend would be sufficient to produce the amount of investment income that we projected in setting the premium rates. Experience rating and deductible credits This year we'll begin using a completely revised experience rating formula for property/casualty members. The new formula is modeled after the workers compensation experience rating formula. The underlying concept is to compare the city's actual loss history with the amount of losses that would be expected in a city of that size if the city were a perfectly average LMCIT member. These are the key elements of the recommended new experience rating formula: • Experience rating applies only to general liability and auto liability premiums. Property premiums are not currently experience rated,though this could be a possibility for the future. Only cities over 1000 population are experience rated. • The formula compares actual and expected losses for a three-year period, excluding the most recent year. • The formula looks at the gross loss amount, before deductibles. 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Citi¢s LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Citi¢s promoting exc¢n¢nce Web Site: http://www.lninc.org November 19, 1999 To: LMCIT members and agents From: Pete Tritz Subject: Property/casualty rates and dividends for 1999-2000 There's good news for LMCIT members in the property/casualty program. • Property/casualty rates are reduced very slightly. The rate changes this year are all relatively minor adjustments. The net effect is a very slight overall reduction. • $7 million in dividends to be returned in December. This will bring the total to over $107 million in dividends returned to property/casualty program members since 1987. Last year LMCIT returned a $10 million dividend to property casualty program members. • Revised experience rating formula and schedule of deductible credits. The experience rating formula and the schedule of deductible credits have been revised for 1999-2000. The effect of these changes will be phased in over several years to avoid big year-to-year swings in cities' costs. Rates The property/casualty rate changes affect coverage written or renewed on or after November 15, 1999. This year's rate changes are comparatively modest"fine-tuning"type adjustments. Liability rates will decrease 2%; bond and excess liability rates will decrease 5%; and auto physical damage rates will increase 2%. Rates will be unchanged for property, auto liability, machinery breakdown, liquor liability, open meeting law defense, and petrofund supplement coverages. All else being equal, cities will see little change in their total premiums for the coming year as a result of the rate changes. Keep in mind, of course, that changes in the city's exposures —city expenditures, value of covered property, numbers of vehicles, etc.—will also affect the city's premiums, as will the city's own loss experience. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • A couple points regarding this year's rates LMCIT Liability Rates are worth noting. General liability Average Rate Per$1000 Expenditures represents about half of LMCIT's total premiums and losses, so the liability rates $15.00 are the single most important factor in the $10.00 i total premium cost to the city. We've `. been able this year to continue the pattern $5.00. 4 of the past several years of bringing the al 4 liability rates down ver y gradually, '92 '93 '94 '95 '96 '97 '98 '99 '00 though we've expanded coverage in some important ways during that time. This is partly due to cities' and LMCIT's success in controlling and reducing loss costs. The substantial reduction in the number and cost of employment-related claims is a big part of this. We've also reduced somewhat the safety margin that's built into the rates, in light of the program's strong fund balance. The other comment concerns rates for LMCIT Property Rates property coverage. In 1997 and 1998 A■,erage rate per$100 value for buildings and contents LMCIT cities were hit with an unusualnumber of large property ........................................................................._......................................................_..................._.............._.. losses, most of them weather-related. $0.15. If we were to project losses as we $0.10 normally would by looking at a six- $0.05 year historical average, it would have indicated an increase in property rates $0.00 -F3 for the coming year, because of the 92 '93 94 '95 '96 '97 '98 '99 '00 effect of those two high-loss underwriting years. However, the LMCIT Board concluded that increasing rates at this point might be an over-reaction, and decided instead to keep rates stable for another year. Fortunately, LMCIT's financial condition is very strong, so it's feasible to provide that rate stability. And so far this year at least, property losses are looking much better than the past couple years. Dividends LMCIT Property/casualty Dividends $109 million since 1987 This year's$7 million dividend brings the total to $109 million that the $15,000,000 - — --- property/casualty program has - returned to member cities since 1987. $10,000,000 — — There are a couple of main reasons $5,000,000 - - why these surplus funds are available to be returned this year: '87 '88 '89 '90 '91 '92 '93 '94 '95 '96 '97 '98 '99 • Part of the dividend stems from the safety margin that's built into the rates. LMCIT sets premium rates at a level that when combined with investment income will be enough to • • LMC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence Web Site: bttp://www.lrnnc.org November 22, 1999 To: LMCIT member cities and agents From: Pete Tritz Re: Coverage changes for 1999-2000 The LMCIT Board has approved a number of changes in LMCIT's liability, property, workers compensation, and other coverages for the coming year. Many of these changes are relatively minor tweaks and clarifications, but there are also a number of important substantive changes. The changes summarized below affect property/casualty coverage written or renewed on or after November 15, 1999, and workers compensation coverage written or renewed on or after January 1, 2000. A major issue for cities this year is the increase in the statutory tort liability limit which takes effect January 1, 2000. A separate enclosed memo explains how LMCIT will handle that change. Liability coverage changes 1. Land use regulation, development, and franchise litigation—late reporting. The LMCIT liability coverage includes coverage for costs of litigation relating to land use regulation, development or redevelopment, or franchising, even if that litigation doesn't include a claim for damages. The change provides that any litigation costs which the city incurs prior to reporting the litigation to LMCIT will be reimbursed at only 50%. Prompt reporting of this type of litigation is therefor now even more important. 2. Joint powers exclusion. The recommended change clarifies that the "joint powers" exclusion only applies to claims arising from the activities of a joint powers entity of which the city is a member. 3. Nurses'professional liability—vaccinations. Some city fire departments, ambulance services, or first responder teams have registered nurses who are members of the department and who administer the hepatitis and other vaccinations that are required by OSHA. The LMCIT liability coverage will now pick up any professional liability arising from these kinds of services by nurses who are city volunteers. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • 4. ERISA exclusion. The exclusion for fiduciary claims under ERISA has been eliminated. (This really doesn't have much practical effect since ERISA doesn't apply to governmental benefit programs anyway.) S. Personal injury definition. The definition of"personal injury"is amended to include "advertising injury", bringing it into conformance with the way that term is defined in CGL policies. The purpose of this change is to better coordinate with the specialty liability insurance the city may purchase from a private insurer for airports, hospitals, nursing homes, or clinics. 6. Coverage duplication. In certain rare circumstances, claims from a single event arguably could be covered under each of two successive policies. (It's possible to imagine a circumstance in which a police chase, for example, conceivably could lead to both an auto liability claim and a general liability claim.) The change clarifies that if a particular event results in claims that arguably are covered under each of two successive city policies, the later policy excludes those claims and coverage is provided only under the earlier policy. Property coverage changes 1. Property loss valuation. Several changes clarify how property losses will be adjusted in specific circumstances: • Property is deemed to be "destroyed" if the cost to repair it plus the reduction in appraised value of the repaired property would be greater than the cost to replace it. • If property is damaged but not destroyed and the city chooses to raze the property rather than repairing it, LMCIT will pay the city an amount equal to the estimated cost to repair the property on a "replacement cost" basis. • If the city and LMCIT cannot agree on a figure for the estimated cost to repair property in that situation, the issue will be resolved by arbitration. (The coverage already provides that disagreements over the property's appraised value would be resolved by arbitration.) • Increased costs to comply with building codes are considered part of "replacement cost". This has always been both the intent and LMCIT's actual practice, but the revision makes this clear, explicit, and unambiguous. 2. Police dogs. The changes clarify that LMCIT will cover the cost of veterinary treatment of a police dog for injuries but not for disease; that for purposes of coverage, a police dog is considered to be "destroyed" if because of injury or disease the dog can no longer perform the dog's normal functions; and clarify that the • replacement cost coverage for police dogs is subject to the same limit of 200%of appraised value which applies to other"mobile property". 3. Business personal effects. The change clarifies that LMCIT's coverage for"business personal effects"—i.e., employees' tools or other personal property used in performing their city duties—is primary. 4. Limits for golf course property and for business personal effects. The change clarifies that these limits are sub-limits within the blanket limit, rather than additional limits. 5. Computer virus damage. This change clarifies that damages caused by a computer virus are covered. Such damages might include, for example, the cost to reconstruct or replace data or programming that's been damaged or destroyed by a virus, or loss of income from business interruption, etc. Crime coverage changes The coverage for crime losses has been completely re-written to be broader, clearer, and easier to understand. All coverage for theft of city funds by persons other than city officers and employees is now combined into a single broad coverage part within the property coverage form. The separate coverage forms for"theft, disappearance, and destruction" and "forgery and alterations" are eliminated. There are also some important substantive changes: 1. All cities will automatically receive a $100,000 coverage limit for crime losses, with no additional premium charge. Higher limits are available if needed. The coverage and the coverage limit are now on a blanket basis, rather than being tied to specific locations. 2. Theft of city funds by computer fraud is now clearly covered. 3. Several exclusions are eliminated, broadening the coverage: • Theft from coin-operated devices • Transfer or surrender of property by threat or by unauthorized instruction (extortion, in other words) • "Exchanges or purchases" and "voluntary parting" (tricks or swindles, in other words) The old form also excluded coverage for theft from an armored car unless the city had first tried and failed to recover from the armored car company or their insurer. That restriction is now eliminated as well. • Public employee fidelity and faithful performance bond changes Limits. The most significant change in the bond coverage is that LMCIT will no longer offer bond limits of less than$25,000. Some cities have historically carried very low bond coverage limits - $5,000 or$10,000 or even less. However, the Trustees concluded that it just didn't make sense for LMCIT to offer bond limits that are so low that they really don't give the city any significant protection. Bond form changes. LMCIT's "public employee fidelity bond" and "public employee faithful performance bond" forms have also been completely re-written to be easier to use and to understand. A second goal in revising the faithful performance bond form was to make it more specifically fit the statutory requirements for these bonds in Minnesota. The faithful performance bond actually serves three distinct purposes: • Like a fidelity bond, it would reimburse the city for losses resulting from an officer's or employee's dishonesty. • It would also reimburse the city for losses resulting from other types of"malfeasance, willful neglect of duty, or bad faith"by the employee, besides dishonesty. • It would reimburse a member of the public for losses caused by the employee's malfeasance, willful neglect of duty, or bad faith for which the employee is liable. The revised form now makes it clear and explicit that if LMCIT pays any loss resulting from the employee's malfeasance, willful neglect of duty, or bad faith in any of these three situations, LMCIT can and will recover that loss if possible from the employee who is responsible. The revision also addresses a quirk in the statutes that arguably requires a faithful performance bond to respond to other liability claims as well; i.e., claims based on ordinary negligence, rather than malfeasance, willful neglect of duty or bad faith. In most cases this is irrelevant, since the city's LMCIT liability coverage covers those claims. For those few"ordinary negligence" claims excluded by the LMCIT liability coverage,the bond form now provides a very limited amount of coverage— 10% of the bond limit. Unlike the "malfeasance" situation, LMCIT would not and could not seek reimbursement from the employee in these cases. (We'd stress that the purpose of this new provision of the bond coverage is to provide strict compliance with what the statute seems to require. It should not be viewed as providing any real substantive protection to the city or to anyone else.) Open Meeting Law Defense Coverage changes The coverage limit for the Open Meeting Law Defense Coverage is increased to $50,000 per official per year, up from the current limit of$20,000. There's no additional premium charge for the increased limit. Workers compensation coverage changes Peace officers'post-traumatic stress benefits. A 1999 law(Chapter 216, Article 5, Section 3 of the 1999 Laws, codified as M.S. 299A.411) requires cities to provide up to a year's paid leave and to pay the costs of any necessary psychological,psychiatric, or other medical care for a peace officer suffering from post-traumatic stress syndrome as a result of a use of force which resulted in death or great bodily harm. If there is no physical injury to the officer in these situations, workers compensation would not apply, but the new law would still require the city to provide these benefits. For 2000, coverage for these benefits will be included as a standard feature of the LMCIT workers compensation coverage. The new coverage will reimburse the city for the direct costs the city incurs to provide the required benefits. "No-fault sewer back-up coverage" option The LMCIT Board is continuing to review the possibility of adding a"no-fault sewer back-up coverage" option, and is interested in comments and feedback from cities on the concept. Currently, the LMCIT liability coverage covers claims for damages caused by sewer back-ups. Those claims are handled like any other liability claim. The law on liability for sewer back-up damages in Minnesota is clear and well-established. The key question is whether the sewer back-up damages were caused by some negligence on the city's part. If so, the city is legally liable for those damages, and LMCIT pays those damages on behalf of the city. If the damages aren't attributable to city negligence, the city is not legally liable, and LMCIT then denies the claim. Unfortunately, that legal analysis may not satisfy the homeowner who has suffered a back-up. City councils and staff often hear very emotional complaints in these situations, to the effect that"It's the city's sewer, I didn't do anything wrong, so the city should pay for cleaning it up and repairing the damage." The idea of the "no-fault sewer back-up coverage" would work like this. The city would have the option to pay an additional premium to LMCIT, in return for which LMCIT would agree to reimburse any property owner for damages from a sewer back-up, irrespective of whether the city had been negligent and was legally liable for those damages. The no-fault coverage would be subject to a relatively low limit—perhaps • • $5,000-$10,000 per claimant per occurrence. A possible variation would be to provide no-fault coverage only for clean-up costs. The additional cost to the city is estimated to be in the range of 5-10% of the city's liability premiums. It would likely be a requirement that the city have a regular sewer inspection and maintenance program in place in order to qualify for the coverage. If you have any suggestions or comments on whether it would make sense for LMCIT to develop this option, how it might best be structured, or whether it's something your city might be interested in, please let us know by phone, fax, or e-mail to ptritz @lmnc.org,. S IP il------,,,7 L MC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence J Web Site: h w ttp://ww.lmnC.org November 22, 1999 To: LMCIT member cities and agents t From: Pete Tritz Re: Statutory tort liability limit increase On January 1, 2000, the statutory municipal tort liability limit increases from $750,000 to $1,000,000 per occurrence. (The per-claimant limit of$300,000 does not change.) Here's how LMCIT will adjust members' liability coverage limits to reflect the change: • All liability coverage written or renewed on or after November 15 will carry a limit of $1,000,000 per occurrence. • All cities whose current coverage expires after January 1 will receive an automatic endorsement increasing their coverage limit to $1,000,000 per occurrence effective January 1. There will be no additional charge for this endorsement. The LMCIT liability coverage also has sub-limits and/or annual aggregate limits on coverage for certain exposures. These will be adjusted as follows both on newly-issued coverage and on the mid-term endorsements: Exposure Current limit New limit Products/completed operations $750,000 annual aggregate $1 M annual aggregate Failure to supply utilities $750,000 annual aggregate $1 M annual aggregate Electromagnetic fields $1.5 M annual aggregate No change Fire damage $50,000/occurrence No change Medical payments $1000/$10,000 No change Limited pollution* $750,000 annual aggregate $1 M annual aggregate Lead and asbestos* $200,000 annual aggregate No change Land use litigation* $1 M annual aggregate No change Uninsured/underinsured motorist $50,000 /occurrence No change Employers liability (work comp) $750,000 annual aggregate $1 M annual aggregate Y2k—basic* $25,000 annual aggregate No change Y2k—expanded* $750,000 annual aggregate No change * This limit applies to both damages and defense costs. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • Here are answers to some common questions about the change in the statutory liability limit and LMCIT's coverage limits. Our coverage doesn't renew until after January 1. What do we have to do to get our coverage endorsed to increase the coverage limits? You don't have to do anything. LMCIT will issue the endorsements automatically. How does this affect cities that carry excess liability coverage? If your city carries excess liability coverage, after the switch you'll have $250,000 more of coverage limits available. If you carry $1 million of excess coverage, you currently have $1.75 million of total limits available - $750,000 under the primary coverage plus $1,000,000 of excess coverage. After the change, you'll have $2 million of total limits - $1,000,000 of primary coverage plus $1,000,000 of excess coverage. How does this affect our decision to waive or not to waive the statutory liability limits? At each renewal, each LMCIT member city decides whether or not to waive the statutory liability limits. The changes in LMCIT's coverage limits don't affect that decision. Whatever your city decided at the last renewal remains in effect. If you have chosen not to waive the statutory limits, the amount that claimants can recover (assuming that it's a kind of claim that the statutory limits apply to) will vary depending on the date of the occurrence. For"non-waiver" cities, even though you'll now have $1,000,000 of coverage available, the $300,000/$750,000 statutory limit will still apply to claims arising from events that occurred before 1/1/2000. For claims arising from events that occur on or after 1/1/2000, the $300,000/$1,000,000 statutory limit would apply. However, if your city has chosen to waive the statutory limits, the amount that claimants can recover will increase when the coverage limits change. For"waiver"cities, on any claim that's made after January 1 (or after the city's renewal if earlier), one or more claimants could now recover up to $1,000,000 per occurrence, regardless of whether the occurrence was before or after January 1. S L MC 145 University Avenue West, St. Paul, MN 55103-2044 Phone: (651) 281-1200 • (800) 925-1122 TDD (651) 281-1290 League of Minnesota Cities LMC Fax: (651) 281-1299 • LMCIT Fax: (651) 281-1298 Cities promoting excellence Web Site: http://www.lmnc.org vaccine Program Update Cities may now save MORE money on employee vaccines. SmithKline Beecham recently announced they have further reduced the cost of Hepatitis B vaccine for Minnesota Cities allowing them to purchase this vaccine for their employees at $22.50 per dose (three doses needed). This reduction compares to the previous cost of$24.04 and is under the agreement between the League of Minnesota Cities Insurance Trust (LMCIT) and SmithKline Beecham Pharmaceuticals. For young workers, under age 20, SmithKline Beecham has a pediatric version available for $8.25 per dose (plus .75 excise tax). Young city employees that could benefit from this lower cost method of immunization could include recreational and seasonal employees such as lifeguards, park, and other temporary workers who may have exposure. The following vaccines are still available at the following rates: Hepatitis A (two doses needed) $16.36 Lyme Disease (three doses needed) $47.85 LMCIT wants to increase the number of city employees who receive immunizations who may be at occupational risk of exposure for these diseases. SmithKline Beecham will also provide free disease prevention materials to cities. The order form for these materials is enclosed. If you have any questions about this program, contact Rachel Stapleton, LMCIT at 651- 215-4069 or Mark Prueter at SmithKline Beecham612-471-8403. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • League of Minnesota Cities Insurance Trust SmithKline Beecham Vaccine Price Sheet SIBSmithKhne Beecham (This is not an order form) Pharmaceuticals PRODUCT NDC NUMBER PACKAGE PRICE SIZE **ADULT Engerix-B®(Hepatitis B Vaccine[Recombinant]) 58160-860-01 1's $22.50/dose** VACCINES 20 mcg/mL Single-Dose Vial Engerix-B®(Hepatitis B Vaccine[Recombinant]) 20 mcg/mL Tip LokTMPrefilled Syringe 58160-861-35 5 s $112.50/pkg** Engerix-B® (Hepatitis B Vaccine[Recombinant]) 25's $562.50/ k ** 20 mcg/mL Single-Dose Vial-25 pack 58160-860-16 p g Engerix-B® (Hepatitis B Vaccine[Recombinant]) 1's 20 mcg/mL Multi-Dose Vial 58160-862-01 $225.00/pkg** ADULT Havrix® (Hepatitis A Vaccine, Inactivated) 1's $16.36/dose VACCINES 1440 EL.U./mL Single-Dose Vial 58160-835-01 Havrix® (Hepatitis A Vaccine, Inactivated) 5's $81.80/pkg 1440 EL.U./mL Prefilled Syringe 58160-835-05 HavrixTM (Hepatitis A Vaccine, Inactivated) 5's $81.80/pkg 1440 EL.U./mL Tip Lok TM Prefilled Syringe 58160-835 35 ADULT LYMErixTM (Lyme Disease Vaccine[Recombinant 58160-845-11 10's $478.50/pkg VACCINES OspA]) 30mcg/0.5mL Single Dose Vial LYMErixTM (Lyme Disease Vaccine[Recombinant 5's $239.25/pkg OspA]) 58160-845-35 30mcg/0.5mL Tip-Lok TM Prefilled Syringe **PEDIATRIC Engerix-B® (Hepatitis B Vaccine[Recombinant]) 10's $82.50/pkg** VACCINE 10 mcg/ml Single Dose Vial 10 pk 58160-85911 ** Price does not include Federal Excise Tax of $0.75 per dose for Engerix-B® vaccine. Manufactured by SmithKline Beecham Biologicals, Rixensart, Belgium Distributed by SmithKline Beecham Pharmaceuticals, Philadelphia, PA PLEASE NOTE: PRICES ARE SUBJECT TO CHANGE '•League of Minnesota Citie• SmithKline Beecham Vaccine Agreement SaSmhthKIIne Beecham Vaccine Order Information Sheet Pharmaceuticals Local Government Name Customer#(if known) Ship to Address Customer#(if known) Ordering Customer I (Please print:) (Government Unit) Name Contact Person/Title Contact Person Street Address Street Address City, State, ZIP City, State, ZIP -- Telephone Telephone P.O. Number: Physician's Name*: Order Date: Requested Delivery Date: Physician's name required if ship-to party is not a health care provider Ordering Customer: As a courtesy, please call your health care provider to notify them of incoming vaccine and arrange appropriate vaccination times. Attn Customer Satisfaction: Please type name(Government Unit) of Ordering Customer in special shipping instructions to appear on packing slip. REQUESTED DELIVERY DATE: / / PRODUCT NDC NUMBER PACKAGE ORDER DOSE CONVERSION SIZE QTY. (EA) ADULT Engerix-B®(Hepatitis B Vaccine[Recombinant]) l's X 1= VACCINES 20 mcg/mL Single-Dose Vial 58160-860-01 doses Engerix-BO(Hepatitis B Vaccine[Recombinant]) 5's 20 mcg/mL Tip LokTMPrefilled Syringe 58160-861-35 X 5= doses Engerix-B®(Hepatitis B Vaccine[Recombinant]) 20 mcg/mL Single-Dose Vial-25 pack 58160-860-16 25 s X 25= doses Engerix-B®(Hepatitis B Vaccine[Recombinant]) l's 20 mcg/mL Multi-Dose Vial 58160-862-01 x 10= doses ADULT Havrix®(Hepatitis A Vaccine,Inactivated) l's x 1= VACCINES 1440 EL.U./mL Single-Dose Vial 58160-835-01 doses Havrix®(Hepatitis A Vaccine,Inactivated) 5's 1440 EL.U./mL Prefilled Syringe 58160-835-05 X 5= doses Havrix®(Hepatitis A Vaccine,Inactivated) 5's 1440 EL.U./mL Tip Lokni Prefilled Syringe 58160-835-35 X 5— doses ADULT LYMErixTM(Lyme Disease Vaccine[Recombinant OspA]) 10's x 10= VACCINES 30mcg/0.5mL Single Dose Vial 58160-845-11 doses LYMErixTM(Lyme Disease Vaccine[Recombinant OspA]) 5's X 5= 30mcg/0.5mL Tip LokwPrefilled Syringe 58160-845-35 doses PEDIATRIC Engerix-B®(Hepatitis B Vaccine[Recombinant]) 10's VACCINES 10 mcg/ml Single Dose Vial 10 pk 58160-859-11 x 10= doses Engerix-B®(Hepatitis B Vaccine[Recombinant]) 5's 10 mcg/ml Tip Lok'*MPrefilled Syringe 1"23 gauge needles 58160-859-35 X 5= doses Manufactured by SmithKline Beecham Biologicals, Rixensart,Belgium You may fax your order to(215)751-5605 or(215)751-4759 Distributed by SmithKline Beecham Pharmaceuticals,Philadelphia,PA Or call(800)877-1158 (If ordering by phone,please have your customer no.avail when you call.) Mailing Address: SmithKline Beecham One Franklin Plaza, FP1235 Philadelphia, PA 19101-7929 1Land1][ aIrk ][nsuraine err ice's 232 South Lake Street • Forest Lake, MN 55025 • Phone: (651)464-3333 • Fax: (651)464-7596 Since 1903 OCT Ian ' ' I October 14, 1 ,- City of Oak Park Heights 14168 N 57th St, Box 2007 Stillwater,MN 55082 ATTN: Judy RE: CMC19785; MEL3468; & OML1437 Dear Judy: LMCIT-Berkley Risk Services has finally completed the renewal of the the city's Package,Umbrella and Open Meeting Law policies. These renewals extend coverage from 07/07/99 to 07/07/00. I would ask you to place these renewabwith your other insurance documents. s Please take a moment to review your policies. Should there be any changes needed in coverage or policy limits contact me direct at 464-3333,ext 209 and I would be happy to review the information with you. Claim information can be reported directly to LMCIT or you may contact us here at Landmark Insurance Services Your premium will be billed as follows: Pay direct to LMCIT- invoices enclosed(faxed previously)Pit, .', • ‘i C -1, .' -. ' , . ,i. : ■ I would like to take this time to say thank you for continuing your insurance with our agency. Landmark Insurance Services handles a full line of Property,Casualty,Life and Health Insurance for both individuals and businesses. Our agency would be happy to provide a no obligation quotation should you have any additional insurance needs. Sincerely, Kate Tipping Landmark Insurance Services Enclosure: 7 r,S. Soy.,� 4l-�(j�'vp �' ow( (��C�✓cx P °�` i -+mss ��,�1� �� I League of Minnesota Cities Cities promoting excellence League of Minnesota Cities 145 University Avenue West St. Paul, MN 55103-2044 (651)281-1200 - Comprehensive Municipal Property and Casualty Coverage Administered By: Berkley Risk Services,Inc. 145 University Avenue West St.Paul,MN 55103-2044 (651)281-1200 **IMPORTANT** PLEASE READ YOUR AGREEMENT Covenant Number: WMMON COVERAGE DECLAIITIONS CMC 19785 Coverage is Provided by: THE LEAGUE OF MINNESOTA CITIES Previous Covenant Number: INSURANCE TRUST LMC CMC 18745 (Herein called LMCIT) League of Minnesota Cities Item 1. CITY and MAILING ADDRESS: Cities promoting excellence OAK PARK HEIGHTS ATTN: THOMAS MELENA P.O.BOX 2007 STILLWATER MN 55082 Item 2. COVERAGE PERIOD: ONE YEAR From: 07/07/99 To: 07/07/00 12:01 AM Standard Time at Mailing Address on Common Coverage Declarations Item 3. THE COVERED PARTY IS: CITY Item 4. COVERAGE PARTS: IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS COVENANT,LMCIT AGREES TO PROVIDE THE COVERED PARTY WITH COVERAGES SHOWN BELOW FOR WHICH A PREMIUM CHARGE IS STATED: PROPERTY and CRIME Premium Property $ 9,182 Additional Covered Loss or Damages INCLUDED Water and Supplemental Flood Coverage INCLUDED Crime NOT COVERED Boiler and Machinery NOT COVERED Municipal Liability $ 28, 7 0 9 Medical Payments INCLUDED Automobile Liability $ 3,534 Automobile Physical Damage $ 1,749 TOTAL $ 43,174 Item 5. GENERAL ANNUAL AGGREGATE DEDUCTIBLE: DOES NOT APPLY Item 6. PREMIUM IS DUE AND PAYABLE: ANNUAL - IN ADVANCE Item 7. FORMS APPLICABLE TO ALL COVERAGE PARTS: CCM(11-95) CMC(11-98) DEC-011(11-97) DEC-012(11-98) DEC-013(11-98) DEC-016(11-97) E066(11-96) ME073(11-97) Executi e D' ctor,LMCIT LMCIT DEC-011(11197) Common Conditions All coverage parts included in this covenant are subject to the following conditions: 1. CANCELLATION AND NON-RENEWAL The first "city" shown in the Declarations is authorized to make changes in the terms of this a. The first "city" shown in the Declarations may cancel coverage agreement with the consent of LMCIT. this covenant by mailing or delivering to LMCIT advance The coverage terms can be amended or waived only written notice of cancellation. by endorsement issued by LMCIT and made a part of this covenant or by acknowledgement by LMCIT that b. LMCIT may cancel this covenant by mailing or an endorsement will be issued at a later date. delivering to the first "city" shown in the Declaration page, written notice of cancellation at least: 3. RATING AUTHORITY AND EXAMINATION OF "YOUR" BOOKS AND (1) 10 days before the effective date of the RECORDS cancellation if LMCIT cancels for nonpayment of premium; or LMCIT shall have full discretionary authority to promulgate rates and establish the premium to be (2) 30 days before the effective date of the charged for the coverage provided under this cancellation if LMCIT cancels for any other covenant. LMCIT may at its discretion or at reason. Y "your" request examine and audit "your" books - c. LMCIT will mail or deliver its notice to the first "city" as they relate to this covenant during the shown in the Declaration's last mailing address known to coverage period and up to one year thereafter LMCIT. and accordingly make any necessary adjustments in premium. No premium adjustments will be d. Notice of cancellation will state the effective date of made after one year following the expiration of cancellation. The coverage period will end on that date. the coverage period. e. If,this covenant is cancelled, LMCIT will send the first 4. INSPECTIONS AND SURVEYS "city" shown in the Declaration any premium refund due. If LMCIT cancels, the refund will be pro-rata. If the first "city" cancels, the refund may be less than pro-rata. The LMCIT has the right, but it is not obligated to: cancellation will be effective even if LMCIT has not made or offered a refund. a. Make inspections and surveys at any time; " f. If "we" decide not to renew this covenant "we" will mail or deliver to the first "city" shown in the b. Give the "city" reports on the conditions it Declarations written notice of the non-renewal not less finds; and than 30 days before the expiration date. If notice is mailed, c. Recommend changes. g. , proof of mailing will be sufficient proof of notice. Neither LMCIT's right to make inspections nor its 2. CHANGES making any report thereon shall constitute any undertaking on behalf of or for the benefit of the "city" or others to determine or warrant that such This covenant contains all the agreements between property or operations are safe or healthful or free LMCIT and "you" concerning the coverage afforded. from hazard or are in compliance with any law, rule or regulation. LMCIT CCM(11-89)(Rev. 11-95) 1 of 3 . . ' .! These conditions apply not only to LMCIT, but also to The terms of the covenant, including those with any rating advisory, rate service, or similar organization respect to: which makes inspections, surveys, reports, or recommendations. (a)the LMCIT's rights and duties with respect to the defense of suits; and 5. PREMIUMS (b)the "covered party's" duties, in the event of The first "city" shown in the Declarations: an occurrence, apply irrespective of the application of the deductible amount. a. Is responsible for the payment of all premiums; and LMCIT may pay any part or all of the deductible amount to effect settlement of any claim or suit and b. Will be the payee for any return premiums. upon notification of the action taken, the first "city" shall promptly reimburse LMCIT for such part of the 6. TRANSFER OF "CITY'S" RIGHTS AND deductible amount as has been paid by LMCIT. DUTIES UNDER THIS COVENANT 9. ASSESSIBILITY The "city's" rights and duties under this covenant may not be transferred without the written consent of LMCIT. All "cities" in the joint coverage pool are jointly and severally liable for all claims and expenses of the 7. OVERLAP OF COVERAGE pool. The amount of any liabilities in excess of assets may be assessed to the members of the pool In the event of a dispute between LMCIT and one or when a deficiency is identified. more insurers as to which policy or coverage agreement applies to a covered loss, LMCIT shall indemnify the 10. SEPARATION OF "COVERED "city" for any legal or other expenses which are PARTIES" necessarily incurred by the "city" in determining whether LMCIT or the insurer(s) shall bear the loss. Such As respects the particulars and statements contained indemnification shall be made only if it is determined that in the application for this coverage and the exclusion payment of the loss shall be made under this covenant. set forth herein, this coverage shall be construed as a If the loss is shared by LMCIT and one or more insurers, separate agreement with each "covered art ". P Y indemnification shall be made in the same proportion as Nothing in this paragraph shall be construed to the loss payment. The "city" and LMCIT shall cooperate increase LMCIT's maximum liability set forth in the in the development and execution of reasonable Declarations. procedures to resolve the dispute. 11. NUCLEAR HAZARD 8. DEDUCTIBLES LMCIT under this covenant does not cover any loss LMCIT shall be liable to the "city" or to others on behalf or claim for damage that is caused in part or in total of the "city" only to the amount of damages in excess of by nuclear reaction or radiation, or radioactive any deductible amounts. contamination, however, caused. For purposes of this section, damages include defense 12. CONCEALMENT OR FRAUD costs. Defense costs means those costs which are allocated to each claim to include attorneys' fees, court This covenant is void if any "covered party" has costs, court reporting and transcript fees, the cost of intentionally concealed or misrepresented any obtaining records, general witness and expert witness fees material fact or circumstance relating to this and expenses and similar defense related costs. Damages covenant. do not include claim adjuster fees that are not allocated to each claim. LMCIT CCM(11-89)(Rev. 1145) 2 of 3 • • • 13. OTHER COVERAGE This coverage is excess over any other valid and collectible insurance policy or other coverage whether primary, excess, contingent, or any other basis, except other coverage written specifically to be excess over this coverage. LMCIT CCM(11-89)(Rev. 11-95) 3 of 3 • • COMPREHENSIVE MUNICIPAL COVERAGE Various provisions in this covenant restrict coverage. The words "city" and "covered party" are defined Read the agreement entire coverage a reement carefully to under SECTION II - WHO IS COVERED. determine rights, duties and what is and is not covered. Throughout this covenant the word "city" refers to the Other words and phrases that appear in italics have first "city" shown in the Declarations. The word special meaning, as given in SECTION IV - of LMCIT refers to the League o M innesota Cities DEFINITIONS. g Insurance Trust. SECTION I - COVERAGES COVERAGE A. MUNICIPAL LIABILITY 2. CLAIM AND OCCURRENCE DATES COVERAGE (CLAIMS MADE BASIS) a. For any claim for damages, the date of the 1. COVERAGE AGREEMENT occurrence shall be deemed to be as follows: a. Except as otherwise provided in this agreement, (1) For claims for bodily injury or property LMCIT will pay on behalf of the "covered damage, the date of the occurrence is the �� which the bodily injury or property party" all sums which the "covered party" shall date on wh h y > ry p p ry become legally obligated to pay as damages as damage first took place or is alleged to a result of an occurrence,. if the following have taken place. conditions are met: (2) For any other claim for damages, the date (1) The claim for such damages must be first of the occurrence is the date on which the made against the "covered party" during wrongful act giving rise to the claim for the coverage period; and damages took place or is alleged to have taken place. If the damages are alleged to (2) The date of the occurrence giving rise to have arisen from a series of wrongful acts the claim for damages must be on or after the date of the occurrence is deemed to be the retroactive date, if any, shown in the the date when the first such wrongful act Declarations; and took place or is alleged to have taken place. (3) The occurrence must have taken place in If both (1) and (2) apply to claims for damages the coverage territory. arising from a single occurrence, the date of the occurrence is the earlier of the dates b. LMCIT will have the right and duty to defend defined by (1) and (2), respectively, any such claim or suit seeking damages. LMCIT may, at its discretion, investigate any b. For any claim for damages, the date the claim actual or potential claim; and unless the "city" is made is deemed to be as follows: has given notice as provided in Section VI, 7, below, LMCIT may settle any claim or suit. (1) For any employment liability claim, the claim is deemed to have been made on the c. The amount LMCIT will pay for damages is earliest of: limited as described in SECTION III - LIMITS OF COVERAGE. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 1 of 21 (a) The date the claimant files a charge (1) An employee of the "city" arising out of with the Federal Equal Employment and in the course of employment by the Opportunity Commission, the "city"; or Commissioner of the Minnesota Department of Human Rights, or a (2) Damages to the spouse, child, parent, local human rights commission as brother or sister of that employee as a defined in Minn. Stat.§363.01, subd. consequence of(1) above. 23, whichever comes first; or This exclusion applies: (b) The date when notice of claim for damages is received by any covered (1) Whether the "city" may be liable as an party or by LMCIT, whichever comes employer or in any other capacity; and first. (2) To any obligation to share damages with (2) For any other claim for damages, the claim or repay someone else who must pay is deemed to have been made when notice damages because of the injury. of such claim is received and recorded by any "covered party" or by LMCIT, This exclusion does not apply to liability whichever comes first. assumed by the "covered party" under a covered contract. (3) All claims for damages arising from a single occurrence will be deemed to have d. Any loss, cost, or expense arising out of any been made at the time the first of those direction, demand, or request by the claims is made against any "covered government or any other entity that the "city" party". or any other entity test for, monitor, clean up, remove, contain, treat, detoxify or neutralize 3. EXCLUSIONS pollutants; or This coverage does not apply to: Damages arising out of the actual, alleged or threatened discharge, dispersal, seepage, a. Damages for which the "covered party" is migration, release or escape of pollutants: liable by reason of the assumption of liability in a contract or agreement. This exclusion does (1) At or from premises the "city" owns, rents, not apply to liability for damages: leases, uses, or occupies, and premises the "city" no longer owns, rents, leases, uses, (1) Assumed in a contract or agreement that is or occupies; a covered contract; or (2) At or from any landfill, dump, or other site (2) The "covered party" would have in the or location presently or formerly used by or absence of the contract or agreement. for the "city" or others for the handling, storage, disposal, processing or treatment of b. Damages for which the "covered party" may be pollutants; liable by reason of the Minnesota Civil Damages Act (M.S. 340A.801-340A.802), or (3) Which are or were at any time transported. any other law governing liability for illegal handled, stored, treated, disposed of, or sales of alcoholic beverages, processed as waste by or for the "city" or any person or organization for whom the c. Bodily injury to: "city" may be legally responsible; or LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page Lof 21 • • (4) At or from any site or location on which the This exclusion does not apply to: "city" or any contractors or subcontractors working directly or indirectly on the "city's" (1) A watercraft while ashore on premises the behalf are or have been performing "city" owns or rents; operations; (2) A watercraft that is: (a) If the pollutants are brought on or to the site or location in connection with such (a) Less than 26 feet long; and operations; or (b) Not being used to carry persons or (b) If the operations are to test for, monitor, property for a charge; clean up, remove, contain, treat, detoxify or neutralize the pollutants. (3) Parking an auto on, or on the ways next to, premises the "city" owns or rents, provided This exclusion does not apply to any of the the auto is not owned by or rented or loaned following: to the "covered party". (1) Any Limited Pollution Liability Claim. f. Damages due to war, whether or not declared, or any act or condition incident to war. War (2) Any claim arising out of the discharge or includes civil war, insurrection, rebellion or dispersal of mace, tear gas or similar agent, revolution. if such discharge was for the purpose of protecting persons or property or incident to g. Property damage to: an arrest. (1) Property the "city" owns, rents, or occupies; (3) Any lead or asbestos claim, unless the actual, alleged, or threatened discharge, (2) Premises the "city" sells, gives away or dispersal, release, escape, use, distribution, abandons, if the property damage arises out or handling of lead or asbestos took place at of any part of those premises; or from any landfill, dump, or other site or location presently or formerly used by or for (3) That particular part of real property on the "city" or others for the handling, which the "city" or any contractors or storage, disposal, processing or treatment of subcontractors working directly or indirectly pollutants. on the "city's" behalf are performing operations, if the property damage arises out (4) Any damages arising out of heat, smoke, or of those operations; or fumes from a hostile fire. A hostile fire is a fire which becomes uncontrollable or breaks (4) Work performed by or on behalf of the out from where it was intended to be. "city" arising out of your work or any portion thereof, or out of materials, parts or e. Damages arising out of the ownership, equipment furnished in connection maintenance, use or entrustment to others of any therewith; aircraft, auto or watercraft owned or operated by or rented or loaned to any "covered party". (5) Your product arising out of it or any part of Use includes operation and loading or it. unloading. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 3 of 21 • Paragraphs (3) and (4) of this exclusion do not (1) Attorney, unless the attorney is an apply to liability assumed under a sidetrack employee of the "city" and not an agreement. independent contractor, and the professional services are within the scope This exclusion does not apply to property damage of the attorney's duties as a "city" by fire to premises rented to the "city". A separate employee, including professional services limit of coverage applies to this coverage as performed for any of the "city's" boards, described in SECTION III - LIMITS OF commissions, authorities or agencies, or COVERAGE. joint powers entities in which the "city" participates. h. Damages claimed for any loss, cost or expense incurred by the "city" or others for the loss of (2) Architect use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal (3) Doctor of Medicine of: (4) Dentist (1) Your product; (5) Nurse, except with respect to those (2) Your work; or activities in the capacity of an emergency medical technician or first responder. (3) Impaired property; (6) Pharmacist if such product, work, or property is withdrawn or recalled from the market or from m. Damagesarising out of the failure or bursting use by any person or organization because of a of any: known or suspected defect, deficiency, inadequacy or dangerous condition in it. (1) Class I or Class II dam as classified by the Commissioner of the Department of i. Bodily injury to any volunteer while acting on Natural Resources pursuant to Minnesota behalf of the "city" if the volunteer is an Rules Section 6115.0340; or employee within the meaning of a Workers Compensation law or similar law, or is covered (2) Any dike, levee or similar structure. under a voluntary endorsement to a Workers Compensation insurance policy. n. Damages arising out of the "city's" ownership, sponsorship or operation of: j. Damages for bodily injury,property damage or personal injury arising out of the "city's" (1) Motorized amusement devices if the ownership, operation or maintenance of any power supply motor is rated at greater airport. than 5 horsepower; k. Damages for bodily injury,property damage or (2) Any mobile equipment, automobile, personal injury arising out of the "city's" snowmobile or motorcycle in any racing, ownership, operation or maintenance of any pulling, pushing, speed, or demolition hospital, nursing home or medical clinic. contest or in any stunting activity; 1. Damages arising out of the. rendering of or (3) Rodeos; or failure to render professional services by any professional listed below: (4) Fireworks displays or exhibitions. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 4 of 21 • o. Damages arising from or relating to the dedication by adverse use. This exclusion does • detention or confinement of any person(s) in not apply to any claim for taking of property any jail, holding cell or similar detention wherein the taking of property is incident to an facility, which the "city" owns, operates or arrest or for the purpose of protecting persons maintains, if the date of the occurrence or property in an emergency. causing such damages takes place after a continuous detention or confinement period of t. Any criminal proceedings or proceedings 30 days, or in any detention facility which is under the open meeting law against any intended and regularly used for confinement of "covered party". persons for periods in excess of 30 days; u. Damages with respect to any claim(s) made by p. Damages arising out of the activities of any of LMCIT or the "city" against any other the following "city" boards, commissions, or "covered party". agencies: v. Any claim for damages asserted in any land (1) Gas, electrical or steam utilities use, development or franchise litigation. commission; COVERAGE B. MEDICAL AND RELATED (2) Port authority, housing and redevelopment PAYMENTS authority, economic development authority area or municipal redevelopment 1. COVERAGE AGREEMENT authority, or similar agency; LMCIT will pay to or for each person who (3) Municipal power agency; or sustains bodily injury caused by accident all reasonable medical and related expense incurred (4) Municipal gas agency; within one year from the date of the accident as a result of such bodily injury provided such bodily unless such board, commission, authority, or injury arises out of a condition in the covered agency is named in the Declarations, in which premises. case the "city" will also be covered to the extent of coverage provided under this 2. EXCLUSIONS covenant to the named board, commission, authority or agency for damages arising out of LMCIT will not pay expenses for bodily injury: the activities of the respective named board, commission, authority or agency. a. Arising out of the operation or use of any snowmobile or trailer designed for use q. Damages arising out of the activities of a joint therewith; powers entity unless the joint powers entity is named in the Declarations. b. Included within the completed operations hazard or the products hazards; r. Damages arising out of any obligations imposed or imputed to any "covered party" c. Arising out of operations performed for the under the Employee Retirement Income "city" by an independent contractor other Security Act of 1974 and any law amendatory than: thereof; (1) Maintenance and repair of the covered s. Damages arising out of condemnation, inverse premises; or condemnation, adverse possession, or LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 5 of 21 • (2) Structural alterations at such premises services, including prosthetic devices, necessary which do not involve changing the size of ambulance, hospital, professional nursing and ' - or moving buildings or other structures; funeral services, and replacement or repair of damaged eye glasses or clothing. d. To any tenant or other person regularly residing on the covered premises; 4. ADDITIONAL CONDITION MEDICAL REPORTS; PROOF AND PAYMENT OF e. To any other tenant if the bodily injury occurs CLAIM. on that part of the covered premises rented from the "city"; As soon as practicable the injured person or someone on his behalf shall give to LMCIT written f. To any person while engaged in maintenance proof of claim, under oath if required, and shall, and repair of the covered premises or after each request from LMCIT, execute alteration, demolition or new construction at authorization to enable LMCIT to obtain medical such premises; reports and copies of records. g. To any person practicing, instructing or The injured person shall submit to physical participating in any physical training, sport, examination by physicians selected by LMCIT athletic activity or contest whether on a formal when and as often as LMCIT may reasonably or informal basis; require. LMCIT may pay the injured person or any person or organization rendering the services h. To a member or guest of any club, tourist and the payment shall reduce the amount payable court or trailer park operated or owned by the hereunder for such injury. Payment hereunder "city"; shall not constitute an admission of liability of any "covered party" or of LMCIT. i. For any injury for which the injured party has received or is entitled to receive workers COVERAGE C. AUTOMOBILE LIABILITY- compensation benefits. BODILY INJURY AND PROPERTY DAMAGE The exclusions of the Municipal Liability Coverage Part (Coverage A) also apply to this 1. COVERAGE AGREEMENT Coverage Part as respects bodily injury. LMCIT will pay on behalf of the "covered party" 3. ADDITIONAL DEFINITIONS all sums which the "covered party" shall become legally obligated to pay as damages because of When used herein: bodily injury or property damage to which this coverage applies, caused by an occurrence and Covered premises means all premises owned or arising out of the ownership, maintenance or use, rented to the "city" with respect to which the including loading or unloading, of any "city" is afforded coverage for bodily injury automobile. This coverage applies only to bodily liability under this covenant, and includes the ways injury or property damage which occurs during the immediately adjoining on land; however, covered coverage period and within the covered territory. premises does not include streets, sidewalks, or boulevards that do not abut a "city"-owned LMCIT will have the right and duty to defend any building or "city"-owned parking lot. suit seeking those damages. However: Medical and related expense means expenses for a. The amount LMCIT will pay for damages is necessary medical, surgical, x-ray and dental limited as described in SECTION III - LIMITS OF COVERAGE; LMCIT CMC(11=86)(Rev. 11-96; 11-97:11-98) Page 6 of 21 • b. LMCIT may, at its discretion, investigate any (a) Property damage to a residence or occurrence and settle any claim or suit that may private garage by a private passenger result. automobile covered by this covenant; or 2. EXCLUSIONS (b) Property damage to an automobile that is rented by the covered party on a This coverage does not apply to: weekly or daily basis and is used for "city" business. a. Any obligation for which the "covered party" or any carrier as his insurer may be held liable (c) Personal property of others which comes under any workers' compensation, into the care, custody, and control of unemployment compensation or disability police, fire, or emergency medical benefits law, or under any similar law; services personnel in the course of performing public safety services; b. Any liability the "city" may have for bodily injury to: d. Bodily injury due to war, whether or not declared, civil war, insurrection, rebellion or (1) An employee of the "city" arising out of revolution or to any act or condition incident and in the course of employment by the to any of the foregoing; "city"; or e. Any loss, cost, or expense arising out of any (2) Damages to the spouse, child, parent, direction, demand, or request by the brother or sister of that employee as a government or any other entity that the "city" consequence of(1) above. or any other entity test for, monitor, clean up, remove, contain, treat, detoxify or neutralize This exclusion applies: pollutants; or (1) Whether the "city" may be liable as an Damages arising out of the actual, alleged or employer or in any other capacity; and threatened discharge, dispersal, seepage, migration, release or escape of pollutants: (2) To any obligation to share damages with or repay someone else who must pay damages (1) At or from premises the "city" owns, because of the injury. rents, leases, uses, or occupies, and premises the "city" no longer owns, rents, This exclusion does not apply to liability leases, uses, or occupies; assumed by the "covered party" under a covered contract. (2) At or from any landfill, dump, or other site or location presently or formerly used c. Property damage: by or for the "city" or others for the handling, storage, disposal, processing or (1) To property owned or being transported by treatment of pollutants; the "covered party"; or (3) Which are or were at any time (2) To property rented to or in the care, custody transported, handled, stored, treated, or control of the "covered party", or as to disposed of, or processed as waste by or which the "covered party" is for any purpose for the "city" or any person or exercising physical control, other than: organization for whom the "city" may be legally responsible; or LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 7 of 21 S • (4) At or from any site or location on which 3. ADDITIONAL DEFINITIONS the "city" or any contractors or subcontractors working directly or These additional definitions apply for purposes of indirectly on the "city's" behalf are or Coverage C: have been performing operations; Automobile business means the business or (a) If the pollutants are brought on or to occupation of selling, repairing, servicing, storing the site or location in connection with or parking automobiles; such operations; or Hired automobile means an automobile not owned (b) If the operations are to test for, by the "city" which is used under contract on monitor, clean up, remove, contain, behalf of, or loaned to, the "city", provided such treat, detoxify or neutralize the automobile is not owned by a) a partner or pollutants. executive officer of the "city", or b) an employee or agent of the "city" who is granted an operating This exclusion does not apply to any of the allowance of any sort for the use of such following: automobile. (1) Any Limited Pollution Liability Claim. Non-owned automobile means an automobile which is neither an owned automobile nor a hired (2) Any claim arising out of the discharge or automobile. dispersal of mace, tear gas or similar agent, if such discharge was for the Owned automobile means an automobile owned by purpose of protecting persons or property the "city". or incident to an arrest. Private passenger automobile means a four wheel (3) Any lead or asbestos claim unless the private passenger or station wagon type actual, alleged, or threatened discharge, automobile. dispersal, release, escape, use, distribution, or handling of lead or asbestos Trailer includes semi-trailer but does not include took place at or from any landfill, dump, mobile equipment. or other site or location presently or formerly used by or for the "city" or COVERAGE D. LAND USE, others for the handling, storage, disposal, DEVELOPMENT OR FRANCHISE processing or treatment of pollutants. LITIGATION (4) Any damages arising out of heat, smoke, 1. COVERAGE AGREEMENT or fumes from a hostile fire. A hostile fire is a fire which becomes uncontrollable or For any land use, development or franchise breaks out from where it was intended to litigation which is first filed or served against the be. "city" or a "city" officer or employee during the annual coverage period of this agreement, LMCIT f. Liability assumed under any contract or will pay the following on the "city's" behalf: agreement, but this exclusion does not apply to liability assumed under a covered contract. a. 100% of the first $50,000 of defense costs, 85% of the next $200,000 of defense costs, and 60% of any defense costs in excess of $250,000; and LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 8 of 21 S • b. 85% of any damages which the "city" shall be 2. LITIGATION MANAGEMENT required to pay. For any land use, development or franchise The amount LMCIT will pay for damages and litigation defense counsel will be selected by mutual defense costs for land use, development or agreement of the "city" and LMCIT. If LMCIT franchise litigation covered under this section is and the "city" are not able to agree on selection of limited as described in SECTION III- LIMITS OF counsel, LMCIT will provide a list of five defense COVERAGE. attorneys experienced in land use, development or franchise litigation matters; and the "city" will The amount LMCIT pays for damages or defense select defense counsel from that list. costs for land use, development or franchise litigation is subject to the Municipal Liability A land use, development or franchise litigation suit Deductible shown in the Municipal Liability may not be settled without the approval of both Declarations or the General Annual Aggregate LMCIT and the "city". Deductible if any shown in the Common Coverage Declarations. SECTION II - WHO IS COVERED 1. "City" means the "city" or other governmental (2) Member of a "city" board, commission, or body or entity first named in the Declarations. committee which is not excluded by the Unless specifically named in the Declarations, definition of "city"; "city" shall not include any of the following: (3) Elected or appointed official of the "city"; a. Gas, electrical or steam utilities commission; (4) Employee of the "city"; b. Port authority, housing and redevelopment authority, economic development authority, area (5) Volunteer person or organization while or municipal redevelopment authority or similar acting on behalf of the "city" and subject to agency; the "city's" direction and control; c. Municipal power agency; (6) Other authorized person or agent of the "city" while acting on behalf of the "city", d. Municipal gas agency; but excluding independent contractors; e. Welfare or public relief agency; (7) "City" relief association and its members, officers, and employees. f. School board; or (8) Person while acting in the administrative g. Joint powers entity. capacity of medical director or medical advisor to the "city" ambulance service. 2. For purposes of Coverage A, "covered party" means: c. With respect to a joint powers entity named in the Declarations: a. The "city", and any other entity named in the Declarations; (1) The joint powers entity; b. For actions within his duties as such, any (2) While acting on behalf of the joint powers present or former: entity, or with respect to liability arising out of the activities of the joint powers entity, (1) Member of the "city" council; any present or former: LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 9 of 21 410 • (a) Governmental member of the joint d. A present or former firefighter with respect powers entity; to any automobile while such automobile is ' - or was being used in the performance of his (b) Elected or appointed official of the official duties; governmental member; e. Any other person or organization but only with (c) Employee of the governmental member; respect to his or its liability because of acts or omissions of a "covered party" under (a), (b) or (d) Other authorized person or agent of the (c) above. governmental member, but excluding independent contractors. For purposes of Coverage C, none of the following is a "covered party": 3. For purposes of Coverage C, "covered party" means: a. An elected or appointed official or employee of the "city" with respect to an automobile owned a. The "city", and any other entity named in by a member of his household unless such the Declarations; automobile is specifically described in this covenant; b. Any present or former elected or appointed official or employee of the "city" with respect to b. Any person or organization, other than the a non-owned automobile only while such "city", with respect to: automobile is or was being used in the business of the "city"; (1) A motor vehicle while used with any trailer owned or hired by such person or c. Any other person while using an owned organization and not covered by LMCIT automobile or a hired automobile with the (except a trailer designed for use with a permission of the "city", provided his actual private passenger automobile and not being operation or (if he is not operating) his other used for business purposes with another type actual use thereof is within the scope of such of motor vehicle); or permission, but with respect to bodily injury or property damage arising out of the loading or (2) A trailer while used with any motor vehicle unloading thereof, such other person shall be a owned or hired by such person or "covered party" only if he is or was: organization and not covered by LMCIT. (1) A lessee or borrower of the automobile; or c. Any person while employed in or otherwise engaged in duties in connection with an (2) An employee of the "city" or of such lessee automobile business, other than an automobile or borrower; business operated by the "city". SECTION III - LIMITS OF COVERAGE 1. The limits of coverage shown in the Declarations c. Persons or organizations making claims or and the rules below fix the most LMCIT will pay as bringing suits. damages under each coverage part regardless of the number of: 2. LMCIT's maximum limit of liability for Coverages A and C combined shall be the per occurrence or a. "Covered Parties"; sudden occurrence limit shown in the Declarations whether the claim or claims fall under Coverage A, b. Claims made or suits brought; or Coverage C, or both. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Paee 10 of 21 • • 3. The Products-Completed Operations Annual period of this agreement shall not exceed Aggregate Limit is the most LMCIT will pay under $1,000,000, regardless of the number of suits, Coverage A for damages included in the defendants, or claimants. products-completed operations hazard. 11. For any year 2000 claim, the following limits 4. The Fire Damage Limit is the most LMCIT will apply regardless of any other cause or event that pay under Coverage A for damages because of contributes concurrently or in any sequence to the property damage to premises rented to the "city" damages, costs or expenses: arising out of any one fire. a. The liability of LMCIT for any year 2000 5. The Medical Expense Limit is the most LMCIT claim shall be limited to 85% of the incurred will pay under Coverage B for all medical expenses damages, defense costs, and loss adjustment because of bodily injury sustained by any one expenses. person, and the occurrence aggregate limit is the most LMCIT will pay under Coverage B for all b. The amount LMCIT will pay for damages, medical expenses because of bodily injury to two or defense costs, and loss adjustment expenses more persons resulting from one occurrence. for year 2000 claims shall not exceed $25,000 regardless of the number of claims, claimants, 6. The Limited Pollution Liability Annual Aggregate or occurrences. Limit is the most LMCIT will pay for limited pollution liability claims during the annual coverage c. The amount LMCIT pays for damages, period. The Limited Pollution Liability Annual defense costs, or loss adjustment expenses for Aggregate limit applies to the sum of damages and year 2000 claims is subject to the Municipal loss adjustment expense, including defense costs. Liability Deductible shown in the Municipal Liability Declarations or the General Annual 7. The Lead or Asbestos Claim Annual Aggregate Aggregate Deductible if any shown in the Limit is the most LMCIT will pay for lead or Common Coverage Declarations. asbestos claims during the annual coverage period. The Lead or Asbestos Claim Annual Aggregate 12. LMCIT shall not be obligated under this covenant Limit applies to the sum of damages and loss to pay any claim or judgment or to defend any adjustment expense, including defense costs. suit after the applicable limit of LMCIT's liability under Coverages A or C has been exhausted by 8. The Failure to Supply Annual Aggregate Limit is payment of judgments or settlements or by tender the most LMCIT will pay for damages for failure to any excess carrier or excess coverage including to supply claims during the annual coverage period. excess coverage provided by LMCIT. 9. The EMF Annual Aggregate Limit is the most 13. For any Annual Aggregate Limit shown in the LMCIT will pay for damages for EMF claims Declarations, the limit shall apply separately to during the annual coverage period. each consecutive annual period and to any remaining period of less than 12 months, starting 10. LMCIT's total liability for defense costs and with the beginning of the coverage period shown damages for all land use, development or in the Declarations, unless the coverage period is franchise litigation which is first filed or served extended after issuance for an additional period of against the "city" during the annual coverage less than 12 months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the limits of coverage. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 11 of 21 • • SECTION IV - DEFINITIONS 1. Automobile (Auto) means a land motor vehicle, of another to pay damages to a third person or trailer or semi-trailer designed for travel on public organization, if the contract or agreement is made roads, including any attached machinery or prior to the date of the occurrence giving rise to equipment. But automobile does not include the damages. Tort liability means a liability that mobile equipment. would be imposed by law in the absence of any contract or agreement. 2. Bodily injury means bodily injury, sickness or disease sustained by a person, including death Covered contract does not include that part of any resulting from any of these at any time. contract or agreement: 3. Coverage territory means: a. That indemnifies an architect, engineer or surveyor for injury or damage arising out of: a. The United States of America (including its territories and possessions), Puerto Rico and (1) Preparing, approving or failing to prepare Canada; or approve maps, drawings, opinions, reports, surveys, change orders, designs or b. International waters or airspace, provided the specifications; or injury or damage does not occur in the course of travel or transportation to or from any place (2) Giving directions or instructions, or failing not included in a. above; or to give the same, if that is the primary cause of the injury or damages; c. All parts of the world if: b. Under which the "city's" architect, engineer or (1) The injury or damage arises out of: surveyor, assumes liability for injury or damages arising out of the "city's" rendering or (a) Goods or products made or sold by the failing to render professional services, "city" in the territory described in a. including those listed in a. above and above; or supervisory, inspection or engineering services; or (b) The activities of a person whose home is in the territory described in a. above, c. That indemnifies any person or organization for but is away for a short time on the damages by fire to premises rented or loaned to "city's" business; and the "city". (2) The "covered party's" responsibility to pay 5. Damages means money damages, and includes damages is determined in a suit on the awards for attorneys' fees with respect to federal merits, in the territory described in a. civil rights suits and state human rights suits. With above or in a settlement LMCIT agrees to. respect to any land use, development or franchise litigation, damages also includes amounts the 4. Covered contract means: "city" is obligated to pay for loss of use of property during the time prior to a final An indemnification of a municipality as required determination by the court that enforcement of a by ordinance, or that part of any contract or land use, zoning, subdivision, or similar ordinance agreement pertaining to the "city's" business under or regulation constitutes a taking of private which the "city" assumes the tort liability property. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) - Page 12 of 21 ! • Damages does not include any of the following: 6. EMF claim means any claim for damages arising out of the actual or alleged exposure to a. Any obligation of a "covered party" under a electromagnetic fields; electromagnetic radiation workers' compensation, disability benefits, or or stray voltage. unemployment compensation law or any similar law. 7. Failure to supply claim means any claim for damages arising out of the complete or partial b. Exemplary damages or punitive damages failure to supply water, electricity, gas or steam. except punitive damages claimed or levied against an officer, employee or volunteer of the 8. Impaired property means tangible property, other "city", provided that the officer, employee or than your product or your work, that cannot be volunteer: used or is less useful because: (1) Was acting in the performance of the duties a. It incorporates your product or your work that of the position; and is known or thought to be defective, deficient, inadequate or dangerous; or (2) Was not guilty of malfeasance in office, willful neglect of duty, or bad faith. b. The "city" has failed to fulfill the terms of a contract or agreement; c. Fines or penalties imposed by law. If such property can be restored to use by: d. Injunctive or equitable relief, or quasi-judicial or administrative orders. a. The repair, replacement, adjustment or removal of your product or your work; or e. Repayment of any tax, assessment, fee, or other charge that was wrongfully obtained, or any b. The "city's" fulfilling the terms of the contract interest on, or any other amount claimed for or agreement. loss of use of, such tax, assessment, fee, or other charge. 9. Joint powers entity means an operating entity created by two or more governmental units f. Amounts paid or payable for the purchase or entering into an agreement as provided by statute permanent acquisition of property or property for the joint exercise of governmental powers. An rights, or for the right to permanently enforce intergovernmental agreement will be deemed to an ordinance, regulation, or restriction on the create a joint powers entity if the agreement use of property. establishes a board with the effective power to do any of the following, regardless of whether the g. Amounts due under the terms of any contractual specific consent of the constituent governmental obligation, except for liability: units may also be required: (1) Assumed in a covered contract; or a. To receive and expend funds; (2) Assumed in an employment contract b. To enter contracts; between the "city" and its employees. c. To hire employees; h. Any wages and employment benefits for work that has been performed by the employee d. To purchase or otherwise acquire and hold real making the claim, or any claimed increases in or personal property; or such wages and employment benefits for work that is hereafter performed by the employee e. To sue or be sued. making the claim. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 13 of 21 • • 10. Land use, development or franchise litigation threatened discharge, dispersal, release, escape, means: use, distribution, or handling of lead or asbestos. a. Any litigation relating to the application or 12. Limited pollution liability claim means any claim interpretation of a land use, zoning, for damages which resulted from a sudden subdivision, or similar ordinance or occurrence which took place on or after the regulation; or retroactive date shown in the Declarations and prior to the expiration date of this covenant, and b. Any litigation relating to the "city's" which: involvement_in the financing or approval of any development or redevelopment project. a. Was caused by an actual, alleged, or threatened discharge, dispersal, release, or c. Any litigation relating to the granting, refusal, escape of pollutants which took place entirely interpretation, or enforcement of any above ground and not within or on the surface franchise, ordinance, permit, license, or other of any lake, stream, surface water, or other mechanism through which the "city" body of water, and in which any resulting authorizes or regulates the provision of cable damages occurred entirely above ground and communications, electricity, gas, heat, not within or on the surface of any lake, telephone, or other public utilities within the stream, surface water, or other body of water; city. or Any litigation meeting the criteria listed above will b. Arises from the accidental rupture, backup or be considered to be land use, development or overflow of the "city's" sanitary sewer, storm franchise litigation in its entirety, regardless of sewer, or water supply systems. whether the litigation may assert other claims as well. 13. Loading or unloading means the handling of property: But land use, development or franchise litigation does not include litigation that seeks only: a. After it is moved from the place where it is accepted for movement into or onto an aircraft, a. Compensation or other relief for an actual or watercraft or auto; alleged physical occupation, invasion, or use of property by the "city"; or b. While it is in or on an aircraft, watercraft or auto; or b. Reduction or invalidation of a special assessment; or c. While it is being moved from an aircraft, watercraft or auto to the place where it is c. Compensation for damages based on the finally delivered; but loading or unloading "city's" actual or alleged negligent inspection does not include the movement of property by or enforcement of the state building, plumbing, means of a mechanical device, other than a electrical, fire, or similar codes; or hand truck, that is not attached to the aircraft, watercraft or auto. d. Amounts due or allegedly due under contract, including any "city" bonds or other 14. Mobile equipment means any of the following obligations. types of land vehicles, including any attached machinery or equipment: 11. Lead or asbestos claim means any claim for damages arising out of the actual, alleged, or LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 14-of 21 • a. Bulldozers, farm machinery, forklifts and monetary limits on the "city's" tort liability. other vehicles designed for use principally off public roads; 16. Personal injury means injury other than bodily injury, arising out of one or more of the b. Vehicles that travel on crawler treads; following offenses: c. Vehicles, whether self-propelled or not, a. False arrest, detention, or imprisonment, or maintained primarily to provide mobility to malicious prosecution. permanently mounted: b. The publication or utterance of a libel or (1) Power cranes, shovels, loaders, diggers or slander or other defamatory or disparaging drills; or material, or a publication or utterance in violation of an individual's right of privacy. (2) Road construction or resurfacing equipment such as graders, scrapers or c. Wrongful entry or eviction, or other invasion rollers. of the right of private occupancy. d. Vehicles not described in a., b., or c. above d. Assault or battery committed for the purpose of that are not self-propelled and are maintained protecting persons or property or incident to an primarily to provide mobility to permanently arrest. attached equipment of the following types: 17. Pollutants means any solid, liquid, gaseous or (1) Air compressors, pumps and generators, thermal irritant or contaminant, including smoke, including spraying, welding, building vapor, soot, fumes, acids, alkalis, chemicals and cleaning, geophysical exploration, lighting waste. Waste includes materials to be recycled, and well-servicing equipment; or reconditioned or reclaimed. (2) Cherry pickers and similar devices used to 18. Products-completed operations hazard includes raise or lower workers; all bodily injury and property damage occurring away from premises the "city" owns or rents and e. Vehicles not described in a., b., or c. above arising out of your product or your work except: maintained primarily for purposes other than the transportation of persons or cargo. a. Products that are still in the "city's" physical possession; or 15. Occurrence means: b. Work that has not yet been completed or a. With respect to Coverage A, a wrongful act or abandoned. a series of related wrongful acts. 19. Your work will be deemed completed at the b. With respect to Coverage C, an accident, earliest of the following times: including continuous or repeated exposure to substantially the same general harmful a. When all of the work called for in the "city's" condition. contract has been completed; Provided, that for purposes of Section III, b. When all of the work to be done at the site has occurrence shall be given the same meaning as been completed if the "city's" contract calls given in the applicable statute establishing for work at more than one site; LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 15 of 21 • c. When that part of the work done at a job site 23. System or system component means any of the had been put to its intended use by any person following: or organization other than another contractor or subcontractor working on the same project. a. Computer hardware, including microprocessors; Work that may need service, maintenance, correction, repair or replacement, but which is b. Computer application software; otherwise complete, will be treated as completed. c. Computer operating systems and related 20. Property damage means: software; a. Physical injury to tangible property, including d. Computer networks; all resulting loss of use of that property; or e. Microprocessors or other computer chips not b. Loss of use of tangible property that is not part of any computer system; or physically injured. f. Any other computerized or electronic 21. Sudden occurrence means an accident which takes equipment or components. place entirely above ground or water, and the pollution resulting therefrom, which begins and 24. Wrongful act means any actual or alleged error, ends within 72 hours following the accident. A statement, act, omission, offense, neglect, related series of accidents shall be deemed to be accident, or violation. "Violation" includes a single sudden occurrence. In the case of a violation of any rights, immunities, or privileges related series of accidents, the sudden occurrence secured by the Constitution and Laws of the will be deemed to have taken place when the first United States of America. accident in the related series of such accidents took place. 25. Year 2000 claim means any claim for damages arising directly or indirectly out of: 22. Suit means a civil proceeding in which damages to which this coverage applies are alleged. Suit a. Any actual or alleged failure, malfunction, or includes an arbitration proceeding alleging such inadequacy of any system or system damages to which the "city" must submit or component, whether belonging to the city or to submit with LMCIT's consent. Suit does not others, which is due to any year 2000 mean any criminal proceeding against any problem. "covered party" or any open meeting law proceeding, unless damages are also alleged in b. Any actual or alleged failure, malfunction, or that proceeding. A charge of employment inadequacy of any product, service, data, or discrimination filed with the Federal Equal function that directly or indirectly uses or Employment Opportunity Commission, the relies on any system or system component, Commissioner of the Minnesota Department of which is due to any year 2000 problem; or Human Rights, or a local human rights commission as defined in Minnesota Statute § c. Any advice, consultation, design, evaluation, 363.01; Subd. 23, shall be deemed to be a suit inspection, installation, maintenance, repair, alleging damages. replacement, or supervision done by a covered party to determine, rectify, or test for any potential or actual year 2000 problem. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 16 of 21 • • • '26. Year 2000 problem means the inability of any Your product includes warranties or system or system component to correctly representations made at any time with respect to recognize, process, distinguish, interpret, or the fitness, quality, durability or performance of accept the year 2000 and beyond. any of the items included in a. and b. above. 27. Your product means: Your product does not include vending machines or other property rented to or located for the use a. Any goods or products, other than real of others but not sold. property, manufactured, sold, handled, distributed or disposed of by: 28. Your work means: (1) The "city"; a. Work or operations performed by the "city" or on the "city's" behalf; and (2) Others trading under the "city's" name; or b. Materials, parts or equipment furnished in (3) A person or organization whose business connection with such work or operations. or assets the "city" has acquired; and Your work includes warranties or representations b. Containers (other than vehicles), materials, made at any time with respect to the fitness, parts or equipment furnished in connection quality, durability, or performance of any of the with such goods or products. items included in a. or b. above. SECTION V - SUPPLEMENTARY PAYMENTS - COVERAGES A AND C LMCIT will pay, with respect to any claim or suit including actual loss of earnings up to $100 a day LMCIT defends: because of time off from work. 1. All expenses LMCIT incurs. 5. All costs taxed against the "covered party" in the suit. 2. Up to $250 for cost of bail bonds required because of accidents or traffic law violations arising out of 6. Prejudgment interest awarded against the "covered the use of any vehicle to which the coverage party" on that part of the judgment LMCIT pays. applies. LMCIT does not have to furnish these If LMCIT makes an offer to pay the applicable bonds. limit of coverage, LMCIT will not pay any prejudgment interest based on that period of time 3. The cost of bonds to release attachments, but only after the offer. for bond amount within the applicable limit of coverage. LMCIT does not have to furnish these 7. All interest on the full amount of any judgment bonds. that accrues after entry of the judgment and before LMCIT has paid, offered to pay, or deposited in 4. All reasonable expenses incurred by the "covered court the part of the judgment that is within the party" at LMCIT's• request, to assist it in the applicable limits of coverage. investigation or defense of the claim or suit, LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 17 of 21 • • SECTION VI - CONDITIONS In addition to the Common Conditions, Liability 3. "COVERED PARTY'S" DUTIES IN THE Coverage Parts A and C are subject to the following EVENT OF OCCURRENCE, CLAIM OR conditions: SUIT 1. LIMITATIONS ON LMCIT'S DUTY TO a. In the event of a claim or suit, notice INDEMNIFY containing particulars sufficient to identify the "covered party" and also reasonably obtainable LMCIT's duty to pay on behalf of or to indemnify information with respect to the time, place and a "covered party" other than the "city" shall not circumstances thereof, and the names and apply to any act, error, omission, or violation: addresses of the injured and of available witnesses, shall be given by or for the a. Which constitutes malfeasance in office; or "covered party" to LMCIT or any of its authorized agents as soon as practicable. The b. Which constitutes willful neglect of duty; or "city" shall promptly take, at its own expense, all reasonable steps to prevent damages from c. Which constitutes bad faith; or arising out of the same or similar conditions; provided that: d. For which the "city" is not authorized to indemnify any person by statute; or (1) A failure to take such preventative measures shall not constitute a breach of e. Which constitutes dishonesty on the part of a this condition unless LMCIT has requested "covered art "; or the "city" in writing to undertake such P Y Y g c preventative measures; and f. Which constitutes the willful violation of a statute or ordinance by any official, employee, (2) Such expense shall not be recoverable or agent of the "city". under this covenant. The terms "malfeasance", "willful neglect of Notice of damages or injury is not notice of a duty", and "bad faith" shall be given the same claim. meaning in this covenant as given in the applicable statute with respect to the "city's" duty to defend b. If claim is made or suit is brought against the or indemnify its officers, employees or agents. "covered party", the "covered party" shall immediately forward to LMCIT every demand, 2. FINANCIAL RESPONSIBILITY LAW notice, summons or other process received by him or his representative. When this covenant is certified as proof of financial responsibility for the future under the c. The "covered party" shall cooperate' with provisions of any motor vehicle financial LMCIT and, upon LMCIT's request, assist in responsibility law, such coverage as is afforded by making settlements, assist in the conduct of this covenant shall comply with the provisions of suits and assist in enforcing any right of such law to the extent of the coverage and limits contribution or indemnity against any person or of liability required by such law. organization who may be liable to the "covered party" because of damages for which LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 18 of 21 • • coverage is afforded under this covenant; and the Number of years since "covered party" shall attend hearings and trials and retroactive date shown assist in securing and getting evidence and on Declarations page Additional cost obtaining the attendance of witnesses. The "covered party" shall not, except at his own cost, 1 55.0% voluntarily make any payment, assume any 2 57.0% obligation or incur any expense other than for first 3 60.3% aid to others at the time of accident. 4 65.9% 5 70.8% 4. EXTENDED REPORTING PERIOD 5+ 70.8% a. LMCIT will provide one or more extended d. An extended reporting period does not extend reporting periods, as described below, if: the coverage period or change the scope of coverage provided. It applies only if the date of (1) Coverage A is canceled or not renewed; or the occurrence giving rise to the claim for damages is after the retroactive date and before (2) LMCIT renews or replaces Coverage A the end of the coverage period. with coverage that: Claims for damages which are first received and (a) Has a retroactive date later than the date recorded during the basic extended reporting shown on the Declarations page; or period (or during the supplemental extended reporting period, if it is in effect) will be (b) Does not apply on a claims made basis. deemed to have been made on the last day of the coverage period. b. A basic extended reporting period of 60 days from the end of the coverage period is Once in effect, extended reporting periods may automatically provided without additional not be cancelled. charge. e. Extended reporting periods do not reinstate or c. A supplemental extended reporting period of increase the limits of coverage applicable to any unlimited duration is available, but only by an claim to which this coverage part applies. endorsement and for an extra charge. The supplemental extended reporting period starts f. Neither the basic extended reporting period nor 60 days after the end of the coverage period. the supplemental extended reporting period is applicable to, and no extended reporting period The "city" must give LMCIT a written request is provided for, the following: for the endorsement within 60 days after the end of the coverage period. The supplemental (1) Any limited pollution liability claim; extended reporting period will not go into effect unless the "city" pays the additional (2) Any land use or development litigation; premium promptly when due. (3) Any lead or asbestos claim; or The additional premium for the supplemental extended reporting period will be a percentage (4) Any year 2000 claim. of the annual expiring premium for Coverage Part A. LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 19 of 21 S • , 5. ACTION AGAINST LMCIT 7. CONSENT TO SETTLE No action shall lie against LMCIT unless as a The "city" may prohibit LMCIT from settling any condition precedent thereto, there shall have been claim or suit against a "covered party" without the full compliance with all of the terms of this "city's" consent, as provided below: covenant, nor until the amount of the "covered party's" obligation to pay shall have been fully a. At any time before LMCIT has offered or made determined either by judgment against the "covered a settlement of a claim or suit, the "city" may party" after actual trial or by written agreement of notify LMCIT that LMCIT may not settle the the "covered party", the claimant and LMCIT. claim or suit without the "city's" consent. The "city" must give a separate notice for each Any person or organization or the legal claim or suit which the "city" intends to representative thereof who has secured such prohibit LMCIT from settling without the judgment or written agreement shall thereafter be "city's" consent. entitled to recover under this covenant to the extent of the coverage afforded by this covenant. No b. If the "city" notifies LMCIT that the claim or person or organization shall have any right under suit may not be settled without the "city's" this covenant to join LMCIT as a party to any consent, the "city" must designate an individual action against the "covered party" to determine the authorized to give or refuse consent on the "covered party's" liability, nor shall LMCIT be "city's" behalf. The "city's" notice must impleaded by the "covered party" or his legal include the name, address, and telephone representative. Bankruptcy or insolvency of the number of the individual authorized to give or "covered party" or of the "covered party's" estate refuse consent on the "city's" behalf. shall not relieve LMCIT of any of its obligations hereunder. c. If the "city" has notified LMCIT that the claim or suit may not be settled without the "city's" 6. WAIVER OF STATUTORY LIABILITY consent, LMCIT will notify the "city" of the LIMITATIONS terms and conditions of any proposed settlement. If the "city" does not consent to the a. It is the express intent of the city and of LMCIT proposed settlement, the "city" must notify that the procurement of this covenant shall not LMCIT within 14 days of the date the "city" waive any monetary limits of liability provided receives notice of the proposed settlement, by Minnesota Statute 466.04 by any unless the "city" and LMCIT have mutually comparable or successor statute, or by common agreed to a longer or shorter period. If within law, which may be applicable to any "covered that time the "city" does not notify LMCIT that party"; and that any previous waiver of liability the "city" does not consent to the settlement, limits is revoked to the extent that it may apply the "city" will be deemed to have consented to to claims covered under this covenant. the settlement. b. It is the express intent of the city and of LMCIT d. If the "city" refuses to consent to a settlement that the procurement of this covenant shall not recommended by LMCIT, LMCIT will not be waive any other immunities, limitations, or liable for any excess amount. "Excess amount" defenses imposed by or available under any means the sum of all damages and legal defense statute or common law which is applicable to costs for the claim or suit minus the sum of: any "covered party". (1) The amount of the settlement proposed by LMCIT; and LMCIT CMC(11-86)(Rev. 11-96; 11-97:11-98) Page 20 of 21 • • (2) Any costs of defense incurred before the defend and indemnify LMCIT for any claim or date of the "city's" refusal. Any excess suit arising out of the failure to settle the amount shall not be included in the original claim or suit. calculation of damages for purposes of any applicable "Each Occurrence Deductible" 8. RETROACTIVE JOINT POWERS or "General Aggregate Deductible". COVERAGE. e. If the "city" refuses to consent to a settlement LMCIT will, upon the "city's" request, issue recommended by LMCIT, LMCIT may, at its retroactive comprehensive municipal coverage to sole discretion, exercise either of the following any joint powers entity in which the "city" options: participates and which is not named as a "covered party" under any other LMCIT coverage. (1) LMCIT may pay to the "city" an amount Pursuant to this section, LMCIT will issue its equal to the amount of the recommended standard Comprehensive Municipal Coverage settlement, minus any applicable document to the joint powers entity but coverage deductible. If LMCIT makes such shall be subject to an annual aggregate limit of payment, LMCIT has no further duty to $200,000. This limit shall apply to the sum of defend or to indemnify the "city" or any damages and loss adjustment expenses including other covered party for this claim or suit, defense costs for all claims to which the coverage and the "city" assumes any duty which applies. Coverage issued pursuant to this section LMCIT would otherwise have had to will be issued with the same inception date and defend and to indemnify any other covered the same retroactive date as this covenant. party. The premium must be paid to LMCIT before the (2) LMCIT may continue to defend the claim coverage goes into effect. The premium for or suit. If LMCIT elects to continue to coverage issued pursuant to this section shall be defend the claim or suit, the "city" must equal to the greater of$5,000 or the premium the reimburse LMCIT for any excess amount. joint powers entity would otherwise pay for coverage at LMCIT's current rates. f. If the "city" refuses to consent to a settlement recommended by LMCIT, the "city" must LMCIT CMC(I1-86)(Rev. 11-96; 11-97:11-98) Page 21 of 21 r 0 • COMPREHENSIVE MUNICIPAL LIABILITY COVERAGE , X Coverage A Municipal Liability Coverage A Municipal Liability but only for "Bodily Injury", "Property Damage" or "Personal Injury" Coverage A Municipal Liability, except for "Bodily Injury", "Property Damage" or "Personal Injury" X Coverage B Medical and Related Payments X Coverage C Automobile Liability - "Bodily Injury" and "Property Damage" X Coverage D Land Use or Development Litigation In consideration of the premium charged, it is understood and agreed that the Declarations and Section II - Who Is Covered are amended to include: Economic Development Authority subject to a retroactive date of July 7, 1998 for all coverage where ❑ is X'd above. All other terms and conditions remain unchanged. LMCIT ME066(11/96) Page 1 of 1 • COMPREHENSIVE MUNICIPAL COVERAGE WAIVER OF STATUTORY LIABILITY LIMITATIONS ENDORSEMENT In consideration of the additional premium paid by the "city", Section VI- Conditions, paragraph 6, is deleted and is replaced by the following: 6. STATUTORY LIABILITY LIMITATIONS AND IMMUNITIES a. It is the express intent of the "city" and of LMCIT that for any claim to which this covenant applies, the monetary limits of liability provided by Minnesota Statute 466.04 are waived to the extent of the limits of coverage shown in the declarations and further described in Section III - Limits of Coverage. This waiver shall not apply to any claim not covered under this covenant, and shall not affect any limitations which may apply by virtue of any other statute or common law. b. It is the express intent of the "city" and of LMCIT that the procurement of this covenant shall not waive any other immunities, limitations, or defenses imposed by or available under any statute or common law which is applicable to any "covered party". All other terms and conditions remain unchanged. ME073(11/97) Covenant #: ICIPAL PROPERTY and CRI*and CMC 19785 BOIL AND MACHINERY DECLARXI'IONS Coverage is provided by: LMC THE LEAGUE OF MINNESOTA CITIES INSURANCE TRUST (Herein called LMCIT) League of Minnesota Cites Citias promoting excellence J Item 1. CITY: OAK PARK HEIGHTS ATTN: THOMAS MELENA Item 2. COVERAGE PERIOD: ONE YEAR From: 07/07/99 To: 07/07/00 12:01 A.M. Standard Time at Mailing Address indicated on Common Coverage Declarations Item 3. THE COVERED PARTY IS: CITY Item 4. COVERAGE: IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS COVENANT, LMCIT AGREES TO PROVIDE THE COVERED PARTY WITH COVERAGES SHOWN BELOW FOR WHICH A LIMIT IS STATED: Item 5. COVERAGE PART ONE - PROPERTY Section I - Property Blanket Limit of Coverage Per Occurrence $ 5, 719, 718 This blanket limit is subject to the sublimits as described in Section V, Limits of Coverage and Valuation Section II- Additional Covered Loss or Damages 1 . Asbestos Clean up, Abatement and Removal $ 250 ,000 Per Location 2. Loss of Revenue,Extra Expense and Expediting Expense $5,000,000 Per Location 3 . Debris Removal(Direct Physical Damage to Covered Property) $1,000,000 Per Occurrence (No Direct Physical Damage to Covered Property) $ 50,000 Per Occurrence 4. Leasehold Interest $ 500,000 Per Location 5 . Pollutant Cleanup and Removal $ 10,000 Per Location 6 . Errors . $ 500,000 Per Occurrence 7 . Rental Reimbursement $ 25,000 Annual Aggregate 8. Arson Reward $ 5,000 Per Fire Loss 9. Accounts Receivable $ 500,000 Per Location 10. Valuable Papers & Records $ 500,000 Per Location 11 . Year 2000 -Ex t a Ex pence 5,000 Per Occurrence/ 5,000 Annual Aggregate Section IV-Water and Supplemental Flood Coverage $ 500,000 Per Occurrence/ 500,000 Annual Aggregate This blanket limit is subject to the sublimits as described in Section V, Limits of Coverage and Valuation LMCIT DEC-012(11-98) Page 1 of 3 • • LMC League of Minnesota Cities Cities promoting excellence Item 6. REFER TO SCHEDULE OF COVERED PROPERTY FOR THOSE LOCATIONS INCLUDED IN THE SECTION I COVERAGE; THE SCHEDULE OF COVERED MOBILE PROPERTY FOR THE MOBILE PROPERTY INCLUDED IN THE SECTION I COVERAGE AND THE SCHEDULE OF COVERED PROPERTY FOR THOSE LOCATIONS INCLUDED IN SECTION IV COVERAGE. Item 7. DEDUCTIBLES (Deductible applies per occurrence subject to General Annual Aggregate Deductible, if any, shown on Common Coverage Declarations) COVERAGE PART ONE - PROPERTY $ 500 PER OCCURRENCE Item 8. COVERAGE PARTS,FORMS, SCHEDULES AND ENDORSEMENTS APPLICABLE TO THIS COVERAGE. ME063(11-95) MPC(12-98) PM-100(11-97) PM-109(11-97) PM-110(11-97) Item 9. COVERAGE PART TWO - CRIME LOCATIONS, LIMITS AND DEDUCTIBLES APPLICABLE: THEFT, DISAPPEARANCE AND DESTRUCTION Location#1 I Location#2 I Location#3 I i I I Theft,Disappearance Limits & Destruction Inside *Deductible I Coverage I I Theft,Disappearance Limits & Destruction Outside *Deductible I I J Coverage I ( I Location#1: Location#2: Location#3: LMCIT DEC-012(11-98) Page 2 of 3 THE LEAGUES MINNESOTA CITIES INSURANCE *ST Property and Crime Coverage Declarations - (continued) LMC League of Minnesota Cities Cities promoting excellence FORGERY AND ALTERATION I Location#1 I Location#2 I Location#3 Forgery or Alteration I Limits I I I I I *Deductible J Coverage I I I { { Location#1: Location#2: Location#3: PUBLIC EMPLOYEE DISHONESTY I Limit of Coverage 1 Per Loss I *Deductible j Public Employee Dishonesty Coverage I I I PUBLIC EMPLOYEE FAITHFUL PERFORMANCE { I Limit of Coverage ( Per Loss I *Deductible I Public Emmloyee Faithful Performance Coverage I I I PUBLIC EMPLOYEE DISHONESTY WITH FAITHFUL PERFORMANCE OF DUTY FOR SPECIFIED POSITIONS OR OBLIGEE Limit of Coverage Per Loss *Deductible Public Employee Dishonesty I I { Faithful Performance of Duty for Specified Positions I See Form or Obligee Coverage I { * Deductible applies per occurrence subject to General Annual Aggregate Deductible, if any, shown on Common Coverage Declarations. Item 10. COVERAGE PARTS,FORMS, SCHEDULES and ENDORSEMENTS APPLICABLE TO THIS COVERAGE Item 11. BOILER and MACHINERY COVERAGE-COVERAGE PARTS,FORMS,SCHEDULES and ENDORSEMENT APPLICABLE TO THIS COVERAGE. Item 12. DEDUCTIBLE BOILER AND MACHINERY $ PER ACCIDENT LMCIT DEC-012(11-98) Page 3 of 3 • Definition of "City" Endorsement It is understood and agreed that "city" is amended to include: Economic Development Authority All other terms and conditions remain unchanged. LMCIT ME063 11/95 • • -3EN1- =1.1 1111 League of Minnesota Cities PROPERTY AND CRIME COVERAGE LMCIT MPC(11/97)(REV.12/98) • • ♦ M PROPERTY AND CRIME COVERAGE WHAT IT IS AND WHERE YOU CAN FIND IT INDEX LI I PROPERTY COVERAGE - PART ONE League of Minnesota Cities SECTION I - PROPERTY COVERAGE Page A. Covered Property 1 B. Property Not Covered 1 -2 SECTION II - ADDITIONAL COVERED LOSS OR DAMAGE 1. Asbestos Clean Up, Abatement and Removal 2 2. Loss of Revenue, Extra Expense and Expediting Expense 2 3. Debris Removal 2 -3 4. Leasehold Interest 3 5. Pollutant Clean Up and Removal 3 6. Errors 3 - 4 7. Rental Reimbursement 4 8. Arson Reward 4 9. Accounts Receivable 4 10. Valuable Papers and Records 4 11. Year 2000 Extra Expense 4 SECTION III - CAUSES OF LOSS AND DAMAGES NOT COVERED 4 - 6 SECTION IV - WATER AND SUPPLEMENTAL FLOOD COVERAGE 6 -7 SECTION V - LIMITS OF COVERAGE AND VALUATION 7 - 11 SECTION VI - DEFINITIONS 11 - 16 SECTION VII - CONDITIONS 16 - 19 LMCIT MPC(11/97)(REV.12/98) • • PROPERTY AND CRIME COVERAGE WHAT IT IS AND WHERE YOU CAN FIND IT INDEX — II CRIME COVERAGE - PART TWO League of Minnesota Cities Page SECTION I - CRIME COVERAGE 1 SECTION II - EXCLUSIONS 1 SECTION III - LIMITS OF COVERAGE AND VALUATION 2 SECTION IV - CONDITIONS 2 -5 SECTION V - DEFINITIONS 5 -6 LMCIT MPC(11/97)(REV.12/98) u r • • —y- League of Minnesota Cities MUNICIPAL PROPERTY COVERAGE PART ONE LMCIT MPC(11/97)(REV.12/98) • • MUNICIPAL PROPERTY COVERAGE PART ONE Various provisions in this covenant restrict coverage. Insurance Trust. The word you and your refer to the Read the entire covenant carefully to determine city shown in the Declarations. The words we, us, rights, duties and what is or is not covered. and our refer to LMCIT providing this covenant. Throughout this covenant, the word city refers to the Other words and phrases that appear in italics have first city shown in the Declarations. The word special meaning, as given in SECTION VI - LMCIT refers to the League of Minnesota Cities DEFINITIONS. SECTION I - PROPERTY COVERAGE I. COVERAGE AGREEMENT 2. We will pay for loss to Newly Acquired Covered Property as described in SECTION We will pay for direct physical loss of or damage V - LIMITS OF COVERAGE AND to your Covered Property unless the cause of loss VALUATION. or damage is not covered, as described under SECTION III - CAUSES OF LOSS AND 3. We will pay for loss to your Buildings in the DAMAGES NOT COVERED. The amount we Course of Construction, Alteration, or will pay for loss or damage is limited as described Repair as described in SECTION V- in SECTION V- LIMITS OF COVERAGE AND LIMITS OF COVERAGE AND VALUATION. VALUATION A. Covered Property 4. We will pay for loss to Covered Property in Transit as described in SECTION V - 1. We will cover the following types of LIMITS OF COVERAGE AND property. VALUATION. a. Building/contents described in the 5. We will pay for loss to Covered Property Schedule of Covered Property. that is temporarily at an Unscheduled Location that you do not own, lease or b. Property in the open described in the operate, as described in SECTION V- Schedule of Covered Property. LIMITS OF COVERAGE AND VALUA- TION. c. Mobile property valued at $25,000 replacement cost or less if identified as B. Property Not Covered covered on the Schedule of Covered Mobile Property; and Mobile property 1. We will not cover the following types of valued at greater than $25,000 property: replacement cost and is listed on the Schedule of Covered Mobile Property. a. Aircraft; LMCIT MPC(11/97)(REV.12/98) Page 1 of 19 • I ' b. Animals (except for police dogs); j. Underground and buried pipes, flues or drains; c. Automobiles, vehicles, or self-propelled machines that are licensed for use on k. Foundations of buildings, structures, public roads; or machinery or boilers if their foundations are below: d. Bills,currency,deeds,evidences of debt, money, notes or securities; (1) The lowest basement floor; or e. Bridges, roadways, walks, patios or (2) The surface of the ground, if there is other paved surfaces, except golf course no basement; property; 1. Retaining walls that are not part of the f. Contraband or property in the course of Covered Property; illegal transportation or trade; m. Transmission and distribution lines and g. Cost of excavations, grading, backfilling poles and equipment that are usual to or filling; the transmission of electricity. This does not include substations and h. Land, subsoil, crops or lawns, except transformers. golf course property; n. Trees and shrubs that are not within 100 i. Pilings, piers, wharves or docks; feet of a building. SECTION II - ADDITIONAL COVERED LOSS OR DAMAGE We will provide coverage for the following loss or 2. LOSS OF REVENUE, EXTRA EXPENSE damage unless the cause of loss or damage is not AND EXPEDITING EXPENSE covered, as described under SECTION III- CAUSES OF LOSS AND DAMAGES NOT We will pay for the actual loss of revenue, extra COVERED. The amount we will pay for loss or expense or expediting expense sustained by you damage is limited as described in SECTION V - due to the necessary suspension of your LIMITS OF COVERAGE AND VALUATION operations during the period of recovery caused by direct physical loss or damage to any 1. ASBESTOS CLEANUP,ABATEMENT AND Covered Property. REMOVAL 3. DEBRIS REMOVAL a. We will pay for your expense to clean up, abate or remove from Covered Property We will cover the following debris removal asbestos particles that are discharged, expenses: dispersed, or released. a. The cost of removal of debris of Covered b. The expenses to clean up, abate or remove Property and non-Covered Property from a asbestos particles will be paid only if such covered location resulting from direct expenses are incurred within 90 days of the physical loss or damage to Covered date of direct physical loss or damage. Property; or LMCIT MPC(11/97)(REV.12/98) Page 2 of 19 • • b. The cost of removal of debris of non-Covered d. We will cover your leasehold interest when Property from your covered location which your Covered Property is rendered wholly or results from a specified cause of loss. partially untenantable and the lease is canceled by the lessor in accordance with the conditions 4. LEASEHOLD INTEREST of the lease or by statutory requirements of the state in which the damaged or destroyed a. We will provide coverage for leasehold Covered Property is located. interest resulting from direct physical loss or damage to Covered Property. e. We will cover your leasehold interest for the first three months succeeding the date of the b. Leasehold interest means: loss and the net lease interest for the remaining months of the unexpired lease. We will not be (1) The excess of the fair rental value of liable for any increase of loss that may be similar premises over the actual rent occasioned by the suspension, lapse, or payable by you as lessee (including any cancellation of any license,or by the exercising maintenance or operating charges paid by of any option to cancel the lease. the lessee) during the unexpired term of the lease; and 5. POLLUTANT CLEANUP AND REMOVAL (2) The rental income that would have been a. We will provide coverage for pollutant cleanup earned by you from sublease agreements, and removal resulting from direct physical loss over and above the rental expense or damage to Covered Property. We will cover specified in the lease between you and the the expense to extract pollutants from land or lessor. water on a covered location if the discharge, dispersal, seepage, migration, release, or c. When Covered Property is rendered wholly or escape of the pollutants is caused by any partially untenantable by a direct physical loss covered cause of loss. or damage and the lease is canceled by the lessor in accordance with the conditions of the b. We will cover the costs of testing that are lease or by statutory requirements of the state incurred in the course of extracting pollutants in which the damaged or destroyed Covered from land or water and any expense incurred to Property is located, we will cover the pro rata test for, monitor, or assess the existence, proportion from the date of loss to expiration concentration, or effects of pollutants. date of the lease (to be paid without discount) on your interest in: 6. ERRORS (1) Improvements and betterments to Covered a. We will pay for loss to any Covered Property Property during the unexpired term of the if the loss is not covered solely because of: lease that is not covered under any other section of Part One of the covenant; or (1) Any inadvertent error in the description or location of the building and contents, (2) The amount of advance rental paid by property in the open or mobile property you and not recoverable under the terms covered by the covenant,which inadvertent of the lease for the unexpired term of the error existed at the inception date of the lease. covenant; or • LMCIT MPC(11/97)(REV.12/98) Page 3 of 19 • (2) Any inadvertent error in the description or 8. ARSON REWARD location of the building/contents,property in the open or mobile property in In the event that a covered fire loss was the result endorsements to the covenant; or of an act of arson, we will reimburse you for rewards you pay for information leading to (3) Failing through an inadvertent error to convictions for that act of arson. schedule (a) any building/contents, property in the open, or mobile property 9. ACCOUNTS RECEIVABLE owned by the city at the inception of the covenant, or (b) any newly acquired We will pay for loss or damage to your accounts building/contents, property in the open or receivable caused by direct physical loss or mobile property during the term of the damage to your accounts receivable. coverage document. 10. VALUABLE PAPERS AND RECORDS (4) It is a condition of this coverage that such inadvertent error shall be reported and We will pay for loss or damage to valuable corrected when discovered. papers and records caused by direct physical loss or damage to valuable papers and records. 7. RENTAL REIMBURSEMENT 11. YEAR 2000 EXTRA EXPENSE We will pay for rental reimbursement expenses incurred by you for the rental of mobile property. We will pay for your expenses that are necessarily incurred: a. No deductibles apply to this coverage. a. To mitigate loss that is directly or indirectly b. This coverage does not apply while there is caused by a year 2000 problem; and spare or reserve equipment available to you for your operations. b. To implement any contingency plan to maintain your operations if any of your operations are impaired by a year 2000 problem. We will not pay any of your expenses to determine or to correct a year 2000 problem. SECTION III - CAUSES OF LOSS AND DAMAGES NOT COVERED I. CAUSES OF LOSS NOT COVERED: a. Flood,surface water,waves,tides,tidal waves, overflow of any body of water, A. We will not pay for loss or damage caused or their spray, all whether driven by directly or indirectly by any of the following. wind or not; Such loss or damage is excluded regardless of any other cause or event that contributes b. Mudslide or mudflow; concurrently or in any sequence to the loss. c. Water that backs up or overflows from 1. Water a sewer, drain or sump; or LMCff MPC(11/97)(REV.12/98) Page 4 of 19 • • d. Water under the ground surface c. Insurrection, rebellion, revolution, pressing on, or flowing or seeping usurped power, or action taken by through: governmental authority in hindering or defending against any of these. (1) Foundations, walls, floors or paved surfaces; 3. Year 2000 Claims (2) Basements, whether paved or not; Any year 2000 problem. or But if loss or damage by a "specified cause (3) Door, windows or other openings, of loss" results, we will pay for the except for coverage that is provided resulting loss or damage. by Water and Supplemental Flood Coverage as described in SECTION This exclusion does not apply to Year 2000 IV - WATER AND SUPPLE- Extra Expense as provided in Section II.9. MENTAL FLOOD COVERAGE. II. DAMAGES NOT COVERED: But if loss or damage by fire, explosion or sprinkler leakage results, we will pay for A. We will not pay for the following damages. that resulting loss or damage. 1. Damage to your electrical devices, This exclusion does not apply to: appliances or wires caused by artificially generated electric current including a. Mobile property electric arcing. 2. Nuclear Hazard This exclusion does not apply to: Nuclear reaction or radiation, or a. Computer equipment data and media. radioactive contamination, however caused. 2. Damage from the discharge, dispersal, seepage, migration, release or escape of But if loss or damage by fire results, we pollutants. will pay for that resulting loss or damage. This exclusion does not apply if the 3. War discharge,dispersal, seepage , migration, release of pollutants is itself caused by a a. War, including undeclared or civil war; specified cause of loss. b. Warlike action by a military force, 3. Damages caused by dishonest or criminal including action in hindering or acts by you, or your employees, defending against an actual or expected attack, by any government, sovereign a. Acting alone or in collusion with others; or other authority using military or personnel or other agents; or b. Whether or not occurring during the hours of employment. LMCIT MPC(11/97)(REV.12/98) Page 5 of 19 4 • This exclusion does not apply to acts of This exclusion does not apply to: destruction by your employees; but theft by employees is not covered. a. Computer equipment data and media. 4. Damages caused by explosion of steam 7. Damages caused by: boilers,steam pipes,steam engines or steam turbines owned or leased by you, or a. Rust, corrosion, fungus, decay, operated under your control. deterioration, hidden or latent defect, mold or disease; But if loss or damage by fire or combustion explosion results, we will pay for that b. Settling, shrinking or expanding; or resulting loss or damage. c. Wear and tear. We will also pay for loss or damage caused by or resulting from the explosion of gases This exclusion does not apply if the above or fuel within the flues or passages through damage results from a specified cause of which the gases of combustion pass. loss. 5. The cost to repair or replace faulty 8. Unexplained loss, mysterious workmanship, materials, construction or disappearance, or shortage disclosed upon design. taking inventory. This exclusion does not apply to: 9. Seizure or destruction of property by order of governmental authority. a. Computer equipment data and media. But we also will pay for acts of destruction 6. The cost to repair or replace mechanical ordered by governmental authority and breakdown, including rupture or bursting taken at the time of a fire to prevent its caused by centrifugal force. spread, if the fire would be covered under this Coverage Part. SECTION IV - WATER AND SUPPLEMENTAL FLOOD COVERAGE I. COVERAGE AGREEMENTS COVERED LOSS OR DAMAGE as a result of direct physical loss of or damage A. For your building/contents or property in the to your building/ contents or property in open, subject to the exclusions and limitations the open; in Paragraph B below, we will pay for: which are caused by: 1. Direct physical loss of or damage to your buildings/contents or property in the open 1. Flood, surface water, waves, tides, described in the Schedule of Covered tidal waves, overflow of any body of Property; and water, or their spray, all weather driven by wind or not; 2. Any additional covered losses or damages as described in SECTION II - ADDITIONAL 2. Mudslide or mudflow; LMCIT MPC(11/97)(REV.12/98) Page 6 of 19 ` • 3. Water that backs up or overflows from a 3. For any building/contents or property sewer, drain or sump; or in the open for which Code C is shown on the Schedule of Covered Property, 4. Water under the ground surface pressing on, we will not pay for any loss or any or flowing or seeping through: damage resulting from any occurrence for which a National Flood Insurance (a) Foundations, walls, floors or paved Program Coverage would cover any surfaces; loss or any damage. (b) Basements, whether paved or not; or 4. For any Newly Acquired Covered Property, Buildings in the Course of (c) Doors, windows or other openings. Construction, Alterations or Repair, Covered Property in Transit or But if loss or damage by fire, explosion or Covered Property that is temporarily at sprinkler leakage results,we will not pay for an Unscheduled Location as provided that resulting loss or damage under this by SECTION I, IA Covered Property SECTION IV. that are not shown on the Schedule of Covered Property;we will pay any loss B. 1. For any building/contents or property in the or any damage as if the WATER and open for which Code A is shown on the SUPPLEMENTAL FLOOD COVER- Schedule of Covered Property,no additional AGE was shown as Code C on the exclusions apply to the coverage provided Schedule of Covered Property. under this section. II. LIMITS OF COVERAGE 2. For any building/contents or property in the open for which Code B is shown on the The maximum amount we will pay for all Schedule of Covered Property, the coverage losses or damages covered under this provided by this section is specifically in SECTION IV is limited as described in addition to and in excess of the applicable SECTION V-LIMITS OF COVERAGE AND National Flood Insurance Program VALUATION. Coverage. SECTION V - LIMITS OF COVERAGE AND VALUATION A. LIMITS OF COVERAGE b. Fine Arts: $ 500,000 1. We will not pay for more than the blanket limit per occurrence specified in Item 5 of the c. Covered Property in Transit: Declaration. $250,000 2. The sublimits stated below are per occurrence d. Unscheduled Locations: and are part of and not in addition to the $500,000 blanket limit of occurrence: e. Personal Effects: a. Computer Equipment Data and Media: $25,000 per occurrence, but not to $1,000,000 exceed $2,500 per employee LMCIT MPC(11/97)(REV.12/98) Page 7 of 19 • • 3. The sublimits stated below are in addition to i. Accounts Receivable: the blanket limit of occurrence. $500,000 Per Location a. Newly Acquired Covered Property: j. Valuable Papers and Records: $5,000,000 $500,000 Per Location b. Buildings in the Course of Construction, k. Year 2000 Extra Expense: Alterations or Repair: 85% of the expense, up to a limit of $2,000,000 $5,000 per occurrence and a $5,000 Annual Aggregate 4. The limits for the Additional Covered Loss or Damage are specified in Item 5 of the 5. The limits for Water and Supplemental Flood Declaration and are listed below. The limits Coverage are specified in Item 5 of the are in addition to the blanket limit of Declarations and are stated below. occurrence. a. $500,000 per occurrence a. Asbestos Clean Up, Abatement and Removal: b. The Water and Supplemental Flood $250,000 Per Location Coverage Annual Aggregate is the most we will pay for Water and Supplemental Flood b. Loss of Revenue, Extra Expense and Coverage loss during the annual coverage Expediting Expense: period. $5,000,000 Per Occurrence c. The sublimits stated below are per c. Debris Removal: occurrence and are part of and not in $1,000,000 Per Occurrence addition to the per occurrence limit: However, if there is no direct physical loss (1) Golf Course Property: $100,000 or damage to Covered Property, the most we will pay is $50,000 per occurrence. (2) Property In Transit: $250,000 These limits do not apply to golf course 6. Golf Course Property property. The most we will pay for direct damage to d. Leasehold Interest: Golf Course Property and Debris Removal of $500,000 Per Location Covered Property and non-Covered Property is $100,000 per occurrence. e. Pollutant Cleanup and Removal: $10,000 Per Location 7. Business Personal Effects f. Errors: The most we will pay for direct physical loss 90% of the loss, subject to $500,000 or damage to business personal effects is Per Occurrence $25,000 per occurrence but not to exceed $5,000 per employee. g. Rental Reimbursement: $25,000 Per Annual Aggregate B. LOSS VALUATION h. Arson Reward: 1. General Provisions $5,000 Per Fire Loss LMCIT MPC(11/97)(REV.12/98) Page 8 of 19 r • • a. Except as provided in 2. below, in the LMCIT will pay the cost to replace event of direct physical loss of or damage destroyed equipment with equipment of to your Covered Property, the basis of greater processing ability; the cost to adjustment will be as follows: reproduce or restore the data; and the cost to repair or replace media with the same (1) If the Covered Property is destroyed kind and quality of material. Any and is replaced or rebuilt,LMCIT will replacement equipment must be able to pay the cost to rebuild or replace the perform the same function as the destroyed Covered Property with new materials equipment. of equivalent size, kind and quality. If the Covered Property is replaced at a c. Accounts receivable. For accounts different site, the cost cannot be receivable,LMCIT will pay for all amounts greater than if you would have rebuilt due from your customers that you are at the same site. unable to collect; interest charges on any loan required to offset amounts you are (2) If the Covered Property is destroyed unable to collect pending our payment of and is not replaced or rebuilt, LMCIT these amounts; collection expenses in will pay the appraised value of the excess of your normal collection expenses property at the time of the loss. that are made necessary by the loss; and other reasonable expenses you incur to re- (3) If the Covered Property is damaged establish your accounts receivable. If you but not destroyed and is repaired, are unable to establish the amount of LMCIT will pay the actual cost to accounts receivable outstanding at the time repair the property. of the loss, we will use the average monthly amounts of account receivable for (4) If the Covered Property is damaged the 12 months immediately preceding the but not destroyed and remains in month in which the loss occurs, adjusting service without being repaired,LMCIT to reflect the normal business during the will pay the amount of the reduction if loss month. any in the appraised value of the damaged property. d. Fine arts. For fine arts which are destroyed, LMCIT will pay the appraised In any event, LMCIT will not pay you more value, regardless of whether the Covered than your financial interest in the Covered Property is replaced or not. Property. e. Mobile property. For mobile property that 2. Special Provisions is damaged or destroyed, LMCIT will not pay for more than the amount you actually a. Valuable papers. For valuable papers and spent to repair or replace the damaged records, LMCIT will pay the cost of blank mobile properly; or 200% of the appraised materials for reproducing the records,plus value of the damaged property, whichever the cost of labor to transcribe or copy the is less. records when there is a duplicate, or to reproduce the data of records. f. Police Dogs. For police dogs that are destroyed LMCIT will pay for the b. Computer equipment, data and media. For replacement cost of the dog and the cost of computer equipment, data, or media, any necessary training. LMCIT MPC(11/97)(REV.12/98) Page 9 of 19 • g. Trees and shrubs and (1) For a tree or shrub which is destroyed, (c) Deeds, liens or contracts. LMCIT will pay the actual cost to replace it with a tree or shrub of b. The amount of extra expense loss LMCIT similar type and of a size that is will pay, will be determined based on: normally considered to be reasonable and practical to transplant, regardless (1) All expenses that exceed the normal of whether the tree or shrub is replaced operating expenses that would have or not. been incurred by operations during the period of recovery if no direct physical (2) For a tree or shrub that is damaged but loss or damage had occurred. We will not destroyed, LMCIT will pay the deduct from the total of such expenses: actual cost of any service, treatment, or repair that is actually performed. (a) The salvage value that remains of any property bought for temporary But, we will not pay more than the use during the period of recovery actual cost to replace it with a tree or once operations are resumed; and shrub of similar type and of a size that is normally considered to be (b) Any extra expense that is paid for reasonable and practical to transplant. by other insurance, except for insurance that is written subject to 3. Loss of Revenue, Extra Expense and the same plan, terms and Expediting Expense Provisions conditions and provisions as this insurance; and a. The amount of loss of revenue loss LMCIT will pay, will be determined based on: (2) All necessary expenses that reduce the business income loss that otherwise (1) The gross revenue of the city before would have been incurred. the direct physical loss or damage occurred; We will reduce the amount of your: (2) The likely gross revenue of the city if a. Loss of revenue loss, other than extra no physical loss or damage had expense or expediting expense to the extent occurred; you can resume your operations, in whole or in part, by using damaged or (3) The operating expenses, including undamaged property (including merchan- payroll expenses, necessary to resume dise or stock) at the described location or operations with the same quality of elsewhere. service that existed just before the direct physical loss or damage, and b. Extra expense or expediting expense loss to the extent you can return your operations (4) Other relevant sources of information, to normal and discontinue such extra including: expense or expediting expense. (a) Your financial records and However, if you do not resume operations, or accounting procedures; do not resume operations as quickly as possible, we will pay based on the length of (b) Bills, invoices and other vouchers; time it would have taken to resume operations as quickly as possible. LMCIT MPC(11/97)(REV.12/98) Page 10 of 19 • • • 4. Appraisal be made by a judge of a court having juris- diction. The appraisers will state separately If the city and LMCIT disagree on the the value of the property. If they fail to appraised value of covered property either agree,they will submit their differences to the prior to the loss or damage, after the loss or umpire. A decision agreed to by any two will damage, or after repair, either party may be binding. Each party will: make a written demand for an appraisal of the loss. In this event, each party will select a a. Pay the cost of its own appraiser; and competent and impartial appraiser. The two appraisers will select an umpire. If they b. Bear the other expenses of the appraisal cannot agree,either may request that selection and umpire equally. SECTION VI - DEFINITIONS Accounts Receivable means: 3. Any covered property in the open at each location; or 1. All amounts due from your customers that you are unable to collect and there is a loss; 4. Any covered mobile property. 2. Interest charges on any loan required to offset Building means the building or structure including; amounts you are unable to collect pending our payment of these accounts; 1. Completed additions; 3. Collection expenses in excess of your normal 2. Permanently installed fixtures, machinery and collection expenses that are made necessary by the equipment; loss; and 3. Outdoor fixtures; 4. Other reasonable expenses that you incur to re- establish your records of accounts receivable. 4. Contents owned by you that is used to maintain or service the building or structure or its premises, 5. Accounts receivable does not include: including: a. The amount of the accounts that you are able to a. Fire extinguishing equipment; re-establish or collect; b. Outdoor furniture; b. An amount to allow for probable bad debts that you are normally unable to collect; and c. Floor coverings; and c. All unearned interest and service charges. d. Appliances used for refrigerating, ventilating, cooking, dishwashing or laundering; or Automobile means a land motor vehicle, trailer or semi-trailer designed for travel on public roads. 5. If not covered by other insurance: Blanket means the limit of coverage can be applied to a. Additions under construction, alterations and any of the following: repairs to the building or structure; • 1. Any covered building at each location; b. Materials, equipment, supplies and temporary structures, on or within 100 feet of the 2. Any covered contents at each location; described building, used for making additions, LMCIT MPC(11/97)(REV.12/98) Page 11 of 19 • alterations or repairs to the building or 2. Facts,concepts or instructions in a form usable for structure. communications; Building/Contents as described in the Schedule of 3. Interpretation or processing by automatic means; Covered Property, means the following: or 1. Building; or 4. Computer programs and materials on which the data is recorded. 2. Contents. Contents means property located in or on the building Business Personal Effects means personal property of described in the Declarations or in the open (or in a your employees that is used to maintain the operations vehicle) within 100 feet of the described building, of the city. consisting of the following: City means governmental body or entity first named 1. Furniture and fixtures; in the Declarations. For purposes of this coverage city includes relief associations. Unless specifically 2. Machinery and equipment; named in the Declarations, city shall not include: • 1. Gas, electrical, or steam utilities commission; 3. Stock; 4. All other contents owned by you and used in your 2. Port authority, housing and redevelopment municipal operations; authority, economic development authority, area or municipal redevelopment authority, or similar 5. Labor,materials or services furnished or arranged agency; by you on contents of others; 3. Municipal power agency; 6. Your use interest as tenant in improvements and betterments are fixtures, alterations, installations 4. Municipal gas agency; or additions: 5. Hospital or nursing home board or commission; a. Made a part of the building or structure you occupy but do not own; and 6. Airport commission; b. You acquired or made at your expense but 7. Welfare or public relief agency; cannot legally remove; or 8. School board; or 7. Contents of others that is in your care, custody and control. 9. Joint powers entity. However, our payment for loss or damage to Computer Equipment, Data and Media means a contents will be for the account of the owner of network of machine components capable of accepting the property. information, processing it according to plan and producing the desired results. It includes: 8. Trees and shrubs; 1. Air conditioning, fire protection equipment and 9. Accounts receivable; electrical equipment used exclusively in your computer operations; 10. Computer equipment data or media; or LMCIT MPC(11/97)(REV.12/98) Page 12 of 19 T • i 11. Valuable papers and records; or Extra expense means the excess total cost necessarily incurred to continue your operations as reasonably as 12. Personal Effects practicable during the period of recovery that is over and above the cost that would normally have been 13. Fine Arts incurred to conduct the operations during the same period had no loss or damage occurred. It includes: Employee means: 1. Extra expense to avoid or minimize the suspension 1. A person whom you compensate directly by of business and to continue operations: salary, wages or commissions and who you have the right to direct or control while performing a. At the described location; or duties for you; b. At a replacement location or at temporary 2. Member of the city council; locations, including: 3. Member of a city board, commission, or (i) Relocation expenses; and committee which is not excluded by the definition of city; (ii) Costs to equip and operate the replacement or temporary locations. 4. Elected or appointed official of the city; 2. Extra expense to minimize the suspension of 5. Volunteer person or organization while acting on business if you cannot continue operations. behalf of the city and subject to the city's direction and control; 3. Extra expense to: 6. Other authorized person or agent of the city while a. Repair or replace any Covered Property; or acting on behalf of the city, but excludes independent contractors; b. Research, replace or restore to the lost information on damaged valuable papers and 7. City relief association members, officers, and records; employees; or to the extent it reduces the amount of loss that 8. Any natural person employed by an employment otherwise would have been payable under this contractor while that person is subject to your covenant. direction and control and performing services for you excluding, however, any such person while Fine Arts means property or articles of artistic or having care and custody of property outside the historical value including paintings, etchings, premises. pictures, tapestries, statuary, marbles, bronzes, porcelain,rare glass,antique silver,china,books and But employee does not mean any agent, broker, manuscripts, rugs and similar articles. factor,commission merchant,consignee,independent contractor or representative of the same general Golf Course Property means bridges, paved character. roadways,paved cart paths and other paved surfaces, shelters, restrooms, ball washers, screens, flags, Expediting expenses means the reasonable extra cost markers, signs, tees, fairways and greens. of temporary repair and expediting the repair of damaged Covered Property, overtime and express freight or other rapid means of transportation. LMCIT MPC(11/97)(REV.12/98) Page 13 of 19 Joint Powers Entity means an operating entity created 7. Mobile Property in your care, custody and by two or more governmental units entering into an control. agreement as provided by statute for the joint exercise of governmental powers. An intergovern- Occurrence means an accident or event that causes a mental agreement will be deemed to create a joint direct physical loss or damage to covered property. powers entity if the agreement establishes a board Any continuous accident or event that causes more with the effective power to do any of the following, than one direct physical loss or damage to covered regardless of whether the specific consent of the property during a seventy-two (72) hour period constituent governmental units may also be required: constitutes an accident or event as a single occurrence. 1. To receive and expend funds; Operations means: 2. To enter into contracts; 1. Your city activities occurring at the described 3. To hire employees; location; or 4. To purchase or otherwise acquire or hold real or 2. The tenantability of the described location. personal property; or Period of Recovery means the period of time that: 5. To sue or be sued. 1. Begins immediately after the time of direct Location means the site of any building/contents or physical loss or damage to Covered Property. property in the open listed in the Declarations or attached schedules. 2. Ends on the earlier of: Loss of Revenue means gross revenue, including a. The date Covered Property is actually repaired, rental value, less charges and expenses that do not rebuilt or replaced and operations are resumed; necessarily continue. and your operations would generate the loss of revenue amount that would have existed if no Mobile property means: direct physical or damage had occurred; or 1. Machinery or equipment designed for use b. Sixty (60) consecutive days after the date, principally off public roads; when the Covered Property is actually repaired, rebuilt or replaced and operations are 2. Police Dogs resumed. 3. Vehicles maintained for use solely on or next to However, the expiration date of the covenant will locations owned or rented by you and not licensed not cut short the period of recovery. for highway use; Personal Effects means personal property of your 4. Vehicles and its equipment whether self-propelled employees. or not,maintained primarily to provide mobility to permanently mounted equipment; or Pollutants means any solid, liquid, gaseous or thermal irritant or contaminant, including smoke, 5. Tools. vapor, soot, fumes, acids, alkalis, chemicals and waste. Waste includes materials to be recycled, 6. Business Personal Effects; or reconditioned or reclaimed. LMCIT MPC(11/97)(REV.12/98) Page 14 of 19 • • Property in the Open means: 3. Water Damage means accidental discharge or leakage of water or steam from any part of a g YP 1. Equipment such as, but not limited to, benches, system or appliance containing water or steam. fences,light poles,playground equipment,statues, scoreboards, traffic signals or signs that are in the Stock means merchandise held in storage or for sale, open and are not part of a building; or raw materials and in-process or finished goods, including supplies used in their packing or shipping. 2. Golf Course Property. System or system component means any of the following: Rental Value means the sum of: 1. Computer hardware, including microprocessors; 1. The total anticipated gross rental income from tenant occupancy of the Covered Property as 2. Computer application software; furnished and equipped by you; and 3. Computer operating systems and related software; 2. The amount of all continuing charges that are the legal obligation of the tenant and that would 4. Computer networks; otherwise be your obligation; and 5. Microprocessors or other computer chips not part 3. The fair rental value of any portion of the of any computer system; or Covered Property that you occupy. 6. Any other computerized or electronic equipment Specified Causes of Loss means fire; lightning; or components. explosion; windstorm or hail; smoke; aircraft or vehicles;riot or civil commotion;vandalism;leakage Valuable Papers and Records means inscribed, discharge from fire extinguishing equipment;sinkhole printed or written documents,manuscripts or records, collapse; volcanic action; falling objects; weight of including abstracts, books, deeds, drawings, films, snow, ice or sleet; or water damage. maps and mortgages. 1. Sinkhole collapse means the sudden sinking or But valuable papers and records does not mean collapse of land into underground empty spaces money or securities, converted data, programs or created by the action of water on limestone or instructions used in your data processing operations, dolomite. This cause of loss does not include: including the materials on which the data is recorded. a. The cost of filling sinkholes; or Year 2000 claim means any claim for damages arising directly or indirectly out of: b. Sinking or collapse of land into man-made underground cavities. 1. Any actual or alleged failure, malfunction, or inadequacy of any system or system component, 2. Falling Object does not include loss or damage to: whether belonging to the city or to others, which is due to any year 2000 problem; a. Property in the open; or 2. Any actual or alleged failure, malfunction, or b. The interior of a building or structure, or inadequacy of any product, service, data, or property inside a building or structure, unless function that directly or indirectly uses or relies on the roof or an outside wall of the building or any system or system component, which is due to structure is first damaged by a falling object. any year 2000 problem; or LMCIT MPC(11/97)(REV.12/98) Page 15 of 19 3. Any advice, consultation, design, evaluation, Year 2000 problem means the inability of any system inspection, installation, maintenance, repair, or system component to correctly recognize,process, replacement, or supervision done by a covered distinguish, interpret, or accept the year 2000 and party to determine, rectify, or test for any beyond. potential or actual year 2000 problem. SECTION VII - CONDITIONS A. CONTROL OF PROPERTY E. COVERAGE PERIOD, COVERAGE TERRITORY Any act or neglect of any person other than you beyond your direction or control will not affect Under this Coverage Part: this coverage. 1. We cover loss or damage commencing: The breach of any condition of this Coverage Part at any one or more locations will not affect a. During the coverage period shown in the coverage at any location where, at the time of Declarations; and loss or damage, the breach of condition does not exist. b. Within the coverage territory. B. COVERAGE UNDER TWO OR MORE 2. The coverage territory is: COVERAGES a. The United States of America(including its If two or more of this covenants coverages apply territories and possessions); to the same loss or damage, we will not pay more than the actual amount of the loss or damage. b. Puerto Rico; and C. LEGAL ACTION AGAINST US c. Canada No one may bring legal action against us under F. LOSS CONDITIONS this Coverage Part unless: 1. Abandonment. 1. There has been full compliance with all of the terms of the Coverage Part; and You cannot abandon your property to us. 2. The action is brought within 2 years after the 2. Duties In The Event of Loss or Damage. date on which the direct physical loss or damage occurred. You must see that the following are done in the event of loss or damage to Covered D. NO BENEFIT TO BAILEE Property: No person or organization, other than you, a. Notify the police if a law may have been having custody of Covered Property will benefit broken. from this coverage. b. Give us prompt notice of the loss or damage. Include a description of the property involved. LMCIT MPC(11/97)(REV.12/98) Page 16 of 19 • c. As soon as possible, give us a description 4. Recovered Property. of how, when and where the loss or damage occurred. If either you or we recover any property after loss settlement, that party must give the other d. Take all reasonable steps to protect the prompt notice. At your option, the property Covered Property from further damage. If will be returned to you. You must then return feasible, set the damaged property aside to us the amount we paid to you for the and in the best possible order for property. We will pay recovery expenses and examination. Also keep record of your the expenses to repair the recovered Property, expenses, for consideration in the subject to the amount applying under this settlement of the claim. Covenant. e. At our request, give us complete G. PREMIUMS AND PREMIUM ADJUST- inventories of the damaged and undamaged MENTS property. Include quantities, costs, values, and amount claim of loss demand. 1. You agree to furnish us with a Schedule of Locations and Buildings, Schedule of Mobile f. Permit us to inspect the property and Property and Schedule and Location of records proving the loss or damage. Property in the Open prior to the beginning of each covenant period. The initial annual g. If requested, permit us to question you premiums will be based upon these Schedules under oath at such times as may be and the appropriate replacement cost values. reasonably required about any matter relating to this Covenant or your claim, 2. You will pay us additional premium if: including your books and records. In such event, your answers must be signed. a. Building/contents, mobile equipment or property in the open is added during the h. Send us a signed, sworn statement of loss covenant period. containing the information we request to settle the claim. You must do this within b. Additional Covered Loss or Damage 60 days after our request. We will supply limits, or property sublimits are increased you with the necessary forms. during the covenant period. i. Cooperate with us in the investigation, or c. Buildings in the Course of Construction, settlement of the claim. Alteration or Repair is added during the covenant period. 3. Loss Payment d. Newly acquired Covered Property is added a. We will give notice of our intentions within during the covenant period. 30 days after we receive the sworn statement of loss. 3. We will return premium to you if: b. We may adjust losses with the owners of a. Building/contents, mobile equipment or lost or damaged property if other than you. property in the open are deleted during the If we pay the owners, such payments will covenant period. satisfy your claims against us for the owners' property. We will not pay the b. Additional Covered Loss or Damage limits owners more than their financial interest in or property sublimits are reduced during the Covered Property. the covenant period. LMCIT MPC(11/97)(REV.12/98) Page 17 of 19 • ! H. CANCELLATION J. MORTGAGE HOLDERS 1. You may cancel Part One of this covenant. 1. The term mortgage holder includes trustee. You must mail or deliver not fewer than thirty (30) days advance written notice to us stating 2. We will pay for covered loss of or damage to when the cancellation is to take effect. buildings or structures to each mortgage holder shown in the Declarations in their 2. We may cancel Part One of this covenant. We order of precedence, as interests may appear. must mail or deliver to you not fewer than thirty(30)days advance written notice stating 3. The mortgage holder has the right to receive when the cancellation is to take effect. loss payment even if the mortgage holder has Mailing that notice to you at your mailing started foreclosure or similar action on the address shown in the Declaration will be building or structure. sufficient to prove notice. However, we may cancel with ten (10) days written notice for 4. If we deny your claim because of your acts or nonpayment of premium. because you have failed to comply with the terms of this Coverage Part, the mortgage 3. The covenant period will end on the day and holder will still have the right to receive loss hour stated in the cancellation notice. payment if the mortgage holder; 4. If Part One of this covenant is canceled, we a. Pays any premium due under this will send you any premium refund due. If we Coverage Part at our request if you have cancel, the refund will be pro rata. If you failed to do so; cancel, the refund may be less than pro rata, computed in accordance with our current b. Submits a signed, sworn proof of loss cancellation rules. The cancellation will be within 60 days after receiving notice from effective even if we have not made or offered us of your failure to do so; and a refund. c. Has notified us of any change in I. DEDUCTIBLE ownership, occupancy or substantial change in risk known to the mortgage All losses, damages, or expenses arising out of holder. any one occurrence will be adjusted (net of salvage, subrogation, recoveries, and any other All of the terms of this Coverage Part will recoveries) as one loss, and from the amount of then apply to the mortgage holder. this adjusted loss will be deducted the sum that you selected as a deductible as shown in Item 7 5. If we pay the mortgage holder for any loss or of the Declarations for property coverage. damage and deny payment to you because of your acts or because you have failed to The deductible applies against the total loss comply with the terms of this Coverage Part: incurred by you from any one occurrence, regardless of the number of locations involved. a. The mortgage holder's rights under the mortgage will be transferred to us to the If two or more deductibles in Item 7 of the extent of the amount we pay; and Declarations for property coverage apply to one occurrence for you, the total to be deducted will b. The mortgage holder's right to recover the not exceed the largest deductible applicable. full amount of the mortgage holder's claim LMCIT MPC(11/97)(REV.12/98) Page 18 of 19 • will not be impaired. At our option, we K. TRANSFER OF RIGHTS OF RECOVERY may pay to the mortgage holder the whole AGAINST OTHERS TO US principal on the mortgage plus any accrued interest. In this event,your mortgage and If any person or organization to or for whom we note will be transferred to us and you will make payment under this Coverage Part has pay your remaining mortgage debt to us. rights to recover damages from another, those rights are transferred to us to the extent of our 6. If we cancel this covenant, we will give payment. That person or organization must do written notice to the mortgage holder at least: everything necessary to secure our rights and must do nothing after loss to impair them. But a. Ten (10) days before the effective date of you may waive your rights against another party cancellation if we cancel for your non- in writing: payment of premium; or 1. Prior to a loss to your Covered Property or b. Thirty (30) days before the effective date Covered Income. of cancellation if we cancel for any other reason. 2. After a loss to your Covered Property or Covered Income only if, at time of loss, that 7. If we do not renew this covenant we will give party is one of the following: written notice to the mortgage holder at least ten(10)days before the expiration date of this a. Someone insured by this Covenant; covenant. b. A business firm: (1) Owned or controlled by you; or (2) That owns or controls you; or (3) Your tenant. This will not restrict your Covenant. LMCIT MPC(11/97)(REV.12/98) Page 19 of 19 O Li II League of Minnesota Cities CRIME COVERAGE PART TWO • • MUNICIPAL CRIME COVERAGE PART TWO Various provisions in this covenant restrict coverage. The word LMCIT refers to League of Minnesota Read the entire covenant carefully to determine Cities Insurance Trust. The word you and your rights, duties and what is or is not covered. refer to the city shown in the Declarations. The words we, us, and our refer to LMCIT providing this Throughout this covenant, the word city refers to the covenant. first city shown in the DECLARATIONS. SECTION I - CRIME COVERAGE and Valuation 1. COVERAGE AGREEMENT an Valuation, General Conditions and General Definitions apply to all Crime Coverage Forms We will pay for loss as provided by each coverage forming part of this covenant. form that is designated in the DECLARATION. Other words and phrases that appear in italics Unless stated otherwise in any Crime Coverage have special meaning, as given in SECTION V - Form, DECLARATIONS or endorsement, the DEFINITIONS. following General Exclusions, Limits of Coverage SECTION II - EXCLUSIONS We will not pay for loss as specified below: a loss covered under this covenant. 1. Governmental Action: Loss resulting from seizure C. Payment of costs, fees or other expenses you or destruction of property by order of incur in establishing either the existence or the governmental authority. amount of loss under this covenant. 2. Indirect Loss: Loss that is an indirect result of 3. Legal Expenses: Expenses related to any legal any act or occurrence covered by this covenant action. including, but not limited to, loss resulting from: 4. Nuclear: Loss resulting from nuclear reaction, A. Your inability to realize income that you nuclear radiation or radioactive contamination, or would have realized had there been no loss of, any related act or incident. or loss from damage to, Covered Property. 5. War and Similar Actions: Loss resulting from B. Payment of damages of any type for which war, whether or not declared, warlike action, you are legally liable. But, we will pay insurrection, rebellion or revolution, or any compensatory damages arising directly from related act or incident. LMCIT MPC(11/97)(Rev. 12/98) Page 1 of 6 410 0 SECTION III - LIMITS OF COVERAGE AND VALUATION 1. LIMITS OF COVERAGE occurrence is the applicable Limit of Coverage shown in the DECLARATION. The most we will pay for loss in any one SECTION IV - CONDITIONS 1. Consolidation-Merger: C. Give us a detailed, sworn proof of loss within 120 days. If through consolidation or merger with, or purchase of assets of, some other entity: D. Cooperate with us in the investigation and settlement of any claim. A. Any additional persons become employees; or 5. Joint Parties B. You acquire the use and control of any additional premises; A. If more than one city is named in the DECLARATIONS, the first named city will any coverage afforded for employees or premises act for itself and for every other city for all also applies to those additional employees and purposes of this covenant. If the first named premises, but only if you: city ceases to be covered, then the next will become the first named city. A. Give us written notice within 30 days thereafter; and B. If any city or employee or officer of that city has knowledge of any information relevant to B. Pay us an additional premium. this covenant, that knowledge is considered knowledge of every city. 2. Coverage Extensions: Unless stated otherwise in the Coverage Form, our liability under any C. An employee of any city is considered to be Coverage Extension is part of, not in addition to, an employee of every city named in the the limit applying to the Coverage or Coverage Declarations. Section. D. If this covenant is cancelled or terminated 3. Discovery Period for Loss: We will pay only for as to any city, loss sustained by that city is covered loss discovered no later than one year covered only if discovered no later that one from the end of the covenant period. year from the date of that cancellation or termination. 4. Duties in the Event of Loss: After you discover a loss or a situation that may result in loss of, or E. We will not pay more for loss sustained by loss from damage to, Covered Property you more than one city than the amount we would must: pay if all the loss had been sustained by one city. A. Notify us as soon as possible. 6. Legal Action Against Us: You may not bring B. Submit to examination under oath at our any legal action against us involving loss: request and give us a signed statement of your answers. A. Unless you have complied with all the terms of this covenant; and B. Until 90 days after you have filed proof of LMCIT MPC(11/97)(Rev. 12/98) Page 2 of 6 r • • loss with us; and If any loss is covered: C. Unless brought within 2 years from the date A. Partly by this covenant, and you discover the loss. B. Partly by the prior cancelled or terminated 7. Loss Covered Under More Than One covenant that we or any affiliate had issued to Coverage of This Covenant: If two or more you or any predecessor in interest, the most coverages of this covenant apply to the same loss, we will pay is the larger of the amount we will pay the lesser of: recoverable under this covenant or the prior covenant. A. The actual amount of loss; or 10. Non-Cumulation of Limit of Coverage: B. The sum of the limits of coverage applicable to that loss. Regardless of the number of years this covenant remains in force or the number of premiums 8. Loss Sustained During Prior Insurance paid, no Limit of Coverage cumulates from year to year or period to period. A. If you or any predecessor in interest sustained loss during the period of any prior 11. Other Insurance: insurance that you or the predecessor in interest could have recovered under that This covenant does not apply to loss recoverable insurance except that the time within which to or recovered under other insurance or indemnity. discover loss had expired, we will pay for it However, if the limit of the other insurance or under this covenant provided: indemnity is insufficient to cover the entire amount of the loss, this covenant will apply to (1) This covenant became effective at the that part of the loss, other than that falling time of cancellation or termination of the within any deductible amount, not recoverable prior insurance; and or recovered under the other insurance or indemnity. However, this covenant will not (2) The loss would have been covered by apply to the amount of loss that is more than this covenant had it been in effect when the applicable Limit of Coverage shown in the the acts or events causing the loss were DECLARATIONS. committed or occurred. 12. Ownership of Property; Interests Covered: B. The coverage under this Condition is part of, not in addition to, the Limits of Coverage The property covered under this covenant is applying to this covenant and is limited to the limited to property: lesser of the amount recoverable under: A. That you own or hold; or (1) This covenant as of its effective date; or B. For which you are legally liable. (2) The proper covenant had it remained in effect. However, this covenant is for your benefit only. It provides no rights or benefits to any other 9. Loss Covered Under This Covenant and Prior person or organization. Covenant Issued by Us or Any Affiliate: 13. Covenant Period: A. The covenant period is shown in the LMCIT MPC(1 1/97)(Rev. 12/98) Page 3 of 6 P • • DECLARATIONS. Others to Us: B. Subject to the Loss Sustained During Prior You must transfer to us all your rights of Insurance condition, we will pay only for recovery against any person or organization for loss that you sustain through acts committed any loss you sustained and for which we have or events occurring during the coverage paid or settled. You must also do everything period. necessary to secure those rights and do nothing after loss to impair them. 14. Records: 18. Valuation-Settlement You must keep records of all Covered Property so we can verify the amount of any loss. A. Subject to the applicable Limit of Coverage provision we will pay for: 15. Recoveries: (1) Loss of money but only up to and A. Any recoveries, less the cost of obtaining including its face value. We may, at our them, made after settlement of loss covered option, pay for loss of money issued by by this covenant, will be distributed as any country other than the United States follows: of America: (1) To you, until you are reimbursed for any (a) At face value in the money issued loss that you sustain that exceeds the by that country; or Limit of Coverage and the Deductible Amount, if any; (b) In the United States of America dollar equivalent determined by the (2) Then to us until we are reimbursed for rate of exchange on the day the loss the settlement made; was discovered. (3) Then to you until you are reimbursed (2) Loss of securities but only up to and for that part of the loss equal to the including their value at the close of Deductible Amount, if any. business on the day the loss was discovered. we may, at our option: B. Recoveries do not include any recovery: (a) Pay the value of such securities or (1) From insurance, suretyship, reinsurance, replace them in kind, in which event security or indemnity taken for our you must assign to us all your rights, benefit; or title and interest in and to those securities; (2) Of original securities after duplicates of them have been issued. (b) Pay the cost of any Lost Securities Bond required in connection with 16. Territory: issuing duplicates of the securities. However, we will be liable only for This covenant covers only acts committed or the payment of so much of the cost events occurring within the United States of of the bond as would be charged for America, U.S. Virgin Islands, Puerto Rico, a bond having a penalty not Canal Zone, or Canada. exceeding the lesser of the: 17. Transfer of Your Rights of Recovery Against i. Value of the securities at the close LMCIT MPC(11/97)(Rev. 12/98) Page 4 of 6 • • of business on the day the loss If we cannot agree with you upon the actual was discovered; or cash value or the cost of repair or replacement, the value or cost will be ii. Limit of Coverage. determined by arbitration. (3) Loss of, or loss from damage to property B. We may, at our option, pay for loss of, or other than money and securities or loss loss from damage to property other than from damage to the premises for not money: more than the: (1) In the money of the country in which the (a) Actual cash value of the property on loss occurred; or the day the loss was discovered; (2) In the United States of America dollar (b) Cost of repairing the property or equivalent of the money of the country in premises; or which the loss occurred determined by the rate of exchange on the day the loss (c) Cost of replacing the property with was discovered. property of like kind and quality. C. Any property that we pay for or replace We may, at our option, pay the actual becomes our property. cash value of the property or repair or replace it. SECTION V - DEFINITIONS City means the governmental body or entity first 9. Joint powers entity. named in the Declarations. For purposes of this coverage city includes relief associations. Unless Crime Coverage Form means the following crime specifically named in the Declarations, city shall not forms: include; 1. Theft, Disappearance and Destruction Coverage 1. Gas, electrical, or steam utilities commission; Form MPC 201; 2. Port Authority, housing and redevelopment 2. Forgery or Alteration Coverage Form MPC 202; authority, economic development authority, area or municipal redevelopment authority, or 3. Public Employee Dishonesty Coverage Form similar agency; MPC 203; 3. Municipal power agency; 4. Public Employee Faithful Performance Coverage Form MPC 204; or 4. Municipal gas agency; S. Hospital or nursing home board or commission; 6. Welfare or public relief agency; School board; 7. Sch , 8. Airport commission; or LMCIT MPC(11/97)(Rev. 12/98) Page 5 of 6 • • 5. Public Employee Dishonesty Coverage with intergovernmental agreement will be deemed to Performance of Duty for Specified create a joint powers entity if the agreement Faithful tY Position or Obligee Form MPC 205. establishes a board with the effective power to do any of the following, regardless of whether the Employee means: specific consent of the constituent governmental units may also be required: 1. A person whom you compensate directly by salary, wages or commissions and who you have 1. To receive and expend funds; the right to direct or control while performing duties for you; 2. To enter into contracts; 2. Member of the city council; 3. To hire employees; 3. Member of a city board, commission, or 4. To purchase or otherwise acquire and hold real or committee which is not excluded by the definition personal property; or of city; 5. To sue or be sued. 4. Elected or appointed official of the city; Money means: 5. Volunteer person or organization while acting on behalf of the city J and subject to the city's direction 1. Currency, coins, and bank notes in current use � and control; and having a face value; and 6. O ther authorized person or agent of the city ty while 2. Travelers checks, register checks and money acting on behalf of the city, but excludes orders held for sale to the public. independent contractors; Property Other Than Money and Securities means 7. Ci ty relief association members, officers, and any tangible property other than money and securities employees; or that has intrinsic value but does not include any property listed in any Crime Coverage Form as 8. Any natural person employed ed b an employment Property Not Covered. contractor while that person is subject to your direction and control and performing services for Securities means negotiable and non-negotiable however, any such person while instruments or contracts representing either money or you excluding, y P havin g custody P care and custod of property outside the other property and includes: premises. 1. Tokens, tickets, revenue and other stamps But employee does not mean any agent, broker, (whether represented by actual stamps or unused factor,commission merchant,consignee, independent value in a meter) in current use; and five of the same general contractor or representative g character. 2. Evidences of debt issued in connection with credit or charge cards, which cards are not issued by Joint powers entity means an operating entity created e you; , by or more governmental overnmental units entering into an agreement as provided by statute for the joint but does not include money. exercise of governmental powers. An LMCIT MPC(11/97)(Rev. 12/98) Page 6 of 6 LEAGUE OF M1lkSOTA CITIES INSURANCE TRUST i SCHED E OF COVERED PROPERTY t Covenant#: C M C 19785 LMC League of Minnesota Cities CITY : OAK PARK HEIGHTS Cities promasngesoe�%Iloe COVERAGE AT EACH OF THE BELOW LOCATIONS APPLIES ONLY FOR BUILDING/CONTENTS OR PROPERTY IN THE OPEN DESCRIBED AND FOR THE *SECTION IV - WATER AND SUPPLEMENTAL FLOOD COVERAGES INDICATED. **Type of ***Section IV-Water ' I i I Covered and Supplemental !Lodi ! Location ! Occugnca I Property ! Flood Coverage _ j 1 j 14168 57TH STREET N j CITY HALL/GARAGE I B j Code C I I I 1 I 1 1 I 2 58TH&NORELL j WATER TOWER&WELL I B ; Code C 1 I I 1 1 I 1 3 j 14168 57TH STREET N j WATER TOWER&WELL I B ; Code C I I I I I 1 1 4 i BREKKE PARK i SHELTER 1 B i Code C 1 I 1 1 i 1 1 1 5 13425 60TH STREET i LIFT STATION I B ; Code C I I I I I 1 1 L 1 j 6 j 14168 57TH STREET N j PUMP HOUSE#3 I B ; Code C I 1 I 1 1 I 1 1 _ j 7 j SWAGER PARK j SHELTER I B ; Code C I I I I I 1 1 S COVER PARK i RECREATION BUILDING 1 B ; Code C I I 1 1 I 1 9 VALLEY VIEW PARK i SHELTER I B ; Code C I I I I I 1 I j 10 j BEADETTE ON LOOKOUT TRAIL j LIFT STATION I B ; Code C I 1 I I 1 1 11 SUNYSIDE MARINA i LIFT STATION 1 B ; Code C I I I ■ I 1 1 1 1 12 j 14200 53RD STREET i LIFT STATION I B ; Code C 1 I 1 I I 1 1 1 _ j 13 j 14168 57TH STREET N j CITY HALL I P I O ; Code C ' I 1 I I I 1 1 1 14 SWAGER PARK PARK I P I O ; Code C I I 1 I 1 1 15 COVER PARK i PARK I P I O ; Code C I I I I 1 1 I 1 16 j VALLEY VIEW PARK j PARK I P I O ; Code C I I I I 1 1 17 BREKKE PARK PARK I P I O ; Code C I I I I 1 I I 1 *The limit of coverage for Section IV-Water and Supplemental Coverage is$500,000 per occurrence/500,000 Annual Aggregate **B = Building / Contents **PIO = Property in the Open ***Code A:LMCIT Water and Supplemental Flood Coverage applies with no additional exclusions. ***Code B:LMCIT Water and Supplemental Flood Coverage applies in addition to and in excess of the applicable National Flood Insurance Program Coverage. ***Code C:LMCIT Water and Supplemental Flood Coverage excludes damages from any occurrence for which any loss or any damage would be payable under a National Flood Insurance Program Coverage. PM-100(11/95)(Rev 11/97) LEAGUE OF MSOTA CITIES INSURANCE TRUST. SCHED E OF COVERED PROPERTY Covenant#: CMC 19785 LMC Laague of Minnesota Cities CITY : OAK PARK HEIGHTS Cities promoting e:osnanas COVERAGE AT EACH OF THE BELOW LOCATIONS APPLIES ONLY FOR BUILDING/CONTENTS OR PROPERTY IN THE OPEN DESCRIBED AND FOR THE *SECTION IV - WATER AND SUPPLEMENTAL FLOOD COVERAGES INDICATED. **Type of ***Section IV-Water Covered and Supplemental Loc# Location Occupancy Property Flood Coverage _ j 18 j CITY WIDE j VARIOUS ; P I O ; Code C *The limit of coverage for Section IV-Water and Supplemental Coverage is$500,000 per occurrence/500,000 Annual Aggregate **B = Building / Contents **PIO = Property in the Open ***Code A:LMCIT Water and Supplemental Flood Coverage applies with no additional exclusions. ***Code B:LMCIT Water and Supplemental Flood Coverage applies in addition to and in excess of the applicable National Flood Insurance Program Coverage. ***Code C:LMCIT Water and Supplemental Flood Coverage excludes damages from any occurrence for which any loss or any damage would be payable under a National Flood Insurance Program Coverage. PM-100(11/95)(Rev 11/97) • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST =_ SCHEDULE OF COVERED MOBILE PROPERTY I Covenant#: CMC 19785 League of Minnesota Cities CITY: OAK PARK HEIGHTS COVERAGE APPLIES TO MOBILE PROPERTY VALUED AT REPLACEMENT COST VALUES OF$25,000 OR LESS PER ITEM IF IDENTIFIED AS COVERED AND TO MOBILE PROPERTY THAT HAVE REPLACEMENT COST VALUES GREATER THAN$25,000 PER ITEM THAT ARE LISTED. COVERED/NOT COVERED A. MOBILE PROPERTY VALUED AT$25,000 OR LESS COVERED B. MOBILE PROPERTY VALUED AT GREATER THAN$25,000 Description of Mobile Property Serial No. (Make, Model and Year) 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 PM-109(11/97) • • PROPERTY IN THE OPEN ENDORSEMENT This Endorsement modifies coverage provided under the Municipal Property and Crime Coverage. Loc. # Location Occupancy Property in the O p en 18 CITY WIDE VARIOUS OUTDORR SIRENS A. Section VI -Definitions property in the open is amended to read as described above for each location. All other terms and conditions remain unchanged. PM-110(11/97) Covenant Number: M ICIPAL LIABILITY DECLARIAIONS CMC 19785 Coverage is Provided by: T E LEAGUE OF MINNESOTA C IES INSURANCE TRUST L] I� (Herein called LMCIT) Item 1. CITY: OAK PARK HEIGHTS g�ofMi,,nesota cities Cities promoting excellence ATTN: THOMAS MELENA Item 2. COVERAGE PERIOD: One Year From: 07/07/99 To: 07/07/00 12:01 A.M. Standard Time at Mailing Address Indicated on Common Coverage Declarations Item 3. THE COVERED PARTY IS: CITY "CLAIMS-MADE" Item 4. COVERAGE: IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS COVENANT,LMCIT AGREES WITH THE COVERED PARTY TO PROVIDE THE COVERAGE AS STATED IN THIS COVENANT, SUBJECT TO THE FOLLOWING LIMITS: EACH OCCURRENCE LIMIT $ 750,000 PRODUCTS & COMPLETED OPERATIONS ANNUAL AGGREGATE LIMIT $ 750,000 FAILURE TO SUPPLY ANNUAL AGGREGATE LIMIT $ 750,000 EMF ANNUAL AGGREGATE LIMIT $ 1,500,000 FIRE DAMAGE LIMIT $ 50,000 MEDICAL EXPENSE LIMIT $ 1,000/$10,000 occurrence/Aggregate LIMITED POLLUTION LIABILITY *$ 750,000 Per"Sudden Occurrence"/ $750,000 Annual Aggregate LEAD OR ASBESTOS CLAIM LIMIT *$ 200,000 Per Claim/$200,000 Annual Aggregate LAND USE,DEVELOPMENT OR *$ 1,000,000 Annual Aggregate FRANCHISE LITIGATION YEAR 2000 CLAIM *$ 25,000 Per Claim/$25,000 Annual Aggregate *Limit includes loss, loss adjustment expense, and legal defense costs Item 5. MUNICIPAL LIABILITY DEDUCTIBLE: (Subject to General Annual Aggregate Deductible, if any, shown on Common Coverage Declarations) $ 500 Per Occurrence Item 6. RETROACTIVE DATES: MUNICIPAL LIABILITY RETROACTIVE DATE: 07/07/87 LIMITED POLLUTION LIABILITY CLAIM RETROACTIVE DATE: 05/24/88 LEAD OR ASBESTOS CLAIM RETROACTIVE DATE: 07/07/93 Item 7. ENDORSEMENTS ATTACHED TO THIS COVERAGE PART: MGL-1(01-95) LMCIT DEC-013(11-98) • MUNICIPAL LIABILITY MCITY OAK PARK HEIGHTS COVENANT NUMBER CMC 19785 -j ATTN: THOMAS MELENA HAZARD : PREMIUM BASIS :ADVANCED PREMIUM: 1 Premises Operations Code Basis OPERATING EXPENDITURES A 2,281,455 PREMIUM INCLUDED FOR ALL HAZARDS WATERWORKS D 61 ,500 WHERE A PREMIUM BASIS IS SHOWN STREETS B 15 1 Independent Contractors G 3,193,450 Products/Completed r n Operations s WATERWORKS H 207,000,000 1 LMCIT MGL-1(01-95) Page 1 of 2 • MUNICIPAL LIABILITY (Cont'd.) Municipal Li Liability abi ty Hazard Codes When used as a premium basis: * Code (A) "Operating expenditures" means all expenditures used to operate p p ate the city, excluding capital purchases, where the individual project or item exceeds five percent (5%) of the total operating expenditures of the city; expenditures for the independent contractors that provide the city with certificates of insurance indicating adequate limits; welfare benefits and expenditures for those exposures which we are separately rating, per $1,000. (B) "Per mile" means the total number of miles of streets, paved or unpaved, owned by the city, within the city limits, not including toll roads or bridges, per mile. (C) "Receipts" means the gross amount of money charged by the city, including taxes, for operations rated on a receipts' basis (this does not include taxes which are collected separately and remitted directly to this or any other governmental entity), per $100 of receipts. (D) "Payroll" means the entire payroll (remuneration) earned during the coverage period, including overtime, employees of the city working in the department (classification) shown, per $100 payroll. (E) "Each" means per unit. (F) "Square footage" means per square foot. (G) "Cost" means the total cost for operations performed for the city by an independent contractor during the coverage period, including the cost of labor, materials and equipment furnished, and all fees or commission made, whether paid or due. (H) "Per gallon" means annual usage of water, per 1 000 p ,000 gallons. LMCIT MGL-1 (01-95) Page 2 of 2 Covenant Number: 1VOTICIPAL AUTOMOBILE DECIMATIONS CMC 19785 Coverage is Provided by: THE LEAGUE OF MINNESOTA CITIES INSURANCE TRUST (Herein called LMCIT) League of Minnesota Cities Cities promoting excellence Item 1. CITY: OAK PARK HEIGHTS ATTN: THOMAS MELENA Item 2. COVERAGE PERIOD: ONE YEAR From: 07/07/99 To: 07/07/00 12:01 AM Standard Time at Mailing Address Indicated on Common Coverage Declarations Item 3. THE COVERED PARTY IS: CITY Item 4. SCHEDULE OF COVERAGES AND COVERED AUTOS: THIS COVENANT PROVIDES ONLY THOSE COVERAGES WHERE A SYMBOL IS SHOWN IN THE COVERED AUTO COLUMN BELOW. EACH OF THESE COVERAGES WILL APPLY ONLY TO THOSE AUTOS SHOWN AS COVERED AUTOS. AUTOS ARE SHOWN AS COVERED AUTOS FOR A PARTICULAR COVERAGE BY THE ENTRY OF ONE OR MORE OF THE SYMBOLS FROM ITEM SIX NEXT TO THE NAME OF THE COVERAGE. COVERAGES I COVERED AUTOS* LIMIT LIABILITY 1 ** $750,000 Per Occurrence PERSONAL INJURY PROTECTION ( 2 ** , Basic Minnesota Statutory Coverage Uninsured&Underinsured Motorists In 4. 2 ** $750,000 Per Occurrence COMPREHENSIVE COVERAGE ! 6 ** SPECIFIED PERILS COVERAGE NOT COVERED ** COLLISION COVERAGE 6 ** *(Entry of one or more of the symbols from Item Six shows which autos are covered autos) Item 5. **DEDUCTIBLE (SUBJECT TO GENERAL ANNUAL AGGREGATE DEDUCTIBLE,IF ANY, SHOWN ON COMMON COVERAGE DECLARATIONS). $ 500 per occurrence (unless otherwise indicated on ME021). Item 6. DESCRIPTION OF COVERED AUTO DESIGNATION SYMBOLS: SYMBOL DESCRIPTION 1 ANY AUTO 2 OWNED AUTOS ONLY. Only those autos you own(and for liability coverages any trailers you don't own while attached to power units you own). 3 SPECIFICALLY DESCRIBED AUTOS.Only those autos described in ITEM FOUR for which a premium charge is shown (and for liability coverages any trailers you don't own while attached to any power unit described in ITEM FOUR). 4 HIRED AUTOS ONLY.Only those autos you lease,hire,rent or borrow.This does not include any auto you lease,hire, rent or borrow from any of your employees or members of their households. 5 NON-OWNED AUTOS ONLY. Only those autos you do not own,lease,hire or borrow which are used in connection with your business.This includes autos owned by your employees or members of their households,but only while used in your business or your personal affairs. 6 OWNED AUTOS ONLY.Only those autos you own and are scheduled on ME021. This includes autos that you acquire ownership after the covenant begins. Item 7. SEE ATTACHED SCHEDULE OF COVERED AUTOS YOU OWN (ME021). Item 8. FORMS AND ENDORSEMENTS ATTACHED TO THIS COVERAGE PART: A0010(11-95) A2108(11-96) A2225(11-89) M E021(O 1-95) LMCIT DEC-016(11-97) S Municipal Auto Physical Damage Coverage Part In return for the payment of the premium and subject to a. To received and expend funds; all the terms of this Coverage Part, we agree with you as follows: b. To enter into contracts; PART I -- WORDS AND PHRASES WITH c. To hire employees; SPECIAL MEANING -- READ THEM CAREFULLY d. To purchase or otherwise acquire and hold real or personal property; or The following words and phrases have special meaning throughout this Coverage Part and appear in quotes e. To sue or be sued. when used: PART II -- WHICH AUTOS ARE COVERED A. "You" and "your" mean the person or organization AUTOS shown as the "city" in ITEM ONE of the declarations. A. ITEM FOUR of the declarations shows the "autos" B. "We", "us", "our" mean League of Minnesota for each of "our" coverages. The numerical Cities Insurance Trust. symbols, explained in ITEM SIX of the declarations describe which "autos" are covered C. "Auto" means a Iand motor vehicle, trailer or "autos". The symbols entered next to a coverage semitrailer designed for travel on public roads. designate the only "autos" that are covered under "autos". D. "Loss" means direct and accidental damage or loss. B. OWNED AUTOS YOU ACQUIRE AFTER THE POLICY BEGINS E. "City" means governmental body or entity first named in the Declarations. For purposes of this 1. If symbol "3" is entered next to a coverage in coverage "city" includes relief associations. ITEM FOUR, an "auto" "you" acquire will Unless specifically named in the Declarations, be a covered "auto" for that coverage only if: "city" shall not include a gas, electrical, or steam utilities commission; port authority, housing and a. "We" already cover all "autos" that "you" redevelopment authority, economic development own for that coverage if it replaces an authority, area or municipal redevelopment "auto" "you" previously owned that had authority, or similar agency; municipal power that coverage; and agency; municipal gas agency; hospital or nursing home board or commission; welfare or public b. "You" tell "us"within 30 days after "you" relief agency; school board; airport commission; acquire it that "you" want "us" to cover it or "joint powers entity". for that coverage. "Joint powers entity" means an operating entity 2. If symbol "6" is entered next to a coverage in created by two or more governmental units . ITEM FOUR,an auto "you" acquire will be a entering into an agreement as provided by statute covered "auto" for that coverage until the for the joint exercise of governmental powers. An covenant period ends. intergovernmental agreement will be deemed to create a "joint powers entity" if the agreement establishes a board with the effective power to do PART III -- WHERE AND WHEN THIS any of the following, regardless of whether the COVERAGE PART COVERS specific consent of the constituent governmental units may also be required: "We" cover "losses" which occur during the coverage period: LMCIT A0010 (11/89) (Rev. 11-95) page 1 of 3 • A. In the United States of America, its territories or 6. "Loss" to tape decks or other sound possessions, Puerto Rico or Canada; or reproducing equipment not permanently installed in a covered "auto". B. While the covered "auto" is being transported between any of these places. 7. "Loss" to tapes, records, or other sound reproducing devices designed for use with PART IV--PHYSICAL DAMAGE COVERAGE sound reproducing equipment. A. "WE" WILL PAY 8. "Loss" to any sound receiving equipment designed for use as a citizens' band radio, two- 1. "We" will pay for "loss" to a covered "auto" way mobile radio or telephone or scanning or its equipment under: monitor receiver, including its antennas and other accessories,unless permanently installed a. Comprehensive Coverage. From any in the dash or console opening normally used cause except the covered "auto's" by the "auto" manufacturer for the installation collision with another object or its of a radio. overturn. C. HOW WE WILL PAY FOR LOSSES -- THE b. Specified Perils Coverage. Caused by: MOST WE WILL PAY (1) Fire or explosion; 1. At "our" option "we" may" (2) Theft; a. Pay for, repair or replace damaged or stolen property; or (3) . Windstorm, hail, or earthquake; b. Return the stolen property, at "our" (4) Flood; expense. "We" will pay for any damage that results to the "auto" from the theft. (5) Mischief or vandalism; 2. The most "we" will pay for "loss" is the (6) The sinking, burning, collision smaller of the following amounts: or derailment of any conveyance transporting the covered "auto". a. The actual cash value of the damaged or c. Collision Coverage. Caused by the stolen property at the time of"loss"; covered "auto's" collision with another object or its overturn. b. The cost of repairing or replacing the damaged or stolen property with other of B. WE WILL NOT COVER-EXCLUSIONS like kind or quality. This coverage does not apply to: 3. For each covered "auto" "our" obligation to pay for, repair, return or replace damaged or 1. Wear and tear, freezing, except freezing of the stolen property will be reduced by the pumping apparatus of a fire truck or similar applicable deductible shown in the declarations. emergency or other utility truck, mechanical or electrical breakdowns unless caused by other D. GLASS BREAKAGE -- HITTING A BIRD OR "loss" covered by this Coverage Part. ANIMAL, FALLING OBJECTS OR MISSILES 2. Blowouts, punctures, or other road damage to "We"will pay for glass breakage, "loss" caused by tires unless caused by other "loss" covered by hitting a bird or animal or by falling objects or this Coverage Part. missiles under Comprehensive Coverage if "you" carry Comprehensive Coverage for the damaged 3. "Loss" caused by declared or undeclared war covered "auto". However, "you" have the option or insurrection or any of their consequences. of having glass breakage caused by covered "auto's" collision or overturn considered a "loss" 4. "Loss" caused by the explosion of a nuclear under Collision Coverage. weapon or its consequences. E. ERRORS AND OMISSIONS 5. "Loss" caused by radioactive contamination. We will pay for loss to any owned "auto" if the LMCIT A0010 (11/89) (Rev. 11-95) page 2 of 3 loss is not covered solely because of: amount of"loss", either may 1. Any error or omission in the description of the demand an appraisal of the "loss". In such owned "auto" covered by the covenant, which event, "you" and "we" shall each select a error omission existed at the inception date of competent appraiser. The two appraisers will the covenant, or select a competent and disinterested umpire. If they cannot agree, either may request that 2. Any errors or omissions in the description of selection be made by a judge of court having the owned "auto" in endorsements to the jurisdiction. The appraisers will state covenant, or separately the actual cash value and the amount of"loss". If the appraisers fail to agree, they 3. Failing through error to schedule an owned will submit their differences to the umpire. An "auto" at the inception of the covenant. award agreed to by any two will be binding. Each party will: such loss shall be covered hereunder, but in no case to exceed $500,000 Any One "Auto" a. Pay its chosen appraiser; and subject to a maximum of$500,000 Any One Loss. With respect to this loss, we will pay b. Bear the other expenses of the appraisal 90% of the loss and the "city" will pay 10% of and umpire equally. the loss. It is a condition of this coverage that such error or omission shall be reported and 2. "We" shall not be held to have waived any of corrected when discovered. "our" rights by any act relating to appraisal. PART V--CONDITIONS C. RENTAL VEHICLES A. "YOUR" DUTIES AFTER LOSS If "you" rent an "auto" and it is used for "city" business, this coverage will be primary. 1. "You" must promptly notify "us" or "our" agent of any "loss". "You" must tell "us" how, when, and where the "loss" happened. "You" must assist in obtaining the names and addresses of any witnesses. 2. Additionally, "you" must: a. Cooperate with "us" in the investigation, settlement or the conduct of any suit. "You" shall not, except at "your" own cost, voluntarily make any payment, assume any obligation, or incur any expense. b. Permit "us" to inspect and appraise the damaged property before its repair or disposition. c. Do what is reasonably necessary after "loss" at "our" expense to protect the covered "auto" from further loss. d. Submit a proof of"loss"when required by "us". e. Promptly notify the police if the covered "auto" or any of its equipment is stolen. B. APPRAISAL 1. If "you" and "we" fail to agree as to the LMCIT A0010 (11/89) (Rev. 11-95) page 3 of 3 • I Uninsured and Underinsured Motorists Coverage A. WORDS AND PHRASES WITH SPECIAL a. Owned or operated by a self-insurer under MEANING any applicable motor vehicle law. In addition to the WORDS AND PHRASES WITH b. Owned by a governmental unit or agency. SPECIAL MEANING in the COVENANT, the following words and phrases have special meaning for c. Designed for use mainly off public roads UNINSURED MOTORISTS COVERAGE, and while not on public roads. UNDERINSURED MOTORISTS COVERAGE. 4. "Underinsured motor vehicle" means a land 1. "Family Member" means a person related to you motor vehicle or trailer for which the sum of all by blood, marriage or adoption who is a resident liability bonds or policies at the time of an of your household, including a ward or foster accident provides at least the amounts required child. by the applicable law where a covered auto is principally garaged but their limits are less than 2. "Occupying" means in, upon, getting in, on, out the limit of this insurance. However, or off. "underinsured motor vehicle" does not include any vehicle: 3. "Uninsured motor vehicle" means a land motor vehicle or trailer: a. Owned or operated by a self-insurer under any applicable motor vehicle law. a. For which no liability bond or policy at the time of an accident provides at least the b. Owned by a governmental unit or agency. amounts required by the applicable law where a covered auto is principally garaged, c. Designed for use mainly off public roads or while not on public roads. b. For which the sum of all liability bonds or d. Which is an uninsured motor vehicle. policies at the time of an accident provides at least the amounts required by the applicable B. WE WILL PAY law where a covered auto is principally garaged but their limits are less than the limit 1. We will pay all sums the beneficiary is legally of this insurance, or entitled to recover as "damages" from the owner or driver of an uninsured motor vehicle or c. For which an insuring or bonding company underinsured motor vehicle. The "damages" denies coverage or is or becomes insolvent, must result from bodily injury sustained by a or "covered party" caused by an accident. The owner's or driver's liability for these "damages" d. Which is a hit-and-run vehicle and neither the must result from the ownership, maintenance or driver nor owner can be identified. The use of the uninsured motor vehicle or vehicle must hit a beneficiary, a covered auto underinsured motor vehicle. or a vehicle a beneficiary is occupying. 2. If this coverage provides a limit in excess of the However, "uninsured motor vehicle" does not amounts required by the applicable law where a include any vehicle: covered auto is principally garaged, we will pay A2108(11/96) Page 1 of 2 • only after all liability bonds or policies have been 2. Any amount payable under this COVERAGE exhausted by judgments or payments. shall be reduced by: 3. Any judgment for "damages" arising out of a suit a. All sums paid by or for anyone who is legally brought without written notice to us is not responsible, including all sums paid under the binding on us. COVENANT'S LIABILITY coverage. C. WE WILL NOT COVER- EXCLUSIONS F. CHANGES IN CONDITIONS This does not apply to: The CONDITIONS of the COVENANT are changed for UNINSURED MOTORISTS COVERAGE as 1. Any claim settled without our consent, follows: 2. The direct or indirect benefit of any insurer or 1. YOUR DUTIES AFTER ACCIDENT OR LOSS self-insurer under any workers' compensation, is changed by adding the following: disability benefits or similar law. a. Promptly notify the police if a hit-and-run 3. Bodily injury sustained by you or any family driver is involved, and member while occupying or struck by any vehicle owned by you or any family member b. Promptly send us copies of the legal papers if which is not a covered auto. a suit is brought. 4. Anyone using a vehicle without a reasonable 2. OUR RIGHT TO RECOVER FROM OTHERS belief that the person is entitled to do so. is changed by adding the following: D. WHO IS COVERED If we make any payment and the "covered party" recovers from another party, the beneficiary shall 1. You or any family member. hold the proceeds in trust for us and pay us back the amount we have paid. 2. Anyone else occupying a covered auto or a temporary substitute for a covered auto. The covered auto must be out of service because of its breakdown, repair, servicing, loss or destruction. 3. Anyone for "damages" he or she is entitled to recover because of bodily injury sustained by another beneficiary. E. OUR LIMIT OF LIABILITY 1. Regardless of the number of "covered parties", claims made or vehicles involved in the accident, the most we will pay for all "damages" resulting from any one accident is the limit of UNINSURED AND UNDERINSURED MOTORISTS COVERAGE shown in the declarations. A2108(11/96) Page 2 of 2 • S Personal Injury Protection Endorsement (Minnesota) LMCIT agrees to provide Statutory Minnesota No-Fault Coverage for all autos described on the Municipal Automobile Declarations. The Comprehensive Municipal Coverage Common Conditions also apply unless they are in conflict with the Minnesota No-Fault law. In that event, Minnesota No-Fault law shall govern. LMCIT A-2225(11/89) SCHEDULE OF VEHICLES - K PARK HEIGHTS 0 P ATTN: THOMAS MELENA t 'COVENANT NUMBER - CMC 19785 LJ 'IC COVENANT PERIOD: 07/07/99 07/07/00 1.009140 Of Mi,NelOt,Cities Cities promoting excellence ..J 1 [l COMP. I I 1 I [] SP. PERILSI I I VEH VEH 1 ACV I COMP.I STATED I 1 COLL I NO. DESCRIPTION ID 1 COMP. DED. I AMOUNT ! COLL. I DED. L I 1 I I 1 I 1 "Autos owned at inception of this covenant and shown ! ! 1 l ! L I { I I { I I ion this schedule have coverage as indicated by "X". ! I I J ! L I I I 1 I { I iCoveraae is subject to the deductible indicated. I 1, I ! I L ±001) 1987 CHEV 1 TON TRUCK 6960! X ! 500! ! X I 500L 1002) 1995 FORD CROWN VICTORIA 1817! X I 5001 I X ! 500L I i I 1 I I 1 1003) 1997 FORD CROWN VICTORIA 70691 X ! 5001 I X I 5001 1004) 1997 CHEV PICKUP 6571 ! X I 500! I X [ 500L 1 I I 1 I 1 1 1005) 1990 CHEV PICKUP 5936! X I 500! I X I 500L 1006) 1998 FORD CROWN VICTORIA 50181 X I 5001 I X 1 500L 1 I I 1 I I 1 1007) 1995 CHEV CAPRICE 45211 X 1 500! 1 X I 500L I 1 I I I I I 1008) 1996 CHEV BLAZER 1236! X I 5001 I X I 5001 1009) 1999 FORD F350 4X4 W/PLOW 35071 X I 5001 I X I 5001 1 I I 1 1 I 1 1010) 1999 FORD F550 DUMP W/PLO 33331 X ! 5001 I X I 500L 1011) 1999 GMC YUKON 1704! X I 500! I X ! 5001 1 { I 1 I I 1 1 I I I I I L I I I I 1 I I 1 ! I I I I L I I I I I 1 I I 1 I I L I I I I I I 1 I I I f I 1 I I I 1 I I I 1 I I 1 I I L I I I I 1 I I I I I 1 I I I I I 1 1 1 I 1 I I I L I I I 1 I I I 1 I ! I I I L I I I I I 1 1 I I I I 1 L I { { I I I I 1 I ! I I I 1 ME021 (01-95) 1 , • • ''''-'7 o League of Minnesota Cities Cities promoting excellence J League of Minnesota Cities 145 University Avenue West St. Paul,MN 55103-2044 (651)281-1200 Municipal Excess Liability Coverage Administered By: Berkley Risk Services,Inc. 145 University Avenue West St.Paul,MN 55103-2044 (651)281-1200 **IMPORTANT** PLEASE READ YOUR AGREEMENT Covenant Number: MUNICIPAL EXCESS • MEL- 3468 LIABILITY DECLARATIONS Coverage is Provided by: =i= THE LEAGUE OF MINNESOTA CITIES Previous Covenant Number: INSURANCE TRUST MEL- 3178 (Herein called LMCIT) League of Minnesota Cities CITY and MAILING ADDRESS: Item 1. CITY OF OAK PARK HEIGHTS P.O. BOX 2007 STILLWATER, MN 55082-200gCLAIMS-MADE" item z. COVERAGE PERIOD: ONE Year(s) From: 7/7/99 To: 7/7/00 12:01 AM Standard Time at Mailing Address Indicated on ITEM ONE. Item 3. RETROACTIVE DATE: 7/7/87 item a. THE COVERED PARTY IS: X City Joint Powers Entity Other(Describe) Item 5. LIMITS OF COVERAGE: Each Occurrence $ 1,000,000. Aggregate Limit $ 1,000,000. Minimum Retention $ 10,000. (If Applicable) item 5. PREMIUM: $ 7,283. Item 7. AUDIT PERIOD: Annual X None Other(Describe) Item a. SCHEDULE OF UNDERLYING COVERAGE: Primary Coverage Provided by LMCIT Covenant Number: CMC 19785 Coverage Period: From: 7/7/99 To: 7/7/00 Including those coverages X'd below: LIMITS: X Automobile X Municipal Land Use or Municipal Liability Liability Development Liquor Litigation Liability Liability $750,000 CSL $750,000 CSL* $1,000,000 CSL* $ $ *See underlying coverage document for other specific limits that may apply. Employers Liability: $750,000./$750,000. Carrier: LMCIT Coverage B Limits: Policy Number: Policy Term: From: 7/7/99 To: 7/7/00 Other: Carrier: Policy Number: Policy Term: From: To: Item 9. FORM NUMBERS AND/OR ENDORSEMENTS FO ING A PART OF THE AGREEMENT AT ISSUE: MELC(11-97). UME-4(01-95) , UME-43(01-95) , UME-4 —9 ) UME-46(01-95) , UME-47(11-97) Exec i e' . , LMCIT LMCIT DEC-017 (11/86)(Rev.3/93; 11/97) Administered by: Berkley Risk Services, LLC • MUNICIPAL EXCESS LIABILITY COVERAGE Various provisions in this covenant restrict coverage. League of Minnesota Cities Insurance Trust, Read the entire coverage agreement and any hereinafter referred to as LMCIT. underlying coverage carefully to determine rights, duties and what is covered and not covered. The words "this coverage"mean the liability coverage provided under this covenant. Throughout this covenant the words "you" and "your" refer to the "city" shown in the Declarations. The Other words and phrases that appear in italics have words "we", "us" and "our" refer to the special meaning. Refer to SECTION III - DEFINITIONS. SECTION I - LIABILITY COVERAGE 1. COVERAGE AGREEMENT d. With respect to any coverage provided by underlying coverage on a claims made basis, "this a. "We" will pay those sums, in excess of the amount coverage" does not apply to any injury or damage, or payable under the terms of any underlying coverage, personal injury offense, or negligent act, error, that the covered party becomes legally obligated to omission, or violation(or the first in a series of related pay as damages because of injury or damage to which acts, errors, omissions, or violations)which occurred this covenant applies, provided that the underlying or were committed before the retroactive date, if any, coverage also applies, or would apply but for the shown in the Declarations of this covenant or which exhaustion of its applicable limits of coverage. If, occurs or is committed after the coverage period. however, a Minimum Retention applies, as set forth in paragraph 4 below, "we" will pay only those sums in e. This covenant is subject to the same terms, excess of the Minimum Retention. conditions, agreements, exclusions and definitions as the underlying coverage, except: b. "We" will have the right to participate in the defense of claims or suits against the covered party (1) "We" will have no obligation under this seeking damages because of injury or damage to covenant with respect to any claim or suit that is which "this coverage" may apply. "We" will have a settled without "our" consent; and duty to defend such claims or suits when the applicable limit of coverage of the underlying (2) With respect to any provisions to the contrary coverage has been used up by payment of judgments, contained in this covenant. settlements and any cost or expense subject to such limit. 2. EXCLUSIONS This right or duty to defend is limited as set forth in The exclusions applicable to the underlying coverage paragraph 3, below. also apply to this covenant. Additionally, this covenant does not apply to: c. The amount "we" will pay for damages and defense expense is limited as described in SECTION II - a. Any obligation to pay expenses under any LIMITS OF COVERAGE. Damages include medical payments coverage. prejudgment interest awarded against the insured. LMCIT MELC(11/86)(Rev.12/95; 11/96; 11/97) 1 of 7 • • b. Any obligation imposed by law under any c. When "we" control the defense of a claim or suit, automobile no-fault, uninsured motorist, "we" will pay for the defense expense. If by mutual underinsured motorist, Workers' Compensation, agreement or court order the covered party assumes disability benefits or unemployment compensation control before the applicable amount of coverage law or any similar law. available is used up, "we" will reimburse the covered party for reasonable defense expense. In either case, c. Any loss or claim for damage that is caused in the amounts "we" pay will reduce the amount of part or in total by nuclear reaction or radiation, or coverage available as provided under SECTION II - radioactive contamination, however caused. LIMITS OF COVERAGE. d. Any "lead or asbestos claim" as defined in the d. As soon as practicable after "we" become aware underlying coverage. that an amount of coverage available is used up: e. Any "failure to supply claim" as defined in the (1) "We" will notify "you" of any outstanding underlying coverage. claims and suits subject to that amount; and f. Any loss or claim for damages with respect to (2) "You" will then arrange to assume control of personal property in the care, custody or control of the defense of all such claims and suits against any covered party. "you" or any other covered party when "our" right or duty to defend them ends. 3. DEFENSE OF CLAIMS OR SUITS e. "We" will assist the covered party in the transfer of a. When "we" have the duty to defend, and except as control of the defense of claims and suits under(c.)or provided under Section II - Limits of Coverage, (d.) above. Until such arrangements are completed, paragraph 4, with respect to "land use or development "we" will take on behalf of any covered party those litigation", "we" will pay for all defense expense once steps that "we" think appropriate: "our" duty to defend begins. "We" may make investigation of any claim or suit as "we" think (1) To avoid a default in any claim or suit; or appropriate. (2) To the continued defense of a claim or suit. If "we" exercise "our" right to defend when there is no duty, "we" will pay only that defense expense "we" "You" agree that if"we" take such steps: incur. (1) "We" do not waive or give up any of "our" If"we" provide a defense, "we" may investigate any rights under this covenant; and claim or suit at "our" discretion. "We" may settle such claim or suit within the amount of coverage available (2) "You" will reimburse "us" for any defense at the time of the settlement, except for any "land use expense that arises out of such steps if the or development litigation" suit which may not be applicable amount of coverage available has been settled without the approval of both LMCIT and the used up. "city". 4. MINIMUM RETENTION b. "Our" right or duty to defend ends when "we" have used up the amount of coverage available in the The Minimum Retention, if any, shown in the payment of any combination of judgments, settlements Declarations applies to all injury and damage arising or defense expense, as provided under SECTION II- out of any one occurrence, if at the time of the first LIMITS OF COVERAGE. This applies both to claims claim or suit for any such injury or damage the and suits pending at that time and those filed applicable aggregate limit of the underlying coverage thereafter. has been used up by payment of judgments, settlements, and any costs or expenses subject to such limit. LMCIT MELC(11/86)(Rev.12/95; 11/96; 11/97) 2 of 7 • • SECTION II - LIMITS OF COVERAGE 1. The limits of coverage shown in the Declarations 3. Subject to (2) above, the each occurrence limit is and the rules below fix the most "we" will pay under the most "we" will pay for the sum of damages under the terms of this covenant regardless of the number of: SECTION I-LIABILITY COVERAGE because of all injury and damage arising out of any one occurrence. a. Covered parties; 4. For any "land use or development litigation" as b. Claims made or suits brought; defined in the underlying coverage to which "this coverage" applies, "we" will pay the same c. Persons or organizations making claims or suits. percentages of defense costs and/or damages as would otherwise be paid by the underlying coverage subject 2. The amount of coverage stated as the aggregate to the limits shown in the Declarations for this limit is the most "we" will pay for the sum of: covenant. a. Damages under SECTION I - LIABILITY 5. The limits of "this coverage" apply separately to COVERAGE; and each consecutive annual period and to any remaining period of less than 12 months, starting with the b. Defense expense for claims and suits seeking beginning of the coverage period shown in the damages payable under a. above, except as Declarations, unless the coverage period is extended provided in the Appeals Condition. after issuance for an additional period of less than 12 months. In that case, the additional period will be Each payment "we" make for such damages or deemed part of the last preceding period for purposes defense expense reduces by the amount of the payment of determining the limit of coverage. the aggregate limit. This reduced limit will then be the amount of coverage available for further expenses and damages of these kinds. SECTION III - DEFINITIONS 1.Aggregate limit means the maximum amount stated (d) The cost of bonds to release attachments, but in the covenant for which LMCIT will be liable, only for bond amounts within the amount of regardless of the number of covered claims. coverage available; 2. Defense expense means payments allocated to a (e) Reasonable expenses incurred by the covered specific claim or suit for its investigation, settlement, party at "our" request to assist "us" in the or defense, including: investigation or defense of the claim or suit, including actual loss of earning up to $100 a day (a) Attorney fees and all other litigation expenses; because of time off from work; (b) The cost of bonds to appeal a judgment or (f) Cost taxed against the covered party in the suit; award in any suit "we" defend; (g) Interest on the full amount of any judgment that (c) Up to $250 for the cost of bail bonds required accrues after entry of the judgment and before because of accidents or traffic law violations "we" have paid, offered to pay, or deposited in arising out of the use of any vehicle to which court the amount available for the judgment under bodily injury liability coverage provided by the provisions of SECTION II - LIMITS OF underlying coverage applies; COVERAGE. • LMCIT MELC(11/86)(Rev.12/95; 11/96; 11/97) 3 of 7 • 3. Defense expense does not include: Constitution and the laws of the United States of America or a series of related acts, errors, omissions, (a) Salaries and expenses of "our" employees or or violations of which the series of related acts, the covered party's employees, other than: errors, omissions, or violations shall be deemed to have occurred when the first act, error, omission, or (b)That portion of"our" employed attorney's fees, violation occurred. salaries and expenses allocated to a specific claim or suit; and 5. Occurrence limit means any specific limit, other than an aggregate limit, applicable to any underlying (c) The expenses described in(e) above. coverage, regardless of whether such limit is subject to an aggregate limit in the underlying coverage. (d) Fees and expenses of independent adjusters "we" hire. 6. Underlying coverage means the liability coverage provided under coverage agreements shown in the 4. Occurrence means: Declarations, for the limits and period indicated. It includes any coverage agreements issued to replace a. With respect to bodily injury to persons other those coverage agreements during the term of this than "your" employees and property damage, an covenant that provide: accident, including continuous or repeated exposure to substantially the same general harmful a. At least the same coverage limits; conditions; and b. The same hazards covered, except as modified b. With respect to bodily injury to "your" by general program revisions or as agreed to by employees arising out of and in the course of their "us" in writing; and employment by "you", the accident or disease which causes the bodily injury; and c. The same retroactive date, if issued on a claims made basis. c. With respect to personal injury liability, all personal injury arising out of a single offense or a Underlying coverage also includes any extended series of related offenses of which the series of reporting periods on the policies shown in the related offenses shall be deemed to have occurred Declarations. It includes only coverage agreements when the first offense in such series occurred; or shown in the Declarations or endorsed onto this covenant. d. With respect to errors or omissions injury, a negligent act, error, omission, or violation of any 7. Underlying carrier means any carrier who issues rights, privileges, or immunities secured by the underlying coverage. SECTION IV - CONDITIONS If any of the following conditions are contrary to 2. BANKRUPTCY OF UNDERLYING CARRIER conditions contained in the underlying coverage the provisions contained in "this coverage" apply. In the event of bankruptcy or insolvency of any underlying carrier, the coverage afforded by this 1. APPEALS covenant shall not replace such underlying coverage, but shall apply as if the underlying coverage was valid In the event the underlying carrier elects not to appeal and collectible. a judgment in excess of the limits of the underlying coverage, "we" may elect to make such appeal. If "we" so elect, "we" shall be liable, in addition to the applicable amount of coverage, for all defense expenses "we" incur. LMCIT MELC(11/86)(Rev.12/95; 11/96; 11/97) 4 of 7 • • 3. DUTIES IN THE EVENT OF OCCURRENCE, (5) Notify "us" immediately of any judgment or CLAIM OR SUIT settlement of any claim or suit brought against any covered party. a. "You" must see to it that "we" are notified as soon as practicable of an occurrence which may result in a d. No covered party will, except at its own cost, claim to which "this coverage" applies. To the extent voluntarily make a payment, assume any obligation, possible, notice should include: or incur any expense, other than for first aid, without "our" consent. (1) How, when and where the occurrence took place; 4. MAINTENANCE OF UNDERLYING COVERAGE (2)The names and addresses of any injured person and witnesses; and a. "You" agree to maintain the underlying coverage in full force and effect during the term of this (3) The nature and location of any injury or covenant and with respect to any claims made damage arising out of the occurrence. underlying coverage, during any extended reporting period of this covenant, and to inform "us" within 30 Notice of an occurrence is not notice of a claim. days of any replacement of that underlying coverage by the same or another company. b. If a claim is received by any covered party "you" must: " b. "You" must notify "us" immediately: (1) Immediately record the specifics of the claim (1) Of any changes to the underlying coverage. and the date received; and "We" may adjust "our" premium accordingly from the effective date of the change to the underlying (2) Notify "us" as soon as practicable. coverage; "You" must see to it that "we" receive written notice (2) If any underlying coverage is cancelled or not of the claim as soon as practicable. renewed and not replaced, "we" will not be liable under this covenant for more than "we" would c. "You" and any other involved covered party must: have been liable if that underlying coverage had not terminated. Except as provided in paragraph (1) Immediately send "us" copies of any demands, (3) below, "we" may cancel the portion of this notices, summonses or legal papers received in covenant that applies to that underlying coverage as connection with the claim or suit; of the date of termination of the underlying coverage. If "we" cancel, and the underlying (2) Authorize "us" to obtain records and other coverage is on a claims made basis, "we" will: information; (a) Provide a basic extended reporting (3) Cooperate with "us" in the investigation, period; and settlement or defense of the claim or suit; (b) Offer a supplemental extended reporting (4) Assist "us", upon "our" request, in the period endorsement, but only if"you" obtain enforcement of any right against any person or a similar endorsement for the underlying organization which may be liable to the covered coverage, as provided in CONDITION 7 - party because of injury or damage to which "this EXTENDED REPORTING PERIOD. coverage" may also apply; and LMCIT MELC(11/86)(Rev.12/95; 11/96; 11/97) 5 of 7 411 (3) If the retroactive date of any underlying a. LMCIT will provide one or more extended coverage is changed, "we" may: reporting periods, as described below if: (a) Cancel this covenant as of the effective (1) SECTION I - LIABILITY COVERAGE is date of the change in the retroactive date; and cancelled or not renewed; or (b) Offer to renew or rewrite this covenant (2) LMCIT renews or replaces SECTION I - with the same retroactive date as the underlying LIABILITY COVERAGE with coverage that: coverage. (a) Has a retroactive date later than the date c. Reduction or exhaustion of the aggregate limits of shown on the Declarations page; any underlying coverage by payments or judgments, settlements or defense expense will not be a failure to (b) Does not apply to bodily injury, property maintain underlying coverage in full force and effect. damage, personal injury, or errors or omissions injury on a claims made basis. d. No statement contained in this condition limits "our" right to cancel or not renew this covenant. b. A basic extended reporting period of 60 days from the end of the coverage period is automatically 5. OTHER COVERAGE provided without additional charge. "This coverage" is excess over any other valid and c. A supplemental extended reporting period of collectible coverage whether primary, excess, unlimited duration is available, but only by an contingent or any other basis, except other coverage endorsement and for an extra charge. The written specifically to be excess over "this coverage". supplemental extended reporting period starts 60 days after the end of the coverage period. 6. COVERAGE PERIOD "You" must give "us" a written request for the a. If the underlying coverage applies on a claims made endorsement within 60 days after the end of the basis, "this coverage" will respond to injury or coverage period. The supplemental extended reporting damage only if a claim for damages is first received period will not go into effect unless "you" pay the and recorded, in the manner prescribed by the additional premium promptly when due. underlying coverage, during the coverage period of this covenant shown in the Declarations, including any The additional premium for the supplemental extended extended reporting period applicable to this covenant, reporting period will be a percentage of the annual regardless of any extended reporting period applicable expiring premium. to underlying coverage. Number of years b. If the underlying coverage does not apply on a since retroactive claims made basis, "this coverage" will respond to date shown on the injury g in J u or damage that page occurs or arises from an offense Declarations a e Additional cost committed, during the coverage period of this covenant shown in the Declarations. 1 50% • 2 70% 7. EXTENDED REPORTING PERIOD 3 80% 4 90% With respect to coverage under this covenant that is 5 100% excess over underlying coverage which applies on a 5+ 100% claims made basis: LMC1T MELC(11/86)(Rev.12/95; 11/96; 11/97) 6 of 7 • d. Extended reporting periods g p nods do not extend the e. Extended reporting periods do not reinstate or coverage period or change the scope of coverage increase the limits of coverage applicable to any claim provided. to which "this coverage" applies. They apply y pp y only to claims: 8. NO WAIVER OF STATUTORY LIABILITY LIMITATIONS OR IMMUNITIES (1) For bodily injury or property damage which occurs before the end of the coverage period; a. It is the express intent of the city and of LMCIT that the procurement of this covenant shall not waive (2) For personal injury caused by an offense any monetary Iimits of liability provided by Minnesota which occurs before the end of the coverage Statute 466.04, by any comparable or successor period; or statute, or by common law, which may be applicable (3) For errors or omissions injury caused by a to any "covered party"; and that any previous waiver negligent act, error, omission, or violation that of liability limits is revoked to the extent that it may occurs before the end of the coverage period; apply to claims covered under this covenant. but not before the retroactive date shown in the b. It is the express intent of the city and of LMCIT Declarations. that the rocure p ment of this covenant shall not waive any other immunities, limitations,or defenses imposed Claims for injury or damage which are first received by or available under any statute or common law and recorded during the basic extended reporting which is applicable to any "covered party". period(or during the supplemental extended reporting period, if it is in effect) will be deemed to have been made on the last day of the y coverage period. Once in effect, extended reporting periods may not be cancelled, unless underlying coverage is not maintained. LMC1T MELC(11/86)(Rev.12/95; I1/96; 11/97) 7 of 7 • • UNINSURED/UNDERINSURED MOTORISTS - FOLLOW FORM It is understood and agreed that in so far as coverage is provided in the underlying coverage, uninsured and underinsured motorists coverage is on a follow form basis. apply. All other terms and conditions remain unchanged. LMCIT UME-4 (01-95) Page 1 of 1 ~ . • EXTENDED REPORTING PERIOD - LIMITED POLLUTION EXCEPTION With respect to Limited Pollution Coverage under this Covenant, which is excess over underlying coverage, the basic extended reporting period and the supplemental extended reporting periods under Section IV - Conditions are not available. All other terms and conditions remain unchanged. LMCIT UME-43 (01-95) Page 1 of 1 • WAIVER OF STATUTORY MONETARY LIABILITY LIMITS In consideration of the additional premium charged the "city" in procuring excess liability coverage under the above stated covenant expressly waives its statutory monetary liability limits (commonly known as municipal damages "caps")to the extent of the limits of coverage shown in the Declarations and further described in Section II - Limits of Coverage. All other terms and conditions remain unchanged. LMCIT UME-45 (01-95) Page 1 of 1 1_ • • EXTENDED REPORTING PERIOD - LAND USE LIABILITY EXCEPTION With respect to Land Use Liability Coverage under this Covenant, which is excess over underlying coverage, the basic extended reporting period and the supplemental extended reporting periods under Section IV - Conditions are not available. All other terms and conditions remain unchanged. LMCIT UME-46 (01-95) Page 1 of 1 • r MUNICIPAL EXCESS LIABILITY COVERAGE WAIVER OF STATUTORY LIABILITY LIMITATIONS ENDORSEMENT In consideration of the additional premium paid by the city, Section IV- Conditions, para. 8, is deleted and is replaced by the following: 8. STATUTORY LIABILITY LIMITATIONS AND IMMUNITIES a. It is the express intent of the city and of LMCIT that for any claim to which this covenant applies, the monetary limits of liability provided by Minnesota Statute 466.04 are waived to the extent of the limits of coverage shown in the declarations and further described in Section III - Limits of Coverage. This waiver shall not apply to any claim not covered under this covenant, and shall not affect any limitations which may apply by virtue of any other statute or common law. b. It is the express intent of the city and of LMCIT that the procurement of this covenant shall not waive any other immunities, limitations, or defenses imposed by or available under any statute or common law which is applicable to any "covered party". All other terms and conditions remain unchanged. UME-47(11/97) • • Ft I I Agreement Number: Agreement Declarations OML- 1437 Open Meeting Law League of Minnesota Cities Defense Cost Reimbursement Agreement Is Provided By: THE LEAGUE OF MINNESOTA CITIES INSURANCE TRUST (Herein called LMCIT) Previous Agreement Number: Claims-Made Item I. COVERED PARTY AND MAILING ADDRESS: CITY OF OAK PARK HEIGHTS P.O. BOX 2007 STILLWATER, MN 55082-2007 Item 2. AGREEMENT TERM: 12:01 AM Standard Time at From: 7/1/99 To.: 7/1/00 Mailing Address Indicated Above. Item 3. RETROACTIVE DATE: 11/9/94 Item 4. THE COVERED PARTY IS: X City Joint Powers Entity Other (Describe) Item 5. REIMBURSEMENT LIMITS: A. "Reimbursable Costs": MAXIMUM 1. Defense Costs Per Lawsuit Per Official: $ 20,000 2. Agreement Term Aggregate Per Official: $ 20,000 Item 6. CHARGE: $600. Item 7. FORMS AND ENDORSEMENTS APPLICABLE TO AGREEMENT: OMLRA-1(11-94) , OML-001(11-97) Executive Director, CIT LMCIT DEC-019(11-93) Administered by Berkley Risk Services.Inc. • • OPEN MEETING LAW DEFENSE COST REIMBURSEMENT AGREEMENT I. OPEN MEETING LAW DEFENSE COST the Minnesota Open Meeting Law; however, COVERAGE LMCIT shall have the right to intervene at its expense in the investigation or defense of such LMCIT will reimburse a city official for 80 percent of legal action. the defense costs incurred by the city official in defending an Open Meeting Law lawsuit, if the 3. The city or the city official shall give prompt following conditions are met: notice to LMCIT of any actual or threatened legal action against the city official seeking 1. The date on which the Open Meeting Law penalties against the city official for an alleged lawsuit is commenced must be within the violation of the Minnesota Open Meeting Law. term of this agreement; and 4. The city and the city official shall at all times 2. The date on which the violation took place or cooperate with and promptly respond to is alleged to have taken place must be on or LMCIT's requests for information, after the retroactive date, if any, shown in investigative data, records, or any other the Declarations. material documentation. 5. The city official will be reimbursed only for ty � An Open Meeting Law lawsuit is deemed to be Y P g commenced on the date the city official is served defense costs incurred with respect to legal notice of the lawsuit. services actually rendered and expenses actually incurred. II. LIMITS 6. The city official shall have complete freedom The Open Meeting Law Defense Cost to choose an attorney licensed in the State of Reimbursement Agreement Limit is $20,000. This Minnesota to provide the city official with legal is the most LMCIT will reimburse any one city services with respect to which defense costs are official for defense costs for Open Meeting Law reimbursable under this Agreement. lawsuits commenced during the term of this It is the express intent of the parties to this agreement, regardless of the number of lawsuits, the Agreement that neither the city nor the city number of actual or alleged violations, or the date official waive any immunities, defenses, or the defense costs are actually incurred. limitations on liability available under III. CONDITIONS AND EXCLUSIONS Minnesota statutes or common law. 1. The term of this Agreement shall be one year 8• In the event that a city official makes a beginning with the effective date stated in the recovery of defense costs from any third party, LMCIT shall be reimbursed for any payment it Declarations. Subsequent renewals of this has made under this Agreement after the city Agreement shall be treated as separate terms. official has been fully reimbursed for his/her 2. LMCIT shall have no duty to provide a 20% share of the defense costs. defense to a city official with respect to a 9. LMCIT may cancel this Agreement by mailing legal action against that city official seeking or delivering written notice to the city at least: penalties based upon an alleged violation of LMCIT OMLRA-1 (11-93)(Rev. 11-94) 1 of 2 • a. Ten (10) days before the effective 3. "Defense costs" means reasonable and date of cancellation for nonpayment necessary attorney fees, court costs, court of the charge for this Agreement; or reporter and transcript fees, general witness and expert witness fees and expense, and b. Thirty (30) days before the effective similar defense related costs. Defense costs date of cancellation for any other does not include any fines or penalties, or any reason. attorney's fees awarded to a plaintiff in a suit charging a violation of the Open Meeting Law. If LMCIT decides not to renew this Agreement, LMCIT will mail or deliver to 4. "Joint powers entity" means an operating entity the city written notice of nonrenewal not less created by two or more governmental units than thirty (30) days before the expiration entering into an agreement as provided by date. statute for the joint exercise of governmental powers. An intergovernmental agreement will 10. It is mutually understood and agreed that the be deemed to create a joint powers entity if the city and all other LMCIT pool participants agreement establishes a board with the are jointly and severally liable for all claims effective power to do any of the following, and expenses of the pool. The amount of regardless of whether the specific consent of any liabilities in excess of assets may be the constituent governmental units may also be assessed to LMCIT pool participants when a required: deficiency is identified. a. To receive and expend funds; IV. DEFINITIONS b. To enter into contracts; 1. "City" means the city or other governmental c. To hire employees; body or entity first named in the Declarations. Unless specifically named in d. To purchase or otherwise acquire and the Declarations, city shall not include a gas, hold real or personal property; or electrical, or steam utilities commission; port authority, housing and redevelopment e. To sue or be sued. authority, economic development authority, area or municipal redevelopment authority, 5. "LMCIT" means the League of Minnesota or similar agency; municipal power agency; Cities Insurance Trust. municipal gas agency; hospital or nursing home board or commission; airport 6. "Open Meeting Law lawsuit" means a lawsuit commission; welfare or public relief agency; seeking penalties against a city official based school board; or joint powers entity. on an allegation that the city official has violated M.S. §471.705, commonly known as 2. "City official" means any former or present the Minnesota Open Meeting Law. elected or appointed official of the city or any present or former employee of the city. LMCIT OMLRA-1 (11-93)(Rev. 11-94) 2 of 2 OPEN MEETING LAW DEFENSE COST REIMBURSEMENT AGREEMENT REIMBURSEMENT PARTICIPATION ENDORSEMENT It is understood and agreed that Section I. Open Meeting Law Defense Cost Coverage is amended to modify the percentage of reimbursement of "defense costs" from 80% to 100%. This modification does not change the maximum amount of reimbursement as specified in Section II. Limits and as shown in the Agreement Declarations. All other terms and conditions remain unchanged. OML-001(11/97) 1-1-------\,.7 OCT 1 5 1999 , LMC I1 145 University Avenue West, St. Paul, MNL.51.03-2044 League of Minnesota Cities Fax: (612) 281-1297 • TDD (612) 281-1290 Cities promoting excellence J • October 14,1999 Attn: Thomas Melena ) City of Oak Park Heights PO Box 2007 Oak Park Heights, MN 55082 '�,SA— Lk0-1`t` Dear Mr. Melena, Here are the audit worksheets per your request. Thanks, 30,/,-,---, n-■ alr Barbara Meyer Policy Service Tech Phone number(651) 215-4173 AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • INSURED CLIENT: CITY OF OAK PARK HEIGHTS #135 PO BOX 2007 Berkley Administrators OAK PARK HEIGHTS, MN 55082 AUDITOR NAME: Heather Schley POLICY NUMBER: POLICY PERIOD: AUDIT PERIOD: FILE ID: DATE: 02-729 07/07/98 To 07/07/99 07/01/98 To 07/01/99 AA9 09/10/99 Page 1 of 6 SUMMARY PAGE KEY= A-AREA B-FRONTAGE C-REMUNERATION D-SALES/RECEIPTS E-COST F-ADMISSIONS -G-PER CAPITA/EACH K R CLASSIFICATION E A CODES BASIS OF A PREMIUM Y E PREMIUM T E — Workers Compensation Summary STREETS&MAINTENANCE C MN 5506 107,228 POLICE OFFICERS&D C MN 7720 496,596 CLERICAL OFFICE EMPLOYEES&NOC C MN 8810 303,913 PARK NOC-ALL EMPLOYEES&D C MN 9102 54,872 MUNICIPAL,TOWNSHIP,COUNTY OR STATE EMPLOYEE C MN 9410 89,876 ELECTED OFFICIALS: MAYOR&COUNCIL C MN 9411 23,250 RINK OPERATIONS C MN 9016 4,678 1,080,413 General Liability Summary LESS AMOUNT PREVIOUSLY BILLED EARNED PREMIUM LESS PREVIOUS BILLING LESS DEPOSIT PREMIUM (]AP OR (]RP DIVIDEND BALANCE DUE (]INSURED(]COMPANY 1 AA9.WK4 09/10/99 BJM • • INSURED CLIENT: CITY OF OAK PARK HEIGHTS #135 PO BOX 2007 Berkley Administrators OAK PARK HEIGHTS, MN 55082 AUDITOR NAME: Heather Schley POLICY NUMBER: POLICY PERIOD: AUDIT PERIOD: FILE 1D: DATE: 02-729 07/07/98 To 07/07/99 07/01/98 To 07/01/99 M9 09/10/99 i.Ca9Wl� n �l 0)0`, ,x • ' Page 2ofS Description of operations--Provide detailed description of all operations/services. Include all locations,products or services,distribution or delivery methods,and materials handled etc. List all officers partners or Owners-Their duties, remuneration and class codes. Co ration Individual Closely Held Corporation Partnership Other Limited Liability Corporation NI of Audit Notes Key Questions Y N 1. Premium overtime excluded? If no explain. 2. Are relatives employed? If yes list on audit I 3. Did the condition or type of records cause additional audit time? 4. Is there a"125'Cafe Plan or 401K Plan? 5. Board or Lodging provided' 6. Are commissions or bonuses paid? Audit Records: Use Policyholder Terminology 7. Did the insured request a division of any �R employees payroll? 8. If yes to 7 did records reflect proper division? ■■ 9. Casual or contract labor? ■..;. 10. Aircraft operation? • 11. Any sub-contractors used? 12. Are certificates on file for all subs?(if no provide complete details) 13. All classifications of policy accounted for? Next Audit: 14. 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OP DATE Forest Lake,MN 55025 OAKPA-1 KT 09/27/99 Phone: 651-464-3333 Support: 651-464-7596 POLICY INFORMATION POLICY# 51062482 TYPE EFFECTIVE EXPIRATION SB 07/07/98 07/07/99 City of Oak Park Heights Thomas M.Melena,City Admin. 14168 N 57th St, Box 2007 r' Stillwater,MN 55082 SEP 2 8 1 j ` Judy Re: Renewal Binder Here ' s the binder for your July renewal . The total package premium is $1072 . less than last year - Property & Auto are up (but then so are their values) , all others are down. Open Meeting Law premium is the same . The Excess premium is $693 . less than last year. The Employee Dishonesty coverage is also bound with the League, but you need to make a choice between the coverages offered on the second page of the binder. Your premium for this coverage last year (with United Fire) was $1035 . , but the limit was only a total of $150, 000 . for three scheduled positions . You asked me to use the higher limit of $250, 000 . and the underwriter felt that the deputy clerk was the only one that needed to be scheduled; all other employees would be covered, just not named. Let me know. Thank you. - • f�1 U Kate Tipping f r f CllIfi ri r4 t 7 • f V - fi ppr SE Ibt i .x yl W�'y� °ue e't -Paul MN 55103-2044 145 L.niversity Aven �` ,� , Phone: (651) 281-1200 • (800) 925-1122 League of Minnesota cities Fax: (651) 281-1299 • TDD (651) 281-1290 Cities Promoting excellence Web Site: www.lmnc.org Landmark Insurance Services Date: September 8, 1999 P.O. Box 188 Forest Lake, MN 55025 Re: City of Oak Park Heights Eff. Date: 7/07/99 RENEWAL PREMIUM SUMMARY AND BINDER. *Property $8,162. *Mobile Property 1,020. *Municipal Liability 28,709. *Automobile Liability 3,358. *UM/UIM 176. *Automobile Physical Damage 1,749. *Crime Not Covered. *Bonds See Optional Quotes Attached. Excess Liability See Renewal Binder Attached. Open Meeting Law 600. TOTAL $43,774. TORT LIMIT $750,000.5750,000. *Deductible: $500. REMARKS: DO NOT PAY UNTIL YOU RECEIVE INVOICES! Renewal coverage is bound up to 60 days pending issuance of renewal based on L.M.C.I.T. forms and practices in effect on renewal date. Sincerely. 11/97 v:. ~ LMCIT22 _---�__.�.�.__ AN EOUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER i • • FOR BOND: (1) $100,000. BLANKET EMPLOYEE DISHONESTY ONLY=$469. (2) BLANKET EMPLOYEE DISHONESTY AND FAITHFUL PERFORMANCE FOR$100,000. =$593. (3) BLANKET EMPLOYEE DISHONESTY WITH POSITION SCHEDULED FAITHFUL PERFORMANCE FOR DEPUTY CLERK FOR$250,000. =$1,319. 4111P' 411P Landmark Insurance Services P.O. Box 188 Forest Lake, MN 55025 RE:EXCESS LIABILITY PREMIUM SUMMARY&BINDER FOR CITY OF OAK PARK HEIGHTS,MN. LIABILITY LIMIT: $1,000,000 ANNUAL PREMIUM WITH WAIVER OF IMMUNITY: $7,283 ANNUAL PREMIUM WITHOUT WAIVER OF IMMUNITY: Not Requested FOLLOW FORM: UNDERLYING COVERAGE AS SCHEDULED SPECIAL EXCLUSIONS: MEDICAL PAYMENTS AUTOMOBILE NO FAULT WORKERS' COMPENSATION NUCLEAR REACTION FAILURE TO SUPPLY LEAD OR ASBESTOS PROPERTY IN CARE, CUSTODY OR CONTROL UMIUIM UNLESS ADDED BY ENDORSEMENT UME-4 ANY Y2K OTHER ENDORSEMENTS: REMARKS: RENEWAL COVERAGE IS BOUND BASED ON LMCIT FORMS AND PRACTICES,AND ELECTION FORM IN EFFECT ON RENEWAL DATE. Don Daraskevich September 9,1999 Underwriter Date • 410 LMCIT PREMIUM BREAKDOWN DATE: 09/01/1999 Coverage Period: 07/07/1999 - 07/07/2000 TO: CITY OF: OAK PARK HEIGHTS COVERAGE AVERAGE RATE AMOUNT OF COVERAGE PREMIUM PROPERTY (Per $100 Coverage) * . 14447 $ 5,649,459 $ 8,162 MOBILE PROPERTY(Per $100 Coverage) : UNSCHED.25,000 & LESS $ 70,259 $ 1 ,020 MUNICIPAL LIABILITY SEE ATTACHED $ 28, 709 AUTO LIABILITY & PHYSICAL DAMAGE *SEE ATTACHED $ 5 ,283 *These AVERAGE RATES are to be used TOTAL PREMIUM: $ 43,174 for ESTIMATES of PREMIUM ALLOCATION ONLY 09/19 PREPARED BY: r • • SCHEDULE of VEHICLES - OAK PARK HEIGHTS COVENANT Number: CMC 19785 COVENANT Period: 07/07/1999 TO 07/07/2000 VEH# YR TRADE NM MODEL - ID - PREMIUM HNO HIRED/NONOWNED $ 104 001 1987 CHEV 1 TON TRUCK 6960 $ 329 002 1995 FORD CROWN VICTORIA 1817 $ 536 003 1997 FORD CROWN VICTORIA 7069 $ 536 004 1997 CHEV PICKUP 6571 $ 364 005 1990 CHEV PICKUP 5936 $ 312 006 1998 FORD CROWN VICTORIA 5018 $ 536 007 1995 CHEV CAPRICE 4521 $ 536 008 1996 CHEV BLAZER 1236 $ 536 009 1999 FORD F350 4X4 W/PLOW 3507 $ 405 010 1999 FORD F550 DUMP W/PLO 3333 $ 553 011 1999 GMC YUKON 1704 $ 536 TOTAL VEHICLES $ 5,283 I 411 MUNICIPAL LIABILITY - OAK PARK HEIGHTS COVENANT Number: CMC 19785 COVENANT Period: 07/07/1999 TO 07/07/2000 PREMIUM ADVANCED --HAZARD-- BASIS PREMIUM OP EXP/TERR 2/POP 2501-10000 $ 2,281,455 $ 19,699 WATERWORKS - PAYROLL $ 61,500 $ 2,727 WATERWORKS - PER 1 MIL GALLONS 207 $ 288 MILES-STREETS-PER MILE - 15 $ 331 INDEPENDENT CONTRACTORS-PER $100 $ 3,193,450 $ 938 Y2K - BASIC LIABILITY 25,000 $ E&0 OTHER 5 YEAR PRIOR ACTS 5000M TO 8000M EXP $ 6,206,735 $ 4,726 TOTAL LIABILITY $ 28,709 411 IIM MUNICIPAL PROPERTY - OAK PARK HEIGHTS COVENANT Number: CMC 19785 COVENANT Period: 07/07/1999 TO 07/07/2000 LOC BLD COV DESCRIPTION COVERAGE PREMIUM 001 001 BLD 14168 57TH STREET N 1,545,000 958 CITY HALL/GARAGE 001 001 CNT 14168 57TH STREET N 206,000 171 CITY HALL/GARAGE 002 001 BLD 58TH & NORELL 1,545,000 649 WATER TOWER & WELL 003 001 BLD 14168 57TH STREET N 1,287,500 541 WATER TOWER & WELL 004 001 BLD BREKKE PARK 187,283 1,777 SHELTER 005 001 BLD 13425 60TH STREET 114, 190 48 LIFT STATION ' 006 001 BLD 14168 57TH STREET N 51,500 27 PUMP HOUSE #3 006 001 CNT 14168 57TH STREET N 51,500 32 PUMP HOUSE #3 007 001 BLD SWAGER PARK 5,347 72 SHELTER 008 001 BLD COVER PARK 35,361 153 RECREATION BUILDING 009 001 BLD VALLEY VIEW PARK 74,244 704 SHELTER 010 001 BLD BEADETTE ON LOOKOUT TRAIL 50,703 21 LIFT STATION . 011 001 BLD SUNYSIDE MARINA 50,703 21 LIFT STATION 012 001 BLD 14200 53RD STREET 81 ,955 34 LIFT STATION 013 001 PIO 14168 57TH STREET N 3, 169 25 CITY HALL 014 001 PIO SWAGER PARK 60,466 492 ' PARK 015 001 PIO COVER PARK 68,569 558 PARK 016 001 PIO VALLEY VIEW PARK 36, 787 299 PARK 017 001 PIO BREKKE PARK 132, 382 1,077 PARK 018 001 PIO CITY WIDE 61,800 503 VARIOUS 500 001 BLD ALL LOCATIONS 5,000 Y2K . MUNICIPAL PROPERTY - OAK PARK HEIGHTS COVENANT Number: CMC 19785 COVENANT Period: 07/07/1999 TO 07/07/2000 LOC BLD COV. DESCRIPTION COVERAGE PREMIUM TOTAL PROPERTY 8,162 League of Minnesota Cities In rance Trust eloup Self-Insured Workers' Corn sation Plan Administrator Berkley Administrators 145 University Avenue West St.Paul,MN 55103-2044 Phone(651)215-4169 Notice of Premium Options The"City" Agreement No.: !0E-000729-13 OAK FARE::: HEIGHTS Agreement Period: From: 0%07 f 1999 PG BOX 2007 To: 07/07/2000 . OAK PARK HEIGHT MN 55082-200: Enclosed is a quotation forworkers'compensation depositpremium.Deductible options are now available inreturn for a premium credit applied to your estimated standardpremium of$ 18804. . The deductible will apply per occurrence to paid medical costs only.There is no aggregate limit. Please indicate below the premium option you wish to select. You may choose only one and you cannot change P options during the agreementperiod. OPTIONS NET DEPOSIT PREMIUM 1 jZi RegularPremiumOption i74!.93. Deductible Premium Credit per Occurrence Credit Amount - 2 ❑ • $250 3% 564. . • 3 ❑ 500 4.5% 346. 16647. 4 ❑ 1,000 6% 1128. 16365. 5 ❑ 2,500 10% 1880. 15613. 6 ❑ 5,000 13.5% 2539.. : 14954: 7 ❑ - 10,000 - 18% 3285. 14108 This should be signedby an authorized re resentative ofthe cit requesting coverage. One ofthe abov options tions must be selected. Please return a signed copy ofthis notice to us with payment and make checks payable to the LMCIT. Administr o r at 6/24/99 Signature Title Date Formore information on the premium options that apply to your city,refer to the enclosed brochure. LM4501(11/98) League of Minnesota Cities Inance Trust *up Self-Insured Workers' CornOWsation Plan Administrator Berkley Administrators 145 University Avenue West St Paul,MN 55103-2044 Phone(651)215-4169 Self-Insured Workers' Compensation Quotation (RENEWAL of Agreement No. 02-000729-12) OAK PARK: HEIGHTS • 07/07/1999 07/07/2000 ESTIMATED DEPOSIT CODE RATE PAYROLL PREMIUM STREET CONSTRUCTION a MAINTENANCE 5506 4.00 21900. 876. WATERWORKS 7520 2.21 164800, 4631, POLICE 7720 6.74 542800. 14873. CLERICAL 8010 0.43 339750. 1461 . PARKS 9102 2.34 40500. 948. MUNICIPAL EMPLOYEES -9410 0.86 73250. 630. ELECTED OR APPOINTED OFFICIALS 9411 0.33 26000. 86. Manual Premium 23505. Experience Modification 0.80 Standard Premium 16804. Managed Care Credit 0% 0. Deductible Credit 0% 0, Premium Discount 1311. Discounted Standard Premium • 17493. LMC Insurance Trust Discount 0% 0. Net Deposit Premium 17493. The foregoing quotation is for a deposit premium based on your estimate of payroll. Your final actual premium will be computed after an audit of payroll subsequent to the close of your agreement year and will be subject to revisions in rates, payrolls and experience modification. While you are a member of the LMCIT Workers' Compensation Plan,you will be eligible to participate in distributions from the Trust based upon claims experience and earnings of the Trust. If you desire the coverage offered above,please complete the enclosed"Notice of Premium Options" and return it and your check for the deposit premium(made payable to the LMCIT)to us at the above address. LM 4410 (11/98) • ENASEMENT RECAP Page 1 LEAGUE MN CITIES INS TRUST C/O BERKLEY RISK SERVICES, INC. Invoice Date 6/08/99 920 2ND AVE. SOUTH, SUITE 700 Due Date 07/06/99 MINNEAPOLIS MN 55402-4023 Bill To Agent 00874 OAK PARK HEIGHTS LANDMARK INSURANCE SERVICES ATTN: THOMAS MELENA 232 SOUTH LAKE STREET P.O.BOX 2007 P.O. BOX 188 STILLWATER MN 55082 FOREST LAKE MN 55025 Type of Coverage: MUNICIPALITY Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/99 Covered Party: OAK PARK HEIGHTS Endorsement Endorse Deferred Due Transaction Effect Date Amount Amount Amount Description 2/25/99 179.00 .00 179.00 ADD VEH#12 1999 FORD F350 4X4 W/PLOW#3507 2/25/99 179.00- .00 179.00- ADD VEH#12 USING WRONG CLASSBACKING OUT ENDT 2/25/99 134.00 .00 134.00 ADD VEH#12 BACK IN USING CORRECTING CLASS CODE 3/08/99 167.00 .00 167.00 ADD VEH#13 1999 FORD F550WIPLO DUMP TRUCK#3333 4/08/99 112.00 .00 112.00 ADD99GMCYUKON#1704 TOTAL 413.00 .00 413.00 1 411� ��U 73088 INVOICE /_��ue� League of Minnesota Cities Insurance Trust PREMIUM NOTICE C/O Invoice Date 5/29/99 92O Second South, Suite ' Ave.� ' Due Date Upon Receipt pi LI U N °�� 55402�O23 » m N (612) 376-4200 Bill To 0874 OAK PARK HEIGHTS LAN IiRK INSURANCE SERVICES ATTN: THOMAS MELENA JUN _ ?34 / `'IX]TH LAKE STREET P.O.BOX 2007 188 UU V GTILLWATER MN 55082 FO|`F.: ' LAKE MN 55025 Type of Coverage: MUNICIPALITY Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/99 Covered Party: OAK PARK HEIGHTS ------------------------------------------------------------------------------- Payment Plan Selected: ANNUAL PAY PLAN DUE DATE AMOUNT DUE DUE DATE AMOUNT DUE DUE DATE AMOUNT DUE 07/06/99 413.00 TOTAL AMOUNT 413.00 - .: Ibis :PeeeiLle Due 4‘10t*Ce show +hm current amount 4u0 mn this PmliCy:D0cUMOnt*,.. ' Revised Premium Due Current Total Prior Total Total Current Installment Policy Premium Balance Due Amount Paid Charge/Credit Charge 40,135.00 39,722.00 39,722.00 .00 .00 *** We must receive the minimum due by the due date. Total Due: 413.00 Minimum Due: .00 ------------------------------------------------------------------------------- LEAGUE MN CITIES INS TRUST C/O BERKLEY RISK SERVICES LLC ' INVOICE# �� ~y 920 2ND AVE. SOUTH, SUITE 700 ( `�ue�J MINNEAPOLIS MN 55402-4023 Type of Coverage: MUNICIPALITY Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/99 Covered Party: OAK PARK HEIGHTS DUE DATE: Upon Receipt AMOUNT DUE: .00 � E 0 ICE # ��"f �-�� -� ( League of Minnesota Cities Insuran :1 \IUM NOTICE C/O ice Date 5/O7/99 L___________Ji 8Q0 Second Am,. South, Suite 700 Date Upon Receipt I °��K i N =~� 654O2~02J U N � (612) �- 376-4200 Bill To Agent 00874 OAK PARK HEIGHTS LANDMARK INSURANCE SERVICES ATTN: THOMAS MELENA 232 SOUTH LAKE STREET P.O.BOX 2007 P.O. BOX 188 STILLWATER MN 55082 FOREST LAKE MN 55025 Type of Coverage: MUNICIPALITY Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/99 Covered Party: OAK PARK HEIGHTS ------------------------------------------------------------------------------- Payment Plan Selected: ANNUAL PAY PLAN DUE DATE AMOUNT DUE DUE DATE AMOUNT DUE DUE DATE AMOUNT DUE 07/06/99 413.,00 TOTAL AMOUNT 413.O0 „:-7777777.77'T"r77:777-7-T7':"'77T7T7-7-7.7:.77-7 -777.77.77-7-77.7777-77777777,77,777,777777: ===i4^pu".. =,"".. ` Revised Premium Due Current Total Prior Total Total Current Installment Policy Premium Balance Due Amount Paid Charge/Credit Charge 40,135.00 39,722.00 40,023.00 .00 .00 *** We must receive the minimum due by the due date. Total Due: 112.00 Minimum Due: 301 .00- - ------ -- - LEAGUE MN CITIES INS TRUST C/O BERKLEY RISK SERVICES LLC ~�� ^� ' �� t � 920 2110 AVE. SOUTH, SUITE 700 MINNEAPOLIS MN 55402-4023 Type of Coverage: MUNICIPALITY Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/99 Covered Party: OAK PARK HEIGHTS DUE DATE: Upon Receipt CREDIT DUE: 301 .00- DO NOT PAY QTY OF • fb . • • - • OAK PARK HEIGHTS 14168 North 57th Street • P.O.Box 2007 •Oak p� -y, •• .Mk 550182-2807 •Phone 651/4344439 • Fax:651/- Fax Transmittal To: /�w � j; ✓, '� Fax #: From: J �� ( /o (s • Date: 6 -- /S - 5 Subject: L, 7 - /?&'u/c c Total Number of Pages, including cover sheet: j ••�♦ ♦ •i�i��••:•♦ i�i♦%♦.�• :•.::i 0.• ••:•• .0...0.•.:•• •••••••i♦••••.i i Tree City U.S.A. w Landmark InsurancRervices M 0 Page 1 PO Box 188 ACCOUNT NO. OP DATE Forest Lake,MN 55025 OAKPA-1 KT 06/02/99 Phone: 651-464-3333 Support: 651-464-7596 POLICY INFORMATION' POLICY# CMC18745 TYPE EFFECTIVE EXPIRATION CP MigM 07,41.7/97/99 City of Oak Park Heights 1 ___-- Thomas M.Melena,City Admin. 14168 N 57th St, Box 2007 1, .�� — 4 �ggg Stillwater,MN 55082 J Mr.Melena Re: Endorsements I find we have duplicates of endorsements #1, 2 & 3 so I thought I be sure and send a copy of each along to you - you would have received the invoice for endorsement #1 in October . #7 is more recent and that invoice would have been mailed to you last month. If you have any questions please let me know. In the near future we need to get together to review the City' s coverage for the upcoming July renewal . As in the past I will "pre-fill-out" the applications based on the expiring information so as to not take up too much of your time . If you would call with a time that would be convenient (other than June 9th or 16th) I would appreciate it . Thank you. CfrAU., 522'1,1 , 9, OJT -cdtr-- Kate Tipping Cvf 00'° • • ENDORSEMENT # 1 ES 10/26/98 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK HEIGHTS I CMC 18745 7/7/98 IT IS HEREBY UNDERSTOOD AND AGREED THAT MUNICIPAL LIABILITY FORM MGL-1 01-95 IS AMENDED AS FOLLOWS: OPERATING EXPENDITURES PREMIUM BASIS IS AMENDED TO 254 2 $ ,835. IN LIEU OF $2,786,158. E&O PREMIUM BASIS IS AMENDED TO $5,908,465. IN LIEU OF $6,439,788. Total Endorsement Premium: $ 4,711. RP S e Below f ( e for Billing information) x PREMIUM DUE NOW: $ 4,711. RP (See Invoice Attached) J OR DO NOT PAY NOW PREMIUM ADJUSTMENT NT TO BE MADE AT EXPIRATION. ,� All other terms and conditions remain unchanged. `1/ 1 Executive Director, LMCIT LMCIT ME044(01-95) Page 1 of 1 • • ENDORSEMENT # 2 ES 10/26/98 ICITY OF OAK PARK HEIGHTS I CMC 18745 I 8/12/98 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages A., 1996 CHEV. BLAZER #1236 ALL LIABILITY COVERAGES D ACV $500. DED. COMP. D $500. DED. COLL. I O N = s ' 1993 CHEV. CAPRICE #0238 ALL COVERAGES D`'- E T>; I 0 N ; S Total Endorsement Premium: $ NO CHANGE (See Below for Billing information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged. Executive Director, LMCIT LMCIT ME020(1/95) Page 1 of 1 • ENDORSEMENT # 3 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE City of Oak Park Heights I CMC 18745 7/7/98 This endorsement modifies coverage provided under the Municipal Property and Crime coverages. Section V.B Loss Valuation is amended to include: g: Trees and Shrubs For a tree or shrub which is destroyed, LMCIT will pay the actual cost to replace it with a tree or shrub of similar type and of a size that is normally considered to be reasonable and practical to transplant, regardless of whether the tree or shrub is replaced or not. For a tree or shrub that is damaged but not destroyed, LMCIT will pay the actual cost of any service, treatment, or repair that is actually performed. We will not pay more than the actual cost to replace it with a tree or shrub of similar type, and of a size that is normally considered to be reasonable and practical to transplant. Total Endorsement Premium: $NO CHANGE (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. All other terms and conditions remain unchanged Executive Director, LMCIT LMCIT ME044(1/95) Page 1 of 1 ENDORSEMENT 110 4-28-99 JH COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK CMC 18745 4-08-99 HEIGHTS It is understood and agreed that the Schedule of Vehicles is amended as follows: Description Coverages 1999 GMC YUKON #1704 ALL LIABILITY COVERAGES A ACV $500. DED. COMP. D $500. DED. COLL. ilf 0 N..`> D . Ei L 0 N Total Endorsement Premium: $ 112. AP (See Below for Billing Information) PREMIUM DUE NOW: $ (See Invoice Attached) OR X DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION All other terms and conditions remain unchanged 1ff Executive Director, LMCIT LMCIT ME020(1!95) Page 1 of 1 • 110 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST Administered by: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103 (612)281-1200 APPLICATION FOR THE CITY OF: Qc c �C:c., k ,14.A P- County: (A CY1 Mailing Address: 3 s P O 1 Phone: (012-- (439- V43 9 City, State, Zip: -,..a..�ct-Q•v /`i 65082 - Z<l City Contact: I IA0 S /"i.Q (e}✓`O.. Title: C ° AJ t n 1990 Census Population: 34 g(o Current Estimated Population: `U 4 Total Expenditures All Operations: ' Is the City a Member of The League of Minnesota Cities? X Yes No Submitting Agency: LOc>n:x /hod./Q.. n Sz c-''a-v\Ce.- 5 e-✓-v c.e-`y Address: P C c C City, State, Zip: �o'V.t' , M '� S S U YZ`j Telephone: ( S( 1 LI aLt - 3 333 Facsimile: 7S-1 ) � ` 7 597(4 Agency Contact: 13-^' t GA". CC( v v. Kc - ( �� r i _ Date of Council Resolution or Contract Appointing the Agency: AGENT COMPENSATION: X 10% City Will Compensate the Agent Directly Other Please specify: Standard Deductible: 500• (Applies to All Lines. Optional All Lines Deductibles are Available.) Current Information on Coverage You Are Applying For: Carrier Policy Type Expiration Date Premium L-MC ► T rack-ct 7(-i !9q 11 t � t� Vmb LMCITAPP.TBL(1 I/97) Plop 1 of 10 'AGUE OF MINNESOTA CITIES INSURANC• E TRUST PROPERTY Deductible:$ (Standard) Limit of Coverage per occurrence to be established by LMCIT. This limit is established by totaling the replacement cost values of all your buildings/contents, property in the open and mobile property. MOBILE PROPERTY Mobile property with replacement cost values of$2,5,000 or less can be covered with no schedule. There is a flat premium charge. Do you want this coverage? y�`,4 YES [ j NO CRIME COVERAGE Form Location Limit Deductible Forgery & Alteration (Standard) Theft, Disappearance & Destruction (Standard) Please describe Safe and Vault LMCITAPP.30(11/97) Page 2 of 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST PROPERTY and AUTOMOBILE PHYSICAL DAMAGE The new covenant provides Errors and Omissions coverage for Property and Automobile Physical Damage. The following information is needed to designate the entities that are to be covered. Please indicate if you want the following entities to have coverage for Property or Automobile Physical Damage. AUTOMOBILE PROPERTY PHYSICAL DAMAGE HOSPITALS YES NO N/A X YES NO_ N/A X NURSING HOME YES NO N/A YES NO N/A �C URS G � _ HEALTH CLINICS YES NO N/A X YES NO_ N/A )C AIRPORTS YES NO_ N/A 1( YES NO_ N/A ) ELECTRIC UTILITY YES NO_ N/A YES NO_ N/A X_ GAS UTILITY YES NO_ N/A j YES NO_ N/A STEAM UTILITY YES NO_ N/A� YES NO_ N/A r HRA YES NO )X N/A_ YES NO X N/A EDA YES .X NO_ N/A_ YES NO_ N/A k PORT AUTHORITY YES NO_ N/A X YES NO_ N/A ADDITIONAL INFORMATION: LMCITAPP.11 (11/97) PAGE 3 OF 19 . • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST MUNICIPAL LIABILITY -SEPARATELY RATED EXPOSURES DO NOT LEAVE ANY SPACES BLANK IF NO EXPOSURE PLEASE INDICATE N/A OR NONE City of Q otAr((- 44 j2;14J1..- Date 1. Golf course annual receipts: v' Number of golf carts: �o 2. Street mileage: i,5 (Round to nearest mile, i.e. 4.2 miles should be 4) 3. Area (square feet) of Exhibition Buildings, Recreation Centers, Arenas, Auditoriums or Community Centers: tnc�•¢. 4. Water Department payroll: 5 _ 0 0 / 5 0 c) Total gallons of water used annually: ;20 7 0 6 v t o (Round to nearest million, i.e. 2,500,000 should'be 3,000,000) 5. Electric Department payroll: inG , 6. Gas Department payroll: 7. Steam Department payroll: 8. Number of powered boats: Horsepower and usage of each: 9. Number of boats and canoes not powered: Explain how they are used: 10. Municipal liquor store receipts: Kta- Store 1 Store 2 Store 3 On Sale Off Sale LMCITAPP.01 (11/97) PAGE 6 OF 19 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 11. Number of seasonal swimming pools: Y, /e. Height of diving boards: 12. Number of inside swimming pools: t,\fa- Height of diving boards: 13. Number of swimming beaches: r joy. Height of diving boards: Number of docks and rafts: 1,, to 14. Number of water slides: I0 Height: Length: Location: Seasonal: Year Round: 15. Number of staff attorneys: (4.. Do you want coverage to be excluded? Yes No Additional Information May Be Necessary LMCTTAPP.O1 (11/Q7) Tin rr-r nc � • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST MUNICIPALITY QUESTIONNAIRE DO NOT LEAVE ANY SPACES BLANK IF NO EXPOSURE PLEASE INDICATE N/A OR NONE City of 0 6-k-- �� /y Date 7(ci ci 1. Does the city own or operate any of the following? *Municipal **Limits of **Type of ** Is the city named Liability Coverage Provided Coverage provided by as an additional Governmental Coverage Desired Projected by the other insurance the other insurance insured on the other Body or Entity (Must See Below) Expenditures company company insurance company's (If Applicable) (If Applicable) policy? (If Applicable) _ Hospitals Yes X No Yes No Nursing Yes X No Yes No Homes Health Yes X No _Yes No Clinics - Airports Yes X No - Yes No Comments: * Municipal Liability, except for bodily injury.property damage or personal injury, is automatically provided for the City and the other Governmental Body or Entity. If you do not want coverage please notify LMCIT. ** These questions are intended to analyze the coverages provided by the other insurance companies. These other policies must provide bodily injury, property damage or personal injury coverage to the City and the other Governmental Body or Entity. LMrTT.APP 02 r1 1,a7) • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 2. A. Damages arising out of the following activities are excluded unless such board, commission, authority, or agency is named in the Declarations, in which case the "city" will also be covered to the extent of coverage provided under this covenant to the named board, commission, authority or agency for damages arising out of the activities of the respective named board, commission, authority or agency. Please designate the activities you want covered below. B. If the Governmental Body or Entity has purchased coverage elsewhere the City needs to evaluate their exposures and the coverage that they need. 1) Is the city named as an additional insured on the other policy and for what coverage? 2) Does the city want coverage from LMCIT for these activities? PLEASE CONTACT LMCIT FOR ASSISTANCE. ADDITIONAL PREMIUM MAY BE NECESSARY Municipal Liability Projected Projected Additional Governmental Body or Entity Coverage Desired Revenue Expenditures Information Gas Utilities Commission Yes No Questionnaire - Needed Electric Utilities Commission _Yes X No Questionnaire Needed Steam Utilities Commission `Yes No Questionnaire Needed Port Authority _Yes _L No Need Full Details Housing & Redevelopment Authority _Yes X No Need Full Details Economic Development Authority '\Yes No Need Full Details Area or Municipal Redevelopment _Yes ..No Need Full Authority Details Municipal Power Agency Yes X, No Need Full Details Municipal Gas Agency Yes No Need Full Details LMCrTAPP.02(11/971 .,. 'AGUE OF MINNESOTA CTTIES INSURANC• E TRUST 3. A. Damages arising out of the following activities are excluded unless the agency or board is specifically named in the Declarations. Please designate the activities you want covered below. B. If the Governmental Body or Entity has purchased coverage elsewhere the City needs to evaluate their exposures and the coverage that they need. 1) Is the city named as an additional insured on the other policy and for what coverage? 2) Does the city want coverage from LMCIT for these activities? Municipal Liability Projected Projected Additional Governmental Body or Coverage Desired Revenue Expenditures Information Entity Welfare or Public Relief Yes No Need Full Agency Details School Board Yes No Need Full Details 4. Does the city operate a dump or landfill? lng What type of material is deposited there? Is the area fenced to keep out the public when closed? Is the area attended during open hours? 5. Does the city own or operate a ski jump, ski lift or tow rope? '\5 If operated by others, please indicate and advise if the city is named as an additional insured on their policy and the policy limits provided. Is coverage desired? Yes No If coverage is desired full details must be submitted. LMCITAPP.02(11/471 part in nr to • LEAGUE OF 11IINNESOTA CITIES INSURANCE TRUST 6. Does the city own or operate a marina? in_Lf If operated by others, please indicate and advise if the city is named as an additional insured on their policy and the policy limits provided. Is coverage desired? Yes No DIf a cmovs ecrlaagse s ifis e dd eass irCedla,sfus I odr etaClials s s mII usbt y be th se uCbmi ottedis. 7. sioner of the Department of Natural Resources or any dike. levee or similar structure - (Failure or bursting is excluded.) A. Age of Dams: Inspected regularly: Yes No By Whom: Height of dam above reservoir: Height of dam above the bottom of spillway: Width: Is the dam fenced to keep the public off? Acre feet of water dam has been designed to retain: acre feet B. Age of Dike or Levee: r\la Height of Dike or Levee: Construction Material of Dike or Levee: Acre feet of water Dike or Levee has been designed to retain: acre feet Who built the Dike or Levee: Is the Dike or Levee inspected regularly: By Whom: LMC ITAPP.02(1 1/97) PAGE 11 OF 19 • • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 8. Describe any large construction projects anticipated for this coming year. 9. Parks and Playgrounds A. Description (including area) of each park or playground: bD°' 5 Ct cto B. Description of playground equipment on each: Gc : 9 C. Description of other special features and sponsored activities: (i.e., ski, toboggan, tubing, water slides, skate board or BMX facilities). 1^cn".12- 10. Does the city operate any aeration devices in the winter to keep an area of local ponds, lakes or rivers ice free? n If so, please give full details and precautions taken. LMCITAPP.02(11/97) PAGE 12 OF 19 • Lf1PGUE OF MINNESOTA CITIES INSURANCE TRUST 11. Firefighters Ccwc.c --cQ - oYn G`'5-`'k "Y ?Dice cY `- Payroll of paid firefighters: r\G'1"-e. Number of volunteers: ^■ - Number of fire trucks: v-101-.12- Describe any fund raising activities or celebrations by the firefighters or relief associations: 12. EMT's and Paramedics hiCt. Number of rescue trucks: Number of ambulances Number of emergency runs: Number of convalescent runs: Number of EMT's: Number of EMT-A's: Number of paramedics: Is there radio contact with hospital doctors? Describe any EMT type losses: 13. Law Enforcement Total law enforcement payroll: Number of law enforcement vehicles: 7 Number of Class A (Full-time): 'f (Part-Time): Number of Class B: 0 Class C: C� Number of Class D: C% Class E: Number of Class F: C) See next page for description of classes. LMCITAPP.02(11/97) PAGE 13 OF 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST A = Armed with arrest power B = Unarmed, no arrest power C = Non-officer employees D = Auxiliary police E = Voluntary unarmed F = Voluntary armed Describe any law enforcement type losses: ►'V'v Describe any jail or detention facilities maintained: untie_ Ccu_ + is Maximum holding p eriod: 0-3 `.o Z- 14. Grandstands and Stadiums A. Number and location of each: Pavic- ^r B. Seating capacity: 1(CO C. Type of construction: S`4 D. Permanent or temporary: v?,6,4' ►"'` -°� 15. Festivals. Parades. Exhibitions or other special events sponsored by city. Describe: 16. Fireworks' Exhibitions - Excluded. (Refer for consideration.) 1--1 Q- 17. Wharf or Docks - Describe: 18. Street or Road Construction or Maintenance Annual expenditures: /611 a 0 Ct.. '- How much work is sublet to others? . < r .r� cx.�,f� �- r" • �t c Are Certificates of Insurance obtained indicating adequate limits? I r 4- (Sac -)t'' Is any blasting done? irvt5 LMCITAPP.02(11/97) PAGE 14 OF 19 I - S LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 19 Please describe any contractual agreements the city has entered into such as: A. Mutual aid: 0„).a. oSc-v^ COX' B. Police or fire protection: i3 C. Other. Describe: 20. Joint Powers Boards are not covered. However, they may be considered for coverage by submitting full details in a separate application. IMPORTANT! Coverage is not bound or in effect until you receive written acceptance from LMCIT. 21. Do you routinely get Certificates of Insurance from all independent contractors? 22. Does the city provide a fire alarm or burglar alarm protection system? lAe If so, please give full details. 23. Any other pertinent information not covered above: 24. City was created in: (Year) LMCITAPP.02(11/97) PAGE 15 OF 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 25. Names and official titles of the Members of the Board of the City: (City Council) Name Official u�'�`�1 S�{►�a�' /17e4y0 MILE/ �u.7�n Sorg Zaizn fn7 (.n/ (' L yto," B y r n d u ct`!.y► 26. Fiscal Year *Revenue *Expenditure Fund Balance At Year End 19 cA c\ Projected Year LI,7 avg,L0 01, 5 S) `d \ a 3 5 19 °\S Current Budget w,-51,o2 2c'- 141g014 \y -311S5, 71 19�� 1st Prior Actual 3\0■0 5, 11 t 3,5` 01 , 8U La, a 3 0 ) a°I 19 al y 2nd Prior Actual "-5‘`I 31%oto, y1 tr S, to , 5? 19 °15 3rd Prior Actual 5\g$�\\- y b,�a�\\ ; 5 5 0'4 , \--\ \ _ *These figures should include all funds includin g g overnmental enterprise, miscellaneous special revenue and debt service funds. If desired, you may send photocopies of appropriate sheets from annual financial report. - 27. a. Total amount of outstanding bonds: b. Latest Moody's and/or Standard and Poors' bond rating: LMCITAPP.02(11/97) PAGE 16 OF 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 28. Have any of the following situations occurred within the last five years? Yes No a. Appropriation or condemnation for which agreed settlements have not been achieved. X b. Improper or alleged wrongful granting of variances, building permits or similar grants or zoning disputes. c. Wrongful or alleged wrongful approval of building plans, designs or specifications. d. Wrongful or alleged wrongful approval of building construction. e. Allegation of unfair or improper treatment regarding employee hiring, renumeration, advancement or termination of employment. f. Disputes involving integration, segregation, discrimination or violation of civil rights. g. Any grand jury indictments of any public officials. h. Assault and battery claims made against the municipality or its officials. I. Any riot or civil commotion in the past five years. X j. Any losses or claims occurred involving contractual disputes. 29. Land Use Liability Number of building permits issued: Number of variances: Granted Denied Number of conditional use permits: Granted Denied 30. Does the city want to exclude Medical Payments? Yes No LMCITAPP.02(11/97) PAGE 17 OF 19 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 31. Please list the additional covered parties required. COPY OF CONTRACT MAY BE REQUIRED BY LMCIT FOR ANY/OR ALL ADDITIONAL COVERED PARTIES LISTED BELOW ADDITIONAL COVERED NAME ADDRESS PARTIES INTEREST 32. Contracts with a railroad and contracts with the contractor performing the actual railroad construction project needs special attention. Please provide a copy of the contract to LMCIT. This does not apply to easement or side track agreements. Please contact LMCIT before you sign a construction agreement with a railroad or the contractor that is performing the actual railroad construction project, 33. Does the City own or operate any trampolines? Describe LMCITAPP.15(11/97) PAGE 18 OF 19 41IP LEAGUE OF MINNESOTA CITIES INSURANCE TRUST AUTOMOBILE LIABILITY AND PHYSICAL DAMAGE CITY OF Dolc- Po-,7 1. Limit of Liability: Physical Damage: $750,000. Combined Single Limit on Bodily I. Comprehensive Deductible: (Standard) Injury and Property Damage II. Collision Deductible: (Standard) $ 50,000. Uninsured and Underinsured III. Please provide color of fire trucks $750,000. Uninsured and Underinsured 1=Lime Yellow; 2 =Red; 3=All Others Motorist Limit * The standard limit is $50,000. Cities may increase if they choose. 2. Cities have the option to make their LMCIT Liability Coverage primary for vehicles used by specified individuals or groups in specified circumstances. Please indicate if you want this optional coverage and provide additional information requested. Yes X No If yes, please indicate type of individuals or groups: If yes, please indicate number of individuals: VEHICLE SCHEDULE (The attached computer printout provides the most current Schedule. However, recent changes may not show on the Schedule.) Dept 111- , Unit Description of Vehicle Serial Used Bldg. Current Comp Coll. Fire No. # By Garaged GVW Value . Ded Ded Trucks 1 2 3 4 5 6 7 8 9 10 OPTIONAL: Replacement cost on Fire Trucks aged 10 years or less (Indicate unit number and replacement value). Replacement cost can also be considered on other high valued vehicles. Please contact your agent. LMCITAPP.15(11/97) PAGE 19 OF 19 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST EXCESS LIABILITY APPLICATION Administered By: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103 (612) 281-1200 jj '' City of Ou- - viz.„k. 4-1 yJ- Date 7 ."1 —of el Limit of,. coverage desired: ,/ $1,000,000 $2,000,000 $3,000,000 $4,000,000 $5,000,000 Do you want the Excess to apply/to the Uninsured and Underinsured coverage provided by the primary covenant? V Yes No If yes, the automobile UM/UIM limits must be $750,000. The Excess Covenant does not automatically apply to liquor liability. Do you want the excess to apply to liquor liability? Yes No Special Note: The liquor liability primary limits must be $1,000,000. Employers Liability: Carrier: ( I Limits: I cD(CO 0 Policy Number: Policy Period: 1 I I ctGt — 200 Does applicant now have or contemplate any exposure under: (If yes, attach sheet with payroll figures.) (a) Jones Act or Admiralty Jurisdiction Yes ✓j No (b) Federal Railroad Employees Act Yes .J No (c) Federal Longshoremen's & Harbor Workers Act Yes \J No To what extent does applicant have primary insurance to cover these exposures? �fG IF THIS IS A RENEWAL, PLEASE INDICATE IF RENEWAL IS TO BE BOUND: YES NO LMCITAPP.12(11/97) PAGE 1 OF 1 "VAGUE OF MINNESOTA CITIES 1T RANCE TRUST Administered By: BERKLEY RISK SERVICES, INC. 145 University Avenue West St. Paul, MN 55103-2044 (612) 281-1200 SUBMITTED BY: PRODUCER: ADDRESS ZIP: APPLICATION FOR MINNESOTA PETROFUND aA-(CA SUPPLEMENTAL REIMBURSEMENT AGREEMENT APPLICANT'S INSTRUCTIONS: 1. Answer all questions. If the answer is NONE, please state NONE. 2. If space is insufficient to provide a complete response, attach a separate sheet. 3. The application must be signed and dated by an authorized representative of the City. 4. PLEASE READ CAREFULLY THE STATEMENTS AT THE END OF THIS APPLICATION. APPLICANT 1. Name of City or other public entities to be covered under the Agreement. LMCITAPP.MPRAAP(11/97) Page 1 of 6 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 2. Principal Address: 3. If Joint Powers entity, identify participants: 4. Designate the public official primarily responsibi or environmental protection: NAME: TITLE ADDRESS: TELEPHONE TANK SITE INFORMATION 1. Please list and describe all active and inactive underground and above ground storage tanks on the attached storage tank schedule. This list must include all tanks acquired through the Housing and Redevelopment Authority and the Economic Development Authority or any similar department/agency. 2. Are all tanks registered with the Minnesota Pollution Control Agency? _ YES NO If NO, please explain below: • LMCITAPP.MPRAAP(11/97) Page 2 of 6 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST 3. Do all tanks including piping meet all local storage tank regulations? YES NO If NO, please explain below: 4. Do all tanks including piping meet all state storage tank regulations? YES NO If NO, please explain below: 5. Do all tanks including piping meet all ederal storage tank regulations? _YES NO If NO, please explain below: 6. Have you received any complaint or notice that any of your tanks including piping are leaking or have you any other indication that any of your tanks including piping are leaking? YES NO If YES, please explain below: LMCITAPP.MPRAAP(11/97) Page 3 of 6 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST CLAIM HISTORY 1. List individual petroleum tank release incidents or claims and damages/expenses: Date of Describe Injury Amounts Paid Incident or Damage or Reserved Location 2. Identify your tank sites that have been the subject of environmen tigation, claim or administrative prosecution or complaint. Please give details: 3. Are you aware of any other incidents conditions which may result in a claim against you? YES NO If YES, give details: 4. Have you ever performed any remedial clean-up actions at any of your tank sites? YES NO If YES, give details: LMCITAPP.MPRAAP(11/97) Page 4 of 6 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST The undersigned authorized representatives of the Applicant represents to the best of his/her knowledge the statements herein are true, and it is agreed that this application shall become incorporated as a part of the Minnesota Petrofund Supplemental Reimbursement Agreement if accepted by LMCIT. LMCIT is hereby authorized to make any investigation and inquiry in connection with this application as it deems necessary. Y Y g q�Y Dated at this day of ,19 (Name of Applicant) BY: (Signature and Title of Authorized Representative) ) LMCITAPP.MPRAAP(11/97) PAGE 5 OF 6 i • v t c C w � O v ETA OA as � Y < H raw ri Z � •r Ci a • o . _. C U �. co te aO o �. GI) d ^ s �n a - s o y a • _ A o << U 3 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST ADMINISTERED BY: Berkley Risk Services, Inc. 145 University Avenue West St. Paul, MN 55103-2044 SUBMITTED BY: £-G^^62- C■j✓ C -CA, 5 e f.' e S PRODUCER: CW / t v ADDRESS: Po .130) l g c(N o / 1'1 A.) 55°3_5 APPLICATION FOR OPEN MEETING LAW DEFENSE COST REIMBURSEMENT AGREEMENT APPLICANT'S INSTRUCTIONS: 1. Please answer all questions. If the answer is NONE, please state NONE. 2. If space is insufficient to provide a complete response, attach a separate sheet. 3. The application must be signed by an authorized representative of the City. Special Note: Please answer all questions. These questions are intended to provide general information only. The information provided will also be used for a proactive loss control procedure if needed. APPLICANT 1. Name of city or other public entity whose ity officialsure to be covered under the Agreement. e i ! • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST CLAIM HISTORY List incidents of threatened or actual open meeting law litigation involving city related individuals in the last five years. For each incident give its approximate date and its resolution,including the penalty imposed. if any,and the amount of attorneys fees incurred in defending the incident. Date of Penalty Imposed, Incident Describe Incident If Any,And Location Attorneys Fees Incurred rZCv`I 2. Are you presently aware of any other incidents or situations which may result in an open meeting law claim or litigation against city related individuals? YES . NO If YES,give details: 3. What action has been taken to prevent future incidents or claims? tiN LMCITAPP.OML(11/97) PAGE 2 OF 3 4111 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST OPEN MEETING LAW QUESTIONNAIRE 1. Description of orientations and/or training provided for all elected officials (GTS programs, League programs, Handbook for Minnesota Cities, loss control seminars ...)on the subject of the open meeting law: 2. Have all new members attended the League Conference for Newly Elected Officials? ✓ YES NO 3. Do all officials understand the Open Meeting Law and the Cities' compliance procedures? t/ YES NO 4. Description of method of documentiRg official meetings(written, audio, video, ...): 5. Does legal council attend all official meetings? . YES NO If no, describe service relationship with city attorney. 6. Is education provided for the elected officials in the proper policy and procedures? a) Land use decision making: YES NO b) Employment practices: ` YES NO 7. Please indicate the percentage of reimbursement of defense costs. 80% 100% BY: (Signature and Title of Authorized Representative) LMCITAPP.OML(11/97) PAGE 3 OF 3 • 'EAGUE OF MINNESOTA CITIES INSURANCE TRUST PUBLIC EMPLOYEE DISHONESTY OR PUBLIC EMPLOYEE FAITHFUL PERFORMANCE COVERAGE APPLICATION ADMINISTERED BY: Berkley Risk Services, Inc. 145 University Avenue West ,• - St. Paul, MN 55103-2044 Limit of Coverage Per Loss: (Deductible) • Public Employee Dishonesty Coverage: $ /°=.2 (Standard) • Public Employee Faithful Performance Coverage: $ /)J Da' (Standards • Public Employee Dishonesty Coverage with Faithful Performance of Duty for Specified Positions or Obligee: Specified Position $ 2S0 UO * (Standard) Specified Position $ * (Standard) Specified Obligee $ * (Standard) Specified Obligee $ * (Standard) *The specified limit of coverage is part of,not in addition to, the limit of coverage per loss. AUDITS: FREQUENCY: BY WHOM?: CPA a'A VNA,4 ;�"'0 Q, _i STAFF AUDITOR OTHER(Explain Fully) DATE OF LAST AUDIT: DISCREPANCIES?: YES NO �t (If YES submit copy of audit or auditors comments.) LOSS HISTORY(LAST 5 YEARS): EMPLOYEES POSITION WHICH CAUSED LOSS: CORRECTIVE MEASURES TAKEN: WILL THERE BE A SUBSTANTIAL INCREASE IN THE NUMBER OF EMPLOYEES DURING THE TERM OF THIS BOND? INTERNAL CONTROLS: 1. ARE BANK ACCOUNTS RECONCILED AT LEAST MONTHLY? YES ✓ NO 2. IS THE PERSON WHO RECONCILES PROHIBITED FROM MAINTAINING BANK ACCOUNT RECORDS? YES ✓ NO 3. ARE ALL PERSONS HAVING AUTHORITY TO MAKE BANK DEPOSITS OR WITHDRAWALS. PROHIBITED FROM EITHER MAINTAINING RECORDS OR RECONCILING THE BANK ACCOUNT? YES NO_ 4. IS COUNTERSIGNATURE OF ALL CHECKS REQUIRED? YES '✓ NO_ ADDITIONAL COMMENTS: LMCITAPP.PEB(11/97) PAGE 1 OF 2 AGUE OF MINNESOTA CITIES INSCE TRUST CLASSIFICATION OF EMPLOYEES BY DUTIES OR RESPONSIBILITIES This classification under Class A, B and C constitutes the cities personnel as of the date of this application and should include Mayor and Council members. CLASS A EMPLOYEES All Executive Administrative Judicial and Supervisory officials,Department and Division Heads is*and all officials and employees whose principal duties require them to: 1.) Handle, receipt for,or have custody of money,checks or securities,or account for su expenditures:approve,certify,sign or countersign checks drafts,warrants,vouchers. �■-/ (j> try of money,securities,supplies or other property,or serve process.or; 9`'- 2.) Maintain or audit accounts of money,checks,,securities,time records,supplies or od c, "'' rides, supplies or other property. 000 *Patrolmen are classified as "A"Employees under"Faithful Performance"Coverage but are clas POSITION #OF OCCUPANTS POSITION #OF ` � .v0 TS • CLASS B EMPLOYEES All personnel whose principal duties consist of: 1. Inside or outside clerical activities; 2. Office work such as stenography,typing,filing,switchboard operation,business machine operation etc.; 3. Operation of vehicles transporting passengers for cash fare or tickets. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION - #OF OCCUPANTS Total Class B CLASS C EMPLOYEES All personnel whose principal duties consist of: 1. Skilled or unskilled labor and craftsmanship; 4. Any teaching capacity in the field of education; 2. Solely the mechanical operation of automotive equipment; 5. Outside or field work of a non-clerical nature; 3. Non-clerical activities of the medical or nursing profession; 6. Patrolmen under the"Dishonesty"Coverage. POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS POSITION #OF OCCUPANTS Total Class C LMCITAPP.PEB(11197) PAGE 2 OF 2 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST BOILER AND MACHINERY APPLICATION clA ADMINISTERED BY: BERKLEY RISK SERVICES,INC. 145 University Avenue West St.Paul,MN 55103-2044 APPLICANT: INSPECTION CONTACT AT CITY: TELEPHONE#: AGENT'S NAME: TELEPHONE# COMPREHENSIVE(INCLUDING PRODUCTION MACHINES) NON-REFERRAL OCCUPANCIES ONLY LIMITS: $ 5,000,000 Per Any"One Accident"Combined Property Damage,Business Interruption and Extra Expense $ 25,000 Expediting Expenses $ 25,000 Ammonia Contamination $ 25,000 Water Damage $ 50,000 Ice Rink Buried Piping 1. Does the applicant currently have Boiler&Machinery coverage? Yes No 2. Name of current Boiler&Machinery carrier Expiration Date: 3. Has the applicant had any boiler and machinery breakdowns in the past 3 years? Yes No If yes,please provide description and amount: 4. 100%Replacement Cost Values of Building,Municipal Personal Property,Personal Property of Others: 5. Non-Referral Occupancies Deductible: $ * Does not include values for referral. LMCITAPP.BOILER(1 1/97) PAGE 1 OF 2 • • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST REFERRAL OCCUPANCIES(Limited Coverage) app C U •�j Important: If the applicant has an exposure to any of the following.further analysis may be required by LMCIT. A representative of Hartford Steam Boiler(the reinsurer of LMCIT)may contact you for further information or inspection appointment. Each exposure must indicate a yes or no response. Special conditions,endorsements.limits and deductibles may apply per occupancy. *MPP *PPO 21131 A. Refuse burning facility(boiler garbage burning systems-HBB) _Yes No B. Diesel electrical generating equipment(boiler diesel utility-HBD) Yes No C. Electrical generating equipment(boiler electrical production Yes No _ utilities-HBE) D. Co-generation facility(boiler co-generation facilities-HBF) Yes No _ (*Does not include emergency back-up generators that serve only a single building or function and are not part of a municipal utility.) E. Equipment for recovering methane or other gases from a sewage treatment plant or landfill,or any other system for producing industrial gases(boiler industry gas production-HBG) _Yes _No _ F. Hospital/Clinic equipment listed below(boiler hospital-HBH) —Yes _No _ 1. CT Scanner Yes _No 2. MRI Unit Yes _No 3. PET _Yes No 4. Linear Accelerator _Yes ^No 5. Lithotripter _Yes No G. Steam or hot water district heating system(boiler municipal steam Yes !No hot water-HBM) H. *100%Replacement Cost Values of Buildings,Municipal Personal Property,Personal Property of Others and 100%of Business Interruption Values. NOTE: Coverage for the above referral occupancies can not be bound unless approved by LMCIT. LMCITAPP.BOILER(1 1/97) PAGE 2 OF 2 1110 • LEAGUE OF MINNESOTA CITIES INSURANCE TRUST WATER AND SUPPLEMENTAL FLOOD COVERAGE APPLICATION y\`q, ADMINISTERED BY: BERKLEY RISK SERVICES,INC. 145 University Avenue West St.Paul,MN 55103-2044 APPLICANT: AGENTS NAME: TELEPHONE#: 1. Please indicate below by listing the location you want NFIP supplemental coverage. 2. NFIP flood insurance coverage must be at the maximum amount of insurance available for the LMCIT Water Supplemental Coverage to be available. Please contact your Berkley Risk Services Underwriter for further information. Loc# Bldg Name/Description Street Address NFIP NFIP Policy# Premium • PAGE 1 OF I • INSTRUCTIONS All expenditures - include all operating expenses, capital outlay, capital projects, debt service (principal and interest) for the following: General Fund 2 , 175 , 215 Debt Service 553 ,500 Enterprise Fund 768,020 Port Authority Special Revenue Funds 6 ,000 Nursing Homes Capital Improvement Funds 530 ,000 Hospitals Airports Clinics HRA Other Construction 2, 150,000 EDA 24,000 II. Transfers III. Please list the expenditures for the categories shown in Item III. a - I). These expenditures may be deducted if LMCIT is NOT providing E & 0 Coverage for these operations. IV. Adjusted total expenditures is the total expenditures for those departments and operations that have E & 0 Coverage with LMCIT V. GL Deductions: A. Please list expenditures for the categories shown in Item V. a - m). These deductions are necessary to subtract expenditures for operations or departments where the exposures are individually rated. B. Work performed by contractors which includes capital projects or services are also subtracted For Your Information a) Contracted Services - All Operations: Expenditures should be deducted if the services are provided by others and they provide a Certificate of Insurance. b) Debt Service (principal and interest) c -j) Please indicate expenditures for these operations (minus contracted services and debt services) m) Special Deductions: There may be some special deductions that are appropriate. Please list these special deductions or list them with your underwriter. VI. The operating expenditures are the expenditures that will be used to develop a portion of the liability premium. Individually rated exposures are used to develop the remainder of the final premium. LMCITAPP.13(11/97)(Rev.2/99) PAGE 5 OF 19 • LMCIT EXPENDITURES WORKSHEET City Oak Park Heights Budget Year 1999 All Expenditures 6 ,206 , 735 II. Transfers 276 ,655 III. E&0 Deductions a) HRA • b) EDA 24,000 c) Port Authority d) Nursing Homes e) Hospitals f) Airports g) Clinics h) Utilities (Water, Electric, Gas and Steam) I) Liquor Store Operations (Cost of goods sold) IV. Adjust Total Expenditures (E &0) 24,000 V. GL Deductions a) Contracted Services - 2 ,963 ,950 b) Debt Service 553,500 c) Water Department 177 ,830 d) Electric e) Steam f) Gas g) Liquor(Operating Expenses Only -Do Not Include cost of goods sold) h) Recreation Buildings(Arenas, Sr. Citizens Centers, Ice Arenas) 15 000 I) Swimming Pools j) Golf Courses k) Individual Purchases which exceed 5% of the adjusted total expenditures(E&0) (List & Describe) 1) Operations or departments that have E&O Coverage with LMCIT, but have their own General Liability with another insurance company. m) Special Deductions(List and Describe) 230,000 Met Council-Environmental Svcs . -Sewer VI. Operating Expenditures (GL) 1, 965 , 800 LMCITAPP.13(11/97) PAGE 4 OF 19 • 41, INSTRUCTIONS All expenditures - include all operating expenses, capital outlay, capital projects, debt service (principal and interest) for the following: General Fund a -7_5-- 213 /Debt Service 5 5 5-9O Enterprise Fund "26,2 Q e) /Port Authority Special Revenue Funds 6 G "°'Nursing Homes Capital Improvement Funds 3 a, v a a °‘'5 Hospitals Airports Clinics HRA OtherLons+� a .oh a tSU,000 )`'5\ s.. EDA _ 11 / A_ / s as, 5; '=' 000 1 St,515�1 7°■61,000 Se" 5 II. Transfers CA y. Z , ,s o.o v 7z5, a to III. Please list the expenditures for the categories shown in Item III. a - I). These expenditures may be deducted if LMCIT is NOT providing E & 0 Coverage for these operations. IV. Adjusted total expenditures is the total expenditures for those departments and operations that have E & 0 Coverage with LMCIT V. GL Deductions: A. Please list expenditures for the categories shown in Item V. a - m). These deductions are necessary to subtract expenditures for operations or departments where the exposures are individually rated. B. Work performed by contractors which includes capital projects or services are also subtracted For Your Information a) Contracted Services - All Operations: Expenditures should be deducted if the services- are provided by others and they provide a Certificate of Insurance. b) Debt Service (principal and interest) c -j) Please indicate expenditures for these operations (minus contracted services and debt services) m) Special Deductions: There may be some special deductions that are appropriate. Please list these special deductions or list them with your underwriter. VI. The operating expenditures are the expenditures that will be used to develop a portion of the liability premium. Individually rated exposures are used to develop the remainder of the final premium. LMCITAPP.13(11/97)(Rev.2/99) PAGE 5 OF 19 0 . LMCIT EXPENDITURES WORKSHEET City 0 .K-- P("v\"1- \)24X - Budget Year i'1 ci c rJ� I. All Expenditures ti i ‘ OCo -73 ( II. Transfers 9' ,J; . a 7c. .5•c-- III. E&0 Deductions , 0 ° " w`f `6 and a) HRA 11�5'�� y,,�' .,- . b) EDA ��B Lj( ,? "! 02`I, U a V JV �' 1 c) Port Authority a . DDS , v d) Nursing Homes �� ,�' .fr 1\ % i e) Hospitals \ � � ) ()-. �- 0'� L2 \i' fl Airports (� �`d`,' 0o' t+/� ),''' ��.; ;,' g) Clinics ` v \ �0, D e r�uut'J x h) Utilities (Water, Electric, Gas and Steam) 'P' 00 3'' 5 I) Liquor Store Operations (Cost of goods sold) �'. �4 \ 7 IV. Adjust Total Expenditures(E&0) � ' 024/ 000 V. GL Deductions a) Contracted Services c.w--.(.A4A f- _ _ q L?, Cj 2 b) Debt Service 54- C.,0,l, SW e to 2C.'1{ r 3‘ \�O v c) Water Department Se.:'', ` ,:ftrz, d) Electric e) Steam t) Gas g) Liquor (Operating Expenses Only -Do Not Include cost of goods sold) h) Recreation Buildings (Arenas, Sr. Citizens Centers, Ice Arenas) 15,000 I) Swimming Pools j) Golf Courses k) Individual Purchases which exceed 5% of the adjusted total expenditures(E&0) (List & Describe) I) Operations or departments that have E&O Coverage with LMCIT, but have their own General Liability with another insurance company. m) Special Deductions (List and Describe) L a?34` Uc�-v ,c-/w4c.,. /yn� (g._,.2, _ /-�tau-v l a— U-1^‘,--47....., ....6.4-(.........4 VI. Operating Expenditures (GL) / 9 G $ qov LMCITAPP.13(11/97) PAGE 4 OF 19 • • Lmc / j 7.` 145 University Avenue West, St. Paul, MN 55103-2044 League of Minnesota Cities � Phone: (651) 281-1200 • (800) 925-1122 Cities promoting excellence Fax: (651)281-1299 • TDD (651)281-1290 January 4, 1999 t JAN is _ TO: Member Cities l': I FROM: LMCIT RE: Coverage for Injuries to Elected and Appointed Officials LMCIT is currently offering open enrollment for accident coverage for injuries to elected and appointed officials. This coverage, which is provided by CIGNA, provides an alternative to workers compensation coverage for elected officials and members of other city boards who may be injured in the course of their duties. The enclosed memo describes the differences in costs and benefits between the two coverages. How do I add this coverage to the city's policy? If you currently have this accident coverage and wish to renew it, or if your city would like to add this accident coverage for the first time, please contact Julie Seidlitz with the Brehm Group at 612/339-7385 and she will send you an application form with information to enroll your city with this coverage. The application form needs to be completed and returned no later than February 1, 1999 for coverage to be effective March 1, 1999 through February 29, 2000. ) (1 AN EQUAL OPPORTUNITY/AFFIRMATNE ACTION EMPLOYER • Risk MCIT anagement Information LMC 145 University Avenue West, St. Paul, MN 55103-2044 League of Minnesota Cities Phone: (651) 281-1200 • (800) 925-1122 Cities promoting excellence Fax: (651)281-1299 • TDD (651)281-1290 COVERAGE FOR INJURIES TO ELECTED AND APPOINTED OFFICIALS The workers compensation statutes provide benefits to an "employee" who is injured while working. M.S. 176.011, subd. 9, (5), provides that "municipal officers elected or appointed for a regular term of office" are considered to be "employees" for workers compensation purposes only if the city has passed an ordinance or resolution to that effect. An elected or appointed official injured while performing his or her duties would not be eligible for workers compensation benefits unless the city had passed that ordinance or resolution. Whom does this affect? This provision clearly applies to mayors and council members. In some cities the clerk and treasurer are elected positions, and are therefor covered by this provision as well. It seems likely that members of other administrative boards that the city creates pursuant to statute such as planning commissions, utilities commissions,park boards,hospital or nursing home boards, etc. would fall under this provision as well. It's not clear though whether a member of a purely advisory committee or commission that the city creates would be considered to be an "officer" or "official" for purposes of this statute. Some charters may provide specific terms for certain appointed positions such as the assessor, engineer,police chief, etc. Under a strict reading of the work comp statute, these individuals would not be covered by workers compensation unless the city has passed an ordinance or resolution to add coverage - assuming that these individuals would be considered "officers" rather than merely "employees." If we want to add coverage, how should the ordinance or resolution be worded? The resolution or ordinance should specifically list the positions the city intends to cover. If the city wishes to extend coverage only to the mayor and council, the ordinance or resolution should refer specifically and only to elected officials. An ordinance to extend coverage to members of other boards and commissions, could be worded this way: "Pursuant to Minnesota Statutes 176.011, subd. 9, clause 6, elected officials and members of the following boards, commissions, and committees are included in the coverage of the workers compensation act: planning commission, park board, utilities commission..." AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • If any of the city's appointed positions such as police chief or assessor have a specific term, these positions should be listed as well. It's not completely clear whether the city can distinguish among its elected and appointed officials, by providing workers compensation to some officials but not to others. The statute perhaps could be read to mean that the city's only options are either to cover all elected and appointed officials or none at all. If so, an ordinance or resolution extending coverage, regardless of how it is worded,might be interpreted to mean that all "officials" are covered. Then the question of whether, say,planning commission members are covered would depend not on whether they are listed in the ordinance or resolution but rather on whether they are "officials" or "officers." Such an interpretation seems unlikely, but cities should at least be aware of the possibility. Is there any reason to use an ordinance rather than a resolution? If the city wishes to provide workers compensation coverage for elected officials, it is preferable to use an ordinance rather than a resolution. Resolutions are often recorded only in the council minutes; years later it can be very difficult and time-consuming to track down a resolution. We've seen a number of cases where a city has been paying premiums for workers compensation coverage for elected officials for years, but now can't find any ordinance or resolution specifying that elected officials are covered. An ordinance will generally be easier to keep track of permanently, since it is recorded in the city's ordinance book as well as in the council minutes. Do we need to do anything special if we don't want to cover elected officials for workers compensation? If the city does not wish to cover its elected officials for workers compensation, it might be wise to pass on ordinance to that effect as well unless you are absolutely certain that the city has never passed a resolution to provide coverage. That resolution could have been passed as long ago as 1967, when the law was first amended to permit cities to opt for coverage. The following language could be used for the ordinance: "The officers of the City of elected or appointed for a regular term of office shall not be included in the coverage of the Minnesota Workers Compensation Act, pursuant to Minnesota Statute 176.011, subdivision 9, clause 6." How much does it cost to add workers compensation coverage for elected officials? Workers compensation for elected officials used to be a pretty expensive proposition. However, over the past several years, LMCIT has very substantially reduced premiums for this coverage,to bring the cost more in line with the actual risk. • • For elected officials, LMCIT's 1999 premium rate is $.33 per $100 of payroll. This rate is applied either to the official's actual salary or to an imputed salary of$701week, whichever is greater. Obviously, the imputed minimum salary will come into play in most cities, since council salaries in most cities are much less than that. Using the imputed minimum salary,the manual premium comes to $60 for a five-member council. The actual cost to the city may be somewhat more or less than that, depending on the city's experience modification, volume discount, and deductible if any. This same approach and rate will also be used to calculate premiums for coverage for any other boards, commissions, or committees which are specified in the city's ordinance or resolution extending coverage. Unless the city specifically indicates that members of a particular board are covered, LMCIT will assume that they are not. For officials other than members of the council and other board members, premiums will be based on the actual salary and the appropriate class rate. What benefits would an official receive under workers compensation? As with any other employee,indemnity benefits would be based on the individual's actual earnings from all employment. In other words, benefits would be based on the total earnings from the official's regular employment plus the salary (if any)he receives from the city. The $70 per week imputed minimum salary is used solely to calculate premiums, and does not figure into the benefit calculation in any way. Are there any alternative ways to protect elected officials and board members? LMCIT has arranged with CIGNA to offer another option through which cities can provide some protection for their council members against the risk of being injured or killed in the course of performing their duties. For a cost of$12.75 per person per year, the city can purchase an accident policy which provides benefits for death or a disabling injury arising out of an accident which occurs while the council member is traveling to,participating in, or traveling from a regularly scheduled council meeting, or while conducting official council business on behalf and at the request of the council. The policy provides a death benefit of$100,000. It also provides a schedule of lump sum benefits for loss of a hand, foot, or eye. The policy also provides a short-term disability benefit of$400 per week. Disability benefits are payable for a maximum of 26 weeks, after a three-day waiting period. Disability benefits would be paid if as the result of a covered injury the individual cannot do at all the substantial and material duties of his type of work. • • This coverage differs significantly from the benefits that would be provided by workers compensation. Some of the more important differences are: P p • The accident policy does not pay for medical costs. The individual would have to look to his own health coverage to pick up these costs. • Disability benefits would continue for a maximum of 26 weeks. By contrast, workers compensation benefits would continue as long as the disability lasts. • Benefits are payable only if the individual is totally disabled from performing the duties of pY Y Y p g his regular employment. Unlike workers compensation, the policy provides no benefits for partial disability. • Death and disability benefits are paid according to a fixed schedule. Workers compensation benefits, by contrast, are based on the individual's actual earnings, from both his regular employment and his council pay. • Workers compensation includes various other benefits, such as rehabilitation, retraining, etc.; the accident policy does not. • Workers compensation benefits are tax-exempt; some or all of the benefits paid under the accident policy might be taxable. Obviously, there are many "borderline" situations where it might be debatable whether a council member is "conducting official council business on behalf and at the request of the council." For example, a mayor or council member might be asked individually to attend a meeting of the Chamber of Commerce or a service club to discuss and explain city policies or proposals the council is considering. Cities might want to consider adopting a resolution specifying whether the city considers such activities to be within the scope of duties that the city expects its elected officials to perform. PST—12/2/98 - fax 66040 �� 71992 TrustPREMIUM NOTICE CIO uou�� umkmom�o Inc. Invoice Date 2/27/99 �0Somu6 Ave. 8ont4So�o �0 Due Date Upon Receipt 55402-4023 (612) 376-4200 Bill To Agent O�874 � [}AK PA�K HE�GHTS �A�DMARX INSURANCE SERVICES ATTN: THO�AS �[LE�A 232 SQUTH L�KE STREET P.O.BOX 2O07 P.O. �OX 188 | S�ILLWATER MN 55O82 FOREST LAKE �K 55O25 Type of Coverage: @ICIPA' -T, �~ � Covenant K^mber: CMC 1874� Coverage Period 7/07/92 To 7/O7/99 Covered Party: OAK PARK �[lGHTS � -_- - -' ---_- ---_--- ' _ --' --_ _ ---_'_ ' __-_--- --- ---_--- '- _----_ - � Paymeot Plan c Seleted: ANNi�A� PAY PL�N _-- ( � U - -- - - , _- ' -- - - � Revi`�ed Premium Due Current Total Prior Total Total Current Installment Policy Premium Balance Due Amount Paid Charge/Credit Charge � 39,722.00 39,722.O0 44,433.O0 .O0 .00 *** We must receive t minimum due by the due date. Total Due: 47 �1 .00- Minimum Due: 4,711 .00 ' --------------- -------------------------------------------'------ ----' ----' CIT-ES IN3 `R'�ST • C/O BERKLEY RISK _� �� RVICES | | C ' INVOICE�� 1 � 92O 2uD AVE. SOU�H, SUITE 70O / �� -�x� 554O2-4O23 � Tyye of Coverage� M��XICI�Ai ITY Coveaant Nomber: CMC �8745 Coverage Period 7/07/98 To 7/07/99 � Covered Party: OAK �ARK HE�GHTS DUE DATE: Opon Receipt CREDIT DUE: 4,711 'OO- DO NOT PAY i . • ENDORSEMENT # 4 ES 2/26/99 COVERED PARTY COVENANT NUMBER EFFECTIVE DATE CITY OF OAK PARK CMC 18745 2/16/99 HEIGHTS IT IS HEREBY UNDERSTOOD AND AGREED THAT COMMON COVERAGE DECLARATIONS FORM DEC-01 1 (1 1-97) ITEM 1 . CITY AND MAILING ADDRESS IS AMENDED TO READ AS FOLLOWS: OAK PARK HEIGHTS I ATTN: THOMAS MELENA II 1) p1 P.O. BOX 2007 1 1 / STILLWATER, MN 55082 MAR - 3 1999 '" Total Endorsement Premium: $ NO CHANGE (See Below for Billing information) PREMIUM DUE NOW: $ (See Invoice Attached) OR DO NOT PAY NOW: PREMIUM ADJUSTMENT TO BE MADE AT EXPIRATION. , All other terms and conditions remain unchanged //:-/ Executive Director, LMCIT LMCIT ME044(1/95) Page 1 of 1 _ -� �� -��1� � 1 ��r INVOICE# 70651 ~~~~ Lm mf Minnesota 0t8mmDmsuuancmTuuet PREMIi]M NOTICE C/O Berkley Risk Services, Inc nvoice Date 10/23/98 92N8em mod� . South, Gn�o �N Due Date 11/11/98 U 55402-4023 n m � (612) 376-4200 Bill To Agent O087 rmn rp � 8AK PARK HEIGHTS LANBMARK I� 232 SOUTH L STREET P.O.BOX 2007 P.O. BOX 1E OCT � � k�� STILLWATER MN 55O82 FOREST LAKE ��» ^~ »M�=�5 Type of Coverage: MUNICIPALITY ' Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/9'.; | Covered Party: OAK PARK HEIGHTS ------------------------------------------------------------------------------- Payment Plan Selected : ANNUAL PAY PLAN DUE DATE AMOUNT DUE DUE DATE AMOUNT DUE DUE DATE AMOUNT DUE � 11/11/98 4,711 .00- 4� ~17 �.� . . TOTAL AMOUNT 711 O0 ADDITICNAL/RETURN PREMIUM ENDORSEMENT 4,711 .00- Current Total Prior Total Total Current Installment Policy Premium Balance Due Amount Paid Charge/Credit Charge � 39 722 0O 44,433.00 OO 4,71.1 .00- .00 . *** We must receive the minimum due by the due date. Total Due: 7.-Q,--)2'17'.0n Minimum Due: 39 722 0O , . -----------------------------------------------------------_------------------- LEAGUE MN CITIES INS TRUST C/O BERKLEY RISK SERVICES LLC 70651 ' �� / ��J- 920 2ND AVE. SOUTH, SUITE 700 MINNEAPOLIS MN 55402-4O23 Type of Coverage: MU�ICIPALITY Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/99 Covered Party: OAK PARK HEIGHTS DUE DATE: 11/11/98 AMOUNT DUE: 39,722.00 ENDSEMENT RECAP • Page 1 LEAGUE MN CITIES INS TRUST C/O BERKLEY RISK SERVICES, INC. Invoice Date 10/23/98 920 2ND AVE. SOUTH, SUITE 700 Due Date 11/11/98 MINNEAPOLIS MN 55402-4023 Bill To Agent 00874 OAK PARK HEIGHTS LANDMARK INSURANCE SERVICES 232 SOUTH LAKE STREET P.O.BOX 2007 P.O. BOX 188 STILLWATER MN 55082 FOREST LAKE MN 55025 Type of Coverage: MUNICIPALITY Covenant Number: CMC 18745 Coverage Period 7/07/98 To 7/07/99 Covered Party: OAK PARK HEIGHTS Endorsement Endorse Deferred Due Transaction Effect Date Amount Amount Amount Description 7/07/98 4,711 .00- .00 4, 711 .00- AMEND RATING BASIS ONE&O AND OPERATING EXPENDITURE TOTAL 4,711.00- .00 4,711.00- M O Page 1 Landmark Insurance Services PO Box 188 ACCOUNT NO. OP DATE Forest Lake,MN 55025 OAKPA-1 BA 12/04/98 Phone: 651-464-3333 Support:651-464-7596 POLICY INFORMATION POLICY# CMC18745 TYPE EFFECTIVE EXPIRATION CP 07/07/98 07/07/99 City of Oak Park Heights [ M ,�, r ) Thomas M.Melena,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 DEC uC - 8 �gUr Judy ! Re: Refund x Just wanted to confirm with you that the League is supposed to issue a check to the City for the credit received from the adjustment made to your policy. Checks are only processed the third week of the month - so it should go out some time the week of the 14th. Please call me if you have any questions . Hope your week off was pleasant . Sincerely rrAA q I.,(62()-4,-;6/ Kate Tipping 08/07/1998 13:14 6124647596 LANDMARK INS SRVCS PAGE 01 • — 7'f Landmark Insurance Services L O Paga 1 3 PO Box 188 OAKPA at 08/07/98 Forest Lake,MN 55025 Phone: 651-464-3333 Support:651-464-7596 POLICY INFORMATION POLICY CMC17704 TYm= YOMICTIVt INPMATION CP 07/07/'98 07/07/99 City of Oak Park Heights Thomas M.Malta*,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 Judy Re: Expenditures Worksheet Here' s the application pages we need completed. But, something you might be able to tell me first is : How much of the Capital Project Fund ($663, 934 . ) is contracted out? The company underwriter was hoping to get that information today if at all possible. Thank you. Kate Tipping PUG-11-1998 09 32 CITY OF OPH P.01/33•\-; • OAK FMK HEIGHTS t 2007 Park Heights,MN 55082•Phone: (612) 439-4439 .FAX 439-0574 14 168 N. 57th Street Box 1$ Fax Transmittal - , Fax : Cg �� To: -�C l � , ,,/ It AUG 11 1 J From: ■ 21 �..'.,.------•-----»... Date: 8 //�.7 i Subject: Total Number of Pages, including cover sheet: o•••••. ••♦♦•. •♦•i••♦••♦•♦••♦••♦•••••i•••••+♦4.•4.•0.•♦•.••♦••4.•+•4.•4••Q.•+•+•4. 1614.-f • --t' :is, its 44/.p-s-„, ov.66".if v, .1( 4 4 • • • • Tree City U.S.A. AUG-11-1998 09 32 CITY OF OPH P.O"'�03 • INSTRUCTIONS • I. All expenditures-include all operating expo,capital outlay,capital projects,debt service (principal and interest)for the following: General Fund 2,095 ,858 EDA 250,000 Enterprise Fund .�-�- 86 8,0 30 Port Authority - 0 - 17 000 Nursing Homes - 0 - Spacial Revenue Funds ---�— Capital Improvement Funds 650 ,000 Hospitals - 0 - Airports - 0 Clinics 0 HRA - 0 - Debt Svc, 308,900 Construction Fds 2,5250,000* IL Transfers III. -Please list the expenditures for the categories shown in Iteon III. a-I). These expenditures may be deducted if LMCIT is=providing E& 0 Coverage for these operations. IV. Adjusted total expenditures is the total expenditures for those departments and operations that have E&0 Coverage with LMCIT V. GL Deductions: A. Please list expenditures for the categories shown in Item V.a•m). These deductions are necessary to subtract expenditures for operations or departments where the exposures are individually rated, B. Work performed by contractors which includes capital projects or services are also subtracted f r yeur Inigimation a) Contracted Services-All a Operations: Expenditures a e should uld be et deducted if the services are provided by others and they provide Debt Service(principal and interest) c-j) Please indicate expenditures for these operations(minus contracted services and debt services) m} Special Deductions: There may be some�them deductions��`��'pp�nate. Please list these special deductions VI. The operating expenditures are the expenditures that will bed�� ,develop��e•fi�premium. bility ' prettlinib •IndividaaUy rated exposures are develop PA(ifSQ9t9 L ,�PP•13(11197) !'' LMCIT EXPENDITURES WORKSHEET Biro ______Via_____,—. ,Cary �0G ?Q,�Ik' 4,1-5 6 ,439 ,788 1_ AU Expenditures 0 - II. Transfers 1 III. E&0 Deductions - 0 r a) HRA b) EPA ay,007 250 000 - d - c) Port Authority - 0 - d) Nursing Homes 0 - e) Hospitals n Airports - 0 - 0 g) Clinics 868 ,430 _ h) Utilities(Water,Electric,Gas and Steam) - 0 _ I) • Liquor Store Operations(Cost of goods sold) IV. Adjust Total Expenditures(E&0) 1,118,030 V. GL Deductions _' 3157 ,705 a) Contracted Services 308,900 b) Debt Service ].37,025 e) Water Department d) Electric - 0 e) Steam - 0 Gas 0 g) Liquor(Operating Expanses O&y - 0 -Do Not Include cost of goods sold) ""— - h) Rocreation Buildings(Arenas,Sr.Citizens Centers,ice Arenas) -50 000 I) Swimming Pools J) - 0 - Golf Courses k) Individual Purchases which exceed S%of the adjusted tout expenditures(E&0)(List&Describe) • . 1) Operations or departments that have E&O Coverage with LMCIT,but have their own General Liability with another insurance company. m) Special Deductions(List and Describe) 2,786 ,158 VI. Operating Expenditures(GL) lA08 4 OF t4 t,�It:TfAtl.1�till!'!) TOTAL P.03 08/07/1998 13:14 6124647596 LANDMARK INS SRVCS PAGE 02 . • p LMCIT EXPENDITURES WORKSHEET City U0k ? (4. 41,4d-6 Budget Year 19 cl g , 1. All Expenditures ; ' 6 ,439 , 788 . II. Transfers j t'j `� �1 , �' — 0 — 3� II 3 III. E&0 Deductions U) I'`:' .. : U,1 a) HRA ,.t 0— — b) EDA • • 250 ,000 c) Port Authority — 0 — d) Nursing Homes — 0 — e) Hospitals — 0 f) Airports — 0 — g) Clinics — 0 — h) Utilities(Water,Electric,Gas and Steam) 868,030 I) Liquor Store Operations(Cost of goods sold) — 0 — IV. Adjust Total Expenditures(E&0) 1',N ; %c`"0 4,/--(3 j?� V. GL Deductions a) Contracted Services 3, 157, 705 b) Debt Service 308,900 c) Water Department 137 ,025 d) Electric — 0 — e) Steam — 0 f j Gas — 0 — g) Liquor(Operating Expenses Only -Do Not Include cost of goods sold) — 0 — h) Recreation Buildings(Arenas, Sr.Citizens Centers,Ice Arenas) `-502_000 — /X / I) Swimming Pools , — 0 — . , j) Golf Courses — 0 — . i k) Individual Purchases which exceed 5%of the adjusted total expenditures(E&0)(List&Describe) . 1) Operations or departments that have E&O Coverage with LMCIT,but have their own General Liability with i another insurance company. . m) Special Deductions(List and Describe) VI. Operating Expenditures(GL) 2,786 ,158 1.MCITAPP.13(11/97) PAGE 4 OF 19 CITY OF OAK PARK HEIGHTS 14168 N. 57th Street•Box 2007 Oak Park Heights,MN 55082 • Phone: (612) 439-4439 • FAX 439-0574 Fax Transmittal To: Ka. /.--C %� ifa,�� , Fax #: From: �� Fid/s-f Date: 8 Subject: Total Number of Pages, including cover sheet: .3 ♦♦♦♦♦♦•♦♦♦♦•♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦O♦♦♦♦ ♦♦♦i♦♦♦ ♦♦♦♦♦♦♦•♦♦♦♦♦♦♦i♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦♦+♦♦♦♦♦♦♦♦♦♦♦♦♦•♦♦♦♦ /Ck,•-f--( H „ ,r, 7L j a,(06 V /c l /II Lt Tree City U.S.A. 08/07/1998 13:14 6124647596 LANDMARK INS SRVCS PAGE 03 • • INSTRUCTIONS I. All expenditures-include all operating expenses, capital outlay, capital projects, debt service (principal and interest) for the following: General Fund 2 ,095 , 858 / EDA 250 ,000 Enterprise Fund 868,030 Port Authority - 0 - Special Revenue Funds 17,000 Nursing Homes - 0 - Capital Improvement Funds 650,000 Hospitals - 0 - Airports - 0 - Clinics - 0 - HRA - 0 - Debt Svc. 308,900 Construction Fds 2,250,000 IL Transfers III. "Please list the expenditures for the categories shown in Item III. a- I). These expenditures may be deducted if LMCIT is NOT providing E& 0 Coverage for these operations. . IV. Adjusted total expenditures is the total expenditures for those departments and operations that have E & 0 Coverage with LMCIT V. GL Deductions: A. Please list expenditures for the categories shown in Item V. a- m). These deductions are necessary to subtract expenditures for operations or departments where the exposures are individually rated. B. Work performed by contractors which includes capital projects or services are also subtracted For Your Information a) Contracted Services -All Operations: Expenditures should be deducted if the services are provided by others and they provide a Certificate of Insurance. b) Debt Service (principal and interest) c -j) Please indicate expenditures for these operations (minus contracted services and debt services) m) Special Deductions: There may be some special deductions that are appropriate. Please list these special deductions or list them with your underwriter. VI. The operating expenditures are the expenditures that will be used to develop a portion of the liability • premimti:-Individually rated exposures are used to develop the-remainder of the•final premium. LMCTFAPP.13(11/97) PAGE 5 OF 19 r r7AAyyV, �I m S O S O 8 s M N g S O I. Q 2 cr.; 2 m Z O 2 t0 S 2 ({8 M ? 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O .-1 cV M cg 1() J C- cc C, 0 .4 N M tr\ C CC C, 0 r-1 r 1 M 111 kip CI N N N r1 (N N N ^J N +i M m m ri m M M M .r 7 " t' ' 7' C S.) ■■ .•1 H4 .H '-. .i .-1 H4 .H ,..1 .H .-1 .. .-1 r1 .-1 -.. .-4 .. .-t r1 -. .. .-1 --I 1-1 .-I • 0 ()0 illill INSURANCE SERVICES•FINANCIAL SERVICES•EMPLOYER'S SERVICES Business Building Information for the Friends and Clients of CFG April/May 1998 612/945.0200 •www.cfginsurance.com • update @cfginsurance.com Volume 9 No. 2 Q >�kue A Safety Strategy That Works to the News Release OSHA announced recently that a Midwest company had agreed to.pay$1,803,500 CFG Update in proposed penalties following an investigation of a catastrophic accident in which eight workers were' killed.An unexpected release of nitrogen pressurized to 5,000 psi was so violent that it shot a 3,000 Executive Benefits pound valve assembly more than 200 yards.OSHA cited numerous violations of its lockout/tagout and Attract&Retain Key forging standards,along with a citation under the General Duty Clause. Employees.......:........pg.2 Sexual Harassment in The Problem with Conventional A comparison between the Safety"Programs" ,° leading causes of nonfatal the Workplace.........pg.3 ,. ^ b ' s The above example is just -, ' 1 ice . occupational lost-time injuries Political Risk Insurance— one of hundreds that appear in i and the leading OSHA viola- Is Your International the newspapers and trade ` ` tions shows that the two lists Business Operation "' ' magazines each year, pointing a , e. have little in common(see Protected?.. .p..,........pg.4 to the continuing problem ' `• 6, °` a table below and page 6). Why Salespeople American industry has with ''° Compliance with federal +. i Fail—AFree Seminar for preventing serious on-the-job - .''.�:�� regulations costs industry an 0 ��®�� CFG Clients...........-Pg.5 employee injuries.While most °� •�� e= = estimated$600 billion per Seminar Schedule....pg.8 companies will tell you that year.At the same time,there they have a safety program, it is little or no appreciable A Workplace Incentive must be admitted that the ,,; improvement in industry's Program That Really ' majority of these programs are safety record over the past Works.: ........ ......pg.11 several years;in some indus- largely ineffective, or need to y Meet McCaren be further developed. wait,',: -' try categories,the accident Designs,Inc...........pg.16 One reason for the failure '< rates have gotten worse. of safety programs is that .� -�� '1: Conventional accident pre- management tries to focus its loss control efforts vention usually takes shape as lots of safety rules primarily on compliance with OSHA requirements. that try to remind people about doing the right This leads to either no significant long-term thing. Strong enforcement is critical to make progress being made in reducing a company's safety record,or an overall deterioration of the accident Safety Strategy/continued on page 6 rate.Management can become frustrated when a Table 1: large commitment of its time and money does not yield an improved safety performance. Nonfatal Occupational Injuries with Days Away The emphasis on OSHA compliance is understand- From Work, 1995 able,considering OSHA's transition over the years Type of Injury % of Total from small fines to large fines,to making referrals to the Justice Department when they learn that compa- Overexertion(lifting) 43.0 vies are not fulfilling requirements of prominent Bruises and Contusions 9.4 RO''1_ - standards.Even with OSHA's vigilance shifting from Cuts and Lacerations 7.5 citing violations of specific standards to making Fractures 6.1 General Duty Clause based citations,the number of Repetitive Motion(CTS) 2.6 • _______________ injuries continues to accumulate. Burns 2.5 Q Some companies have addressed this problem b Y Amputations 0.6 _ _-- --- establishing two goals for safety: • Regulatory compliance Other 28.3 from. — from. TOTAL: 100.0 • Conventional accident prevention These goals,however,are largely unrelated. Source Bureau of Labor Statistics•httpdIstats bls.gov/news.release/osh2.to5.htm Insurance Services 0 F r Financial Services 612/945.0200 Business Building Information Business Planning Strategies III Using Executive Benefits to Attract and Retain Your Most Valuable Employees By Scott Hennessy, CLU, ChFC CFG Financial Services,Inc. Attracting and retaining Advantages to the Employer key executives and • Offers valuable benefits to employees has never been more employee critical to business success since " ��` • Can deduct premium costs Executive the pool of quality people seems } t •IRS approval not required Benefits to be getting tighter each pass- 4 + ,, • Can tailor benefits to ing month. Over the next sever- 1 A4,7,:',10- ' employee needs al issues of the CFG Update,we `' t • Minimal recordkeeping will explore business planning strategies that can help your .1044,4, _ t Advantages to the Employee I business attract and retain your '"' • Ptects f a family if executive dies most valuable employees. ; 4, •Cash value available for ote The Problem:Find a Tax-Deductible Way To retirement or other needs Reward Key Employees •Can keep policy if plan or employment terminates You want a simple,flexible way to recognize •Cash value retirement funds grow tax-free and reward valuable employees,but government • regulations seem to tie your hands. Is there a way Is Executive Bonus An Option For You? you can select specific key employees to reward An executive bonus program is easy to start and while varying compensation on an employee-by- administer. Executive bonus acts as a"golden employee basis? And can you do this while handcuff'for your key executives. The longer the avoiding federal Employee Retirement Income employee stays,the more valuable their benefit. Security Act(ERISA)guidelines? For more information on setting up an executive SOMETHING TO bonus for your key employees,call 612.945.0200, THINK ABOUT... The Solution:An Executive Bonus Plan e-mail us at info @cfginsurance.com or use the It's an agreement between an employer and their faxline on page 17. « employee in which the employer bonuses Being defeated is money to pay for an employee-owned life often a temporary insurance policy. The bonus may also include Executive Works condition. Giving up the additional income tax liability it generates. is what makes it The premiums paid will be currently taxable Employer permanent." to the employee as a bonus and deductible to Pas Premiums the employer as long as they are considered rea- y —Manly vos Savant sonable compensation. Unreasonable compen- Living Benefits Insurance Death Benefits sation is usually a greater issue in the case of an Company owner-employee or a stockholder-employee. If desired, the employer can restrict access r y to the cash values of the policy, over a limited Key Executive Key Executive's time or until retirement. If the employee Beneficiary leaves the company before the end of the 41) agreement date, the employee owes the employer an amount usually equal to premi- ►. IRS Tax urns paid. (See chart Income um p ( ) on Premiums: Employer's Services • .,,,,:,,:,0,.., Iii datE 4:,,,, ,o„, Business Building Information 0 Sexual Harassment In The Workplace What Can An Employer Do? By Roger Stelljes,Esq. CFG Employer's Services,Inc. Boston Globe—Company Will Pay$10 Million In Sexual Harassment Settlement. Astra USA,the American subsidiary of Astra SB,a Swedish company,admitted it allowed a hostile work environment,including requests for sexual favors in return for favorable treatment,for women at its US headquarters. At least 79 women and a man who said he was punished for speaking out will share the award,the biggest sexual harassment settlement ever obtained by the Equal Employment Opportunity Employment Commission. The current and former Astra employees,at least half of who have left the company,will receive up to$300,000 each. PraCtICeS 7- oes this news headline sound familiar? employee handbook puts you in compliance with L Barely a week or month goes by without a Title VII of The Civil Rights Act,The Minnesota mention of sexual harassment in the papers or on Human Rights and most civil or human rights laws the evening news. President Clinton,Eugene in other states. An employer who does not have a McKinney,Clarence Thomas,Bob Packwood, well-drafted policy will have an uphill battle if a Channel 4,Mitsubishi,Army,Navy,Air Force and lawsuit for sexual harassment is brought against Marines. All have either been recently accused of, them. The lack of a policy can often be seen as a Protect Your found liable for, or set- lack of commitment to ,v4; Organization— tied '4 ,t i M tied lawsuits for sexual �* a �� creating a work environ elharassment. Despite the a ;(, ment free of sexual Train Your publicity these cases U� t' harassment. Employees on receive and movies such Your sexual harass- Sexual as Disclosure, sexual ,=u I ment policy should mini- harassment claims in the = malty include the Equal Hara$Sment workplace show no ' Employment Before You Have signs of slowing down. Opportunity pp y a Problem In fact, considering how g Commissions(EEOC) much more aware $ definition of sexual CFG offers on-site employees are of their sew t` ; harassment. The EEOC �, : sexual harassment rights in the workplace, ' .. defines sexual harass- rights training for the number of lawsuits ,, ,:e t,,. ment as: for sexual harassment or other employment issues Unwelcome sexual advances,requests for sexual supervisors and will only continue to rise. favors,sexually motivated physical contact and other employees. Call What Can Employers Do To Avoid Liability? verbal or physical conduct of sexual nature when: 612.945.9191 for While there's no way to ever totally protect your- Submission to the conduct is made either more information, self from lawsuits of this nature,there are two things explicitly or implicitly a term or condition of or e-mail us at info an employer can do to limit the chances of liability an individual's employment;or for sexual harassment being imposed. First,an ® @cfginsurance.com Submission to or rejection of such conduct by an employer should have a well-drafted and thorough individual is used as the basis for employment or use the faxline sexual harassment policy. Second,an employer decisions affecting that individual;or on page 17. should conduct workplace training on sexual harass- ® The conduct has the purpose or effect of [ 4111 ment. unreasonably interfering with an individual's Sexual Harassment Policy Is A Critical work performance;or Component For Employers A well-drafted sexual harassment policy in your Sexual Harassment/continued on page 12 3 cFc Insurance Services • Financial Services 612/945.0200 Business Building Information Political Risk Insurance — Is Your International Business Operation Protected? By Bonnie Klaith, Commercial Insurance Specialist CFG Insurance Services,Inc. CIquestions out the answers to the commonly asked foreign government. questions about political risk insurance and •Law,Order,Decree or Import/Export find out if your company should be protected against Restriction by the foreign government that selec- this risk. tively discriminates against the foreign investment so Q. What is Political Risk Insurance? as to cause the permanent cessation of activities. A. Political Risk insurance protects against financial •Currency Inconvertibility or the inability to International loss to companies involved in international trade and convert and transfer dividends or proceeds from a investments stemming from unexpected, forced sale of the shareholding. Risk discriminatory and/or arbitrary govern Management w •Failure to Repossess where the mental acts,whether committed x foreign government interferes by the foreign or one's own with the investor's rights governmental jurisdic x a4 � .„ *.ib. .. to repossess under a tion. Items like: t. mortgage,lease agree- IN Confiscations, ;', ment or sales contract Expropriation, m, - A �. subsequent to a default Nationalization(CEN) "' � ) in payment. of an investor's permanent •Arbitration Award • or mobile assets. This includesr... Default or the failure of a govern- discriminatory government action that ment joint venture partner to honor an causes the permanent cessation of the operation. arbitration award for payment as set out in the joint Deprivation or the inability to export finished venture agreement. product from the foreign investment or to repatriate Q. Why is Political Risk Insurance Necessary? mobile assets. A. A global perspective has become necessary to •War&Political Violence-Physical damage to remain competitive. Unfortunately,the benefits of the investor's assets caused by any military action, this activity are prone to risks from governmental, civil war,revolution,rebellion,insurrection,coup political,and/or legislative actions. d'etat,strike,riot,sabotage,terrorism,or other civil Q. Who Should be Protected for Political Risk? disturbance that takes the form of organized violence. A. Any company that's involved in commercial •Forced Abandonment of the investment or relations with a country other than their own. This mobile assets due to the foreign country's deteriorat- includes any company exporting overseas,importing ing security situation and where such abandonment from a foreign country,entering into a contract with is at the direction of the investor's government. another party from another country,having any form •Contractors Plant&Equipment coverage for of asset located in a foreign country,or being required mobile assets is a comprehensive policy which to put up guaranties in a foreign country. Some includes CEN,Deprivation,War,Political Violence examples would be:Banks discounting trade receiv- and Forced Abandonment ables of exporters or who have rights to collateral •Abrogation of a production,concession or other overseas;a manufacturer taking equipment-overseas government guaranteed agreement where such an act for a trade fair,etc.;a contractor being awarded a • is expropriatory and discriminatory in nature. project;a broadcasting unit temporarily relocating equipment to complete an assignment,etc. •Forced Divestiture of the shareholding by either the government of the investor's country or the Political Risk Insurance/continued on page 13 4 �� Employer's Services � g� • , Business Building Information • Why Sales People Fail — An Executive Preview Featuring Terry Slattery of Slattery Sales Group Thursday, May 21,1998 . 8 am -9:30 am A Free Seminar for CFG Clients Get Your Sales Force on the Right Track! Discover Why... . •Salespeople spend too much time with the wrong prospects and not enough with the right prospects. _ - •The feature and benefit selling style will cost you money and :. .-� lose you business. %.' ;; ' •Price is never the real issue. •Salespeople would be better off if they stopped selling 4? and presenting. •Clients in more than 160 industries and professions are using ir this"system"to attain consistent sales increases. 4 Who Should Attend: Presidents,Owners&Managers ''— Terry Slattery... is President of The Slattery Sales Group,a sales '1-44r; . ;yi�, and sales management consulting firm headquartered in Edina, .,r: ,4 to-,.._ dedicated to increasing the effectiveness of salespeople and businesses. Terry possesses over 30 years of experience in all facets of complex sales, including training and consulting. Terry has been a regularly featured speaker at major corporate meetings and 4110 national conferences(such as INC.MAGAZINE's Conference on "Growing the Company").He has the reputation for achieving dramatic impact for both session attendees and the sponsoring organizations.Terry is nationally known for the development of"Sales Breakthrough"*a program proven to help salespeople and employees reach their highest potential. This program has received rave reviews from individual salespeople and Fortune 500 Companies.He is also the creator of"Wimp Junction,"a program which has taught thousands of salespeople how to recognize and eliminate nonproductive sales behavior. Early Reservation Recommended — Seating is Limited Call 612.945.0200 to Reserve Your Space Today 1I Human Resources Dilemma f ..:..............:::::..............::.:....:.::::::2Yn.vet.A�;-xm•+hn..5.:.....:..a!w;et:...x.x.,....::.x::'.a.....etM.:::.:;;.' II Q. Susan,one of our customer service representatives,left for FMLA leave and at the end of the 12 weeks has decided not to return to work. At what point do we consider this a COBRA qualifying event? How do we go about collecting her insurance premiums while she was gone? A. COBRA requires employers to offer a COBRA election to qualifying beneficiaries when there is a qualifying event and the event causes,or will cause,a loss in plan coverage that occurs within the maximum coverage period for that event. The taking of FMLA leave(Family and Medical Leave Act)is not the qualifying event. However,failure to return • from FMLA is a qualifying event. Therefore,during the leave,the employer is required to continue providing medical insurance benefits as if the employee did not go on leave. During the leave,the employee must continue paying their regular contribution of the health insurance premium. iii 5 0 F 0 II li# Aii" III Insurance Services Financial Services 612/945.0200 Business Building Information Safety Strategy/continued from page 1 can create a sense of involvement and commitment • to the goals and the objectives of the department." Table 2: Top 10 General Industry Violations, 10/1/93 through 9/30/94 Getting Started With all of this in mind,what can be done to set up an effective safety strategy?First,have manage- Hazard Communication 5,826 ment incorporate the following safety truths into the way companies operate everyday.This is a simple OSHA 200 Log&Summary 3,941 step,but not always easy to accomplish: Hazard Communication Employee Information 3,834 Hazard Communication Labeling 3,367 IN All work-related injuries are preventable. Posting Job Safety&Health Poster 2 895 ®Be open to adopting new approaches that focus on safety instead of the lack of safety. Access to Employee Exposure and Medical Records 2,166 Lock Out/Tag Out Energy Control Program 1,950 ®Involve all employees. Lock auttTag Out Energy Control Procedures 1,951 ®Provide employees with the tools,training and motivation to effectively interact and support safety. Machine Guarding Type of Guarding 1,886 The best companies will want to manage Abrasive Wheel Machinery Exposure Adjustment/Safety 1,735 safety in the same way as all other aspects of their Source:OSHA;also see http://www.halcyon.camlttrieve/osha_gen.html, organizations. + http:l/www.webco n.com/-pathf�,dr/gimf.ht,nl,http://www,ostia.govioshstatsistdt.html The credo for any company wishing to establish ' these kinds of rules work. Such lists of regula- tions fail to address motivational factors that By effortlessly and automatically integrating affect worker behavior, and can lead some work- safety into the way an organization operates ers to actually ignore the rules.The bottom line: every day,safety becomes the way all employees Risk having an unwieldy list of"do's and don'ts"is perform their job responsibilities. Management impractical and virtually impossible to adminis- Sample Basic Safety Strategy III g trate. Quite simply,this kind of program is ill After a company understands and commits to conceived and doomed to failure before it ever this kind of management approach and begins to gets off the ground. work toward changing its corporate culture in a A Better Way:A Cost Effective Safety Strategy positive way,it can check to see that its safety Is there a better way?Yes!As Thomas Smith strategy includes at least these basic elements: writes in"Will Safety Be Ready for Workplace •Written safety policy(including agreed upon 2000"(Professional Safety, February 1996),a safety responsibilities for managers,supervisors CFG Commercial decision needs to be made by management within and line employees) Cilents—Take companies to: •Initial safety orientation and training(using a Advantage of "...choose between managing safety to meet written checklist) CFG's Professional specifications,or using quality methods to satisfy •Supervisor's accident investigation report(safety Safety Services safety customers.These approaches have nothing report completed prior to the first report of injury) in common.Managing to meet safety specifica •Safety observations(brief,written report;proper tions does not result in continual improvement.At Does your workplace best,it maintains the status quo.Managing safety training is needed to enable the observer to need a safety audit? identify symptoms of larger,and frequently using quality methods requires a new level of Or,do you need a Safety thinking in which employees are viewed as safety systemic,problems) program developed Or problem-solvers. •Periodic follow-up to assess progress toward reviewed?Do your Management must continue evolving to meet objectives. workers need on-site customer demands...Using such an approach helps The future of safety is encouraging.Significant training in an area? Call companies achieve a level of safety performance safety achievement is within the reach of any com- once thought impossible." pany that is willing to seriously commit to reaching today#oBf2/945A2o1), This thinking is echoed by Dan Peterson in his visit our website for a g y that lofty goal.This will require a reduction in acci- full listing of safety book,Safety Management. Speaking of future safe dents and losses through methods which employ ty programs,Peterson wrote,"...After all,who effective management and behavior. programs available, knows more about the work and its hazards than (Reprinted with permission from Safety Briefs,published by 0 www.cfginsurance.com, the people actually doing the work?Motivation to The Atlantic Mutual Companies. Information in this newsletter was obtained from sou or e-mail us at info@ follow the safe practice,then,would come from sources believed to be reliable. The informa- i tion in this newsletter is general in nature and should not be cfginsurance.com within each person as a part of the group,and construed or relied upon as legal advice.Atlantic Mutual would not be the result of outside ressure...This Insurance Company cannot guarantee the accuracy or corn- would 1 h pleteness of the information.) Employer's Services • 0 tillrG 0 de Business Building Information 0 Meet McCaren/continued from page 16 contractors. Just this January,McCaren started by the on-staff horticulturists who know exactly pursuing small offices for their interior landscape which plants thrive where. Anderson maintains services,mainly Class A office buildings,large that the key to a good landscape is the quality of atriums,and high-end hotels. the plants. That's why he brings in plants weekly To get a chance at doing large-scale national Client from Florida. And what about bugs you may ask? projects,Anderson, a self-described marketing Profile McCaren was one of the first interior landscape fanatic,does keyword searches on the internet. companies to use integrated pest management,a Using this method has helped him bid on numer- fancy term for using good bugs to eat bad bugs. ous projects across the country—projects that he "What sets us apart is the design and scope of normally would not have known about. our work as well as the responsiveness to the cus- Incredible Growth Rate Means More Headaches tomer..."explains Anderson of their competitive for McCaren—CFG Helps with Transition edge. "We have our whole company set up to Twice now,McCaren Designs has been listed sell—every employee can write a job order. It's on Inc.500's list of Fastest Growing Businesses. our ability to do things,a"can do"attitude." Every company's dream,right? Well,not when it Majority of McCaren's Business Comes from comes to the added problems of managing bene Maintaining Original Landscapes fits,employees(HR issues)and workers'compen- Sixty percent of their$2.1 million business sation. CFG and representative Clyde Stockey comes from maintenance that involves sending a were there when Anderson needed help. weekly crew to keep plants healthy and watered. "As you grow your business and add benefits, Forty percent of sales comes from new projects the management of those benefits becomes unman- and aventure Anderson started just a few years ageable. Clyde and CFG have worked to manage ago—holiday decorating. that part of the business for us," says Anderson. Creative Marketing Generates Business for McCaren For their holiday decorating business,Anderson ■ starts an intense marketing blitz the end of each summer. They send out over 60 holiday gift boxes to management companies in the Twin Cities to highlight their capabilities in the decorating area. , As for the interior landscape portion of their business in the Twin Cities,McCaren markets themselves to architects,building owners,and Political Risk Insurance/continued from page 14 awareness and market loyalty are easily destroyed if totally dependent on the commercial abilities of the you are not a reliable source in supplying your goods corporation. Political risk coverage remove this and services. Political risk protection allows your uncertainty. You're able to get financing at lower company greater staying power; you would be able interest rates and can concentrate on the commercial to offer more lenient terms and withstand adversity aspects of the contract. A policy can be endorsed to at a time when others may have to withdraw or tight- recognize a third party such as a bank,as the loss en their payment terms. payee,in which case the pre-assignment becomes • Success in Start-Up–Increasingly,banks are collateral for the loan extended. reluctant to offer assistance when corporations yen- For more information about protecting your interna- ture overseas for the first time or when they enter tional operations from political risk,call your CFG rep- into a contract with an overseas government entity. resentative today at 612.945.0200,e-mail us at info@ Obviously,they feel the success of the venture is not cfginsurance.com or use the faxline on page 17. m ... .� . ,.., . 7 r ,.„5:P..:';f: Employer's Services An Employer's Human Resources Consulting, Education and Risk Management Firm Seminars to Keep Your III Supervisors & HR Staff Well-Trained CFG -11.-A CFG Mainline All Mainline Client is any company Others Clients j where CFG handles the Coaching Skills group medical plan,the Tuesday,May 19,1998 8:30 a.m.-12:00 p.m. $139 $69 Wednesday,September 9,19913 property/liability program Wednesday,December 2,1998 or the 401k plan. - Hire the Best: Successful Interviewing&Hiring Wednesday,May 20,1998 8:30 a.m.- 3:45 p.m.* $189 $94 Thursday,August 20,1998 Wednesday,November 11,1998 Why Salespeople Fail Thursday,May 21,1998 8:00 a.m.- 9:30 a.m. NA FREE -Discipline&Discharge Workshop Thursday,July 16,1998 8:30 a.m.-12:00 p.m. $139 $69 Wednesday,October 7,1998 I r Thursday,January 21,1999 I I '<Employment Practices I _ Thursday,July 23,1998 8:30 a.m.- 3:30 p.m.* $189 FREE to CFG Thursday,September 17,1998 Hotline Clients/ Thursday,November 19,1998 Others$94 i Register on-line at COBRA Administration-Getting It Right www.cfginsurance.com, • Tuesday,July 28,1998 8:30 a.m.-12:00 p.m. $139 FREE to CFG call 612.945.9191 or use Wednesday,September 23,1998 Employee Benefit Thursday,December 3,1998 Clients/Others$69 ! the faxline on page 17a. Introduction to Supervision Wednesday,August 5,1998-part 1 8:30 a.m.-12:00 p.m. $189 $94 Thursday,August 13,1998-part 2 Thursday,November 5,1998-part 1 Thursday,November 12,1998-part 2 I Employee Appraisals Workshop Tuesday,August 11,1998 8:30 a.m.-12:00 p.m. $139 $69 Wednesday,November 4,1998 Thursday,February 4,1999 --t- Personnel Recordkeeping/Wage&Hour Rules CFG MAINLINE Wednesday,August 19,1998 8:30 a.m.-12:00 p.m. $139 $69 Thursday,December 10,1998 CLIENTS-TAKE All Seminars Held at Our Minnetonka Office *Box lunch Included ADVANTAGE OF O DIRECTIONS TO CFG IN MINNETONKA YOUR 50% BB O From North Hwy.7,5,394,55,3 etc. 169 South to: Londonderry-Bren road DISCOUNT ON ::::::of exit ramp at lights take right I"'""^, �� en)at second set of lights EACH SEMINAR a)take right,turn into first drive* right,Americana Bank Building, . ATTENDEE ®CFO lgfMpU.EMT r ^ � From South Hwy.494,62,etc. Minnetonka,3,1 Rom MN 56343 r�7 ® 169 North to:Londonderry-Bren road III �� exit,top of exit ramp at lights,take left 82 (onto Bren)at second set of lights B2 (Smetana)take right turn into first drive- 4. O , way on right,Americana Bank Building, 3rd floor. 8 ___ _____ - c hedu le S • * CFG Employer's Services An Employer's Human Resources Consulting, Education and Risk Management Firm • Hire the Best Successful Interviewing & Hiring YOUR EXPERT PRESENTERS Presenter: Valerie Oldre,SPHR . To pick the best employees from the very beginning,attend this seminar and find out how ■Carole Lofness's legal to set up the interview process to your advantage. Anyone in a position to make a hiring career includes over six decision should attend this full-day seminar. Business owners,operating managers,supervisors, years of private practice pri- and personnel staff all will dramatically improve their interviewing technique and success rate. manly defending employers •Using job descriptions to hire the best people and individuals in litigation sit- •Application forms—do they comply with employment laws;are you handling them correctly? UationS. Carole's experience *Selecting interview questions to get the information you need to make the right decision: includes presenting employ Creating a"structured"interview cande Lof ee,Esq. ment law cases to all Minnesota courts and various *How to set up the entire interview process administrative agencies,and providing client •How to get essential information from the applicant without violating legal or ethical guidelines consultation,education and training to area busi I` *How to tell the difference between a great interviewee and a great employee—How to find nesses. She also has extensive experience in a out who they really are! variety of employment law issues including fed- •Tests that you can use to help in the selection process and dramatically reduce your risk of a eral and state discrimination claims,harassment bad hire and wrongful termination. Carole holds a law degree from William Mitchell College of Law and "This was the most professional and organized seminar I've ever attended. The a Bachelor of Arts degree from St.Olaf College. examples about errors that have landed other companies in court were very helpful and interesting." ■Valerie Oldre has over 10 –Heidi Schipull,Skyline Displays + years of human resources experience specializing in Coaching Skills for Supervisors&Managers employee recruiting,hiring,inter- viewing,and testing. She has Presenter: Carole Lofness,Esq. developed affirmative action Today's supervisors and managers must be cheerleaders,motivators,teachers and plans and provided employee • confronters,all rolled into one. How can one individual be effective in so many distinct handbooks and other human roles? A good coach changes his/her approach and provides supportive communication resources services to businesses. va SPHR ldre, tailored to each employee's situation. In addition,Valerie has evaluated This seminar helps you define your role as"coach"in the work group. Coaching employees the staff of different companies,setting up employee to success is ultimately the most critical role of any supervisor or manager. You'll see how the testing programs to improve employee productivity. coaching role requires a variety of skills to handle different situations and come away with a She holds a Liberal Arts degree from the University of better understanding of how to succeed as a coach. Minnesota and is certified as a Senior Professional in *What does a coach do? Human Resources(SPHR). •Skills necessary for effective coaching ■Roger Stelljes,Esq.has •Coaching to fit the situation expertise in the areas of •Coaching to fit the individual employment law,human ' , *Recognizing coaching opportunities resources and workers'compen- sation.He fields inquiries from "Absolutely relevant material to the things I encounter everyday. Helps to have real ° meanies,l oym and mall,On world solutions based upon firm legal ground." various employment and human resources issues such as hiring, -Charles Bauer,Hegman Machine Tool Roger Stew es,Esq. terminations,employee discipline Employment Practices issues,employee handbooks and recordkeeping. roger regularly presents seminars on many different Co-Presenters: Carole Lofness,Esq.&Roger Stelljes,Esq. human resources issues. Additionally,he is involved ■ Attention all employers! Attend this intensive half-day seminar and get the information with helping employers implement policies and pro you need to meet your responsibilities under the various employment regulations that cedures in the human resources area. Roger holds a exist for businesses. law degree from William Mitchell College of Law This seminar teaches you and your supervisors: where he graduated cum laude as well as a Bachelor of Science degree from Mankato State University. •How to avoid discrimination complaints in hiring interviews •How to comply with the Family&Medical Leave Act • •Recognizing potential sexual harassment complaints •Meeting the responsibilities under the various "This was a great refresher on the dos and don'ts for employers. Installs employment regulations: great awareness of situations and how to handle them. Strongly recommend -Americans with Disabilities Act it to all employers." -Fair Labor Standards Act Age Discrimination Act -Lisa Iverson,King Technology -Immigration Reform&Control Act 9 0 • Insurance Services 0 # IF 4111P Financial Services 612/945.0200 Business Building Information 1 COBRA Administration: Getting It Right! Introduction to Supervision fa Presenter: Roger Stelljes,Esq. Presenter: Carole Lofness,Esq. ■ Don't take chances when you administer your own COBRA.Recent law ■ Designed for employees new to the supervisor role,this two- changes as well as those already in place make it crucial that you do each part seminar gives an overview of the supervisor position and step of this cumbersome law correct(or suffer the consequences.A great also gives practical assistance: refresher for those already doing their own COBRA administration or ideal for •Transitioning to the role of supervisor those who've never tackled this burden,take this opportunity to review your company's COBRA compliance procedures.Make sure your company is pro •Identifying successful supervising styles tected from potential COBRA liabilities. •Evaluating your employees'performance •Health plans subject to COBRA •Coaching your workforce to success •Qualified Beneficiaries—who falls into this category? •Delegating effectively •Qualifying Events(what should you consider a qualifying COBRA event? •Developing skills to deal with problem employees •Notification Requirements •Discipline and discharge issues •Conversion Rules •Managing the performance of your staff •Terms of COBRA coverage •Effective communication with your employees •FMLA and COBRA •Conducting productive meetings •How the 1996 Portability Act changes COBRA law •Time management strategies "In this age of complicated employee benefit administration,it is critical that every resource be utilized to gain knowledge which may further protect the employer. CFG continues to fill Employee Appraisals Workshop the need. Thanks!" Tanana Kennedy, Twin Cities Taco John's Presenter: Roger Stelljes,Esq. ■ Employee appraisals play a major role in businesses yet they're often avoided by managers.A useful tool for making Discipline & Discharge Workshop the right pay and promotion decisions,appraisals are also crucial to • increasing productivity and managing performance.At this work- Presenter: Roger Stelljes,Esq. shop,you'll learn and practice the techniques of conducting ■ Wrongful discharge is a costly and emotionally unsettling experience. employee appraisals by participating in mock appraisal interviews Now the most common allegation faced by Minnesota employers,disci- and working through difficult situations.After this seminar,your plinary actions are the key aspect in determining the legality of dismissals. skills will be developed and sharpened so you can take advantage of This seminar addresses: this important management tool. •How a discharge becomes"wrongful"? •Conducting a successful appraisal interview •Should we have rules?If so,what kind? •Identifying relevant performance issues •Why shouldn't"progressive discipline"be used? •The role of pay in the appraisal process •How to determine the penalty to apply •How to improve the accuracy of your appraisal process •When you cannot dismiss an employee •Guidelines for reducing your legal exposure from appraisals •What demands can a discharged employee legitimately make of you? •Post-discharge steps to protect your business "The class was very thorough. I feel I walked away from this with info I could have only gained otherwise "The seminar was great as well as the presenter and materials. by years of pass/fail type of experiences. Thanks!" Matter was practical and can be related to everyday situation." -Lisa Branch,Carpet Works,Inc. ' I -Phyllis Wickberg,American Guidance Service ,I Personnel Recordkeeping/Wage & Hour Rules I Presenter: Carole Lofness,Esq. ■ Employers are often confused by the endless records,reports,and rules that are part of an employeefemployer relationship.This seminar covers which state and federal recordkeeping rules you need to comply with as a business.You'll also learn about state and federal wage/hour rules and the advantages of a new employee orientation program. •What goes into personnel files;how many different files do you need to keep? " •Who should have access to records? I was extremely pleased with the seminar. I gained a lot of valuable information." • •Overtime rules—who is paid overtime and when? •The difference between exempt and non-exempt employees -Bonnie Jacobsen, Vanman Companies •Posting and reporting rules •The steps and benefits of implementing a new employee orientation program 10 Employer's Services G Alp Business Building Information • A Workplace Incentive Program That Really Works! Simple Safety Game Makes Your Employees More Safety Conscious; Reduces Your Workers' Compensation Claims Up to 90% ooking for an incentive program that truly Here's What Other Organizations Have to Lmakes a difference? Here's a low-cost Say About Safety Pays.,. approach that reduces your workers'compensation Using Safety Pays, we reduced our accidents from Safety/Risk claims exposure while making your employees more 21 to 2, a drop of better than 90%in just the first Management year using Safety Pays during that year,I would g accountable safety-wise. estimate we saved approximately$26,000 in Safety Pays is a daily safety game that gives your Workers'Comp costs. Needless to say, we like the employees the chance to win cash on a daily basis. program,Safety Pays! How does it work? A cash jackpot grows larger as —Bob Wilcoxon,District Manager NASH DECAMP FRUIT PACKING each day goes by without an injury in your work- In 1995,our workers'comp claims totaled$351,053. place. And because this affects all employees, However,by implementing Safety Pays, our claims in there's peer pressure to be more safety conscious. 1996 were reduced to$138,000—a 60%drop! After The program also includes: deducting the$5,202 paid out in jackpots on the 5 • A built-in bonus program to get employee programs implemented,we realized a net savings of contributions to workplace safety which $207,798. In other words, TIW received a 46 to 1 return on investment during the time we've run the promotes individual initiative and enhanced FREE program. 1 recommend it without exception. Ge#your FRE • safety awareness —Richard W.Parilman,Director Human Resources video on this • Employee recognition posters,safety advisories, TEXAS IRON WORKS employee suggestion forms In the first year working with Safety Pays, we ran a unique new • Spanish language versions available series of pilot programs at 16 different stores. The workplace inceli^ • Easy-to-use administrative guidelines and result was a reduction in their workers'compensa- tion expense of 82%and savings of more than tiv program. recordkeeping tools assure program effective- $300,000! Due to the overwhelming success of ness with minimal supervision Safety Pays, I will be installing it into each of our CFG Mainline •Flexible approach allows management to target company restaurants as well as offering it to our Clients get a wide variety of employee concerns unique to family of franchises. your company(productivity,customer service,etc.) —Vernon D.Crawford,Training&Mgmt Relations special discount IHOP RESTAURANTS pricing—call 612.945.0200. z, /C)tosoiwom Alai* ,% ,$ �,„ , 11 c FG Insurance Services Financial Services 612/945.0200 Business Building Information Sexual Harassment/continued from page 3 impartiality. Additionally,an employee need not • j The conduct has the purpose or effect of creating directly complain of sexual harassment to raise your an intimidating,hostile or offensive working duty to investigate. The standard is if the company environment. knew,or should have known,sexual harassment was Numbers one and two mentioned earlier define taking place. Therefore,hearing through rumor or Quid Pro Quo sexual harassment,otherwise known an unaffected employee raises the same responsibili- as sex as a condition of employment. This type of ty to investigate as it would if the affected employee Employment case generally involves a supervisor/manager harass- came forward. In fact,it's often the case that an ing a subordinate by requiring sex for advancement, employer receives notice in some other way other Practices favorable treatment or further employment. than directly from the employee. ro Numbers three and four are definitions of Hostile Once the investigation is complete,if harassment Work Environment sexual harassment. Hostile is found,discipline must be imposed and the punish- Work Environment sexual harassment is the most ment should fit the crime. For Hostile Work common form of sexual harassment and includes, Environment sexual harassment,you have some but is not limited to: sexual pictures,calendars, flexibility depending on what has taken place and an offensive language,jokes,gestures,touching, oral or written warning may be sufficient. For Quid holding,hugging,massaging,and whistling. Pro Quo sexual harassment,the discipline needs to In addition to the definition above,your sexual be more severe. Often suspension,transfer of the harassment policy should indicate that the company harasser,or termination of employment. has zero tolerance for sexual harassment and that any Finally,your policy should reference the fact that employee who engages in harassment;who permits employees can be held individually liable for sexual harassment;or who retaliates or permits retaliation or other unlawful harassment in the workplace. against an employee,is guilty of misconduct and Often times this serves as the greatest deterrent for will be subject to disciplinary action up to,and sexual harassment in the workplace. Ask your including,termination of employment. employees where they will come up with the money Within your policy,you need to encourage to pay for a damage award. Not just the company employees to report sexual harassment immediately. can be held liable,but also individual employees. Use our Be sure to provide alternate complaint options other Put Your Managers and Employees Through than the employee's direct supervisor. Often times, Training At Your Worksite Faxline page the supervisor may be the harasser,involved in a The EEOC has stated that prevention is the best tool group that is harassing the employee or is indifferent to avoid problems with sexual harassment in the work for easy or unresponsive to the conduct taking place under place. Sexual harassment training can be money well their watch. It's best to provide a number of avenues spent for an employer. Training defines what sexual access to more to report harassment including the direct supervisor, harassment is,the many forms it can take,and the kind human resources,other management members or the of liability to be imposed. Managers/supervisors information, president of the company. should receive training on taking a complaint and what Take Claims Investigation Seriously is involved in investigating complaints for sexual n harassme t. A good training seminar includes video See page 17. Once you receive a complaint of sexual harass- g g ment,you must investigate it immediately. examples of what is and is not sexual harassment. Interview the complainant,alleged harasser and any Besides training for current employees,be sure to witnesses who are involved. Be sure to make one cover new employees as well. When you hire a new person responsible for the investigation so that employee,sit down with them and spend time going everyone is on the same page and the person who through the sexual harassment policy in your drafts the investigative report or disciplinary action employee handbook. Explain that the company has • is the person who interviewed all involved and is zero tolerance for sexual harassment and encourage fully aware of all the facts. This can be handled by employees to report sexual harassment if they feel someone internally or bringing someone from the they or others are being harassed. Employers will outside in to conduct the investigation to assure Sexual Harassment/continued on page 15 12 Employer's Services • 0 CCG 0 date Business Building Information • Political Risk Insurance/continued from page 4 and conditions of the contract;or in some cases, Q. What Types of Trade Activities or Investments are Covered? when the company is at fault due to reasons A. Export contracts--where there's a risk of non beyond their control. payment because of foreign government action or Q. What are Some Traditional Political inaction,license cancellation,currency inconvertibility Risk Coverages? Import contacts—where there's a risk of non A. Confiscation,Expropriation,Nationalization receipt of goods previously paid for and for addition- (CEN)and related coverages: International al losses suffered because of consequential damages •CEN for Permanent Investments Risk Service contracts—which may or may not include Protects a company's investment against confis- the Management actual transfer of goods,but where services are cation by a foreign government. The policy covers being provided for which payments are not made. an investor's net investment,i.e.,equity contribu- Where there may be capricious,unilateral and tion plus retained earnings,direct loans to the arbitrary abrogation by the foreign government of foreign entity or loans that are guaranteed by the any term or condition of the insured contract. company,net accounts receivable,and inventory „,,t.4,0.,,,. carried on the books of the Confiscation of assets, , , ,� .�,r 4 r 4 *41 company that is located in permanent or mobile, for a ,,, corporation's or an individ .' '` the foreign country. ual's investments overseas. -, ki.-r r 'r y ■CEN for Mobile Assets Includes confiscation of an t. Protects a company against individual's assets such as ; ," ;.-4 , ;, confiscation of assets by a 411 bank accounts, real estate, `s° foreign government. Also can other personal property, and include"Deprivation,"that is loss or forced abandonment ,,! ,; t the inability to re-export the thereof, or a corporation's '1, , , equipment out of the foreign CFG Commercial permanent assets overseas, ∎-- country. This policy is appro- Clients... such as equity ownership in a priate for assets that will be Don't forget to foreign corporation(subsidiary),or mobile assets located temporarily in a foreign country. take advantage of such as land-moving equipment used in the com- •CEN for Inventory and Production Equipment our safety/risk pletion of a contract.Under confiscation coverage, Protects a company against confiscation of their management video you're also insured against losses caused by physical inventory or production equipment. library with over damage due to strikes,riots,civil commotion,terror- ism and land-based war for mobile assets,as well as •Currency Inconvertibility(CI) 40 titles to keep loss of net income and relocation costs. Protects a company against the inability to remit your supervisors profits and dividends from a foreign operation to the and employees Some examples of companies needing protection: home country. Only available in conjunction with a educated about •A leasing company whose clients,whether CEN policy, safety issues. foreign or domestic corporations,have the leased equipment,aircraft,ships,etc.,based in a foreign •Business Interruption(BI) To review the list country,or a trading firm,where there is tangible Coverage for loss of net income resulting from a of safety titles,visit evidence of ownership,anticipating the receipt of confiscation may be available on a case by case our website at goods,such as raw materials,and/or agricultural basis in conjunction with a CEN policy. Coverage www.cfginsurance.com products,worried about non receipt of the goods would indemnify the company for losses during a or call • and non-refunds of advance payments, six month period. 612/945.0200 for •Unfair calling of bids,advance payment of •Political Risk Insurance for Joint Ventures a brochure. performance guaranties by a foreign government Protects a company involved in a joint venture put up by a contractor where the contractor was Political Risk Insurance/ not at fault according to the underlying terms continued on page 14 13 0 0 Insurance Services i i Financial Services 612/945.0200 Business Building Information Political Risk Insurance/continued from page 13 411 against such risks as confiscation,selective discrim- •CR for Private Buyers ination,non-transfer of earnings and arbitration Protects a company against transfer risk(the award default,all in one policy. inability of a foreign private buyer to obtain foreign •Deprivation of Collateral exchange to make payments to the company),as Covers a company against the risk of being well as other specified political risks such as license I International unable to exercise their rights with respect to collar cancellation and embargo. Risk eral in a foreign country that is secured under a loan •CR for Letters of Credit Management agreement,as well as the inability to convert or Protects a company against failure of a foreign transfer funds outside a foreign country after the government owned bank to honor its obligation sale of the collateral. under a letter of credit,presuming all documents are •Repossession of Leased Aircraft in order. Coverage is also available for a foreign Protects a company(usually a finance company) private sector bank against transfer risk as well as against the right to repossess an aircraft in a foreign other specified political risks. country that is allowable under the terms of a lease •CR for Promissory Notes or Guarantees agreement. Also covers the failure of the aircraft to Protects a company against failure of a foreign be deregistered. government obligor(such as the Central Bank or Ministry of Finance)to honor its payment obliga- Contract Repudiation(CR)and tions under a promissory note or guarantee. Wrongful Calling of Guarantees(WCG) •WCG 1 •CR for Public Buyers Covers a company against the risk of wrongful or 1 Protects a company against the unilateral termina- unfair draw downs by a foreign buyer of advance tion of a sales or service contract,or the failure of a payment bonds,performance bonds or other contract i government owned buyer to meet contractual pay- related guarantees. Certain specified political risks ment obligations. Also covers other specified politi- that can result in fair draw downs are also covered. cal risks such as export or import license cancella- tion and embargo. Q. Why Should Our Company Use Political Risk Insurance? Companies which: May be interested In: Which covers: A. Balance Sheet Protection—If collecting receiv- Have permanent or mobile ` Confiscation, •The company's equity aales is dependent on a foreign government honoring ■ assets located outside North Expropriation, investment or other assets its contractual obligation,if it's dependent on the sup- America or Western Europe Nationalization Insurance from seizure by the local ply of foreign exchange previously allocated,or if it's government •The company's liability to dependent on completion of projects which are Currency Inconvertibility remit routine profits and dependent on governmental laws,orders or decrees, dividends from a foreign operation, the collectability of your receivables becomes less Export outside North Contract Repudiation •Unilateral termination of certain. However,if payment is insured by a third America or Western Europe Insurance a contract by a government party such as a Best"A"rated insurance company, buyer the company's balance sheet is protected. 1 •Inability of a private buyer to obtain foreign Expand Trade—Increased confidence in trading exchange to effect payment ! abroad,knowing to the company ng that the possibility of unforeseen i •Export/import license losses is covered. cancellation Goodwill—Tapping overseas markets requires a Have advance payment or Wrongful Calling of •Unfair draw down of lot of perseverance and involves substantial expense 1 performance guarantees in Guarantee Insurance standby guarantees by for- in and personnel. It's even more difficult to • conjunction with overseas eign government buyers money contracts •Government intervention maintain such markets. Carefully nurtured brand i which causes private for- eign buyers to unfairly draw down standby guarantees Political Risk Insurance/ continued on page 7 14 _ .. ,, 0 Business Building Information The Quick & Easy Way to Get Information When You Need It! FAX TO: 612.945.9477 PHONE: 612.945.0200 FROM: YOUR COMPANY: PHONE: FAX: Let Us Know What You Think of the CFG Update ❑ I enjoy your newsletter and would like to introduce my business associate to it. I've filled out their name and address below. ❑ Thank you, but please remove my name from your mailing list. Send the CFG Update to: Name Title Company Address City, State, Zip Phone Yes, I have more questions on the following articles, please contact me! Please check all that interest you. ❑ A Safety Strategy That Works ❑ Sexual Harassment in the Workplace ❑ Executive Benefits Attract & Retain —What Can an Employer Do? Key Employees ❑ A Workplace Incentive Program That Cl Political Risk Insurance —Is Your Really Works! International Business Operation ❑ Human Resources Dilemma Protected? ❑ E-Mail Users Send us your questions and comments to update @cfginsurance.com CFG.. . "Leaders in innovative financial security solutions. . . " SIMPLY FAX TO 612.945.9337 page 17 ja illr 0 C ne Business Building Information Seminars to Keep Your Supervisors & HR Staff Well-Trained "Please Ali Enroll Me" Coaching Skills Tuesday,May 19,1998 8:30 a.m.-12:00 p.m. $139 - Wednesday,September 9,1998 t Wednesday,December 2,1998 Call Hire the Best: Successful Interviewing&Hiring 612.945.9191 Wednesday,May 20,1998 8:30 a.m.- 3:45 p.m.* $189 or 800.258.3190 Thursday,August 20,1998 OR Wednesday,November 11,1998 Why Salespeople Fail Thursday,May 21,1998 8:00 a.m.- 9:30 a.m. N/A FAX Discipline&Discharge Workshop -- Thursday,July 16,1998 8:30 a.m.-12:00 p.m. $139 Wednesday,October 7,1998 Fax your registration, Thursday,January 21,1999 X Employment Practices 612.945.9337 Thursday,July 23,1998 8:30 a.m.- 3:30 p.m.* $189 OR Thursday,September 17,1998 Thursday,November 19,1998 COBRA Administration—Getting It Right � s Tuesday,July 28,1998 8:30 a.m.-12:00 p.m. $1' Wednesday,September 23,1998 Thursday,December 3,1998 ° Mail the registration Introduction to Supervision form below Wednesday,August 5,1998—part 1 8:30 a.m.-12:00 p.m. $!» OR Thursday,August 13,1998—part 2 M Thursday,November 5,1998—part 1 Thursday,November 12,1998—part 2 1.1 Employee Appraisals Workshop =' Tuesday,August 11,1998 8:30 a.m.-12:00 p.m. $139 Wednesday,November 4,1998 w Register on-line at Thursday,February 4,1999 www.cfginsurance.com Personnel Recordkeeping/Wage&Hour Rules . Wednesday,August 19,1998 8:30 a.m.-12:00 p.m. $139 Thursday,December 10,1998 All Seminars Held at Our Minnetonka Office K 43C Attendees Method of Payment Name Position IMPORTANT: Tuition is due before the seminar. Please make Seminar Titles checks payable to CFG Employer's Services and return this form to Dates 0 CFG Employer's Services,Inc. Name Position 9800 Bren Road E.,Third Floor Seminar Titles Minnetonka,MN 55343-9951 Dates Please check one of the following(unless seminar is free): 1.0 Registration fee enclosed. (Please list add ition al na m es on a se pa ra te sheet) 2.❑Our purchase order is attached. P.O.# Your Organization Address 3.Charge to:0 Mastercard 0 Visa Exp.Date Acct. No. City/St/Zip Phone Fax Signature SIMPLY FAX TO 612.945.9337 page 17a Employer's Services • 0 ellir" dae AP Business Building Information 40 Sexual Harassment/continued from page 12 aware workforce due to cases such as Anita find that time spent on training,both formal and Hill—Clarence Thomas;Paula Jones vs.President informal,goes a long way towards reducing sexual Clinton;Hunter Tylo vs.Melrose Place;or Casey harassment in the workplace. Martin vs.PGA,employers can and should expect Take Advantage of Protection Offered By more employment-related suits as time goes by. Employment Employment Practices Liability Insurance In the end,employers who commit themselves to Practices If your company has not already done so,consider having a work environment free of sexual harassment purchasing Employment Practices Liability insur- will go a long way towards avoiding lawsuits. Having ance. A recent Boston Globe article pointed out that a thorough sexual harassment policy and conducting companies are purchasing this insurance to protect workplace training are key elements to accomplishing themselves against sexual harassment and bias that goal. Finally,as a backup,purchasing Employ- claims. A 1997 survey of 616 companies cited by ment Practices Liability insurance may protect you if the Globe reported that 56 percent had been sued by a lawsuit arises and damages awarded. a worker for an employment-related lawsuit within For help with issues or training regarding sexual the last five years. Although insurance does not harassment,call CFG Employer's Services,Inc.at shield you from the responsibilities imposed by law, 612.945.9191,e-mail us at info @cfginsurance.com, it may help pay claims for violations. With a more or use the faxline on page 17. CFG...Providing Innovative Financial Security Solutions to Businesses & Organizations Employee Benefits Human Resources Services • Group Medical Programs Human Resources Hotline Group Life&Disability Coverage Human Resources Audit Group Dental Coverage Employee Handbook Development Group Long-Term Care Plans Employee Search&Selection �� s Group Auto&Homeowner's Insurance Applicant Profiling&Testing Retirement Plans New Employee Checklist&Job Applications *_; a� COBRA Administration Employee Background Verification Cafeteria Plan Administration Criminal History b§ 3 .• Professional Employer Organizations(PEOs) Motor Vehicle Record Voluntary Benefits Credit Report 4, International Benefit Programs Human Resources Development ��ifw Employee Benefit Communication Affirmative Action Programs � ��`� Property/Liability Sexual Harassment Policies General Liability&Property Coverage Government Compliance B � j Workers'Compensation Job Descriptions l � i141,7. Employment Practices Liability Coverage SafetyIRisk Management Services , ,� Directors&Officers Protection Safety Program Assessment&Development i, , .• Professional Liability Safety Program Training Workers'Compensation Claim Audit Review Accident Investigation � � International Risk Management AWAIR �� Product Liability Bloodborne Pathogens "� ��+ f �t r Comprehensive Claims Management DOT Truck Driving Regulations „,�s4, =r Umbrella Coverage Drug&Alcohol Testing _ , k e- ,£, Commercial Auto/Fleet Protection Employee Right-to-Know Programs da , Bonds Ergonomics r � Business Planning Job Hazard Analysis 11,014040t Buy/Sell Agreements Loss Control Programs ' F Key Person Coverage Noise/Hearing Conservation 404 • Estate Planning OSHA Compliance 4e' 0 # Executive Bonus Plans Respiratory Protection Plans � � Return-to-Work Plans 0 CFG 612.945.0200 ''' ;Cf010$ $. , 15 16 Meet Mc aren Designs, Inc • Beautifying Indoor Spaces with Creative Landscaping E ver wonder who Great- ' ° of juggling both jobs before he 41)ut, Client ed the indoor paradise could concentrate solely on his Profile of live plants and flowers at new business. Knott's Camp Snoopy at the ".i From the start,McCaren Mall of America? And then ,°;;;„,, Designs focused on commercial wonder why house our Y _ interior landscaping rather than couldn't look like that? A residential. As the second company call McCaren largest interior landscaper in the `As you grow your Designs,Inc.can take the Twin Cities with 39 employees, business and add credit. Creating interior land- McCaren Designs specializes in benefits,the manage- scapes is the specialty of this McRae Anderson,president of p p y McCaren Designs, sits amid one of designing,installing,and main meat of those benefits St.Paul company founded in his landscape creations—this one taming interior landscapes. becomes unmanage- 1977 by McRae Anderson. in the middle of their office. They've done projects for zoos, able. Clyde and CFG With a vision and a business plan,twenty-six aquariums,airports and corporations like Embassy have worked to man- year old Anderson decided he wanted to try out a Suites Hotels,Minneapolis Hilton,Norwest Banks, age that part of the relatively new field called interior landscaping Seagate Technology and more. business for us." after working part-time as a nursery manager. A Expert Designing Behind McCaren,s Success McRae Anderson degree in Agriculture Business/Marketing corn- Every landscape creation is professionally McCaren Designs,inc. bined with a love of plants and a farming back- designed by either Anderson himself or one of his ground served Anderson well for starting McCaren Designs. And it only took a few years two other designers. Each designer is helped out Meet McCaren/continued on page 7 CFG BULK RATE U.S. POSTAGE •• PAID 9800 BREN ROAD EAST•THIRD FLOOR MINNETONKA,MINNESOTA 55343-9951 Permit No. 65 612.945.0200 FAX 612.945.9477 Waconia, MN ADDRESS SERVICE REQUESTED Update this date issue: II p A Safety Strategy gY That Works page I Use Executive Benefits to Attract & Retain Your Most Valuable Employeespage 2 Sexual Harassment in the Workplace What Can an Employer Do?... page 3 Why Sales eople Fail Seminar— • CFG Clients Sign Up Today! page 5 jint As part of CFG's effort to reduce waste,this newsletter is printed on a recycled For information, call 612/945.0200 paper of 50%recycled fibers with a minimum of 10%post-consumer waste. OCFG • • INSURANCE SERVICES, INC. E 1�( July 9, 1998 JUL 1 31998 ji . .......... Tom Melena Oak Park Heights City Hall 14168 57 St N Oak Park Heights, MN 55082-6409 Dear Mr. Melena: I wanted to thank you for taking the time today to speak with me about CFG. We are a Y g Y Pe very unique organization and offer many ideas that will help you in your future planning on your insurance needs,human resource procedures and safety issues. As we agreed, Brian Moe will be meeting with you on Tuesday,July 21, at 10:00 am at your office to find out more about Oak Park Heights City Hall, introduce our services, discuss your specific needs and share what we may be able to do for you. Thank you again for your time and consideration. We look forward to working with you. Sincerely, 7 Kristen Evenson Account Coordinator • 612.945.0200 9800 BREN ROAD EAST•THIRD FLOOR• MINNETONKA, MINNESOTA 55343-9951 FAX 612.945.9477 website : www . cfginsurance . com • email : info @cfginsurance . com 07/01/1998 10:44 6124,596 LANDMARK IN RVCS PAGE 01 t A i! �.!Y1 4+�igl� J�.�1.. ..t e ` 1 y{� 1 r J .r'' I y+1 yStY;N �y yx��j4. Landmark � :...,,, ' ',r l.u...i...'r'.f r� T_ �'.. { � : Insurance Services fir:..,-z.?-,,,T.;,..-. .� "7-.r . «: ..4, < J,t,;:.;. PO Box i'■ i 1) 1a11i y1 1 �i ; s Y1 slirT. "ip,f; t.: 188 1:., - , 14.•Forest Lake, MN 55025 4b ; e *' ►;,,a �;° ., Phone : 612-464-3333 Support 6 '` � 'j_-"' ''"' ^_ z ;� .,,.,. ;^•; " i :r ,t: .y 1 �'':.' ..7ii ,:;':. 4,, �,MNS 02 ., ^^'rte+•* .,w - r;,r o=tm 8 =-L. t.. , i 4f4 •4' i'i7k6t 203,,. ; _: ....:;, Oak Park r' �' r 4 <-. 3:.•7�„,96:'.,:4- ;-.. I City of Oa Heights .. 4 . ;4: ZM. „-.:s ,�:: :.;;:::',,'"f..,.l Mike Robertson, City Admin. 14168 N 57th St, Box 2007 Stillwater, DIN 55082 l*c :is i4=0**: ;*ri.. ;�Hiel d' :�i;. .; caiia4:: f Ci:. I am reviewing your renewal applications for the League of Minnesota renewal policies, and we just need the following application completed. This is the Open Meeting Law Questionnaire. Can you please sign and fax back to our office? Thank you very much and please contact Kate Tipping or myself with any additional questions. • a er Jon n 07101/1998 10:44 6124 7596 LANDMARK IN RVCS PAGE 02 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST OPEN MEETING LAW QUESTIONNAIRE 1. Description of orientations and/or training provided for all elected officials(GI'S programs, League programs, Handbook for Minnesota Cities, loss control seminars ...)on the subject of the open meeting law: hn..$. to W1 1 J� .a 2. Have all new members attended the League Conference for Newly Elected Officials? ✓ YES NO 3. Do all officials understand the Open Meeting Law and the Cities' compliance procedures? YES NO 4. DescriptioR of method of documenting official meetings(written, audio, video, ...): t tYrI 14M -IV I OLO "'I"" 5. Does legal council attend all official meetings? ✓ YES NO If no, describe service relationship with city attorney. 6. Is education provided for the elected officials in the proper policy and procedures? a) Land use decision making: ✓ YES NO b) Employment practices: ✓ YES NO 7. Please indicate the percentage of reimbursement of defense costs. 80% 100% ✓ BY: (Signature and Title of Authorized Representative) C iy kDMl'1S1ct9- LMCITAPP.OML(11/97) PAGE 3 OF 3 • LMCIT Risk Management Information 145 University Avenue West, St. Paul, MN 55103-2044 rogue ta Cities Phone: (612) 281-1200 • (800) 925-1122 cellence Fax: (612) 281-1299 • TDD (612) 281-1290 Things to Think About When You're Renewing Your Property/Casualty Coverage LMCIT tries to make buying coverage for the city's property and liability exposures as simple and straightforward as possible, but it can still be a complicated and confusing business. Unfortunately, overlooking or misunderstanding some of these points can result in an unpleasant surprise at claim time. Here are some points to make sure you review in thinking about your renewal. PROPERTY COVERAGE ISSUES For renewals after November 15, 1997, we've completely revised LMCIT's property coverage forms and approach. The enclosed memo explains the changes in more detail. For your 1998 renewal, here are some key issues and decisions you'll need to address. What do you need to schedule Essentially, the city needs to provide three lists of property to be covered: • Each building for which you want coverage. Any building you list on the schedule is covered for replacement cost, along with the building's contents. You'll also need to supply some basic descriptive information on each building - size, age, construction, occupancy, etc. • Each piece of mobile equipment with a replacement cost of more than$25,000. " Mobile equipment"means property other than vehicles that's not part of a building or the building's contents. It's basically the kind of stuff that would traditionally have been covered by an inland marine"form. (It also includes police dogs.) Items of mobile equipment with a replacement cost of less than$25,000 can be covered automatically without having to be specifically scheduled if the city wishes. The city needs to indicate on the application whether or not they want coverage for under-$25,000 items. • Property in the open. This is a"catch-all"category of property. It's essentially stuff that isn't a building and that doesn't move around. Hydrants, signs, street lights, flagpoles, fences, CD sirens,tennis nets,picnic shelters, etc. are typical examples. You need to identify the property in the open that you want to cover. This can be done either by listing individual items (e.g., the"Welcome to Mosquito Heights"sign on Main Street"), by location(e.g., "property in the open at Mosquito Heights City Park"or"property in the park except picnic benches"), or by some other general description (e.g., "all street lights in the city"). • AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER • • y Flood and water damage The city needs to identify whether or not each building is in a"flood hazard area". A"flood hazard area" is an area that is either within the 500-year floodplain as mapped by NFIP, or is in an unmapped area. On a case by case basis, buildings in unmapped areas can be treated as not being in a flood hazard area if you can provide information to the underwriter showing that it's not at significant risk of flooding. Buildings not in a flood hazard area are covered for water damage, including floods. Buildings in a flood hazard area are covered for water damage except for flood. For any building in a flood hazard area, the city must decide whether to add the supplemental flood coverage which LMCIT makes available as an option. The supplemental flood coverage "wraps around"the NFIP flood insurance, picking up flood damages which the NFIP policy doesn't cover. The supplemental flood coverage is available only if the city has purchased NFIP flood insurance for the building, at the maximum limit available. Utility Poles and Wires LMCIT's standard property coverage excludes coverage for damage to city utility poles and lines. In the past, this has left cities with electric utilities with a significant uncovered loss in the event of a widespread ice or windstorm that downed city lines. To help avoid this potential problem LMCIT offers an optional property coverage for city utility poles and transmission and distribution lines. The coverage is subject to a$50,000 deductible per occurrence and a$500,000 limit. The rates for the coverage are based on the number of miles of transmission and distribution lines in the city. Limits The LMCIT property coverage includes sub-limits on certain types of properties, damages, or exposures. These limits are summarized in the enclosed memo describing the property coverage changes. We think these standard sub-limits should be sufficient for most cities. However, these sub-limits can be increased by endorsement if necessary. Cities should review whether any of these sub-limits need to be increased in order to meet your particular needs and situation. Independent Adminstrative Boards Adminstrative boards, commissions, agencies and authorities and their properties are not covered automatically under the city's LMCIT Property, Inland Marine, or Auto Physical Damage coverage. LMCIT can provide these coverages but the city needs to specifically indicate which board or commission are to be covered and for what coverage. Page 2 • LIABILITY COVERAGE ISSUES Fireworks Displays. Cities sometimes put on fireworks displays for Independence Day or other celebrations. The city's LMCIT liability coverage document excludes coverage for any liability arising out of the city's ownership, sponsorship, or operation of fireworks displays. This exclusion applies both if city employees or volunteers are setting off the fireworks, and if the city itself sponsors or contracts for a fireworks display. (The exclusion does not apply to a fireworks display that is sponsored and operated by someone else. Where the city's only role is in regulating, licensing, or providing public safety services, the city's LMCIT coverage will cover liability the city incurs because of those activities.) If the city is involved in a fireworks display as an operator or as a sponsor,the city won't have coverage for liability for any damages arising out of the display, unless the city takes special steps to put that coverage in effect. There are a couple possible solutions to this problem. The preferred approach is for the city to contract with an experienced, reputable contractor to handle the fireworks display. The city should make sure that the contractor has adequate insurance limits, and that the city is named as an "additional insured" under the contractor's insurance. LMCIT can then on request also delete the fireworks exclusion from the city's coverage for a small cost. The city's LMCIT coverage would then apply as excess over the contractor's coverage; this would give the city additional protection in case of a very large claim, or if the contractor's insurance company went broke, etc. Unfortunately, it's not always possible for cities to hire a private contractor to handle the fireworks display. Sometimes the only feasible option is for the city to put on the display itself, using city staff and volunteers to handle the display. In this situation, LMCIT can by endorsement provide the needed liability coverage to the city, provided the city has adequately trained staff and a safe location for the display. Cities considering putting on a fireworks display themselves should contact LMCIT as early as possible. This will give LMCIT's loss control consultants time to work with the city to help make the display as safe as possible; and it will give LMCIT's underwriters time to evaluate the risk properly to determine whether LMCIT will be able to provide the requested coverage. Joint Powers Contracts The city's LMCIT liability coverage does not apply to "liability arising out of the activities of a joint powers entity." Unless the joint powers entity has arranged for coverage in its own name, neither the city and its officers and employees nor the joint entity and its officers and employees will have coverage for a liability claim or suit arising out of the joint powers entity's activities. Page 3 • • To avoid the problem, if the city is involved in a joint powers contract that creates a separate joint powers entity, make sure that the entity has liability coverage. When LMCIT issues liability coverage to a joint powers entity,that coverage protects not only the joint powers entity and its officers, employees, and volunteers; but also the constituent political subdivisions and their respective officers, employees, and volunteers, for claims arising out of the joint entity's activities. Keep in mind that not every joint powers contract creates a joint powers entity. Most mutual aid contracts do not, for example. Often too, cities enter contracts under which one political subdivision provides certain services to another in return for a fee; again, this kind of contract typically won't create a new joint entity,though there are exceptions. Cities should review all of the joint powers contracts they are involved in, including mutual aid agreements, service contracts, etc. Remember: the name given to a contract doesn't necessarily tell you what's in the contract. We've seen examples of contracts that were called mutual aid agreements, but which very clearly had the effect of creating a new joint operating entity. You need to look at what the contract actually does, not just what it's called. In very general terms, if the joint powers contract creates a separate board with power to do any of the following, the joint powers coverage exclusion will come into play: • receive and expend funds • enter contracts • hire employees • purchase or acquire real or personal property • sue or be sued. If you're not sure about a particular contract, send LMCIT a copy. We'll be glad to review it and give you a definite answer as to whether the city's own coverage will apply or if the contract creates a joint entity that needs its own coverage. Independent Administrative Boards Statutes and some charters allow cities to create independent administrative boards to manage certain city operations; utility commissions and hospital boards are common examples. Other statutes allow cities to create separate public corporations for certain purposes; Port Authorities HRA's, and EDA's are examples of these. The statutes generally give these boards and authorities full power t-) manage the activities for which they are responsible, including the authority to purchase the appropriate liability,property, and other coverages needed for those activities. If your city has one or more of the following, you need to make sure there is adequate coverage for its activities: Page 4 • • • gas, electrical, or steam utilities commission; • port authority, housing and redevelopment authority, economic development authority, municipal redevelopment authority, or similar agency; • municipal power agency; • municipal gas agency; • airport board or commission; or • hospital, nursing home, and medical clinic board or commission There are some particular coverage issues to be aware of for certain specific types of boards, commissions, and entities, as described below: , Air ort Hospital, Nursing Home, and Medical Clinic Boards or Commissions P P g These boards or commissions require specialty coverages. LMCIT can not provide all the coverages that the city and the board or commission require. LMCIT only provides coverage to the city and board and commission for Municipal Liability except for"Bodily Injury","Property Damage", or "Personal Injury". You will need to purchase coverage for the other unique exposures from specialty insurance companies. Contact LMCIT for any assistance. HRA's, EDA's, and Port Authorities These entities are legally separate political subdivisions. They are not covered automatically under the city's LMCIT liability coverage. (This is true even if the council members themselves also make up the board of the political subdivision). Unless the city has specifically indicated that these entities are to be covered, a claim against one of these political subdivisions would not be covered. Nor would the city be covered for claims arising from the activities of these entities. These entities' status as separate political subdivisions creates a coverage limits issue the city needs to consider. Since the city and the EDA (for example) are each a separate political subdivision, each could potentially be liable for up to the statutory liability limit. If the EDA is added as an additional covered party on the city's LMCIT liability coverage and if both the city and the EDA were sued for the same occurrence, you conceivably could have a total of$1.5 million of liability. But you'd have only $750,000 of coverage Iimits available for that occurrence. One solution is for the EDA, HRA, or port authority to purchase separate coverage in its own name. If this is done,the city would then have primary coverage under the political subdivision covenant, and excess coverage for these activities under their own covenant. Another option is to name the political subdivision as a covered art on the city's covenant and then p Y Y also to purchase excess liability This would also eliminate covera e.g laminate the potential limits problem. . If the political subdivision purchases private insurance elsewhere, the city and the board or commission need to review the following questions to assure adequate coverage. Remember, Page 5 • • LMCIT does not automatically cover the city for claims arising from the EDA's, HRA's or port authority's activities. • What type of coverage is provided to the city and the board? Is the coverage as broad as provided by the LMCIT covenant? Does it cover employment-related liability, land use or development litigation, etc.? • Is the city named as an additional insured on the board or commission's policy? If the city needs coverage for a gap left by private insurance that the EDA, HRA, or port authority has purchased, please contact LMCIT. An additional premium may be required. Gas, Electrical or Steam Utilities Commissions These boards and commissions are not covered automatically under the city's LMCIT liability coverage. Unless the city has specifically indicated that these entities are to be covered, a claim against one of these boards or authorities would not be covered. Nor would the city be covered for claims arising from the activities of these boards or commissions. In most cases, LMCIT can provide the needed coverage in either of two ways; by adding the board or authority onto the city's policy, or by issuing separate coverage to the board or authority itself. If the coverage is added to the city's policy, both the city and the board or authority are covered. If the board or authority purchase separate coverage from LMCIT, the city will be added as a covered party under the board's coverage and both would share coverage and limits. Unlike the EDA's,HRA's, and port authorities, a utilities commission is usually not legally a separate political subdivision. (There may be a few exceptions; a few city charters may make the utilities commission a separate legal entity.) Generally though, covering the utilities commission under the city's general coverage doesn't create the same coverage limits problem that you can encounter with EDA's, HRA's or port authorities. If the utilities commission purchases coverage elsewhere, the city and the commission need to review the following questions to assure adequate coverage. Remember that LMCIT does not automatically provide coverage to the city for the utilities commission's activities. If the utilities commission purchases separate private insurance, the city can't just assume that the city's LMCIT liability coverage will protect the city and fill any gaps that the utilities commission's insurance leaves. Again, cities should look at a couple of issues: • What type of coverage is provided the city and the board or commission? Is the coverage as broad as that provided by the LMCIT covenant?Does it cover employment liability, EMF, failure to supply utilities services, etc.? Page 6 • • • Does the utilities commission's insurance company understand that the city and the utilities commission are not separate entities? That is, do they understand that they must handle a claim arising from the utilities operations that names the"City of Mosquito Heights"as the defendant? (One possible way to clarify this might be to have the utilities commission's insurance issued to "City of Mosquito Heights DBA Mosquito Heights Utilities Commission") If the city needs coverage under its covenant to cover a gap in coverage that's left by the utilities commission's private insurance,please contact your LMCIT underwriter. Additional premium may be necessary. Municipal power agencies and municipal gas agencies Under the statutes, a municipal power agency or municipal gas agency is legally a separate political subdivision, even though it's created by contract among two or more cities. Thus these organizations have some characteristics both of political subdivisions and of joint powers entities. The city's LMCIT liability coverage excludes claims arising from the activities of a municipal power or gas agency. If your city participates in a municipal power or gas agency, you need to make sure that the agency has appropriate liability coverage. You need to look at the same kinds of coverage questions that arise with covering EDA's, etc. Medical Payments Coverage The "Medical and Related Payments Coverage"is part of LMCIT's general liability coverage agreement. This coverage provides a limited amount($1,000) of"no-fault"medical payment coverage for those injured on city property because of a condition in the property. Some have questioned whether there is a valid purpose for cities to pay these funds in situations when the city is not legally liable. Others have argued that the payments provide a simple and inexpensive way to possibly head off what might turn into a more expensive liability claim. Cities have the option to delete the medical payments coverage from their LMCIT liability coverage. Uninsured/Underinsured Motorist Coverage Cities need to decide what limits or uninsured/underinsured motorist coverage to provide. The statutes require a minimum limit of$50,000. We believe it makes sense for most cities to carry the minimum limit, rather than providing higher limits. The UM/UIM coverages are designed to help assure that an injured driver will be compensated if s/he is injured in an accident caused by an uninsured or underinsured driver. Essentially, the UM/UIM coverage steps into the place of the liability insurance that the other driver should have Page 7 • had. In the case of city vehicles though, an injury to the driver while operating a city vehicle would in most cases be covered by workers compensation. The amounts the individual would be able to recover from UM/UIM would be in addition to the medical, indemnity, and other benefits paid under work comp, and in many cases would amount to a double recovery for the individual's injuries. A city might decide to carry a higher limit for a couple reasons: if they believe the workers' compensation benefits are insufficient to compensate their injured employees; or if they want to make sure that non-employees riding in city vehicles are fully compensated in the event of an accident with an uninsured or underinsured vehicle. (Note that in most cases the passenger's own UM/UIM would also respond.) In any case, it is an issue that your city should consider. Liability coverage- whether to waive the statutory per person limit Renewals after November 15, 1997, are issued with a$750,000 per occurrence limit. In addition, LMCIT has made an important change in how the liability coverage is structured. Unlike the previous coverage form, under the new coverage form the statutory provisions that limit the city's liability to $300,000 per person are no longer automatically waived. However, the city has the option to waive the statutory per-person limit. If they do so, their coverage would effectively be structured the same as the previous coverage, but with a higher limit. Each city needs to consider whether or not to waive the statutory per-person limit. Here's a shorthand summary of the practical effects of that decision. • If the city does not waive the statutory tort limits, an individual claimant would be able to recover no more than$300,000 on any claim to which the statutory tort limits apply. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would be limited to $750,000. These statutory tort limits would apply regardless of whether or not the city purchases the optional excess liability coverage. • If the city waives the statutory tort limits and does not purchase excess liability coverage,a single claimant could potentially recover up to $750,000 on a single occurrence. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to $750,000, regardless of the number of claimants. • If the city waives the statutory tort limits and purchases excess liability coverage, a single claimant could potentially recover an amount up to the limit of the coverage purchased. The total which all claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited to the amount of coverage purchased, regardless of the number of claimants. Contact LMCIT if you have questions or need further information about statutory liability limits and LMCIT coverage limits. Page 8 • • Excess Liability Coverage The statutes limit the city's tort liability to $750,000 per occurrence. LMCIT provides a standard $750,000 liability coverage limit to match the statutory limit. However, there are a number of ways in which that coverage could turn out not to be enough; federal civil rights suits, liability assumed by contract, liability for actions in another state, inverse condemnation liability for land use claims, the possibility of the caps being found invalid,and exhaustion of annual aggregate limits on products liability, limited pollution and land use claims are some examples. In light of these various ways cities can be exposed to liability beyond the statutory limits, the city should consider purchasing higher limits of liability coverage. LMCIT makes available up to $5,000,000 of additional limits at the city's option. Sometimes city officials reason that "we're only a small city, so we don't need high liability coverage limits." But arguably the opposite is true: A big city has much more tax base and many more taxpayers over which to spread, say, a$1,000,000 excess judgement; in a small city, the burden per taxpayer could be enormous. If your city has considered excess coverage in the past but decided against it for cost reasons, you may want to reconsider. Rate reductions in recent years have reduced the cost substantially. We have prepared a separate memo discussing the various issues that cities ought to think about when deciding whether to buy excess coverage. Contact us at the League office for a copy. Contractual Liability/Additional Covered Parties LMCIT covenant provides coverage for most contracts. The covenant can also be endorsed to provide coverage for additional covered parties when requested. It is important to review all contracts and requests for additional insureds; • Many requests for an additional insured endorsement are really a request for a Certificate of Insurance. • The contract and the hold harmless provisions should be reviewed by legal counsel. • Contracts with railroads or involving work on railroad property need special attention. Contact LMCIT for assistance. Automobile Liability Coverage The cities have the option to make LMCIT Liability coverage primary for vehicles used by specified individuals or groups in specified circumstances, e.g. firefighters responding to calls. There is a premium charge per vehicle for this optional coverage. Page 9 • • Liquor liability coverage If the city is involved in any way in selling liquor or beer, the city should have adequate amounts of liquor liability coverage. This includes not just cities with a municipal liquor store. Fire relief associations, for example, sometimes are involved in special-event beer sales as a fundraiser, for example. LMCIT now offers liquor liability coverage as part of the LMCIT property/casualty program, both for municipal liquor stores and for special-event sales by city -related entities like a fire relief association. Standard coverage limit options are$500,000 or$1,000,000; higher limits are also available on request. Cities should be especially careful to make sure the liquor liability coverage limits are adequate, since there are no statutory limits on liability for illegal liquor sales. A typical liquor liability claim involves a car accident. If a breadwinner with several dependents is killed or disabled in an accident, damages can easily reach or exceed the half-million dollar mark. If the city's coverage limits aren't sufficient, the city can still be liable for the excess. We suggest that as a minimum any city involved in liquor or beer sales have at least $500,000 of coverage, whether from LMCIT or from a private insurer. OTHER ISSUES. Bond Limits and Forms A number of things can go wrong with cities' bond coverage. Many cities, especially small cities, carry very low limits on their bond coverage. $5000 or$10,000 limits are common, especially in smaller cities. Unfortunately, we've seen a couple instances where those limits turned out not to be adequate. Both involved small cities in which a trusted employee misappropriated relatively small amounts of money at a time over a period of many years. In one case, nearly $100,000 was missing by the time the city discovered the problem; in the other case,the total was more than$200,000. In both cases,the loss was several times the city's fidelity bond limits. Another potential problem is with the form of the bond. The statutes call for certain officers to be covered by a"faithful performance" bond; i.e., a bond that guarantees that the officer will faithfully perform the duties of his or her office. This type of bond is required for a statutory city clerk or treasurer, for example. An ordinary fidelity bond protects the city only against losses caused by the individual's dishonesty. If the city suffers a loss because of the officer's mistake, or because the officer simply didn't perform his or her duties properly, an ordinary fidelity bond won't help; a "faithful performance" bond,however. might. To avoid these problems we suggest the following: Page 10 • • • Review the limits on the city's current bond coverage. The Government Finance Officers' Association several years ago developed a formula for suggested bond limits based on the city's annual revenues and the amount of negotiable securities on hand. It's not an absolute or infallible rule, but this formula can give the city a starting point for thinking about what bond limits to carry. We would be happy to provide information on this formula. • Make sure that you have 'faithful performance"bond coverage on those positions where the statutes require it. Some of the most common examples are statutory city clerks and treasurers and their deputies, and relief association treasurers. Most bond companies will provide this coverage on request for an additional premium for positions where the statutes require it,though they may be reluctant to extend "faithful performance" coverage to other positions. Petroleum Tank Leaks or Spills. Minnesota's Petrofund provides reimbursement for 90% of the first$250,000 and 75%of the next $750,000 of clean up and liability costs from a petroleum products storage tank leak or spill. But to be eligible for this reimbursement, the tank owner must be in compliance with applicable PCA and EPA regulations and requirements. The Petrofund reimbursement can be reduced or refused if the owner is not in compliance. And in any event the city will be responsible for at least 10%of the cleanup and liability costs, as well as all legal defense costs associated with the leak or spill. If your city has any tanks,the first priority is make sure you comply with the applicable regulations, so that you'll be eligible for Petrofund reimbursement if you ever have a problem. It's an oversimplification, but key points are: 1)make sure the tank is registered with MPCA; 2) make sure you meet EPA's requirements and timetable for technical improvements to the tank, for leak monitoring, corrosion resistance, spill prevention, etc.; and 3) make sure you report any known leaks or spills to MPCA immediately. Cities with tanks also need to think about how best to handle the costs which Petrofund won't reimburse; i.e., the defense costs and 10% of the first$250,000 and 25%of the next $750,000 of liability and cleanup costs. For most cities, there are two choices: either retain these risks, or purchase LMCIT's optional Petrofund Supplement coverage. EPA financial responsibility compliance is really no longer an issue in Minnesota. EPA now says that Minnesota's Petrofund by itself will satisfy the financial responsibility requirements, so as far as EPA is concerned the city doesn't have to worry about coming up with a plan to demonstrate financial responsibility to satisfy EPA. Thus, most cities can approach this as a straightforward financial risk management issue: Does it make more financial sense to pay the premium to LMCIT to assume these risks for the city, or does it make more sense for the city to simply retain these risks itself? Page 11 1 • • - Machinery Breakdown ("Boiler and machinery') Coverage LMCIT offers Machinery Breakdown Coverage to protect cities from the unexpected cost and expense associated with equipment and machinery breakdowns. The Machinery Breakdown Coverage, which we used to call "boiler and machinery" coverage, was originally developed by the insurance industry to cover the risks of steam boiler explosions. As the coverage has developed, besides explosion risks from steam boilers or other pressure vessels, the coverage now provides protection against the risks of breakdowns of a wide variety of machinery and equipment such as: • Wastewater system equipment such as pumps, agitators,air systems, electronic controls, motors, etc. • Air conditioning, refrigeration, and heating equipment. • Water system pumps, motors, etc. • ElectricaI wiring, breakers, transformers, switches, etc. • Telephone switchboard and related equipment • Compressors for filling fire department air packs Cities may also have other types of equipment such as steam or diesel generators, equipment for municipal gas or district heating systems, or medical equipment such as MRI's which can also be covered but must be evaluated separately. Two types of costs are covered: • The actual cost of repairing or replacing the equipment as quickly as possible; and • Lost income or extra expense you incur to continue operations while the equipment is down. In considering whether to purchase machinery breakdown coverage a city should look at how much it would cost to replace various pieces of machinery, what extra expenses you might incur to continue operation while a key piece of equipment is being repaired, how long it might take to get repairs or replacement equipment, and so on. If your city's budget can handle these kinds of expenses, it probably doesn't make sense to carry the coverage. On the other hand, if the possible cost to repair or replace a particular piece of machinery is more than what your budget can comfortably absorb, machinery breakdown coverage is worth considering. Page 12 � I • • Open Meeting Law Defense Cost Reimbursement. From time to time city council members may get sued for alleged violations of Minnesota's Open Meeting Law. The LMCIT liability coverage does not cover these suits unless there is some other covered claim included as part of the complaint. Consequently, the cost of defending these suits for individual council members can often be fairly expensive. To avoid this uncovered exposure to the council member or to the city, LMCIT has made available Open Meeting Law Defense Cost Reimbursement Coverage. The coverage reimburses individual council members for up to $20,000 of their Open Meeting Law defense costs per person. The city now has the option to select either of two forms,which reimburse these costs at 80%and 100% respectively. Specially Coverages You Probably Don't Need LMCIT provides liability coverage under one coverage document which provides most of the coverages that a city or its independent boards or commissions need. If you are still purchasing any of the following coverages from another insurance company you should review closely for duplication of coverages: • Police Liability • Employment Liability • Employee Benefit Liabilty • Firefighters Professional Liability • Public Officials Liability • Fiduciary Liability for Relief Associations • Ambulance Professional Liability Revised: 1/97(11g)-fax 66060 thingstl.wpd Page 13 1 O a• s i. ! UUr c cD 0 ° R D O " c al b"° $ 0 lilts.) 0 $ 0 c' 0 c- of a:b a°a a� � a' Z ;'� cA r� cp � � � ° � � y � 5 � r•, Inc oc� � oo _.� c O o. y o t,'1 C � CD 55 . a ". 0 .-,: �• cg ' Co ~ 'o bd � ,� o e = co rn Ali 0. a G (D .. p 1 o W y .,0 FP, � � o \J � � rc °- 8 F g IIih oo W O °N ? W 9 p a . N, n o 0 v, O 0. y p y �O n " _ .dQ L..! c L< 4-4 C L ►O A at O.0 D e c o c 8 y q O Q i . � 1E. • ! VP � vc, $ ni"d1304 � � a ° � � :r `° Po O o o ° C.. c. Ci7 til o s o a °5 b ca . �, is °, a 0 �• C! 0 o ;' 0 ti G co c y Cap^ '•.G co 0 Ca E' o o r 0. -oa•�°u• ° r' y -p`"- a` Y � ° o co n .o-„, cpo� oQ 0 n coon n �. b 0. , = a. Nr” p,,00 �. O * ° * ° a °c g• 8O n O . cam '" o s'oo � o' nR '�d v•v § �°. a �°'0 �-3 z0 m c ~ � o. coo ° "' a a. . .a Tv 0. << �. Z. 9.•b n •J • o C =. o �p k- e E o cr p B R D �. y ° ..o E. cp y rs rs o 0 3 a 42 O� a' i P co ccoo coo g co :; 4.e p ? n co o a a dw r a g ,-3 � E• R t 0 '° 2 o, o y' e, " R $ 5 N � 0 CA a o t-. d co a . n r a cao c.,° .d o coo �Gy C'1 naiho << (D a C (D 5 p /� yO o Fi'' any (p 0 vn, :z to Q r:`d ^. 0." c ^ M '.i l [ Li l 3. g r� ro c4 o��, o. c 8 0.3 t � c. �. y O r r 0 ^+ ^ cT 0 `� £' N S 5 do 0 ° Z -r' o cam- A C11 9 ° a '" = c;`< o w, o� a' o R y cu y CD m 6 o g CA cep A� .. O Ao) 14 0 = = co ..1.1 ..- = Co C co a%e co ►� O f+y u.--,,.., a ).„ H $ m ).-1 o r " 4 t H HQOv o ° , a � ao oe N *:'r.� ii 0 V 1J o /.1.14 1'c" x Q s 3 C 2 8 u 14 y 4.1 O '" d" H v N CCI u 0 O u 6 v �� _ .. C , at i�. ..yi w W �� CV 4 b ? r �. `ti r1, w 0 N m N Q� to o o Q III !. • 4 i lilt �� 1 tt • f:C9 N, .. b. .. Q). C.:1 W4 g a 1 • 07/01/1998 17:06 61246 96 LARK INS RVCS PAGE 01 MEMO Pap 1 Landmark Insurance Services PO Box 188 ACCOV ra% or DAT/ Forest Lake,MN 55025 0A1CPA-1 HJ 07/01/98 Phone: 612-464-3333 Support:612-464-7596 POLICY INFORMATION roucY s 51062482 rrrs rYRecreve ixraarTION SR 07/07/97 07/07/98 City of Oak Park Heights Mike Robertson,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 Mr.Thomas Man, Re: Bond Renewal As you may be aware, your Public Employee' s Blanket Bond written with United Fire & Casualty will be expiring on 7-7-98 . In order to secure a renewal quotation from them, we will need the following bond application completed. Can you please complete and fax to our office? Thank you very much and please contact Kate Tipping with any questions . L' 07/01/1998 17:06 6124596 LANDMARK IN,VCS PAGE 02 UNITED FIRE &CASUALTY COMPANY CEDAR RAPIDS,IOWA PUBLIC SCHOOL SYSTEM EMPLOYEES OR PUBLIC EMPLYOYEE'S BLANKET BOND APPLICATION Bond Number. -62482 r. Executed Yes 0 No❑ (.1 \I \I I\Il)I■\I \IIR )\ Premium: 006.1PIFIE NAME OF OBLIGEE CLASSIFICATION: STATE ❑ COUNTY ❑ CITY OF OAK PARK HEIGHTS, MN (m TOWN ❑ VILLAGE ❑ SCHOOL ❑ ADORE 14168 N 5TH ST BOX 2007 OAK PARK HEIGHTS MN 56357 SWEET CITY STATE I l I'1 ( 11 ( R )\ I I: 1I.1 AMOUNT INSURING AGREEMENT 1. ❑ HONESTY BLANKET BOND COVERAGE S /5-0)000 ' INSURING AGREEMENT 2 ❑ HONESTY BLANKET POSITION COVERAGE S D' INSURING AGREEMENT 3 0 FAITHFUL PERFORMANCE BLANKET BOND COVERAGE S INSURING AGREEMENT 4 0 FAi1HFUL PERFORMANCE BLANKET POSMON BOND COVERAGE S PUBLIC EMF1 YEES BLANKET BOND X PUBLIC SCHOOL SYSTEM EMPLOYEE BLANKET BOND ❑ PRBQCJQNCY BY WHOM? ❑(EA O STAFF AUDITOR o OTHER(EXPLAIN FULLY) DATE OF LAST AUDIT DISCREPANCIES? ❑YES ❑NO CIF YES SUBMIT COPY OF AUDIT OR AUDITORS COMMENTS) S) WE HISTORY(LAST 5 YEARS/ EMPLOYEES POSMON WHICH CAUSED LOSS CORRECTIVE MEASURES TAKEN WILL THERE BE A SUBSTANTIAL INCREASE IN THE NUMBER OF EMPLOYEES DURING THE TERM OF THIS BOND? PRESENT COVERAGE IN FORCE—CHECK IF NONE 0 FORAIOF.BOA[D- EPFEC TTVE DATE AMOUNT "NAME OF COMPANY USE SEPARATE SHEET IF NECESSARY. COMPLETE THE CLASSIFICATION OF EMPLOYEES ON REVERSE SIDE. 1St,)til I l( )\ IF ADDITIONAL INDEMNITY UNDER ANY INSURING AGREEMENT IS CESIRED ON ANY POSTO N.COMPLETE THE FOLLOWING INSURING TOTAL NUMBER OF EMPIAY'EE5 AMOUNT OF ADOITIONAL POSITION LOCATION AGREMENT IN EACH PORTION INDEMNITY ON EACH EMPLOYEE Cate Y cade Agency ONIger SIGNATURE AND TTfl-E t j QJj M/1/ � �( CITY STATE e U-2ISTh(6-IN)Nip 1 o12 07/01/1998 17:06 61241196 LANDMARK IN•VCS PAGE 03 CLASSIFICATION OF EMPLOYEES BY DU11ES OR RESPONSIBILITIES This dtasi6cation under Casa A, B and C; together with supplemental daeifcation required in the event coverage under the bond applied for is to be given under more than one Insuring Agreement constitutes the Insured's entire personnel as of the date of this application questionnaire and includes members of Boards and Commissions whether or not such personnel or the members of such Boards and Commissions are to be covered wider the band.If coverage is to be given under more than one Insuring Agreement,separate Classifications of Employees must be completed for each Insuring Agreement and in such event this rtacsifiration applies to Insuring Agreement l I \tip \ I \II'I O\I i i All Ezeartive Adrnatistrative, Judicial and Supervisory officials, Department and Division Heads and Assistant Department and Division Heads All Poke Officers`and all officials and employees whose principal duties are to L HandI4,receipt for or have custody of money,checks or securities,or account for supplies or other property,authorize(or make appropriations for)expenditures;approve,certify,sign or countersign checks, drafts,warrants,vouchers,orders or other documents providing for the paying over or delivery of money,securities supprtes or other property,or serve process or 2. Maintain or audit accounts of money, check% securities time records supplies or other property, or take physical inventories of money, checks seciQities,supplies or other property. `Patrolmen are classified as"A"Employees under both'Taithful Performance"Coverages but are classified as"C"Employees under both"Honesty" POSMON a OCCUPANTS PcsmON .OCCUPANTS- Po6mON I occur,M s TOTAL CLASS A ( I \titi1, I \II'In1)IIti AR personnel whose principal duties consist of L inside or outside deist activities; ' 2 Office work such as stenography,typing filing,switchboard operationn,business machine operation,etc. 3. Operation of vehicles transporting passengers for cash fares or tickets. PO6NITON I OCCUPANTS - P06NT10N I OCCUPANTS PO6TIION a OCCUPANTS TOTAL CLASS B \II'Inr11I •. Al pesorutel whose principal duties consist of 1. Skr1ed or rush led labor and gip 4 Any teaching capacity in the field of education 2. Solely the mechanical operation of automotive equipment 5. Outside or field work of a non.derical nature 3. Non-clerical activities of the medical or=sins profession 6 Patrolmen under the"honest"Coverages. POQTTON .00CUPANTS PosmON IOCCUPANTS POSTnON IP OCCUPANTS i r'• TOTAL CLASS C v ,1 \I'til:ll l )\1\11 \In\ IIrl\ r Wr aa. a_aa � \ 0 Landmark Insura l. u r MEMO Page] r► PO BOX 188 ACCOUNT NO. OP DATE Forest Lake,MN SS025 I I I I' OAKPA-1 HJ 07/01/98 Phone: 612-464-3333 Su i .' 6�c164-�' � � Pol.icx INFORMATION POLICY# CMC17704 TYPE EFFECTIVE EXPIRATION CP 07/07/97 07/07/98 — City of Oak Park Heights Mike Robertson,City Admin. 14168 N 57th St, Box 2007 Stillwater,MN 55082 Mr,Thomas Melena, Re: Boiler Coverage Please be advised that apparently Boiler & Machinery was not included in your commercial package policy with League of Minnesota Cities last year. If this is a coverage you would like quoted, please contact us. Thank you. _i� )D 1tea er''�Jonason ii 0 LEAGUE OF MINNESOTA CITIES INSURANCE TRUST BOILER AND MACHINERY APPLICATION ADMINISTERED BY: BERKLEY RISK SERVICES,INC. 145 University Avenue West St.Paul,MN 55103-2044 APPLICANT: INSPECTION CONTACT AT CITY: TELEPHONE#: AGENT'S NAME: TELEPHONE# COMPREHENSIVE(INCLUDING PRODUCTION MACHINES) NON-REFERRAL OCCUPANCIES ONLY LIMITS: $ 5,000,000 Per Any"One Accident"Combined Property Damage,Business Interruption and Extra Expense $ 25,000 Expediting Expenses $ 25,000 Ammonia Contamination $ 25,000 Water Damage $ 50,000 Ice Rink Buried Piping 1. Does the applicant currently have Boiler&Machinery coverage? Yes No 2. Name of current Boiler&Machinery carrier Expiration Date: 3. Has the applicant had any boiler and machinery breakdowns in the past 3 years? Yes No If yes,please provide description and amount: 4. 100%Replacement Cost Values of Building, Municipal Personal Property,Personal Property of Others: $ * 5. Non-Referral Occupancies Deductible: $ * Does not include values for referral. LMCITAPP.BOILER(11/97) PAGE 1 OF2 Enclosure G 145 University Avenue West League of Minnesota Cities St. Paul, MN 55103-2044 November 13, 1995 To: City officials From: LMCIT Board of Trustees Over the past year,private insurance companies have shown renewed interest in selling insurance to cities. Since your city's renewal is coming up soon, you may well have heard from the St. Paul Companies,the Employers Mutual program sponsored by the MMUA, or one of the other insurance companies that would like to sell you some insurance. LMCIT has done a pretty good job for cities for quite a few years, and we'd like to take a little time to talk about that record. Ultimately we'd ask you to think about one key question: Are cities likely to get better coverage, lower cost, or better service by leaving LMCIT and going to a private insurance company? Can we get better coverage by leaving LMCIT? We've yet to see an insurance company match the coverage LMCIT provides cities. Every year for many years,LMCIT has introduced improvements and refinements to broaden the coverage and better protect cities. Some are relatively minor things that would only rarely come up, like covering the liability for a physician's administrative acts as the city ambulance service's medical adviser. Others are much more significant, such as covering inverse condemnation liability arising out of land use regulations,picking up employment-related charges at the EEOC or Human Rights Commission level,or offering coverage for open meeting law defense costs. Some of the significant changes for 1996 include covering liability for failure to supply utilities; and a"fail-safe" provision to give you coverage even if you forget to schedule a building or item. Many of these coverage improvements came about because city officials identified problems or gaps in coverages and asked LMCIT to find a way to address them. In other cases, LMCIT's Board or staff suggested the changes in response to questions or problems we encountered in handling claims or working with the coverage. The result of this continual process of revision and improvement is that LMCIT member cities have better protection than any we've seen offered to cities anywhere. But the important thing isn't just to toot our horn about how good your LMCIT coverage is (though we have to admit that we kind of enjoy horn-tooting once in a while). The real point is that if you see a problem with some aspect of your LMCIT coverage,you don't have to shop elsewhere to fix that problem.Instead,the first thing to do is to talk to us about it. If it's feasible and it makes sense for cities,we'll do it. AN EQUAL OPPORTUNITY/AFFIRMATIVE ACTION EMPLOYER (612)281-1200 (800)925-1122 TDD(612)281-1290 Fax(612)281-l21 • • / ` Then there's the dividends... Of course,we also have to look at LMCIT's dividend history. LMCIT will LMCIT Property/Casualty return another$8.8 million as a Premiums and Dividends dividend in 1995. That brings the total since 1990 to over$50 million returned to member cities. That's equal to 31% $40 of premiums for that period. Sao "..." .Premiums Besides these dividends, in 1993 the $20 DDividends LMCIT workers compensation program passed a$5.2 million refund from the �` �� . IAA IA! A WCRA through to the member cities. so After a long court fight,private '90 '91 '92 '93 '94 '95 insurance companies ended up keeping their portion of the WCRA refund, rather than returning it to the insurance buyers as the legislature had directed. And then there's the difference in coverage... In comparing LMCIT's cost with a private insurance company's, it's important to remember just how broad LMCIT's liability coverage is. One way to think about it is to look at how many different kinds of insurance policies you'd have to buy to match LMCIT's municipal liability coverage. To even get close to comparing costs with LMCIT,you might have to add up the premiums for as many as 13 separate liability insurance policies: - Comprehensive general liability -Auto liability -Public officials'errors and omissions -Law enforcement professional liability -Employment practices liability -Employee benefits liability -Fiduciary liability (for relief association -Ambulance malpractice liability board members) -Firefighters'professional liability -Lawyers'professional liability (if you have an attorney as an employee) -Accountant's professional liability(if you -Engineer's professional liability(if you have an accountant as an employee) have a professional engineer as an employee) -Limited above-ground pollution liability • • Can we reduce our costs by leaving LMCIT? It's pretty easy to promise lower costs. We could get into a long-winded discussion about whether a private insurance company would be able to reduce losses or expenses enough to bring its costs below LMCIT's while still providing the same coverage and making a profit. But it might be more helpful to just look at LMCIT's rates over the past several years. LMCIT Liability Rates • Municipal liability- For 1995-96, LMCIT's N average rate for liability is 4%lower than g 515 1989-90 rates. E. osn ;� 11111 LMCIT Property Rates t g :° a A AIM "' MUM MN AIM III Including Inland Marine '90 '91 '92 '93 '94 '95 '96 $ Underwriting Year g SO 25 S020 I MIII� H so.i' I • Property- LMCIT's 1995-96 rates for property n. s°.b I I and inland marine coverage are about half of h' s°.°5 • • ` • • 1989-90 levels. so rJo a A A A'. A A A'. ! '90 '91 '92 '93 '94 '95 '96 Underwriting Year LMCIT Work Comp Rates I $6 00 • Workers compensation-LMCIT's average rate o E. per$100 of payroll for 1996 is 33%lower than o $4.00 the 1990 rate. 111' I I 1 n 52.00 g I $0.00 I A A A A A A S '90 '91 '92 '93 '94 '95 '96 Underwriting Year LMCIT Auto Rates $400 5300 Ar A. 0� Ay • Auto -LMCIT's average charge per vehicle for I II I lift tilt auto liability and physical damage coverage is a $200 , , 1 10%less than the 1989-90 rate. LMCIT member 'I slop , , , ' cities pay an average of$308 per vehicle for s° ° A �°' ° 'A A liablity and physical damage. (You might 90 91 d '94 '95 compare that to what you pay for your own imLiability pPhysical Damage 1 personal auto coverage.) In short,LMCIT has a pretty solid record of giving cities stable or decreasing premium rates. • We think LMCIT's record in controlling costs while giving cities much better and broader coverage is pretty impressive. Of course,that's not to say we can rest on our laurels. We're constantly looking for ways we can reduce expenses by operating more efficiently. LMCIT also puts a lot of emphasis on finding ways to help cities reduce losses as well,though the spring loss control seminars,the Loss Control Quarterly, individual consulting assistance and inspections, and so on. But we realize very well that we can always do better, and we'll continue to try to do so. It's easy to promise a lower cost. It can be quite another thing to deliver. LMCIT has been delivering on its promise for a long time. get better service by going somewhere else? Can we ge y g g This one's pretty easy to answer. If you have a problem with service from LMCIT, whether it's from any of our contract service providers-we want to hear about it from LMCIT's own staff or fr m y f p right now. Call Pete Tritz at 281-1265,or Tom Grundhoefer at 281-1266-or use the toll-free number- 1-800-925-1122. Or call any of the individual trustees. We can't guarantee that we'll never make a mistake, or that we'll always be able to deliver everything you need exactly when you need it. But we can guarantee that if you tell us about a problem,we'll be listening and that we will get it fixed just as quickly as we can. We can't emphasize strongly enough that we want to hear about it when you run into problems. The worst problem is the one we can't fix because you didn't tell us about it. A final comment We think LMCIT has done a pretty good job of meeting cities'coverage needs since 1980. We also recognize that there is still plenty of room for LMCIT to improve and to do an even better job for cities in the future. For a long time, cities didn't have many options for their risk management needs. Few insurance companies would even consider writing insurance for cities,and those that did charged steep premiums. That's changed over the past year or so. Cities are beginning to see private insurance companies offering some very attractive-looking premiums. Whether those companies will keep rates as stable over time as LMCIT has remains to be seen. Whether they'll also match LMCIT's record of returning unneeded funds to member cities as dividends seems doubtful. Another point to keep in mind is that with a closer look those low premiums may not be quite the good deal they seem. We've looked at the actual policy forms that some of the private insurance companies are offering to cities. What we've found is a list of exclusions,restrictive language, and coverage limits that add up to a lot less coverage than what LMCIT gives cities. If you're • • • Page 2 Loss Control Quarterly Ramblings on Risk Management by Douglas D. Holm, MS, ASP Loss Control Consultant, North Star Risk Services, Inc. As I travel through cities throughout • Inadequate reflective material; rFeo Minnesota, I've noticed that many • The sign was set too low so the Business or uM'r traffic control signs and construction driver's line of sight could be Residence 50 signs are not installed according to the impeded by an obstacle such as a car District 2' Minnesota Manual on Uniform Traffic or van; Control Devices (MMUTCD). This • Tree branches covered the sign so it would appear to be a trivial observa- was not readily visible to the driver. tion. However, if the city became In this scenario, full or partial liability involved in litigation, it could become for the loss could be transferred from 4.1 an important point and the court could the drunk driver to the municipality. determine the city is negligent for not To reduce this type of loss, we following the proper standards. highly recommend that cities provide Courts measure all cities, large and training for people whose jobs involve o small, by the same standards. Many placing signs and that cities make sure drivers may not know the signs are not signs are installed according to the set to code, but a plaintiff's attorney bmTCD. f can call an expert witness who will be For further information, please con- I' ' • able to determine whether or not the tact any of the following: signs are set to code. 1. North Star Risk Services, Minneap- Minnesota Manual on Uniform Traffic Scenario: A drunk driver goes olis, MN (612) 861-8600 Control Devices, 1986 through a stop sign in a city and hits a 2. Transportation Technology Transfer Stop signs should be two feet from the small child on a bicycle. It would appear Center, North Dakota State Univer- curb and not less than seven feet high. as if the drunk driver is totally at fault. sity, Fargo, ND (701) 237-7051 However, the "expert" witness dis- 3. Minnesota Department of covers that the stop sign had a number Transportation of violations including: 4. Your county engineer Trenching Can Cause Liability League of Minnesota Cities Risks Insurance Trust 183 University Avenue East by Patricia Deshler, LMCIT St. Paul, Minnesota 55101 612-227-5600 Beware! There is a risk of damage To help minimize this risk, cities Loss Control Quarterly Editor: to underground phone lines when should remember two points. Brenda Piatz trenching, and under the Gopher State 1. Always call Gopher State One-Call LMCIT Staff Attorneys: One-Call statutes, the digger can be before any trenching or excavating. Thomas L. Grundhoefer liable for damages in some cir- Be careful to comply with the utility Ellen A. Longfellow cumstances. company ground markings. If you're John E. Hennen Several companies such as US excavating within two feet of the Janet J. Coleman Sprint, US West, and AT&T have marked location, the law requires LMCIT Executive Director: begun installing fiber optic cable in you to first determine the exact Peter Tritz Minnesota. Fiber optic lines are hair- location of the underground facility. thin strands of glass that use laser light 2. Be careful even when you're digging The Loss Control Quarterly is to transmit voice, video, and computer outside areas the utilities have published quarterly by the League data. They can carry enormous quan- marked. Underground lines are not of Minnesota Cities Insurance tities of information at considerably always exactly where they're sup- Trust for the purpose of educating higher speeds than traditional copper posed to be. If you see something in and informing cities about loss con- telephone wires. your excavation that looks like an trol methods and risk manage- Fiber optic cable is much more underground line, stop digging and ment. The opinions expressed in expensive to repair than copper cable. be careful not to damage it. You're this publication are those of the If a city negligently damages a fiber not necessarily immune from liability authors and are not intended to optic cable while trenching or excavat- for damaging an underground line provide specific legal advice. ing, the cost of repairing it could be even if you're digging where there's substantial. not supposed to be a line. 34 Minnesota Cities t • • considering an insurance quote from a commercial insurance company,feel free to give the LMCIT staff a call. We'll be glad to help you identify in detail how their coverage differs from what you have with LMCIT. But the real question we'd like you to think about is this: Which alternative is more likely to produce the results for you in the future-a private insurance company or LMCIT? LMCIT is a non-profit cooperative organization of cities, formed by cities, and governed by city officials,whose sole purpose is to meet cities' coverage and risk management needs. LMCIT is not going to suddenly decide to stop covering cities in order to get into some other line of business that might be more profitable. A private insurance company's basic goal and purpose is to make a profit by selling insurance. We think the choice is obvious. I • League of Minnesota Cities Insurance Trust Property/Casualty Program OAK PARK HEIGHTS Premium and Dividend History $60 $50 a / I / '/ / / $40 ri 2 F $30 jii i $20 i',I $10 1/%4 j %/ I % /% `93 '94 r '93 '92 '91 '9D 8� 88 8T r i Premiums $45,352 $48 060 T $44 539 $44,240 I $35 905 $34,288 I 833,843 i �32�2 $292 ra Dividends t - $15,150 $13556 L $9,697 $10,572 1 $12,2'4 - /303 I $779f2 1 $4,877 L_$4,604 OAK PARK HEIGHTS Premiums and Dividends since 1987 $400 rc' f` $347,871 $300 j 1 0 m o $200 $100 $85,520 I ' Premiums Dividends 11`j . © ('\\i/ �r H PI', 1 JUL 3 1996 i ,; i I i 411 III • CITY OF 1 *s OAK PARK HEIGHTS " te".4-4 * j A MINNESOTA STAR CITY j 1 February 22 , 1994 Berkley Risk Services, Inc. 920 Second Avenue South - #700 Minneapolis MN 55402-4023 t Attention: Douglas D. Holm Dear Doug: This is in response to your letter dated February 18, 1994 relating to your letter dated November 29 , 1993. The following are answers to your recommendations: 1-11/93 I just spoke to our Police Chief. He and our City Attorney are collecting information. As of this 1 date there has been no change and we are doing the same as other communities. 2-11/93 Per our City Attorney, the only thing that has to I be changed is the date of the mutual aid contract. 3-11/93 Approximately, 1/3 of the signs have been changed and the rest will be completed this spring. 4-11/93 Will be completed this spring also. Should you have questions on the above, please do not hesitate to contact me. Sincerely, CITY OF OAK PARK HEIGHTS r 1 LNonne Wilson City Administrator/Treasurer I pc: Brian Alm i 14168 North 57th Street • Box 2007 • Oak Park Heights, Minnesota 55082-2007 f Phone: 612-439-4439 • Fax: 612-439-0574 1 • • b Berkley Risk Services, Inc. IA\ FEB 221994 February 18, 1994 Ms. LaVonne Wilson Administrator-Treasurer City of Oak Park Heights P.O. Box 2007 Oak Park Heights, MN 55082-2007 Dear Ms. Wilson: A letter listing a number of loss control recommendations was sent to your attention on November 29, 1993. A copy of that letter is attached for your reference. These loss control recommendations were a result of a recent loss control survey of the premises and operations of the city in conjunction with the city's participation in the League of Minnesota Cities Insurance Trust property and casualty program. According to our records, we have not as yet received a response to this recommendation g � Y P letter. Would you please advise me of the current status of compliance with these loss control recommendations? Thank you for your assistance. Sincerely, /4 1 / ; , • aA S Douglas D. Holm, CSP, MS, CTM Senior Loss Control Consultant Berkley Risk Services, Inc. DDH:eab�' Enclosure c: Mr. Brian Alm Forest Lake Insurance Agency P.O. Box 188 Forest Lake, MN 55025 920 Second Avenue South,Suite 700 • Minneapolis,Minnesota 55402-4023 • (612)376-4200 • Fax(612)376-4299 A Member of Berkley Risk Management Services Group • S bBerkley Risk Services, Inc. November 29, 1993 Ms. LaVonne Wilson Administrator-Treasurer City of Oak Park Heights P.O. Box 2007 Oak Park Heights, MN 55082-2007 Dear Ms. Wilson: On November 10, 1993, I met with the police chief and with park & streets for a routine loss control visit. This loss control service is provided through the city's participation in the League of Minnesota Cities Insurance Trust (LMCIT) property and casualty program. The purpose of my visit was to assist the City of Oak Park Heights in the reduction of potential loss through loss control and risk management activities. I sincerely appreciate the time and courtesy extended to me at the time of my loss control visit. At the time of my service call, we discussed a number of topics, some of which I would like to call to your attention in the written recommendation form: POLICE DEPARTMENT 1-11/93 At the time of my loss control service call, we discussed our concern over Oak Park •„S Heights city police officers individually contracting out police services to schools and other such entities. We are concerned about the separation of liability, i.e., if 30,,,./Af the officer is in uniform there could possibly be some insurance gaps should a loss C' 4µx'Lit , occur. Therefore, it is highly recommended the city bill the other entity for `""-" � services rendered or the police officer should not be using any city equipment 4 including a city uniform while working for the other entity.. 2-11/93, We also discussed the older mutual aid contract between the city and other entities /c such as the county and other cities. It is highly recommended this mutual aid :445, contract be updated with appropriate assessment of liability usually associated with the chain of command. The city legal counsel or the LMCIT staff attorney should Yilij be able to assist the city in this area. STREET SIGNS 3-11/93 A review should be made of traffic control and regulating signs throughout the City of Oak Park Heights. The signs should be set a minimum of seven feet high as / .).,� measured from the top of the curb to the bottom of the street sign, especially stop 3 .1tP 920 Second lcenue South.Stine-( l • \tnneapoli>. Minnesota;i t0_ +0?3 • 1021 3-6-4200 • Fay 0)1.2)3'6-+299 j i k\lemher pit Berkley Risk\lana�rment senices Group ', • • City of Oak Park Heights November 29, 1993 Page Two signs. To assist the city, I have included an article which appeared in Minnesota Cities magazine. CITY PARK 4-11/93 I also toured the city parks and we discussed the current Consumer Product Safety Guidelines, a copy of which I left at the time of my service call. As was discussed, a number of things have changed, including perimeter distances. Therefore, it is recommended the city review such equipment and make changes where necessary. The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, Cee /4 _,74',/,/ Douglas D. Holm, CSP, MS, CTM 'Senior Loss Control Consultant Berkley Risk Services, Inc. DDH:eab , Enclosures c: Mr. Brian Alm Forest Lake Insurance Agency P.O. Box 188 Forest Lake, MN 55025 Recommendations and comments are provided for loss control and risk exposure improvement purposes only. They are not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations and comments that all sites were reviewed or that all possible hazards were noted. The final responsibility for conducting loss control and risk management programs must rest with the insured. • • Ramblings on Risk Management* by Douglas D. Holm, MS, CSP, CTM, Loss Control Consultant, Berkley Risk Services, Inc. As I travel through cities throughout For further information, please contact Minnesota, I've noticed that many traffic any of the following: control signs and construction signs are not 1. Berkley Risk Services, Inc., installed according to the Minnesota Manual Minneapolis, MN (612) 376-4200 on Uniform Traffic Control Devices (MMUTCD). This would appear to be a 2. Transportation Technology Transfer trivial observation. However, if the city Center, North Dakota State University, became involved in litigation, it could Fargo, ND (800) 362-3145 become an important point and the court 3. Minnesota Department of Transportation could determine the city is negligent for not 4. Your county engineer following the proper standards. Courts measure all cities, large and small, by the same standards. Many drivers may SPEED not know the signs are not set to code, but Business or LIMIT a plaintiff's attorney can call an expert Residence 50 witness who will be able to determine District 2' whether or not the signs are set to code. ) Scenario: A drunk driver goes through a stop sign in a city and hits a small child on a bicycle. It would appear as if the drunk driver is totally at fault. However, the "expert" witness discovers that the stop sign had a number of violations including: • Inadequate reflective material; • The sign was set too low so the driver's line of sight could be impeded by an obstacle such as a car or van; • Tree branches covered the sig n so it �.r was not readily visible to the driver. Most regulatory signs, including "Stop" In this scenario, full or partial liability for signs, should be two feet from the curb and the loss could be transferred from the drunk not less than seven feet high in residential driver to the municipality. areas. To reduce this type of loss, we highly recommend that cities provide training for Minnesota Manual on Uniform Traffic people whose jobs involve placing signs and Control Devices, 1986 that cities make sure signs are installed according to the MMUTCD. *Rewritten from the Loss Control Quarterly • • January 20, 1993 Doug Holm Berkley Risk Services, Inc. 920 2nd Avenue South, Suite 700 Minneapolis MN 55402-4023 Dear Doug: The following are answers to your November 2 , 1992 letter: 1 . Gasoline storage can has been disposed of and has not been replaced to date. 2 . Two have been installed and no council action as of this date. 3. Insurance agent to be contacted for any new construction. 4 . Considered. City engineer to compile cost estimate for sprinkler system in city hall. We do have a fireproof vault for storage of important records and documents. 5 . A, b, and c have been considered and forwarded to the city engineer. D. Certificates of insurance endorsements naming the city as the certificate holder are being collected from all contractors. Should you require further information please feel free to contact me. Sincerely, CITY OF OAK PARK HEIGHTS La Vonne Wilson Administrator/Treasurer 1 ‘ • • lE@ECIWEI Nov oft ; b Berkley Risk Services, Inc. ' November 2, 1992 Ms. LaVonne Wilson Administrator-Treasurer City of Oak Park Heights P.O. Box 2007 Oak Park Heights, Minnesota 55082-2007 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the city. This is in conjunction with the city's participation in the League of Minnesota Cities Insurance Trust property and casualty program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. CITY GARAGE 1-10/92 As we toured the garage/shop area, I noted a gasoline storage can located within the flammable liquids storage cabinet which was not of the self-closing lid variety. Therefore, it is recommended that that style of flammable liquid storage container be removed from the premises and replaced with a U.L. approved flammable liquids storage can which does have a self-closing lid, fire screen and meets OSHA specifications as the other flammable liquids storage cans appeared to do. GENERAL OPERATIONS 2-10/92 As we discussed at the time of my loss control review, I am concerned about the height of the stop signs located in the residential area of Oak Park Heights. For maximum visibility, the stop signs should be set so they are a minimum of seven feet high as measured from the bottom of the stop sign to the top of the curb. This setting has been developed so that if there is a vehicle parked in front of the stop sign, oncoming vehicles can still see the sign. (Reference: Minnesota Manual on Uniform Traffic Control Devices) NEW BUILDING 3-10/92 The city should be evaluating the construction of all new buildings, i.e., a building built of concrete would probably cost more money to build than an all-wood structure, however, the concrete building would probably cost less money to insure 920 Second Avenue South,Suite 700 • Minneapolis,Minnesota 55402-4023 • (612)376-4200 • Fax(612)376-4299 '' A Member of Berkley Risk Management Services Group • • City of Oak Park Heights November 2, 1992 Page Two over the life expectancy of the building. Therefore, I would recommend the city be in consultation with the city Agent-of-Record who can help determine projected insurance costs for the prospective buildings over the life expectancies of such buildings. 4-9/91 Consideration should also be given to having an automatic sprinkler system within the building. This generally costs approximately five to seven percent of the total building cost and can reduce the potential for loss and, oftentimes, reduce the fire insurance premiums over the life expectancy of the building. Additionally, there is a greater probability of important records and documents being saved through the use of an automatic sprinkler system. 5-8/91 Fire engineers tell us that some of the main fire controls which can reduce the potential for loss in a building is that of the engineering that goes into the building at the time of construction. This would include the following: a) Consideration should be given to placing all fire doors in the building to help control the spread of fire and smoke. I would recommend these doors be installed without door props so the doors will remain closed at all times. b) Consideration should be given to placing built in metal fire cabinets within the building which can reduce the potential for theft of a fire extinguisher as well as the loss of a fire extinguisher. c) Consideration should be given to placing large windows on interior walls which enclose offices. This type of window can help reduce the potential for an allegation of sexual harassment against first line supervisors. d) As always, the city should be obtaining certificates of insurance endorsements naming the city as an additional insured from all contractors working on the project. The city's Agent-of-Record and the city's legal counsel should be involved with this process for their input as well. The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. • City of Oak Park Heights November 2, 1992 Page Three For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, /Le,AX1g/9t---- Douglas D. Holm, CSP, MS, CTM Senior Loss Control Consultant Berkley Risk Services, Inc. DDH:eab Enclosure c: Mr. Dean McGowan Forest Lake Insurance Agency P.O. Box 188 Forest Lake, Minnesota 55025 Recommendations and comments are provided for risk exposure improvement purposes only. They are not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations and comments that all sites were reviewed or that all possible hazards were noted. The final responsibility for conducting loss control and risk management programs must rest with the insured. r ROAOSIp SIGN OISioESrIGN RURAL 0T STOP Not L(ff TAN fr • ry SC II e r 1 ft ai • ! •w.0 foOYLCf•l sotto WARNING SIGN Limn WITH ADVISORY 50 SPEED PLATE ' ROADSIDE SIGN l BUSINESS OR '—Y RURAL DISTRICT "p RESIDENCE DISTRICT l_• ..' ~ • 4e tirg i w� w r _ s ime QAv ROADSIDE ASSEMBLY _ - - -- - -• - RURAL DISTRICT Orr 4t WARNING SIGN l © 4D _. ON ISLAND IN THE LINE uF TRAFFIC r-- o,. P e • +YO R K OVERHEAD. • MOUNTING T h.•6 raw Mr{L 2.01AL/• Figure 2-1. Height and lateral location of signs—typical installations. 2A-9 Reference: Minnesota Manual on Uniform Traffic Control Devices, 1986 . I _.. '. . • • D 1 .= r, c` 7m a n 11 1 a -tz, •-t:- .,., .0 A M D a p Z 81 1 0 al, n mho °•y� L \ ?• pS at f� Ta�A p $ yy o. •S A 1 op M., z. HI m i m "� 0,1.' n, -n 0 1 CD g p,.,.._ ...,, oS f i> ' a p 0~I ,- f a i p F 1 drre:Z■ 411 , • ..._ op =-0 * W 0 7- — so 1330r...!...1C2U) O D • C Er o a 2 � < o " d . -I N1 a •C 7D c •m • N sad A C m - C a .41, gl ,,. 7 0 C, w D Z jc) 1. a IDA l` Z 11111MIN'MOO OM Ilk ^z 0. H a 0. E. = ,� v' w d Q7 54 am . . • N * m W = CD C a>_ co 7 ° n • • • u Berkley Risk Services, Inc. November 2, 1992 Ms. LaVonne Wilson Administrator-Treasurer City of Oak Park Heights P.O. Box 2007 Oak Park Heights, Minnesota 55082-2007 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the city. This is in conjunction with the city's participation in the League of Minnesota Cities Insurance Trust property and casualty program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. CITY GARAGE 1-10/92 As we toured the garage/shop area, I noted a gasoline storage can located within the flammable liquids storage cabinet which was not of the self-closing lid variety. ,i 4 ,,Therefore, it is recommended that that style of flammable liquid storage container {' be removed from the premises and replaced approved liquids with a U.L. a roved flammable uids �"f) q storage can which does have a self-closing lid, fire screen and meets OSHA y specifications as the other flammable liquids storage cans appeared to do. GENERAL OPERATIONS 2-10/92,. As we discussed at the time of my loss control review, I am concerned about the height of the stop signs located in the residential area of Oak Park Heights. For maximum visibility, the stop signs should be set so they are a minimum of seven )1' nl ° feet high as measured from the bottom of the stop sign to the top of the curb. This setting has been developed so that if there is a vehicle parked in front of the stop sign, oncoming vehicles can still see the sign. (Reference: Minnesota Manual on Uniform Traffic Control Devices) NEW BUILDING 3-10/92 The city should be evaluating the construction of all new buildings, i.e., a building built of concrete would probably cost more money to build than an all-wood structure, however, the concrete building would probably cost less money to insure 920 Second Avenue South,Suite 700• Minneapolis,Minnesota 55402-4023 • (612)376-4200 • Fax(612)376-4299 A Member of Berkley Risk Management Services Group r • 5 P �- City of Oak Park Heights co_S November 2, 1992 30 Page Two / over the life expectancy of the building. Therefore, I would recommend the city be in consultation with the city Agent-of-Record who can help determine projected insurance costs for the prospective buildings over the life expectancies of such buildings. 4-9/91 Consideration should also be given to having an automatic sprinkler system within the building. This generally costs approximately five to seven percent of the total ./,' ✓ building cost and can reduce the potential for loss and, oftentimes, reduce the fire insurance premiums over the life expectancy of the building. Additionally, there 3 is a greater probability of important records and documents being saved through the S X0 use of an automatic sprinkler system. 5-8/91 Fire engineers tell us that some of the main fire controls which can reduce the potential for loss in a building is that of the engineering that goes into the building at the time of construction. This would include the following: a) Consideration should be given to placing all fire doors in the building to help control the spread of fire and smoke. I would recommend these doors be installed without door props so the doors will remain closed at all times. b) Consideration should be given to placing built in metal fire cabinets within the building which can reduce the potential for theft of a fire extinguisher as well as the loss of a fire extinguisher. c) Consideration should be given to placing large windows on interior walls which enclose offices. This type of window can help reduce the potential for an allegation of sexual harassment against first line supervisors. d) As always, the city should be obtaining certificates of insurance endorsements naming the city as an additional insured from all contractors working on the project. The city's Agent-of-Record and the city's legal counsel should be involved with this process for their input as well. The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. • City of Oak Park Heights November 2, 1992 Page Three For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, ■` /4''c--- Douglas D. Holm, CSP, MS, CTM Senior Loss Control Consultant Berkley Risk Services, Inc. DDH:eab Enclosure c: Mr. Dean McGowan Forest Lake Insurance Agency P.O. Box 188 Forest Lake, Minnesota 55025 Recommendations and comments are provided for risk exposure improvement purposes only. They are not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations and comments that all sites were reviewed or that all possible hazards were noted. The final responsibility for conducting loss control and risk management programs must rest with the insured. laAoidw3 Aliun»oddO 1enb3 ud s1s//e/aads eaueinsui papunj j/as nj U •uopa resu Jo aim'ma!Aus y3!M eouepdwoo ut to In;ggeay JO'apse aae 3uewdmba pus AJauiyosw'eualuado ,.y%' 'seosld)IoM'slanpad'suogeool 3s43 A3p!a!suodseJ Aue awnsss lou uoilsluasadCJ ou asew am'Ja w!"A •AaAins mno u!paaanoo uaaq seq ampaoold to uoq!puoo apraun ALMA. Imp pewnese aq Jou 3snw 31 'uo!Jos ldwo/d mnoA elfin am pus 3uslJodwl s!Suogepuawwooal 03 uopuelly •Sp1ezeq buT;sTxa To.I.uoO /40eaaoO O . 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It's the Law. . . A WORKPLACE ACCIDENT AND INJURY REDUCTION ACT 67.3 ProvidedbyBerkleyAdministrators 1 f . • Note: This edition supercedes all previous editons of AWAIR lists. This is current as of April 12, 1993. "A Workplace Accident and Injury Reduction" Act (AWAIR) Minnesota Statute 182.653 Subd. 8. Workplace programs. An employer covered by this section must establish a written workplace accident and injury reduction program that promotes safe and healthful working conditions and is based on clearly stated goals and objectives for meeting those goals. The program must describe: (1) how managers, supervisors, and employees are responsible for implementing the program and how continued participation of management will be established, mea- sured, and maintained; (2) the methods used to identify, analyze, and control new or existing hazards, conditions, and operations; (3) how the plan will be communicated to all affected employees so that they are informed of work-related hazards and controls; (4) how workplace accidents will be investigated and corrective action implement- ed; and (5) how safe workpractices and rules will be enforced. An employer must conduct and document a review of the workplace accident and injury reduction program at least annually and document how procedures set forth in the program are met. Subd. 8a. Standard Industrial Classification List. The commissioner shall adopt, in accordance with section 182.655, a rule specifying a list of standard industrial classifica- tions of employers who must comply with subdivision 8. The commissioner shall demon- strate the need to include each industrial classification on the basis of the safety record or workers' compensation record of that industry segment. An employer must comply with subdivision 8 six months following the date the standard industrial classification that applies to the employer is placed on the list. The list shall be updated every two years. Subd. 8b. Rulemaking authority. The commissioner's rulemaking authority for the purpose of implementing subdivision 8 is limited to specifying the list of standard indus- trial classifications as provided in subdivision 8a. Minnesota Statute 182.6731 Safety Awards The commissioner may present awards to businesses that have excellent safety records. The award shall be presented jointly to the company and its employees. The commission- er may solicit advice on what businesses shall receive the awards from representatives of labor and business. I • [Laws of Minnesota, 1990, Chapter 508 - Senate File No. 1869] Workplace Accident and Injury Reduction Program 5205.1500 Standard Industrial Classification List. Employers in the Standard Industrial Classifications listed in this subpart must comply with the provisions of Minnesota Statute 182.653, subd. 8. The Standard Industrial 1 Classifications in this subpart are those defined by the Office of Management and Budget published in the Standard Industrial Classification Manual, 1987 Edition. A. Agricultural production--crops 0111 Wheat 0112 Rice 0115 Corn 0116 Soybeans 0119 Cash grains, not elsewhere classified 0131 Cotton 0132 Tobacco 0133 Sugarcane and sugar beets 0134 Irish potatoes 0139 Field crops, except cash grains, not elsewhere classified 0161 Vegetables and melons 0171 Berry crops 0172 Grapes 0173 Tree nuts 0174 Citrus fruits 0175 Deciduous tree fruits 0179 Fruits and tree nuts, not elsewhere classified 0181 Ornamental nursery products 0182 Food crops grown under cover 0191 General farms, primarily crop B. Agricultural production--livestock 0211 Beef cattle feedlots 0212 Beef cattle, except feedlots 0213 Hogs 0214 Sheep and goats 0219 General livestock, not elsewhere classified 0241 Dairy farms 0251 Broiler, fryer, and roaster chickens 0252 Chicken eggs 0253 Turkeys and turkey eggs 0254 Poultry hatcheries 0259 Poultry and eggs, not elsewhere classified 0271 Fur-bearing animals and rabbits 0273 Animal aquaculture 0 • 0279 Animal specialties, not elsewhere classified 0291 General farms, primarily animal C. Agricultural services 0711 Soil preparation services 0721 Crop planting and protecting 0722 Crop harvesting 0723 Crop preparation services for market 0724 Cotton ginning 0741 Veterinary services for livestock 0742 Veterinary services, specialties 0751 Livestock service, except veterinary 0752 Animal specialty services 0761 Farm labor contractors 0762 Farm management services 0781 Landscape counseling and planning 0782 Lawn and garden services 0783 Ornamental shrub and tree services D. Forestry 0811 Timber tracts 0831 Forest products 0851 Forestry services E. Metal mining 1011 Iron ores 1021 Copper ores 1031 Lead and zinc ores 1041 Gold ores 1044 Silver ores 1061 Ferroalloy ores, except vanadium 1081 Metal mining services 1094 Uranium-radium-vanadium ores 1099 Metal ores, not elsewhere classified F. Coal mining 1221 Bituminous coal and lignite--surface 1222 Bituminous coal--underground 1231 Anthracite mining Cr 1241 Coal mining services G. Oil and gas extraction 1381 Drilling oil and gas wells • 1382 Oil and gas exploration services 1389 Oil and gas field services, not elsewhere classified H. Nonmetallic minerals, except fuels 1411 Dimension stone 1422 Crushed and broken limestone 1423 Crushed and broken granite 1429 Crushed and broken stone, not elsewhere classified 1442 Construction sand and gravel 1446 Industrial sand 1455 Kaolin and ball clay 1459 Clay and related minerals, not elsewhere classified 1474 Potash, soda, and borate minerals 1475 Phosphate rock 1479 Chemical and fertilizer mining, not elsewhere classified 1481 Nonmetallic minerals services 1499 Miscellaneous nonmetallic minerals I. General building contractors 1521 Single-family housing construction 1522 Residential construction, not elsewhere classified 1531 Operative builders 1541 Industrial buildings and warehouses 1542 Nonresidential construction, not elsewhere classified J. Heavy construction, except building 1611 Highway and street construction 1622 Bridge, tunnel, and elevated highway 1623 Water, sewer, and utility lines 1629 Heavy construction, not elsewhere classified K. Special trade contractors 1711 Plumbing, heating, air-conditioning 1721 Painting and paper hanging 1731 Electrical work 1741 Masonry and other stonework 1742 Plastering, drywall, and insulation 1743 Terrazzo, tile, marble, mosaic work 1751 Carpentry work 1752 Floor laying and floor work, not elsewhere classified 1761 Roofing, siding, and sheet metal work 1771 Concrete work 1781 Water well drilling 1791 Structural steel erection 1793 Glass and glazing work 1794 Excavation work 1795 Wrecking and demolition work i 1796 Installi• n g building equipment,buildin a ui ment, not elsewhere classified 1799 Special trade contractors, not elsewhere classified L. Food and kindred products 2011 Meat packing plants 2013 Sausages and other prepared meats 2015 Poultry slaughtering and processing 2021 Creamery butter 2022 Cheese, natural and processed 2023 Dry, condensed, evaporated products 2024 Ice cream and frozen desserts 2026 Fluid milk 2032 Canned specialties 2033 Canned fruits and vegetables 2034 Dehydrated fruits, vegetables, soups 2035 Pickles, sauces, and salad dressings 2037 Frozen fruits and vegetables 2038 Frozen specialties, not elsewhere classified 2041 Flour and other grain mill products 2043 Cereal breakfast foods 2044 Rice milling 2045 Prepared flour mixes and doughs 2046 Wet corn milling 2047 Dog and cat food 2048 Prepared feeds, not elsewhere classified 2051 Bread, cake, and related products 2052 Cookies and crackers 2053 Frozen bakery products, except bread 2061 Raw cane sugar 2062 Cane sugar refining 2063 Beet sugar 2064 Candy and other confectionery products 2066 Chocolate and cocoa 2067 Chewing gum 2068 Salted and roasted nuts and seeds 2074 Cottonseed oil mills 2075 Soybean oil mills 2076 Vegetable oil mills, not elsewhere classified 2077 Animal and marine fats and oils 2079 Edible fats and oils, not elsewhere classified 2082 Malt beverages 2083 Malt 2084 Wines, brandy, and brandy spirits 2085 Distilled and blended liquors L 2086 Bottled and canned soft drinks 2087 Flavoring extracts and syrups, not elsewhere classified 2091 Canned and cured fish and seafoods 2092 Fresh or frozen prepared fish 2095 Roasted coffee 2096 Potato chips and similar snacks 2097 Manufactured ice 2098 Macaroni and spaghetti 2099 Food preparations, not elsewhere classified M. Textile mill products 2241 Narrow fabric mills 2254 Knit underwear mills 2257 Weft knit fabric mills 2258 Lace and warp knit fabric mills 2259 Knitting mills, not elsewhere classified 2261 Finishing plants, cotton 2262 Finishing plants, manmade 2269 Finishing plants, not elsewhere classified 2273 Carpets and rugs 2281 Yarn spinning mills 2282 Throwing and winding mills 2284 Thread mills 2295 Coated fabrics, not rubberized 2296 Tire cord and fabrics 2297 Nonwoven fabrics 2298 Cordage and twine 2299 Textile goods, not elsewhere classified N. Apparel and other textile products 2311 Men's and boys' suits and coats 2321 Men's and boys' shirts 2322 Men's and boys' underwear and nightwear 2323 Men's and boys' neckwear s boys' trousers andslacks 2325 Men's and y 2326 Mens's and boys' work clothing 2329 Men's and boys' clothing, not elsewhere classified 235 3 Hats, caps and millinery 2369 Girls' and children's outerwear, not elsewhere classified 2385 Waterproof outerwear 2389 Apparel and accessories, not elsewhere classified 2391 Curtains and draperies 2392 House fu g , rnishin s not elsewhere classified 2393 Textile bags 2394 Canvas and related products 2395 Pleating and stitching 2396 Automotive and apparel trimmings 2397 Schiffli machine embroideries 2399 Fabricated textile products, not elsewhere classified 1 0. Lumber and wood products 2411 Logging 2421 Sawmills and planing mills, general 2426 Hardwood dimension and flooring mills 2429 Special product sawmills, not elsewhere classified 2431 Millwork 2434 Wood kitchen cabinets 2435 Hardwood veneer and plywood 2436 Softwood veneer and plywood 2439 Structural wood members, not elsewhere classified 2441 Nailed wood boxes and shook 2448 Wood pallets and skids 2449 Wood containers, not elsewhere classified 2451 Mobile homes 2452 Prefabricated wood buildings 2491 Wood preserving 2493 Reconstituted wood products 2499 Wood products, not elsewhere classified P. Furniture and fixtures 2511 Wood household furniture 2512 Upholstered household furniture 2514 Metal household furniture 2515 Mattresses and bedsprings 2517 Wood TV and radio cabinets 2519 Household furniture, not elsewhere classified 2521 Wood office furniture 2522 Office furniture, except wood 2531 Public building and related furniture 2541 Wood partitions and fixtures 2542 Partitions and fixtures, except wood 2591 Drapery hardware and blinds and shades 2599 Furniture and fixtures, not elsewhere classified Q. Paper and Allied Products 2611 Pulp mills 2621 Paper mills 2631 Paperboard mills 2652 Setup paperboard boxes 2653 Corrugated and solid fiber boxes 2655 Fiber cans, drums and similar products 2656 Sanitary food containers 2657 Folding paperboard boxes 2671 Paper coated and laminated, packaging 2672 Paper coated and laminated, not elsewhere classified K 2673 Bags: plastics, laminated, and coated 2674 Bags: uncoated paper and multiwall 2675 Die-cut paper and board 2676 Sanitary paper products 2677 Envelopes 2678 Stationery products 2679 Converted paper products, not elsewhere classified P • • R. Printing and publishing 2754 Commercial printing, gravure 2759 Commercial printing, not elsewhere classified S. Chemicals and allied products 2812 Alkalies and chlorine 2813 Industrial gases 2816 Inorganic pigments 2819 Industrial inorganic chemicals, not elsewhere classified 2821 Plastic materials and resins 2822 Synthetic rubber 2823 Cellulosic manmade fibers 2824 Organic fibers, noncellulosic 2833 Medicinals and botanicals 2834 Pharmaceutical preparations 2835 Diagnostic substances 2836 Biological products except diagnostic 2841 Soap and other detergents 2842 Polishes and sanitation goods 2843 Surface active agents 2844 Toilet preparations 2851 Paints and allied products 2861 Gum and wood chemicals 2865 Cyclic crudes and intermediates 2869 Industrial organic chemicals, not elsewhere classified 2873 Nitrogenous fertilizers 2874 Phosphatic fertilizers 2875 Fertilizers, mixing only 2879 Agricultural chemicals, not elsewhere classified 2891 Adhesives and sealants 2892 Explosives 2893 Printing ink 2895 Carbon black 2899 Chemical preparations, not elsewhere classified 1 T. Petroleum and coal products 2951 Asphalt paving mixtures and blocks 2952 Asphalt felts and coatings 2992 Lubricating oils and greases 2999 Petroleum and coal products, not elsewhere classified U. Rubber and miscellaneous plastic products 3011 Tires and inner tubes 3021 Rubber and plastics footwear 3052 Rubber and plastics hose and belting 3053 Gaskets, packing and sealing devices 3061 Mechanical rubber goods 3069 Fabricated rubber products, not elsewhere classified 3081 Unsupported plastics film and sheet • 3082 Unsupported plastics profile shapes • 3083 Laminated plastics plate and sheet 3084 Plastics pipe 3085 Plastics bottles 3086 Plastics foam products 3087 Custom compound purchased resins 3088 Plastics plumbing fixtures 3089 Plastics products, not elsewhere classified V. Leather and leather products 3111 Leather tanning and finishing 3131 Footwear cut stock 3142 House slippers 3143 Men's footwear, except athletic 3144 Women's footwear, except athletic 3149 Footwear, except rubber, not elsewhere classified 3151 Leather gloves and mittens 3161 Luggage 3171 Women's handbags and purses 3172 Personal leather goods, not elsewhere classified 3199 Leather goods, not elsewhere classified W. Stone, clay, and glass products 3211 Flat glass 3221 Glass containers 3229 Pressed and blown glass, not elsewhere classified 3231 Products of purchased glass 3241 Cement, hydraulic 3251 Brick and structural clay tile 3253 Ceramic wall and floor tile 3255 Clay refractories 3259 Structural clay products, not elsewhere classified 3261 Vitreous plumbing fixtures 3262 Vitreous china table and kitchenware 3263 Semivitreous table and kitchenware 3264 Porcelain electrical supplies 3269 Pottery products, not elsewhere classified 3271 Concrete block and brick 3272 Concrete products, not elsewhere classified 3273 Ready-mixed concrete 3274 Lime 3275 Gypsum products 3281 Cut stone and stone products 3291 Abrasive products 3292 Asbestos products 3295 Minerals, ground or treated 3296 Mineral wool 3297 Nonclay refractories 3299 Nonmetallic mineral products, not elsewhere classified • 4110 X. Primary metal industries 3312 Blast furnaces and steel mills 3313 Electrometallurgical products 3315 Steel wire and related products 3316 Cold finishing of steel shapes 3317 Steel pipe and tubes 3321 Gray and ductile iron foundries 3322 Malleable iron foundries 3324 Steel investment foundries 3325 Steel foundries, not elsewhere classified 3331 Primary copper 3334 Primary aluminum 3339 Primary nonferrous metals, not elsewhere classified 3341 Secondary nonferrous metals 3351 Copper rolling and drawing 3353 Aluminum sheet, plate, and foil 3354 Aluminum extruded products 3355 Aluminum rolling and drawing, not elsewhere classified 3356 Nonferrous rolling and drawing, not elsewhere classified 3357 Nonferrous wiredrawing and insulating 3363 Aluminum die-castings 3364 Nonferrous die-casting except aluminum 3365 Aluminum foundries 3366 Copper foundries 3369 Nonferrous foundries, not elsewhere classified 3398 Metal heat treating 3399 Primary metal products, not elsewhere classified Y. Fabricated metal products 3411 Metal cans 3412 Metal barrels, drums, and pails 3421 Cutlery J' 3423 Hand and edge tools, not elsewhere classified 3425 Saw blades and handsaws 3429 Hardware, not elsewhere classified 3431 Metal sanitary ware 3432 Plumbing fixture fittings and trim 3433 Heating equipment, except electric 3441 Fabricated structural metal 3442 Metal doors, sash, and trim 3443 Fabricated plate work (boiler shops) 3444 Sheet metal work 3446 Architectural metal work 3448 Prefabricated metal buildings 3449 Miscellaneous metal work 3451 Screw machine products 3452 Bolts, nuts, rivets, and washers 3462 Iron and steel forgings I 3463 Nonferrous forgings 3465 Automotive stampings 3466 Crowns and closures 3469 Metal stampings, not elsewhere classified 3471 Plating and polishing 3479 Metal coating and allied services 3482 Small arms ammunition 3483 Ammunition, except small arms, not elsewhere classified 3484 Small arms 3489 Ordnance and accessories, not elsewhere classified 3491 Industrial valves 3492 Fluid power valves and hose fittings 3493 Steel springs, except wire 3494 Valves and pipe fittings, not elsewhere classified 3495 Wire springs 3496 Miscellaneous fabricated wire products 3497 Metal foil and leaf 3498 Fabricated pipe and fittings 3499 Fabricated metal products, not elsewhere classified Z. Industrial machinery and equipment 3523 Farm machinery and equipment 3524 Lawn and garden equipment 3531 Construction machinery 3532 Mining machinery 3533 Oil and gas field machinery 3534 Elevators and moving stairways 3535 Conveyors and conveying equipment 3536 Hoists, cranes, and monorails 3537 Industrial trucks and tractors 3542 Machine tools, metal forming types 3543 Industrial patterns 3544 Special dies, tools, jigs, and fixtures 3545 Machine tool accessories 3547 Rolling mill machinery 3548 Welding apparatus 3549 Metalworking machinery, not elsewhere classified 3552 Textile machinery 3553 Woodworking machinery 3554 Paper industries machinery 3555 Printing trades machinery 3556 Food products machinery 3559 Special industry machinery, not elsewhere classified 3561 Pumps and pumping equipment 3562 Ball and roller bearings 3563 Air and gas compressors 3564 Blowers and fans 3565 Packaging machinery • • 3566 Speed changers, drives and gears 3567 Industrial furnaces and ovens 3568 Power transmission equipment, not elsewhere classified 3569 General industrial machinery, not elsewhere classified 3581 Automatic vending machines 3582 Commercial laundry equipment 3585 Refrigeration and heating equipment 3586 Measuring and dispensing pumps 3589 Service industry machinery, not elsewhere classified 3592 Carburetors, pistons, rings, valves 3593 Fluid power cylinders and actuators 3594 Fluid power pumps and motors 3596 Scales and balances, except laboratory 3599 Industrial machinery, not elsewhere classified AA. Electronic and other electric equipment 3612 Transformers, except electronic 3613 Switchgear and switchboard apparatus 3621 Motors and generators 3624 Carbon and graphite products 3625 Relays and industrial controls 3629 Electrical industrial apparatus, not elsewhere classified 3631 Household cooking equipment 3632 Household refrigerators and freezers 3633 Household laundry equipment 3634 Electric housewares and fans 3635 Household vacuum cleaners 3639 Household appliances, not elsewhere classified 3641 Electric lamps 3643 Current-carrying wiring devices 3644 Non-current-carrying wiring devices 3645 Residential lighting fixtures 3646 Commercial lighting fixtures 3647 Vehicular lighting equipment 3648 Lighting equipment, not elsewhere classified 3651 Household audio and video equipment 3652 Prerecorded records and tapes 3661 Telephone and telegraph apparatus 3663 Radio and television communications equipment 3669 Communications equipment, not elsewhere classified 3671 Electron tubes 3672 Printed circuit boards 3674 Semiconductors and related devices 3675 Electronic capacitors 3676 Electronic resistors 3677 Electronic coils and transformers a 3678 Electronic connectors 1 3679 Electronic components, not elsewhere classified • • 3691 Storage batteries 3692 Primary batteries, dry and wet 3694 Engine electrical equipment 3695 Magnetic and optical recording media 3699 Electrical equipment and supplies, not elsewhere classified BB. Transportation equipment 3711 Motor vehicles and car bodies 3713 Truck and bus bodies 3714 Motor vehicle parts and accessories 3715 Truck trailers 3716 Motor homes 3721 Aircraft 3724 Aircraft engines and engine parts 3728 Aircraft parts and equipment, not elsewhere classified 3731 Ship building and repairing 3732 Boat building and repairing 3743 Railroad equipment 3751 Motorcycles, bicycles, and parts 3761 Guided missiles and space vehicles 3764 Space propulsion units and parts 3769 Space vehicle equipment, not elsewhere classified 3792 Travel trailers and campers 3795 Tanks and tank components 3799 Transportation equipment, not elsewhere classified CC. Miscellaneous manufacturing industries 3911 Jewelry, precious metal 3914 Silverware and plated ware 3915 Jewelers' materials and lapidary work 3931 Musical instruments 3942 Dolls and stuffed toys 3944 Games, toys, and children's vehicles 3949 Sporting and athletic goods, not elsewhere classified 3951 Pens and mechanical pencils 3952 Lead pencils and art goods 3953 Marking devices 3955 Carbon paper and inked ribbons 3961 Costume jewelry 3965 Fasteners, buttons, needles and pins 3991 Brooms and brushes 3993 Signs and advertising specialties 3995 Burial caskets 3996 Hard surface floor coverings, not elsewhere classified 3999 Manufacturing industries, not elsewhere classified DD. Trucking waTBhousin S • and S 4212 Local trucking, without storage 4213 Trucking, except local 4214 Local trucking with storage 4215 Courier services, except by air 4221 Farm product warehousing and storage 4222 Refrigerated warehousing and storage 4225 General warehousing and storage 4226 Special warehousing and storage, not elsewhere classified 4231 Trucking terminal facilities EE. Water transportation 4432 Freight transportation on the Great Lakes 4449 Water transportation of freight, not elsewhere classified 4482 Ferries 4489 Water passenger transportation, not elsewhere classified 4491 Marine cargo handling 4492 Towing and tugboat service 4493 Marinas 4499 Water transportation services, not elsewhere classified FR Transportation by air 4512 Air transportation, scheduled 4513 Air courier services 4581 Airports, flying fields, and services GG. Electric, gas and sanitary services 4911 Electric services 4922 Natural gas transmission 4923 Gas transmission and distribution 4924 Natural gas distribution 4925 Gas production and/or distribution 4931 Electric and other services combined 4932 Gas and other services combined 4939 Combination utilities, not elsewhere classified 4941 Water supply 4952 Sewerage systems 4953 Refuse systems 4959 Sanitary services, not elsewhere classified 4961 Steam and air-conditioning supply 4971 Irrigation systems HH. Wholesale trade--durable goods 5012 Automobiles and other motor vehicles 5013 Motor vehicle supplies and new parts 5014 Tires and tubes 5015 Motor vehicle parts, used 5031 Lumber, plywood, and millwork 5032 Brick, stone, and related materials 5033 Roofing, siding, and insulation 5039 Construction materials, not elsewhere classified • • II. Wholesale trade--nondurable goods 5111 Printing and writing paper 5112 Stationery and office supplies 5113 Industrial and personal service paper 5122 Drugs, proprietaries, and sundries 5131 Piece goods and notions 5136 Men's and boys' clothing 5137 Women's and children's clothing 5139 Footwear 5141 Groceries, general line 5142 Packaged frozen foods 5143 Dairy products, except dried or canned 5144 Poultry and poultry products 5145 Confectionery 5146 Fish and seafoods 5147 Meats and meat products 5148 Fresh fruits and vegetables 5149 Groceries and related products, not elsewhere classified 5162 Plastics materials and basic shapes 5169 Chemicals and allied products, not elsewhere classified 5171 Petroleum bulk stations and terminals 5172 Petroleum products, not elsewhere classified 5181 Beer and ale 5182 Wine and distilled beverages 5191 Farm supplies 5192 Books, periodicals, and newspapers 5193 Flowers and florists' supplies 5194 Tobacco and tobacco products 5198 Paints, varnishes, and supplies 5199 Nondurable goods, not elsewhere classified JJ. Building materials and garden supplies 5211 Lumber and other building materials KK.General merchandise stores 5311 Department stores 5331 Variety stores 5399 Miscellaneous general merchandise stores LL. Food stores 5411 Grocery stores 5421 Meat and fish markets 5431 Fruit and vegetable markets 5441 Candy, nut, and confectionery stores 5451 Dairy products stores 5461 Retail bakeries 5499 Miscellaneous food stores MM. Hotels and other lodging places • • 7011 Hotels and motels 7021 Rooming and boarding houses 7032 Sporting and recreational camps 7033 Trailer parks and campsites 7041 Membership-basis organization hotels NN. Miscellaneous repair services 7622 Radio and television repair 7623 Refrigeration service and repair 7629 Electrical repair shops, not elsewhere classified 7631 Watch, clock, and jewelry repair 7641 Reupholstery and furniture repair 7692 Welding repair 7694 Armature rewinding shops 7699 Repair services, not elsewhere classified 00. Health services 8051 Skilled nursing care facilities 8052 Intermediate care facilities 8059 Nursing and personal care, not elsewhere classified 8062 General medical and surgical hospitals 8063 Psychiatric hospitals 8069 Specialty hospitals except psychiatric PP. Executive, legislative and general 9111 Executive offices 9121 Legislative bodies 9131 Executive and legislative combined 9199 General government, not elsewhere classified QQ. Justice, public order and safety 9211 Courts 9221 Police protection 9222 Legal counsel and prosecution 9223 Correctional institutions 9224 Fire protection 9229 Public order and safety, not elsewhere classified Adopted: December 3, 1990 Revised and updated Dec. 12, 1992 • AWAIR A Workplace Accident And Injury Reduction Act Law Summary � 1 ProviJeJ by Berkley Administrators • • AWAIR Who is covered by this law? Employers in industries specified on a list of standard industrial classification codes adopted by the Commissioner of Labor and Industry. What criteria is to be used when identifying SIC codes for the list? The Commissioner of Labor and Industry is required to demonstrate "the need to include" each indus- trial classification on the basis of the safety record or workers' compensation record of that industry segment. Is the list ever updated? Yes. The list of standard industrial classification codes must be updated every two years by the Commissioner. What does AWAIR require? It requires covered employers to establish written workplace accident and injury reduction programs (AWAIR program) that promote safe and healthful working conditions and are based on clearly stated goals and objectives. What must be contained in the AWAIR program? Covered employers must describe in their AWAIR program: •How managers, supervisors and employees are responsible for implementing the program and how continued participation of management will be established, measured and maintained. *The methods used to identify, analyze and control new or existing hazards, conditions and operations. *How the plan will be communicated to all affected employees so that they are informed of work related hazards and controls. *How workplace accidents will be investigated and corrective action implemented. 'flow safe work practices and rules will be enforced. there a requirement to review the program's performance? Yes. Covered employers are required to conduct and document a review of the workplace accident and injury reduction program at least annually and document how procedures set forth in the program are met. Provided by Berkley Administrators LC 001 1 • • Who will enforce this law? The Minnesota Department of Labor and Industry's Occupational Safety and Health division has been given responsibility for enforcement. This occurred as a result of the proposal being amended to the state's OSHA law. Is Minnesota OSHA going to specify further what must be contained in each employer's AWAIR program? No. The commissioner of Labor and Industry's (i.e. Minnesota OSHA) rulemaking authority has been specifically limited to promulgating the list of standard industrial classification codes which is necessary to identify which employers in the state must comply with the law. When does the ACT become effective? The Act went into effect on January 1, 1991. When must covered employers be in compliance with the Act's requirements? Covered employers with 51 or more employees should have been in compliance six months after the effective date (July 1, 1991). Employers who have 50 or fewer employees must be in compliance with the law by July 1, 1993. What are the penalties for not being in compliance? The Act does not provide for any specific penalties for violating its provisions. However, the OSHA penalties specified in Minnesota Statutes Section 182.666 and 182.667 do apply and could be levied for a violation of this Act. The OSHA inspection process allows for substantial discounts of fines levied against an employer based on safety attitude and effort made to provide a safe and healthy workplace. Since the AWAIR Act is basically a well rounded, documented safety program, compliance with the AWAIR Act will help to satisfy this provision. Provided by Berkley Administrators • AWAIR INDICATORS 1. Show responsibilities and methods for implementation and maintenance of the safety program. A. Indicators as to managers, supervisors and employees' responsibility for implementing the safety program. Managers: a) Assign a safety director, officer or engineer b) Develop safety committees c) Hold regular safety meetings d) Allocate sufficient resources (money and material) e) Assign safety responsibilities and hold those persons accountable f) Set safety examples g) Actively promote safety program(communication) h) Interview employees during walk-around Supervisors: a) Set safety examples b) Provide employee training c) Show recognition for a good job; discipline for violation of safety rules d) Talk safety with employees e) Conduct impromptu inspection tours and implement effective corrective action f) Attend supervisory safety training g) Know standards that affect department h) Accept responsibility for safety of their department i) Do hazard analysis of their work areas j) Interview employees during walk-around Employees: a) Participate in safety inspections b) Attend safety training c) Participate in safety committee d) Make safety suggestions e) Take care of their equipment(keep guard in place, housekeeping, watch out for fellow workers) t) Interview employees during walk-around B. Indicators as to management's continued participation in establishing, measuring and maintaining the program. Established: a) A written policy making long-term commitment to safety and health b) Communicated to employees through letters, training and safety committees c) Interview employees during walk-around Measured: a) Annual surveys of workplace b) OSHA 200 Log c) Employee participation Maintained; a) Active participation b) Promotion c) Make it interesting d) Make it part of work program and evaluation e) Support safety efforts f) Have concerned persons involved in program g) Support active safety committees h) Interview employees during walk-around Provided by Berkley Administrators • • 2. Show how hazards were identified, analyzed and controlled. Identified: a) Workplace survey b) Review OSHA 200 Log c) Employee questionnaire Analyze: a) Job hazard analysis Control: a) Correct hazards that are noted b) Repair or replace hazardous equipment c) Conduct effective training d) Provide personal protective equipment e) Enforce safety program f) Hazards noted during walk-around 3. How the plan will be communicated to all affected employees. Communication: a) Written statement b) Training sessions 1. One-on-one 2. Hands on 3. Group 4. Outside 5. Seminars c) Documentation of who did the training, who attended the training, what was covered, when was the training given d) Interview employee during walk-around 4. How workplace accidents will be investigated and corrective action will be implemented. Accident Investigation: a) Written statement on accident investigation and corrective action b) Accident investigation report(if no accidents have occurred, a blank accident form should be on hand)reports should show what happened, what was the cause, what preventive action is being take to prevent similar accidents 5. How safe work practices will be enforced. Enforcement: a) Written statement on how safe work practices and rules will be enforced b) What corrective actions, warnings, counseling or disciplinary action, if any, were taken c) An evaluation of the effectiveness of enforcement program seen on walk-around Provided by Berkley Administrators - - i 410 111 January 3 , 1992 North Star Risk Services, Inc. 1401 West 76th Street, Suite 500 Minneapolis, MN 55423 Attention: Mr. Douglas Holm, CSP, MS Dear Doug: In response to your letter dated September 3, 1991, the following are answers to your recommendations for the City of Oak Park Heights loss control program: #1 The City Attorney and Police Chief are working on this project. Please refer to attached Exhibit "A" . #2 Our Police Chief does not consent to police officers individually engaging in the practice of contracting our their services to private entities on an individual basis. #3 Done. #4 All fire doors are kept closed during the day when the rooms are not in use. All fire doors are closed at 4 : 30 p.m. daily and kept closed weekends and holidays. #5 Done. #6 Please refer to Exhibit "B" . #7 Ordered in 1991. #8 Gravel will be installed Spring of 1992. #9 Will be ordered Spring 1992 . #10 School District and ball teams furnish own bases. #11 Please refer to Exhibit "C" . • . Page two - North Star Risk Services, Inc. #12 Please refer to Exhibit "D" . #13 Discussed with City Attorney and Jack Hennen' s article forwarded. #14 Designated spokesmen for the City of Oak Park Heights in the event of a major catastrophe are Police Chief and Civil Defense Officer. Should you have further need for information or questions on the above, please do not hesitate to contact me. Sincerely, CITY OF OAK PARK HEIGHTS La Vonne Wilson City Administrator/Treasurer -a • • OAK PARK HEIGHTS POLICE DEPT. _ POLICY & PROCEDURE PURSUIT AND EMERGENCY VEHICLE OPERATION PURPOSE: The purpose of this policy is to ensure the safety and proper operation of the vehicle during pursuit and emergency driving situations. The intent of this policy is to provide members of the police department with a clear definition of their responsiblities and restrictions regarding pursuit of a motor vehicle and emergency operation of the Oak Park Heights Police Deparmtent. POLICY: Emergency vehicle operation or pursuit will not begin or continue if a sub- stantial risk exists to public safety which outweighs the need for emergency vehicle operation or pursuit. Officers shall continuously weigh the present danger to themselves and the general public by considering factors such as weather conditions, likelihood of damge to law enforcement vehicles and other property, mechanical condition of the law enforcement vehicle, seriousness of the crime and traffic and pedestrian congestion. The policy for pursuit is to actively pursue and apprehend all violators of the law with due regard for the safety of the general public, all law enforcement officers involved, and occupants of the pursued vehicle. The officer should consider the possibility of identifying the suspect(s) at a later time and other related factors when determining whether or not to continued the pursuit. DEFINITIONS: A. Response Vehicles: Law enforcement vehicle responding to a call for assistance or criminal activity in progress. Police Department vehicles, marked or unmarked, while responding to a call for assistance or criminal activity in progress shall activate all available alert/warning devices on the vehicle and proceed with caution. The driver of such vehicle shall not assume any special privilege of vehicle operation and shall operate the vehicle in such a manner as to not create a situation that endangers public safety or the officers in- volved in the response. B. Emergency Vehicle Operation: Emergency vehicle operation occurs when a law enforcement vehicle is being driven with red lights and siren activated simultaneously. C. Pursuit: Pursuit occurs during the operation of a law enforcement vehicle by use of visual and audible signal, to apprehend a violator who gives indic- ation of willfull failure to obey such direction and who attempts to ..elude the pursuing police vehicle. • • 1. Primary Pursuit Vehicle: The police vehicle initiating the pursuit and/or the closest law enforcement vehicle in proximity to the fleeing vehicle. 2. Support Vehicles: The law enforcement vehicle which, at a safe distance, trails the primary vehicle to assist or be available to assume primary pursuit vehicle status. 3. Back-Up Vehicles: Other law enforcement vehicles assisting with the. pursuit. These vehicles shall monitor the radio traffic and be available to assist as requested. They should remain close enough to assist without interfering with the primary and support vehicles. PROCEDURE FOR EMERGENCY VEHICLE. OPERATION: A. Operation of a law enforcement vehicle in the emergency mode will only be permitted when red lights and siren are activated simultaneously and the situation requires emergency vehicle operation. B. Minn. Stat. 169.03, Sudb 2, "The driver of any authorized emergency vehicle, when responding to an emergency call, upon approaching a red light or stop sign, shall slow down as necessary for safety, but may proceed cautiously past such red stop sign or signal after sound- ing siren and displaying red lights." C. Minn.Stat. 169.03, Subd 3, "The driver of any authorized emergency vehicle, when responding to an emergency call, may enter against the run of traffic of any one-way highway where there is authorized division of traffic to facilitate traveling to the are in which an emergency has been reported." D. Minn.-Stat. 169.03, Subd 5,"No driver of any authorized emergency vehicle shall assume any special privilege under this chapter except when such vehicle is operated in the immediate pursuit of an actual or suspected violator of the law." E. Minn. Stat. 169.17, "The speed limitations set forth in section 169.14 to 169.17 do not apply to the authorized emergency vehicles when responding to emergency calls, but the drivers thereof shall sound audible signal by siren and display at least one lighted red light to :. the front. This provision does not relieve the driver of an authorized emergency vehicle from the duty to drive with due regard for the safety of persons using the street nor does it protect the driver of an authorized emergency vehicle from the consequences of a reckless disregard of the safety of others." F. In certain situations it may be advantageous for an officer to operate the law enforcement vehicle with red lights only. The officer in this mode of operation has no greater authority than the general public. The officer must take this into consideration in operating the law enforcement vehicle in a safe manner. No police vehicle will be con- strued as an emergency vehicle unless both siren and red lights are activated together. • • G. The decision as to when a vehicle is to be operated as an "emergency vehicle" lies with the officer operating the vehicle and responding to the emergency. The officer shall take into consideration the factors listed below when determining whether or not to operate a vehicle in an emergency fashion. This is not an all inclusive list but the officer should at a minimum, take into consideration these factors: 1. The nature of the emergency being responded to; 2. The assistance to be provided by the officer upon arrival at the scene;. 3. Whether or not other law enforcement/medical personnel are closer and will be able to handle the incident. If so, the secondary units should respond at routine (normal) speed. H. When using emergency equipment (red lights and siren) to execute a vehicle stop or anytime an emergency vehicle is stopped/parked in violation of parking regulations and subject to other veicle traffic, the revolving red lights should remain in operation. Whenever the emergency vehicle is not lawfully parked, either on a traffic stop or a call for services, where the vehicle is at risk of being hit by another vehicle, or anytime when safety dictates, the revolving red lights shall be left in operation. If a squad is stopped, and according to this policy, the revolving red lights can be turned off, then at -a minimum the rear flashing light bar and emergency flashers will remain activated. PROCEDURE FOR PURSUIT: A. Unmarked vehicles, even if equipped with red lights and siren, will not be used for pursuit purposes except in emergency situations where there is risk of great bodily injury or death or an offense involving actual or threatened great bodily injury or death. If the above exception exists, a marked police vehicle will assume the primary pursuit function as soon as possible. B. Except in emergency situations where there..is a risk of great bodily inj- ury or death or an offense involving actual or threatened great bodily injury or death, police vehicles will not be used for pursuit purposes when non-sworn members of the police department or other persons who are not sworn peace officers are present in the vehicle unless there are no other law enforcement vehicles available. C. No more than two law enforcement vehicles will routinely become directly involved in any pursuit situation. D. All applicable Minnesota Statutes will be observed during pursuit. Caution must be used in regard to traffic control devices. Pursuing vehicles should attempt to maintain adequate distance to allow for proper reaction time. E. The deliberate striking, ramming, or total blocking of a roadway by a law enforcement vehicle will be allowed only to protect the officer or general public from imminent death or great bodily harm and if no other means of stopping the vehicle is 'available. ° When officers make the decision to set a road block, they will vacate the patrol vehicle upon setting the road block. Only marked law enforcement vehicles shall be used for this purpose. The decision to set a road block or use a firearm in pursuit situations should only be considered when deadly force is authorized by Minn. Stat. • • 609.066. Every reasonable effort should be made to not allow the pursued vehicle to become a deadly weapon to the officer or other vehicular or pedestrian traffic. F. When a police vehicle becomes involved in a pursuit, as soon as possible and practical, the officer will supply the Communications Center via radio with the following information: 1. Officer number 2. Location and direction of travel 3. Description of vehicle being pursued 4. Reason for pursuit 5. Request for 10-33 traffic on local frequency G. The Communication Center will do the following: 1. Clear local channel and notify all officers of 10-33 traffic 2. Notify immediate supervisor or ranking officer on duty of the pursuit situation 3. Control all radio traffic during pursuit 4. Under the direction of the supervisor or ranking officer on duty coordinate assistance with other agencies if applicable 5. Continue to monitor traffic until pursuit is terminated and then release 10-33 restrictions., H. The immediate supervisor or ranking_ officer on duty will take responsib- ility for the pursuit upon being advised of the pursuit. The super- visor or ranking officer will ensure, through communications with the officers involved, that the policy for pursuit is being used. The pursuit should be allowed to continue only after the dangers involved have been carefully weighed. It will be the supervisor's or ranking officer on duty's responsiblity to coordinate other law enforcement agency assistance and any request for assistance under any mutual aid agreement. The primary and secondary units share the responsibility of determining the need for outside assistance and requesting assistance through dis- patch as dictated by the pursuit. When the actions of other agencies are in violation of our policy and the control of our pursuit is lost, it will be the supervisor's or ranking officer's duty to end the pursuit. I. In the event that another non-involved vehicle or pedestrian is struck during the pursuit, the secondary vehicle will immediately break off pursuit and render necessary assistance. The secondary vehicle should also request immediate backup, if available, from other law enforcement units in the area. J. Pursuits shall be discontinued by the officer when: 1. The officer determines that the danger to the peace officer and the public becomes greater than the benefits of an apprehension or, 2. The officer has been notified by immediate supervisor or ranking officer to end the pursuit or, • • 3. There is a mechanical failure of the police vehicle which greatly hampers continued pursuit or, 4. The officer loses visual contact with the violator for an extended period of time. The officer should take into consideration the ability to ident- ify the violator in making a determination as to continuing the pursuit. ' K. The Oak Park Heights Police Department shall not become involved in a pursuit with another agency unless supervisory approval has been obtained or an extreme emergency exists which merits immediate intervention. L. If a pursued vehicle leaves the Oak Park Heights jurisdiction and other law enforcement agencies join the pursuit, the Oak Park Heights primary pursuit vehicle will drop to support vehicle status and the previous support vehicle will drop out of pursuit status and into the backup vehicle mode. M. It will be the responsibility of the supervisor to ensure the following are completed after the pursuit: 1. Dispatch supervisor prepare a taped edition of the pursuit, 2. Actively involved officers prepare a report 3. Critique by supervisor and officers relative to policy changes on pursuit in the future. ADOPTED THIS 5th DAY OF OCTOBER 1989 Chief Gene Ostendorf Arod AI • • RULES • • • ck tM � , NOT ALLOWED ON PLEASURE SKATING RINK.• F ' fi OR HORSEPLAY ON PLEASURE RINK IS NOT PERMITTED. :. . . ON SKATING SURFACE. 1 • LOWING OF OTHER OBJECTS IS PERMITTED ON OR EDE BUILDING. 1 • ON THE ICE OR IN THE BUILDING. IERE EXCEPT IN THE PARKING LOT! ! kNGUAGE OR LOUD ABUSIVE TALK WHILE ON THE RINK OR IN THE BUILDING. • • • • • _ N Cr. . CITY OF 0 ,..„0 PARK HEIGHTS OAK ME M O R A N D UM A MINNESOTA STAR CITY TO: All Contractors Working In The City of Oak Park Heights, MN. FROM: Mick Kaehler - Building Official. DATE: December 11, 1991 RE: State Issued Contractor' s License. To Whom It May Concern: A new State Law relating to the licensing of contractors will become effective January 1 , 1992. The information you will need to become licensed by the State can be obtained at the City Hall. The following will be the policy of the City of Oak Park Heights: 1. If a contractor does not have a State License, then one will be required by the City. 2 . The City License is from January 1 through December 31 and will not be pro-rated or reimbursed once you do obtain a State "required" license. 3. If you obtain a State License, the City will impose a $5 .00 surcharge to the cost of the building permit, as per legislation. Finally, if you have any questions regarding the State Licensin g Requirements uirements contact me any time between the hours of y 7 :00 a.m. and 3:30 p.m. weekdays. I can be reached at (612) 439- 4439 . Mick Kaehler Building Official , City of Oak Park Heights MK: jad 14168 North 57th Street • Box 2007 • Oak Park Heights, Minnesota 55082-2007 Phone: 612-439-4439 • Fax: 612-439-0574 WHAT YOU NEED TO KNOW TO GET A STATE RESIDENTIAL CONTRACTOR OR REMODELER LICENSE Determine whether you are required to be licensed. Minnesota Statute Chapter 326 requires a residential contractor or remodeler who receives more than $15,000 in gross receipts annually from their residential contracting or remodeling activities to obtain a license. Persons whose annual gross receipts from such activities are less than $15,000 or who work on individual projects, involving one or more contracts for which the aggregate contract price is less than $2,500. 00, do not need a state license. The contractor/remodeler license issued by the State will enable a contractor/remodeler to work in any area of the state (with the exception of Minneapolis and St. Paul) without having to obtain a license from the local jurisdiction. Determine who must be licensed. The licensing system established by Chapter 326 requires all companies not exempt pursuant to the criteria noted in the previous paragraph to obtain a license. Each company, regardless of whether it is an individual proprietorship, partnership, or corporation, must have at least one individual (identified on the application) who will serve as a "Qualifying Person." The Qualifying Person is the individual who must take the required examination and fulfill the statute's continuing education requirements. In the case of a sole proprietorship, the owner must be the Qualifying Person. In the case of a partnership, one of the partners must be the Qualifying Person. In the case of a corporation, the chief executive officer, or an employee who is rectularly, employed by the corporation and is actively enciacted in the classification of work for which the corporate license is obtained, may be the Qualifying Person. It is important to remember that the licensing law does not require each employee to be licensed. The statute requires the licensing of "companies. " How do I know which license to apply for? The law defines a "Residential Contractor" as a person (or company) who is in the business of building residential real estate (a new or existing structure constructed for habitation by one to four families) or a person in the business of offering to contract to improve residential real estate. The law defines a "remodeler" as a person in the business of contracting or offering to contract to improve existing a addition, states that a remodeler must have at least two special skills. Probably the most important difference between the two types of license is that a remodeler can only work on existing structures where as a contractor can work on both new and existing structures. How to determine if you need a remodeler's license. business, you offer or contract, If, in the course of your b ► Y .n a ' to perform more than one specialty, you must obtain remodeler's license. A remodeler's license would be required if you offered or contracted to perform: 'n Example 1: Finished carpentry work AND painting. Example 2: Installation of kitchen cabinets AND installation of linoleum. Example 3: Rough carpentry work AND hang sheetrock. Example 4: Apply new shingles to roof AND riles a r e lace rotten ir boar structure or r p roof. A remodeler's license would uld not be required if you only offered or contracted to perform: Exa m p le is Strip and finish hardwood floor. Example 2: Only replace or reshingle old roof. Example 3: Only painting. Example 4: Only laying floor covering. 2 it • 410 Where do I obtain an application and bond form? You can pick up the required license application and bond forms at: your local building inspectors office, builders supply company, or the Minnesota Department of Commerce which is located at 133 East 7th Street, St. Paul, Minnesota 55112, telephone: (612) 296-6319. How do I complete the application? You must answer all questions and provide all information required on the application form. Failure to answer any question will result in the application being returned to the applicant. The first page of the application will ask you to: (1) identify the form of license you are seeking (transitional, renewal, or temporary) (All applicant's should check "transitional" when applying for a license for the period between January 1, 1992 , and March 31, 1993) . Licenses issued during this period will be effective until March 31, 1993 , or March 31, 1994, depending upon the birth date of the Qualifying Person (see page 5) ; (2) identify the applicant's organizational structure (is the applicant a corporation, partnership, or individual proprietorship?) (Remember, if the applicant is a partnership or a corporation you must attach to your application a list which identifies the name and address of each partner, officer, director, or shareholder owning more then 5% of the applicant's outstanding stock; (3) identify the type of license (is the applicant applying for a residential contractor or remodeler license?) . The second page of the application will ask you to: (1) Identify the applicant's full (company) name, address, telephone number and tax identification number. If you intend to conduct business under a name that is different than the "applicant's name," you must provide this information in the appropriate space; (see page 6 for information on filing your "assumed name") ; (2) information identifying who will be the "Qualifying Person" for the licensee (company) . As mentioned 3 earlier, the Qualifying Person for an individual proprietorship must be the owner. For a corporation the Qualifying Person can be either the chie f executive officer, or an employee who is regularly employed by the corporation and is actively engaged in the classification of work for which the corporate license is obtained. For a partnership, the Qualifying Person must be one of the partners. The Qualifying Person will be responsible for success- fully passing the applicable examination and completing the requirements to become effective in 1993 and 1994. Because the State is only issuing Transitional licenses through March, 1993 , the licensee's Qualifying Person will not have to take or pass an examination or complete any continuing education in order for the applicant to be eligible for licensure. Once the examination and educational components of the licensing program are established, licensee's will be notified of when and where they can take the exam and where accredited continuing education course work can be found. The Department expects that this information will be disseminated sometime during April or May of 1992. Page 2 also requires the applicant to answer certain questions regarding the applicant, its partners, officers, directors, shareholders, and Qualifying Person. If you answer "yes" to any of the questions, you must attach a detailed written explanation of the circumstances relating to the question when submitting your application for consideration. The third page of your application requires you to: (1) disclose the Qualifying Person's experience and educational background relating to the type of licensure you are seeking; (2) requires you to identify the Qualifying Person's employment history for the past five years. Page 3 of your application also provides you with the information you will need in determining the amount of bond you must obtain to qualify for licensure. (3) requires that you disclose certain information regarding workers' compensation, unemployment, liability, and property damage insurance. All applicants must have liability insurance which provides coverage of at least 4 !II 410 $100, 000 per occurrence. In addition, they must have property damage insurance which provides at least $10, 000 in coverage. In addition, applicants must also identify: the insurance company providing their Minnesota workers' compensation insurance, their policy number, and their Minnesota Unemployment Insurance Account Number. If the applicant feels they are exempt from the workers' compensation and unemployment insurance requirements they should check "yes" in the appropriate line and attach a detailed explanation of why you are exempt. If applicant is uncertain regarding their need for workers' compensation insurance, they should contact the Minnesota Department of Labor and Industry 612-296-6107. If applicant is uncertain regarding their need for unemployment insurance, they should contact the Minnesota Department of Jobs and Training at 612-296-6141. How long is my license good for and how much will it cost? Some licensee's will initially receive a two year license and some will receive a one year license. This will occur because the Department needs to "stagger" the number of licenses it must process in any one year, in order to keep administrative costs at a minimum. To determine whether you will receive a one or two year license, you must refer to the Qualifying Person's birth date. If the Qualifying Person's birth date falls within an odd numbered year, a one year license will be issued which will expire on March 31, 1993 . The fee for a one year license is $60. 00. Thus, if your Qualifying Person's birth date falls within an odd number year, you must remit $60.00 along with your application and bond in order to be eligible for licensure. If your Qualifying Person's birth date falls within an even numbered year, a two year license will be issued which will expire on March 31, 1994. The fee for a two year license will be $135.00 ($60.00 for the first year plus $75.00 for the second year. ) Thus, if your birth date falls within an even numbered year, you must remit $135.00 with your application and bond in order to be eligible for licensure. After March 31, 1993, all renewal licenses issued will be for a period of two years at a cost of $75 per year. Thus, there is no monetary advantage gained by initially 5 receiving a one year or a two year license, assuming you intend to stay in business for more than one year. Once you have provided all of the information required on the application and obtained a bond in the appropriate amount, you should return your application, bond, and fee (in the form of a money order or check made payable to the Minnesota Department of Commerce) to: The Minnesota Department of Commerce Licensing Division 133 East 7th Street St. Paul, MN 55101 IIVIPORTANT: You must identify your license number on all contracts, permits and advertising materials. BUSINESS NAME FILING INFORMATION Who must file? Any individual, corporation, partnership or limited partnership who is doing business in the State of Minnesota under a name other than the full name of each person involved in the business (or the legal corporate or limited partnership name) must file an assumed name. "Doing business" means engaged in business transactions in the State of Minnesota, in a more or less continuous course of business. Example: "John Smith Construction" would not be required to file, if John Smith is the owner of the business. "Smith's Construction" would be required to file because it does not contain the full name of the owner. Similarly, Dayton Hudson Corporation does business under other brand or trade names, for example: "Dayton's Travel Service." Each of these other names would also be required to file (Minnesota Statutes Chapter 333) . What is the reason for filing? ss ed name is not t o protect The reason for filing an a um n p the name against use by other persons, but to provide information to the consumer on the identity of the business owners. 6 • Is my business name protected? The law does not provide the filer with protection against other persons filing the same assumed name, although the persons filing the name first will be informed of every later filing of that name or similar names. It is up to the individual to take legal action to prevent the use of that name. A common law doctrine does allow you to establish certain rights to a name through mere use, and that doctrine could well prevail in such a case. The filing of an assumed name will result in that name being unavailable for use by corporations, whether formed under Minnesota law or in another state and registered in Minnesota, or by limited partnerships or trademarks. The Office of the Secretary of State will reject any assumed names which are not distinguishable from names already on file. To make sure that the name is available for use, call the Secretary of State's Office at (612) 296-2803 and ask whether the proposed name is "available. " The name check is preliminary and the office is not able to guarantee that the name can be filed when submitted. How do I file? Complete and sign a Certificate of Assumed Name form obtained from the Office of the Secretary of State, 180 State Office Building, St. Paul, Minnesota 55155, telephone (612) 296-2803 . Return the completed and signed form to the Secretary at State along with a $25 filing fee. After the Secretary of State notifies you that your filing has been accepted, have the form published for two consecutive issues in a legal newspaper in the county where you have a registered office or principal place of business. Failure to publish renders your assumed name invalid. Are there any penalties for failing to file? If you do not file your assumed name with the Office of the Secretary of State, you will be assessed $250 in costs at the time of any subsequent lawsuit by or against your business. If you have been in business and have not filed an assumed name, you should file the assumed name as soon as possible so that you will be in compliance with the law. 7 111 How lona is my filing valid? If there are no changes in the information you have submitted, your filing is valid for ten years from the date of filing. The Office of the Secretary of State will give six months notice prior to expiration and will send a renewal form. The filing fee for the renewal is $25. If the information you have submitted changes, you must file an amendment with the Office of the Secretary of State. The fee for filing an amendment is $25. 8 I STATE OF MI NESOTA F DEPARTMENT USE ONLY i 4Education: 4.�y A 4,2)..0-..-. V7 � - tzo Previous/Existing License. 1858 Date Terminated: DEPARTMENT OF COMMERCE Processing Date: 133 East 7th Street St. Paul,Minnesota 55101 License Number: (612)296-6319 BUILDING CONTRACTOR LICENSE APPLICATION The information which you furnish on this form will be used by the Department of Commerce to assess your qualifications for a license. You are not legally required to provide this information; however, if you fail to do so, the Department of Commerce will be unable to grant a license. Disclosure of your tax identification number and social security number is authorized by Minnesota Statute, Chapter 270A. After issuance of a license, information contained in this application, other than your tax identification number and social security number, is public pursuant to Minnesota Statutes,Chapter 13. INSTRUCTIONS 1. To obtain your license,complete(please type or print in ink)and submit this form with the appropriate fees(see back page)to the Department of Commerce at the above address. Check or money order must be payable to "Minnesota Department of Commerce". incomplete forms will be returned to the business address listed below. 2. In order to qualify for licensure,all applicants must have a"Qualifying Person."This individual is responsible for passing the required examination and completing the required continuing education. If applicant is an individual proprietorship, the qualifying person must be the owner. If applicant is a partnership, the qualifying person must be a partner. If applicant is a corporation, the qualifying person must be an officer, director, or employee designated by the corporation. If the "Qualifying Person" leaves the applicant after a license is issued, applicant must notify the Department of Commerce and apply for a temporary license(see"). 3. If applicant is a partnership attach: a copy of the Articles/Agreement of Partnership filed with the Minnesota Secretary of State, and a list identifying the name and address of each partner. (If your partnership is not filed with the Minnesota Secretary of State, you must submit a copy of your articles.The copy must be certified true and correct and signed by each partner.) 4. If applicant is a corporation attach: a certified copy of the Corporate Filing from the Minnesota Secretary of State. If incorporated in another jurisdiction, attach a copy of the Certificate of Foreign Corporation from the Minnesota Secretary of State. Applicants must also provide a list identifying the name and address of each corporate officer, director and all shareholders holding more than 5% of the outstanding stock of the corporation. 5. The name under which business will be conducted must be exactly the same as the name which appears on your license. If you intend to operate under any name other than the exact name of the applicant (sole proprietorship, corporate or partnership name), attach-„a copy of assumed name certificate issued by the Minnesota Secretary of State. 6. If you need assistance in filing or obtaining a copy of your Certificate of Assumed Name, articles of incorporation, or partnership filing, call the Minnesota Secretary of State at(612)296-2803. NATURE OF APPLICATION Transitional Renewal Temporary **PLEASE NOTE: A temporary license is issued if the person who obtains the license under Section 8, Subd. 2, clause (2) or (3), leaves the partnership or corporation due to death, disability, retirement or position change. A temporary license expires after one year and may not be renewed. APPLICANT'S ORGANIZATIONAL STRUCTURE Individual Proprietorship Corporation Partnership TYPE OF LICENSE Residential Building Contractor Remodeler CM-00557-01 (10-91) 1 • INFORMATION OF APPLICANT* Name of Applicant: Name under which the business will be conducted,if different from applicant's name (see#5 above): Business Address: Telephone Number ( 1 City: State: Zip Code: State Tax Identification Number: QUALIFYING PERSON INFORMATION Name: Date of Birth: Place of Birth: Social Security Number: Work Phone: Home Phone: Home Address: City: State: Zip Code: i ADDITIONAL REQUIRED INFORMATION: All applicants must answer the following questions. If any questions are answered "yes", you must attach a detailed written explanation. Have you, any of the owners, partners, officers, directors or any shareholder owning more than 5% of the outstanding stock of the corporation or the"Qualifying Person"ever: Yes No A. held a building contractor license in any state other than Minnesota? If yes, new license applications must include a verification of licensure certified by the state(s)? B. been the subject of any inquiry or investigation by any division of the Minnesota Commerce Department? C. had any occupational license or permit censured, suspended, revoked, canceled, terminated or been the subject of any type of administrative action? D. been convicted or are currently charged with any criminal offense(felony, gross misdemeanor or misdemeanor), other than traffic violations,in any State or Federal Court within the last ten(10)years? E. been a defendant in any lawsuit or been named in a civil judgment,involving claims of fraud,misrepresentation,conversion, mismanagement of funds,breach of fiduciary duty or breach of contract? F. been notified by the Commissioner of Revenue, pursuant to Minnesota Statute §270.72, that you currently owe the State of Minnesota delinquent taxes? G. have any unclaimed property(unclaimed funds or property over 5 years old)to report under Minnesota Statute§345.37? H. ever filed for bankruptcy or protection from creditors or currently have outstanding unsatisfied judgement(s)? 2 a EDUCATION: You must list the "QUALI PERSON'S" educational background (colleg ech, apprenticeship, etc.) related to the type - of license you are seeking(you may use additional paper,if necessary): EDUCATION • (Dates) (Course Title) (Offered By) EMPLOYMENT HISTORY: You must list the "QUALIFYING PERSON'S"employment history for the past five years(you may use additional paper): (From To) (Name of Employer) BONDING REQUIREMENTS: In order to become licensed, applicant must provide the Commissioner of Commerce with a bond (in the form included with this application). The amount of your bond is based on your last years'gross receipts from contracting and/or remodeling activities. If your gross receipts were: S 00.00 to $1,000,000,you must post a S 5,000 bond. $1,000,001 to $5,000,000,you must post a$10,000 bond. Over$5,000,000, you must post a S15,000 bond. INSURANCE REQUIREMENTS:In order to qualify for licensure,you must also provide the following insurance information: Yes No A. Applicant is exempt from Minnesota workers' compensation insurance requirements pursuant to Minnesota Statute §176.041. If"yes",you must attach a detailed written explanation why you are exempt. If"no",you must provide the following information: 1. Insurance Company: 2. Policy/Binder Number:. B. Applicant is exempt from the unemployment insurance requirements pursuant to Minnesota Statute§268.04. If"yes",you must attach a detailed written explanation why you are exempt. If"no",you must provide the following information: 1.Minnesota Unemployment Insurance Account Number: C. Name of Liability Insurance Company: Policy/Binder Number: D. Name of Property Damage Insurance Company: Policy/Binder Number: INSTRUCTIONS: 0 S Ik 1. This side is to be completed by a notary public for both the Principal and the Surety. 2. Please attach the Power of Attorney for the Surety listed herein. ACKNOWLEDGMENT OF INDIVIDUAL STATE OF ) ss. ACKNOWLEDGMENT OF PRINCIPAL COUNTY OF ) On this day of , 199 ,before me personally appeared ,known to me to be the individual whose name is subscribed on this bond form,who acknowledged that this bond was executed for the purposes therein contained. (Notary Seal) Notary Public ACKNOWLEDGMENT OF PARTNERSHIP STATE OF ) ss. ACKNOWLEDGMENT OF PRINCIPAL COUNTY OF ) On this day of , 199 ,before me personally appeared ,known to me to be a partner in the partnership whose name is subscribed on this bond form,who acknowledged to me that the bond was executed on behalf of the partnership for the purposes therein contained. (Notary Seal) Notary Public *********iF*%*R#iF*%%****41-114****%%****.**N iF%iF%%%***%*%**%%*******%%*******%**1141*****%****%***4******%%*******%****%****%****V.*****************.******%**#%%*******% ACKNOWLEDGMENT OF CORPORATION STATE OF ss. ACKNOWLEDGMENT OF PRINCIPAL COUNTY OF ) On this day of , 199 ,before me personally appeared ,who acknowledged that he or she is the of a corporation whose name is subscribed on this bond form, and that, as a corporate officer, he or she is authorized to execute the bond for the purposes therein contained. (Notary Seal) Notary Public 114F%******4.4.11iF******%*******%*i...*%*****i!*1141.iF%%1141 *************%%**********%*********%%%%*%%****%******%********%**********%**********A%%*******.***%***%***.** ACKNOWLEDGMENT OF SURETY STATE OF ) ) ss. ACKNOWLEDGMENT OF SURETY COUNTY OF ) On this day of ,199 ,before me personally appeared ,who acknowledged that he or she is the attorney in fact who is authorized to sign on behalf of (surety company) ,corporation,on behalf of the corporation. (state or place of corporation) (Notary Seal) Notary Public A • 11104113 NUMBER • STATE OF MINNESOTA BUILDING CONTRACTOR/REMODELER SURETY BOND KNOW ALL PERSONS BY THESE PRESENTS: That (Name of Building Contractor,Remodeler or specialty contractor) a (Description or form of business organization,including State of Incorporation,if applicable,e.g.,"a Minnesota Corporation") with business office at (Street Address,City,State,Zip) as PRINCIPAL and • (Name of Surety) a corporation duly organized under the laws of the State of and authorized to do business in the State of Minnesota, as SURETY, are hereby held and firmly bound to the Commissioner of Commerce- State of Minnesota and any person aggrieved by reason of the Principal's failure to faithfully perform the duties, and in all things comply with all laws, ordinances, and rules, pertaining to the Principal's license or any permit applied for and all contracts entered into, the sum of (S. ). For the payment of this sum, Principal and Surety bind themselves, their representatives,successors and assigns,jointly and severally by these presents. WHEREAS,the Principal has made application with the State of Minnesota to be licensed as,or has been licensed as,a(check one) Residential Building Contractor Remodeler _Specialty Contractor NOW THEREFORE,the parties further agree that: 1. The purpose of this obligation, which is required by Minnesota Statutes, Section 326.94, is to secure the Principal's faithful performance of the duties,and compliance with all laws,ordinances,and rules,pertaining to the Principal's license or any permit applied for and all contracts entered into,pursuant to Minnesota Statutes,Section 326.94. 2. This bond is for the benefit of the State of Minnesota and all persons suffering loss or damages by reason of the Principal's failure to faithfully perform the duties, and in all things comply with all laws, ordinances, and rules, pertaining to the Principal's license or any permit applied for and all contracts entered into. 3. If the Principal shall fail to faithfully perform the duties,and in all things comply with all laws,ordinances,and rules,pertaining to the Principal's license or any permit applied for and all contracts entered into, the State of Minnesota as well as any person damaged as a result of said failure by the Principal shall have, in addition to all other legal remedies, a right of action on this bond in the name of the injured party for loss or damages sustained by the injured party. 4. This bond shall become effective on , 199—, and shall be continuous until canceled by the Surety. The Surety may cancel this bond any time upon giving the Principal and the Minnesota Commissioner of Commerce,thirty(30)days written notice.After cancellation, the bond must remain in force for those liabilities incurred by the Principal from the time the bond first became effective until its cancellation, regardless of when compensation was or may be claimed, awarded, or paid. This bond shall not become void upon first recovery but may be sued upon until the full amount shall be exhausted. In no event shall the aggregate liability of the surety on the bond, to any and all persons, exceed the amount of the bond. Immediately upon payment by the Surety of the amount of the bond, the Surety will give written notice to the Commissioner of Commerce and the Principal that the bond has been exhausted and is,therefore,canceled. Signed and Sealed this day of , 199_. (Name of Surety) (Name of Building Contractor,Remodeler or Specialty Contractor) By: By: (Signature of Attorney in Fact) (Signature of President,Partner, or Sole Proprietor) FOR OFFICE USE ONLY Approved as to form and execution by Dennis Poppenhagen,Director of Licensing (Date) CM-00558-01(10/91) • 5 APPOINTMEN,ATTORNEY FOR SERVICE OF PROCESS(FOOON-RESIDENTS ONLY) ' KNOW ALL PERSONS BY THESE PRESENTS: That in compliance with the Laws of the State of Minnesota, I, the undersigned applicant, if a _ • non-resident,do hereby appoint the Commissioner of Commerce of the State of Minnesota,successor or successors,as my true and lawful attorney _ upon whom may be served all legal process in any action or proceeding in which I may be a party and which relates to or involves any transaction covered by Minnesota Statute Chapter §326, and do hereby expressly consent and agree that service upon such attorney shall be as valid and binding as if due and personal service had been made upon me and that such appointment shall be irrevocable. I HEREBY CERTIFY THAT ALL INFORMATION CONTAINED IN THIS APPLICATION IS TRUE AND CORRECT TO THE BEST OF MY KNOWLEDGE. Signature of Owner,Partner or Corporate Officer Date Signature of Qualifying Person Date On this—day of , 19 appeared before me, a Notary Public, and being duly sworn, says that he/she is the applicant;that he/she has read the foregoing application and accompanying exhibits, and that the contents are true to the best of his/her knowledge. Notary Public County Commission SCHEDULE OF FEES Check or money order must be made payable to MINNESOTA COMMERCE DEPARTMENT.WE CANNOT ACCEPT CASH. Residential Remodeler Building Contractor Transitional(See Instruction Sheet) Permanent(2 Year License) S150.00 S150.00 Renewal(2 Year License) S150.00 S150.00 Temporary(1 Year License) S 75.00 S 75.00 IMPORTANT: YOU MUST IDENTIFY YOUR LICENSE NUMBER ON ALL CONTRACTS, PERMITS AND ADVERTISING MATERIALS. 6 Applicanis Statement • e I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for employment as may be necessary in arriving at an employment decision. This application for employment shall be considered active for a period of time not to exceed 45 days. Any applicant wishing to be considered for employment beyond this time period should inquire as to whether or not applications are being accepted at that time. I hereby understand and acknowledge that, unless otherwise defined by applicable law, any employment relationship with this organization is of an "at will " nature, which means that the Employee may resign at any time and the Employer may discharge Employee at any time with or without cause. It is further understood that this "at will " employment relationship may not be changed by any written document or by conduct unless such change is specifically acknowledged in writing by an authorized executive of this organization. In the event of employment, I understand that false or misleading information given in my- application or interview(s) may result in discharge. I understand, also, that I am required to abide by all rules and regulations of the employer. i _ ._ __ Signature of Applicant _ Date The City of Oak Park Heights does not discriminate on the basis of race, color, ;•.national origin.,: sex, religion, age or handicapped status-in-employment. or the provision of services. r �.Zi-z yr vru\ resi�� £ L.vtL1J 14168 No. 57th Street Stillwater, MN.55082- APPLIVION FOR EMPLOYMENO • (PRE-EMPLOYMENT QUESTIONNAIRE] LAN EQUAL OPPORTUNITY EMPLOYER) Date • Name[Last Name Firstl Address i_ Telephone • What kind of work are you applying for? What special qualifications do you have? What office machines can you operate? Are you 18 years or older? Yes No SPECIAL PURPOSE QUESTIONS • DO NOT ANSWER ANY OF THE QUESTIONS IN THIS FRAMED AREA UNLESS THE EMPLOYER HAS CHECKED A BOX 'PRECEDING A QUESTION, THEREBY INDICATING THAT THE INFORMATION IS REQUIRED FOR A BONA FIDE OCCUPATIONAL QUALIFICATION,OR DICTATED BY NATIONAL SECURITY LAWS,OR IS NEEDED FOR OTHER LEGALLY PERMISSIBLE REASONS. ❑HEIGHT FEET INCHES ❑ WEIGHT LBS. ❑CITIZEN OF U.S. YES NO a MILITARY SERVICE RECORD Armed Forces Service Yes No From' To' Branch of Service Duties • Rank or rating at time of enlistment Rating at time of discharge Do you have any physical limitations that prohibit you from performing any work for which you are being considered? Yes No .Please describe. EDUCATION "NO.OF 'DID YOU SCHOOL YEARS NAME OF SCHOOL CITY COURSE GRADUATE? ATTENDED GRAMMAR HIGH 1 1 COLLEGE OTHER The Age Discrimination in Employment Act of 1967 prohibits discrimination on the basis of age with respect to individuals who are at least 40 but less than 70 years of age. EXPERIENCE NAME AND ADDRESS OF COMPANY DATE I LIST YOUR DUTIES STARTING FINAL REASON FOR LEAVING FROM TO ! SALARY I SALARY BUSINESS REFERENCES NAME ( ADDRESS OCCUPATION • • This form has been designed to strictly comply with State and Federal fair employment practice laws prohibiting employment discrimination.This Application for Employment Form is sold for general use throughout the United States.TOPS assumes no responsibility for inclusion in said tom of any Questions which.when asked by the Employer of the Job Applicant.may violate State and/or Federal Law. 04( .GER.ELEASE) • Page 4 Loss Control Quarterly Engineers' Insurance Should Cover Prior Acts by Brenda Piatz, LMCIT Many cities have their engineering sewer system, causing a backup; and calculating the city's premiums. This services provided by an engineer who is so on. In some cases it can take several would be a loss on the city's record not a city employee. Instead, the engi- years before a design defect shows up. which would not otherwise have been neer provides services as an independent For example, in a recent case a there. contractor. These engineers carry sewer backup occurred in the plaintiff's 2. Requiring independent contractors professional errors and omissions insur- home causing a significant amount of to maintain insurance coverage is one ance. LMCIT recently received a ques- damage. The alarm system at a lift of the loss control practices LMCIT tion on whether it was a good idea to station was installed by an electrical recommends. The city's actual loss allow an engineer who works as an engineer acting as an independent con- control practices are a factor the under- independent contractor to purchase tractor to the city. The backup was writers weigh in setting premiums. renewal coverage that does not extend caused by the failure of a fuse which 3. If a defect in some past work to "prior acts." Instead, the renewal resulted in a power outage and the done by an engineer resulted in series coverage would apply only to claims failure of the alarm system to notify of claims, a city could see rate made within the policy year arising out of anyone of the fuse failure. This was an increases, sizeable deductibles for actions taken within the policy year. This obvious design defect because the very those claims, or even complete exclu- would save engineers a considerable outage the alarm should have warned sion of that group of claims. amount in premiums. of caused the alarm system not to Therefore, LMCIT recommends LMCIT does not encourage this type function. that cities require those acting as inde- of insurance. Under insurance which What happens if a claim is made pendent contractors to carry insurance only covers actions taken within the against a city for a past action by an which covers prior acts. • policy year, there would be no cover- engineer? LMCIT could tender the age if a claim were made alleging a claim to the engineer's liability carrier --�' design defect in a project which the for defense. If the engineer's gn p j gineer s insurance engineer designed for the city in the no longer covers these claims, any �` : �► ' past, or if there was a claim that the damages caused by the engineer's neg- engineer had been negligent in super- ligence in designing or supervising a �� ''\ � vising some project in the past. These city project would be covered under \ A\\\ are among the most common types of LMCIT's policy. LMCIT could also try claims LMCIT receives. LMCIT attor- to recover from the engineer person- "1 \„ ne s have defended numerous suits all y, or from the en gineer's firm. This d�± ^ �• ' claiming that there was some defect in increased exposure will ultimately be the design of a street, causing an reflected in the city's premiums. _ \ i accident; or in the design of a sidewalk, 1. LMCIT's underwriters look causing a fall; or in the design of a closely at the city's loss history when League of Minnesota Cities BULK RATE U.S. POSTAGE Insurance Trust PAID 183 University Ave. E. Saint Paul, Minn St. Paul, MN 55101 PERMIT NO.3223 Loss Control Quarterly Page 3 The Snowplow Saga Continues by Dave Drugg, Loss Control Manager North Star Risk Services, Inc. By the time you see this article, units designed for operation by two Applying Wire Rope many municipalities in Minnesota will people are now being operated by one Cli S have put some additional mileage on person,in many cases because of budg- P their snowplowing and snow removal etary constrictions. This may lead to The base of the clip bears against equipment. some serious liability implications. the live end of the rope, while the "U" This article will point out some Some municipalities experiencing of the bolt presses against the dead changes or improvements that can be restrictions in staffing have sought to end. made in your municipal snowplowing/ replace wingplow units requiring two Before ropes are placed under ten- snow removal operations to assist in people to operate them. Newer equip- sion, tighten the nuts on the clips. minimizing the potential for loss. ment that is designed for one-person Tighten them again after the load is on First, has your municipality estab- operation can then be purchased to the rope to take care of any reduction fished a snowplowing policy? Without a include such things as automatic trans- in the rope's diameter caused by the plan or "road map" it's sometimes missions (to reduce the need for con- weight or tension of the load. difficult to make a determination as to tinual attention to shifting), console- Use a wire rope thimble in the loop where you want to set your priorities. mounted hydraulic controls within easy eye to prevent kinking when wire rope This also allows you to address ques- reach of the driver and mounted in clips are used. tions from citizens regarding snow- good ergonomic fashion, and truck Safety Engineering Standards, plowing and provides for a consistent units which have window lites mounted Industrial Indemnity Co., San Fran- approach. Following this type of formal in the lower portion of the passenger- cisco, CA, 1980, p. 135. policy can also assist in providing a side door to allow for better driver good defense posture in claims arising visibility. �� z,,. •��. : � iii/ out of snowplowing activity. Finally, have your equipment opera- t1,-,4!Fr%�,L- (;J% The next area to explore is what tors been given an opportunity to type of preventive and preparative become acquainted with the areas in The Wrong Way to Clip Wire Rope maintenance has taken place with your which they will be working? Have they equipment used for snowplowing and been advised of the proper procedures removal. Do you have a regular inspec- in case there is an accident? This ��', '' lion and maintenance ro am in place? includes ^ p gr p proper documentation of Has the program been "tailored" to things that may result in a claim later. The Right Way to Clip Wire Rope recognize maintenance items specific to A good example is the ongoing prob- snowplowing and removal equipment? lem with mailboxes. It's a good idea to We often see improper wire rope/ advise your operators to make written Clip spacing cable clamp attachments on equipment notes if they notice extremely unstable that utilizes cable systems for control or rickety-looking mailboxes or other Spacing and number of clips shall be of plow attachments. At the end of this roadside structures which appear to in accordance with the table below: article is an illustration indicating the already be damaged. Obviously, care is Rope Diameter Number of Clips Minimum Spacing proper and improper ways to attach also necessary in the plowing operation (inches) Drop Forged (inches) these cable clamp units. to minimize this damage whenever pos- 1/8 2 3/4 Another item to consider: have you sible. Then, if a claim is brought later, 3/16 2 1-1/8 addressed the appropriate training and the city may have better grounds to 5/4 2 1-1/2 education of your plow operators and show it did not cause the damage or 3/86 2 1-7/8 7/8 2 2-1/4 drivers? aggravate it. A few seconds of proper One of the best ways to accomplish documentation can result in a lot of 1/6 2 2-5/8 this is to provide some "hands-on" dollars saved. 1/2 2 3 3 driver safety awareness training. This This is not an all-inclusive list of 5/8 3 4-3/4 7/8 4 4-1/2 can be done by using a series of pylons items to be addressed in a snowplow- and/or barrels set up in a course ing/snow removal program. I'm sure 7/8 4 5-1/4 arrangement whereby the drivers can many of you have additional ideas, and 1 5 6 practice backing through the course we would like to hear from you. 1-1/8 6 6-1/4 and driving back out. There are also a For assistance in loss control efforts, 1 1/4 6 7-1/2 variety of classroom type approaches please contact North Star Risk Ser 1-3/8 7 8-1/4 that can be used to provide refresher vices, Inc.'s Loss Control Department, 14/2 7 9 information for drivers. 1401 West 76th Street, Suite 550, Minnesota Labor and Industry Occupa- We also see a number of instances Minneapolis, Minn. 55423. tional Safety and Health Standards, where municipalities with wingplow Minnesota Rules 5205.0700, Subd. 3, 1988 Supplement Number 1. 1 2i L M LOSS CONTROL QUARTERLYLeague of Minnesota Cities T Winter 1989 A publication of the League of Minnesota Cities Insurance Trust No. 3 ' tions which would make it difficult to City Safety Efforts Result In clear all sidewalks or streets, the city should establish a priority system as to Dividends which streets or sidewalks will be main- tained first based upon the amount of by Peter Tritz, LMCIT traffic, danger involved, etc. The court LMCIT returned $5 million in available for return to the members ruled in one case that establishing such a dividends to the property/casualty as a dividend. priority system would be a discretionary program's member cities in 1988. The LMCIT Board congratulates decision which could be immune under the This dividend was possible because cities on their success in controlling discretionary immunity statute of member cities' continued success losses. If cities can continue this Stat.466.03 3 subd. 6). in reducing and controlling losses. success, it should translate into In terms of sidewalks, it is clear Every dollar that doesn't have to be additional dividends again in the from the statute that the city is respon paid out on losses is another dollar future. sible for maintaining the sidewalks which abut any city owned property. A city should make sure that it regularly maintains any sidewalks adjacent to all Ice and Snow: Does a City have city buildings, city parking lots, in and surrounding city parks, and abutting Immunity? any undeveloped city property. If the ice and snow immunity does by Ellen A. Longfellow, LMCIT Staff Attorney not apply, the court would apply a basic Some city officials believe that cities cause pooling of ice or snow, and other negligence standard which means that do not have to worry about ice and similar conditions. the question would be, "Did the city snow on sidewalks and streets as a A distinction by the courts which is exercise reasonable care?" If the city result of a statutory immunity passed not specifically stated in the statute is makes good faith efforts to use its in 1986. This is not necessarily true. whether the ice and snow condition available resources to maintain the Minnesota Statutes 466.03 subd. 4, was artificially or naturally created. In streets and sidewalks, there is a strong states that a city will not be liable for a recent case, the Minnesota Court of argument that the answer to that ques- "any claim based on snow or ice con- Appeals emphasized that if the condi tion would be yes. ditions on any highway or public side- tion was not caused by the local gov- walk that does not abut a publicly ernment, the government would have Loss Control Videos In owned building or publicly owned park- immunity. This is true even if the High Demand ing lot, except when the condition is condition was artificially caused by affirmatively caused by the negligent other factors such as traffic on the road by Dave Drugg, North Star acts of the municipality." packing down natural snowfall. The Risk Services This immunity does not apply if the court indicated, however, immunity ice or snow condition was caused by may not apply to failure to remove a North Star Risk Services has the negligent acts of the city. For known dangerous icy condition artifi- received a fantastic response to its example, in one case, the court found cially created on a sidewalk. If the city videotape loan program of topics from that a county was liable when a motor- is aware of any dangerous conditions, the spring 1988 Loss Control Work- ist's vision was obscured by a pile of it should attempt to remove them. If shops. Unfortunately, because of the snow that was placed on the median by there is an ordinance requiring the high demand, only one tape per order the county's snowplow operator. adjacent property owner to maintain is available. Please do not keep a tape Therefore, a city should be careful not the sidewalk, the city should notify the for more than 14 days if at all possible. to create any slippery conditions such property owner. In other cases, the If you've been waiting for a tape, as piles of snow, water dripping off of city should remove the ice and snow please be patient; we're doing our best city buildings or from downspouts, dips itself. to keep up with the orders! Thanks for in the street or sidewalk that may In the case of storms or other situa- your understanding. 410 Page 2 Loss Control Quarterly Intergovernmental Agreements: Who Pays? by John E. Hennen, LMCIT Staff Attorney A county road runs through a city. ments are extremely important in and property losses. The party which City utility structures are in the county decreasing a city's liability exposure. exercises control over the use and right of way. Before, during or after a Why? Frequently, if there is no written responsibility for maintenance of the county repaving, one of the utility understanding of who is responsible for property or facility should provide structures was not raised to grade. A what—there is no understanding at all. insurance. man is injured when his bicycle tire If it isn't determined who does what, it 5. Establish policies and procedures strikes the resulting "chuck hole." No frequently doesn't get done. When to assure that intergovernmental one knows how this utility structure someone gets hurt as a result, there is agreements are reviewed and renewed was "missed." The city blames the immediate conflict between the govern- on a regular basis. If actual practice county - the county blames the city. mental entities concerning who should concerning maintenance, inspection, The case settles for $6,000; the city have done what wasn't done. etc. differs from what is set forth in the pays $4,500 and the county pays Written governmental agreements agreement, either the actual practice $1,500. allow all governmental entities involved or the written agreement should be An abandoned city street goes to know who is responsible for what. changed. through a county park. Long ago, the This knowledge helps decrease the Are intergovernmental agreements city installed posts and a cable to possibility of missing something and easy to enter into? Not always. Fre- prevent auto traffic from entering that thereby decreases the possibility of quently, the governmental entity with part of the park. A snowmobiler was somebody getting hurt. Intergovern- the most real responsibility is the gov- killed when he failed to see the cable. mental agreements also allow for reso- ernmental entity least likely to want The case is settled for $250,000. The lution of disputes and actually decrease that responsibility set forth in writing. city pays $75,000; the county pays tensions between the parties. Disputes Conversely, the governmental entity $175,000. can be resolved under the terms of the with the least real responsibility has What do the above scenarios have in intergovernmental agreement rather every interest in making sure that its common? First, they are based on than having the government entities minimal responsibility is clearly set actual LMCIT cases. Second, they blame each other in open court. forth. In the long run clear understand- involve more than one governmental What should an intergovernmental ing of who is responsible for what entity. Third, in neither case was there agreement contain? decreases conflict when someone any written agreement setting forth 1. If property is involved, it should brings a claim. who is responsible for what and who identify which party has control of the What can the city do if another city pays what if someone is hurt. use of the property or facility that is or the county refuses to enter into such Written intergovernmental agree- the subject of the agreement. If control a governmental agreement? Write a is shared, the agreement should say letter in clear and concise language League of Minnesota Cities how that control is to be shared. setting forth your understanding of who Insurance Trust 2. It should specify which party has is responsible for what. In that letter, 183 University Avenue East the responsibility to design, construct, ask the other party to tell you if 1 i S8. Paul, Minnesota 55101 East maintain, and inspect the property and/ anything in your letter does not square or facility. The agreement should with their understanding of the parties' 612-227-5600 address who is responsible for periodic respective responsibilities. A series of Loss Control Quarterly Editor: safety inspections, documenting and these letters are ultimately going to Brenda Piatz maintaining records of inspections, result in a written understanding con- LMCIT Staff Attorneys: maintaining a log to record complaints cerning responsibility whether there is Ellen Longfellow or notice of hazardous conditions on a a formal written agreement or not. John E. Hennen property or facility, employee training, Intergovernmental agreements ulti- and consent or liability waiver forms mately decrease misunderstandings. LMCIT Executive Director: where appropriate. They are effective in promoting Peter Tritz 3. Consider including a hold harmless responsibility by all parties involved. If The Loss Control Quarterly is pub- and indemnification clause. Generally there is no agreement or understand- fished quarterly by the League of speaking, a party which has control ing, it is too easy to assume that the Minnesota Cities Insurance Trust over the use and responsibility for other governmental unit will take care for the purpose of educating and maintenance of the property or facility of the problem. informing cities about loss control is the appropriate party to hold harm- Intergovernmental agreements help methods and risk management. The less and indemnify the other. ensure that a city is only a defendant opinions expressed in this publica- 4. Include an insurance clause iden- or the subject of a claim in cases where tion are those of the authors and are tifying which party is responsible for the city did something wrong or didn't not intended to provide specific legal maintaining insurance to cover liability do something it was supposed to do. ,, C' J advice. • ` i it �` • R 1E C �t1SEP 6 199 . 1991 North Star Risk Services, Inc. °;'`�;/uY September 3, 1991 Ms. LaVonne Wilson Administrator-Treasurer CITY OF OAK PARK HEIGHTS P.O. Box 2007 Oak Park Heights, Minnesota 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. POLICE OPERATIONS 1-8/91 The Police Policy and Procedure Manual should include comprehensive policies on squad cars driving without lights for emergency situations. The city's legal counsel should review all such wording on a periodic basis as the Policy and Procedure Manual is updated. 2-8/91 We are very concerned about the potential for police officers individually engaging in the practice of contracting out their services to private entities on an individual basis. These entities, such as schools and dance halls, should be contracted directly with the city, which would then assign a police officer to that entity. The city's legal counsel should be involved in writing and/or reviewing the legal contract, which should include proper hold-harmless arrangements written in favor of the city. 3-8/91 Consideration should be given to qualifying with a "P" for pass rather than a number score. We are concerned that this procedure will help take away a 1401 West 76th Street,Suite 500 • Minneapolis,Minnesota 55423 • (612)861-8600 • FAX(612)861-8643 A Member of Berkley Risk Management Services Group 12-r ! • City of Oak Park Heights September 3, 1991 Page Two plaintiff argument for negligent shooting. The city should be in consultation with the city's legal counsel for the development of such policies. CITY HALL 4-8/91 As I reviewed the new addition on the city hall, I did note the city has gone to extra expense of placing fire doors within the building. The purpose of these fire doors is to help control the spread of smoke and fire, thus protecting the rest of the building. I did note a number of these doors propped open, thus negating their usefulness. Strong consideration should be given to removing the door props so the doors can remain properly closed in an emergency situation. CITY PARK 5-8/91 It is recommended that a review be accomplished of all city owned and/or maintained playground facilities to determine that these facilities are arranged with appropriate impact absorption material under all playground equipment. This could consist of at least twelve inches of sand or other material with similar impact absorption capability. This material should extend throughout the base of the playground equipment and an area of at least eight to ten feet out surrounding the equipment where potential falls from equipment could occur. This material should be well maintained. 6-8/91 In order to provide a means of communication to users of the ice rink facility, it is recommended that appropriate advisory signage be placed at the ice rinkS to adequately advise and warn users of the area concerning the operation of the area. This advisory signage should be placed outside in an area conspicuous to users of the facility while not creating an obstruction in itself which could be a hazard to skaters. Common types of advisories that we have observed on rink signage can include: hours of rink operation, requirements for separation of hockey activity from pleasure skating activity (either by separation of the rink areas or by skating times for each activity) and use of appropriate personal protective equipment for persons engaged in hockey activity. Comments can also be made indicating the appropriate behavior expected of users of the facility. • S City of Oak Park Heights September 3, 1991 Page Three We highly recommend the city consult with appropriate legal counsel concerning the size, high visibility coloring and placement of this advisory signage. The League of Minnesota Cities Insurance Trust legal staff is also a resource to you in this regard. 7-8/91 In order to help protect youngsters using the playground, I would recommend the city place a shroud over the bearing on the tire swing. We are concerned that youngsters can get fingers pinched within this bearing and sustain an injury. These bearing shrouds are available through a playground manufacturer/ distributor. BALL FIELD 8-8/91 A minimum 15 foot wide warning track should be installed in the outfield on high use baseball fields to assist in warning the outfielder he or she is nearing the outfield fence. 9-8/91 Protective measures should be in place to protect the players not involved on the field of play from flying balls. One method would be to install an adequate protective fence in the dugout or player seating areas. 10-8/91 Consideration should be given to replacing the current bases with a safety style base. Many of these safety bases have tapered edges which can reduce the potential for leg and ankle injuries to ballplayers. GENERAL OPERATIONS 11-8/91 The city should be obtaining certificates of insurance from all insurance • providers as we discussed at the time of my last loss control service call. 12-8/91 I highly recommend the city develop an affirmative action sheet and incorporate this form with the employment application form. This affirmative action sheet should be filled out by a prospective employee, separated from the employment application by a person other than the interviewer. The sheet should be kept on file. 13-8/91 Many cities have situations where other governmental entities, such as counties and the state, have rights-of-way which traverse portions of the city. It is important that an understanding be established between the city and these ! • City of Oak Park Heights September 3, 1991 Page Four other entities concerning the responsibility for maintaining these structures and the responsibility for liability that may be associated with these structures. Hence, it is recommended the city establish written agreements with these other entities so that responsibility for design, engineering, maintenance and responsibility for liability is clear for sidewalks, curbs, gutters and roads which traverse the city. To provide you with some additional information in this regard, enclosed is a copy of an article written by Jack Hennen, League of Minnesota Cities Insurance Trust staff attorney, concerning this topic. This article was published in the Loss Control Quarterly section of the January, 1989 issue of Minnesota Cities magazine. Also, the LMCIT staff attorneys can be contacted directly for additional information in this regard. 14-8/91 In the event a major catastrophe would.strike the city, it is very important that .r• there is a written media policy for communication with the media, whether it 1 1 z be the print media or the electronic media. This media policy usually indicates t J4 a designated spokesperson, be it the city administrator, city legal counsel or department head. This person should then be schooled in dissemination of Binformation to the media. To assist you, we have provided a videotape list which does have at least two videotapes dealing with this subject. The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. id City of Oak Park Heights September 3, 1991 Page Five Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, Douglas . Holm, CSP, MS Senior Loss Control Consultant North Star Risk Services, Inc. DDH:eab Enclosure cc: Mr. Dean McGowan FOREST LAKE INSURANCE AGENCY P.O. Box 188 Forest Lake, Minnesota 55025 These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. i • • Page 2 . • Loss Control Quarterly Intergovernmental Agreements: Who Pays. 1 by John E. Hennen, LMCIT Staff Attorney A county road runs through a city. ments are extremely important in and property losses. The party which City utility structures are in the county decreasing a city's liability exposure. exercises control over t e o and right of way. Before, during or after a Why? Frequently,if there is no written responsibility for maintenance of the county repaving, one of the utility understanding of who is responsible for property or facility should provide structures was not raised to grade. A what—there is no understanding at all. insurance. man is injured when his bicycle tire If it isn't determined who does what, it 5. Establish policies and procedures strikes the resulting "chuck hole." No frequently doesn't get done. When to assure that intergovernmental one knows how this utility structure someone gets hurt as a result, there is agreements are reviewed and renewed was "missed." The city blames the immediate conflict between the govern- on a regular basis. If actual practice county - the county blames the city. mental entities concerning who should concerning maintenance, inspection, The case settles for $6,000; the city have done what wasn't done. etc.differs from what is set forth in the pays $4,500 and the county pays Written governmental agreements agreement. either the actual practice $1,500. allow all governmental entities involved or the written agreement should be An abandoned city street goes to know who is responsible for what. changed. through a county park. Long ago. the This knowledge helps decrease the Are intergovernmental agreements city installed posts and a cable to possibility of missing something and easy to enter into? Not always. Fre- prevent auto traffic from entering that thereby decreases the possibility of quently, the governmental entity with part of the park. A snowmobller was somebody getting hurt. Intergovern- the most real responsibility is the gov- lolled when he failed to see the cable. mental agreements also allow for reso- ernmental entity least likely to want The case is settled for $250,000. The hution of disputes and actually decrease that responsibility set forth in writing. city pays $75,000; the county pays tensions between the parties. Disputes Conversely, the governmental entity $175,000. can be resolved under the terms of the with the least real responsibility has What do the above scenarios have in intergovernmental agreement rather every interest in making sure that its common? First, they are based on than having the government entities minimal responsibility is clearly set actual LMCIT cases. Second, they blame each other in open court. forth. In the long run dear understand- involve more than one governmental What should an intergovernmental ing of who is responsible for what entity.Third in neither case was there agreement contain? decreases conflict when someone any written agreement setting forth 1. If property is involved, it should brings a claim. who is responsible for what and who identify which party has control of the What can the city do if another city pays what if someone is hurt. use of the property or facility that is or the county refuses to enter into such • Written intergovernmental agree- the subject of the agreement. If control a governmental agreement? Write a is shared, the agreement should say letter in clear and concise language how that control is to be shared. setting forth your understanding of who League of Minnesota Cities 2. It should specify which party has is responsible for what. In that letter, Insurance Trust the responsibility to design, construct, ask the other party to tell you if 183 University Avenue East maintain. and inspect the property and! anything in your letter does not square St. Paul, 1Vfmnesota 55101 or facility. The agreement should with their understanding of the parties' 612-227-5600 address who is responsible for periodic respective responsibilities. A series of Loss Control Quarterly Editor: safety inspections. documenting and these letters are ultimately going to Brenda Piatz maintaining records of inspections, result in a written understanding con- LMCIT Staff Attorneys: maintaining a log to record complaints cerning responsibility whether there is Ellen Longfellow or notice of hazardous conditions on a a formal written agreement or not. John E. Hennen property or facility, employee training, Intergovernmental agreements ulti- and consent or liability waiver forms mately decrease misunderstandings. LICIT Executive Director: where appropriate. They are effective in promoting Peter Tritz 3. Consider including a hold harmless responsibility by all parties involved. If The Loss Control Quarterly is pub- and indemnification clause. Generally there is no agreement or understand- fished quarterly by the League of speaking, a ply which has control ing. it is too easy to assume that the Minnesota Cities Insurance Trust over the use and responsibility for other governmental unit will take care for the purpose of educating and maintenance of the property or facility of the problem. informing cities about loss control is the appropriate party to hold harm- Intergovernmental agreements help methods and risk management. The less and indemnify the other. ensure that a city is only a defendant opinions expressed in this publica- 4. Include an insurance clause iden- or the subject of a claim in cases where which is responsible for the city did something wrong or.didn't lion are those of the authors and are �g party to do. not intended to provide specific legal maintaining insurance to cover liability do something it was supposed advice. E Minnesota Cities 7f. f + -4e) North Star Risk Services, Inc. - LOSS CONTROL DEPARTMENT - LOSS CONTROL AND RISK MANAGEMENT INFORMATION AVAILABLE ON VIDEOTAPE (All are VHS Format) GENERAL INTEREST/ADMINISTRATIVE 1. SETTING UP A RISK MANAGEMENT PROGRAM (NSRS #1) With: Peter E. Potemkin, Manager of Safety Services Texas Municipal League Self-Insurance Fund (PRIMAVISION) When it comes to your risk management efforts, have you asked yourself. . . . "How do I get started?" and . . . "How do I put a. risk management program to g e th er?" This presentation will help you find answers to these and many other questions concerning risk management program development from one of the country's recog- nized public entity risk management authorities. Running Time: Approximately 30 minutes 2 . RISK MANAGEMENT FOR SMALL COMMUNITIES (NSRS #2) Produced By: Extension Service, USDA, PRIMA, and Oklahoma State University This presentation is designed to help you with your risk manage- ment efforts by providing an overview of risk management avenues involving areas such as public officials liability, roads and streets, contracts and agreements, law enforcement, parks and recreation employee safety, and environmental impairment liability. Presentations are given by actual city management persons who can relate to "real world" risk management needs. This is an excel- lent primer to beginning and ongoing risk management efforts. A _ risk management manual and support resources are also available. Running Time: Approximately 55 minutes 10/90 • 1401 West 76th Street,Suite 500 a Minneapolis,Minnesota 55423 ■ (612)861-8600 ■ FAX(612)861-8643 A Member of Berkley Risk Management Services Group . . NSRS Videotape Library Page Two 3 . A RISK MANAGEMENT ENDORSEMENT -- A VIEW FROM THE CITY (NSRS #3) With: Frank Boyles, Assistant City Manager City of Plymouth, Minnesota Can a risk management program really work for my city? If you've asked yourself that question, you'll want to see this presenta- tion. Mr. Boyles reviews the risk management efforts undertaken by the City of Plymouth, Minnesota and how those efforts have paid off for them. A real "nuts-and-bolts" view of a working risk management program. Running Time: Approximately 60 minutes (LMCIT Workshop 1989) 4 . INTERDEPARTMENTAL COMMUNICATION (NSRS #4) With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust Does the right hand know what the left hand is doing? Effective communication between departments, cities and other governmental entities is essential to loss control and risk management. This presentation lays out the paths to effective communication between these parties and how it can benefit your risk management efforts. Running Time: Approximately 40 minutes (LMCIT Workshop 1989) 5. LIABILITY CLAIMS - DEALING WITH THE INJURED PARTY (NSRS #5). With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust This presentation uses skits to illustrate desirable and not-so-desirable ways to communicate with persons who have suffered a loss . . . and who may become claimants later. Running Time: Approximately 30 minutes (LMCIT Workshop 1988) 6. DEALING WITH THE INJURED PARTY (& WITH POTENTIAL CLAIMANTS) (NSRS #6) With: Ellen Longfellow, Staff Attorney League of Minnesota Cities Insurance Trust This presentation uses skits and discussion to help you do a more effective job dealing with persons who may become claimants because of injuries or damages occurring in your city. Running Time: Approximately 20 minutes (LMCIT Workshop 1989) 10/90 I _ • NSRS Videotape Library Page Three 7. DEALING WITH THE MEDIA (NSRS #7) With: Ellen Longfellow, Staff Attorney League of Minnesota Cities Insurance Trust Have you ever had to deal with questions from the media or do you get chills thinking about it? This presentation provides valuable information, in skit and discussion form, to help you more effectively deal with the media. Information is also provided relative to media relations involving open and closed meetings and data privacy considerations. Running Time: Approximately 30 minutes (LMCIT Workshop 1989) 8. "A MEDIA RELATIONS SELF-DEFENSE COURSE" (NSRS #8) Presented by Bob Shaw, Public Sector Consultants This presentation lays out some sound principles for maintaining effective media relations without compromising your interests and the public interest. Originally geared toward law enforcement agency administrators, the ideas presented can be used by anyone in public life who may find themselves dealing with or covered by the media. Running time: Approximately 60 minutes 9. LOSS CONTROL AND RISK MANAGEMENT FOR MUNICIPAL FESTIVALS AND SPECIAL EVENTS (NSRS #22). With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust There are literally hundreds of municipal festivals and special events that take place in Minnesota cities every year. There are also multitudes of risk management and loss control concerns that need to be addressed when planning and carrying out these events. This presentation provides valuable information to help you in this process. Running Time: Approximately 30 minutes 10/90 i r NSRS Videotape Library Page Four 10. "HERE COMES THE JUDGE" (NSRS #25). With: Janet Coleman, Staff Attorney League of Minnesota Cities Insurance Trust Some governmental entities may find themselves occasionally facing appearances in Conciliation Court--or they may find it useful to use Conciliation Court to pursue certain claims of their own. This tape provides some information on how Conciliation Court may be used to your best advantage, and guidelines on how you can prepare for Conciliation Court so that the experience is a posi- tive one. Running Time: Approximately 22 minutes (LMCIT Workshop, 1990) 11. "AIN'T NOTHING BUT A HOUND DOG" (NSRS #26), With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust Surprisingly, the process of conducting animal control operations in governmental entities can present a significant liability ex- posure to these entities. It is also often a very highly emotionally charged "service" provided in governmental agencies. This videotape provides you with a basis of information concerning laws which govern animal control and some helpful suggestions on the appropriate equipment and procedures that you can use to con- duct these operations effectively and with a positive public relations image. Running Time: Approximately 42 minutes (LMCIT Workshop, 1990) CONTRACTS AND INSURANCE ISSUES 12. MANAGING YOUR CONTRACTS (NSRS #9) With: Kathleen Magrew, Legal Assistant City of Minnetonka, Minnesota Ms. Magrew discusses risk management and loss control measures relative to contract management, certificates of insurance, and relationships with independent contractors from the perspective of the legal department in an actual city operation. Also included is a discussion concerning inter-agency and inter-governmental relationships from a risk management viewpoint. Running Time: Approximately 30 minutes (LMCIT Workshop 1988) 10/90 . . NSRS Videotape Library Page Five 13 . MUNICIPAL CONTRACTS & INSURANCE ISSUES -- A CITY ATTORNEY'S POINT-OF-VIEW (NSRS #10) With: George Hoff, City Attorney Here's a viewpoint from someone who's "in the trenches. " Mr. Hoff discusses the practical ways that cities can use contracts, certificates of insurance and related tools to maximize risk management in a city. Running Time: Approximately 30 minutes (LMCIT Workshop 1989) ) EMPLOYMENT AND PERSONNEL PRACTICES 14. EMPLOYMENT LIABILITY ISSUES (NSRS #11) With: Chris Harristhal, Attorney at Law Larkin, Hoffman, Daly & Lindgren, Ltd. If you're an administrator concerned about such employment liability issues as sexual harassment in the workplace, hiring, discipline and termination practices, employment handbooks and manuals . . . then this video is a must for you. Chris Harristhal is an attorney specializing in employment liability issues and presents a comprehensive treatment on this wide-ranging topic. Running Time: Approximately 60 minutes (LMCIT Workshop 1989) 15. EMPLOYMENT PRACTICES LIABILITY & PERSONNEL ISSUES (NSRS #12) With: Shannon McCambridge, Attorney at Law Larkin, Hoffman, Daly & Lindgren, Ltd. Employment related issues such as hiring, disciplining and terminating often involve very complex legal issues as well. Ms. McCambridge presents a comprehensive approach to these concerns from an attorney's viewpoint -- with practical tools you can use in your own city. Running Time: Approximately 60 minutes (LMCIT Workshop 1989) 10/90 4 NSRS Videotape Library Page Six 16. "YOU'RE FIRED! !" (NSRS #27) With: Ron Holback, Claims Department, EBA Company and Jim Martin, Attorney at Law, Larkin, Hoffman, Daly and Lindgren, Ltd. Have you ever found yourself in a situation where you just don't feel that you can bring an injured employee back to work? This information will provide you with some guidelines and a thought process to consider when facing this difficult termination situation. Guidelines provided in the information can help you avoid expensive employment practices claims and maximize the effectiveness of a return-to-work program for injured employees. Running Time: Approximately 31 minutes (LMCIT Workshop, 1990) 17. "YOU'RE HIRED! !" (NSRS #28) With: Jim Martin, Attorney at Law Larkin, Hoffman, Daly and Lindgren, Ltd. Employment practices liability claims can be very expensive, time consuming and extremely stressful. Information provided on this videotape will lay out some guidelines for you to use in the hiring and employment process. Information includes proper interviewing approaches, application forms, effective performance reviews and ways to protect yourself from claims for discrimina- tion, sexual harassment, etc. Running Time: Approximately 56 minutes (LMCIT Workshop, 1990) AUTOMOBILE AND EQUIPMENT OPERATIONS 18. A VEHICLE & EOUIPMENT FLEET LOSS CONTROL PROGRAM (NSRS #13). With: Doug Holm, Loss Control Consultant North Star Risk Services, Inc. Most cities have thousands of dollars worth of vehicles and equipment on the road every day as well as valuable personnel operating them. Learn how to set up and operate a comprehensive fleet loss control program in this presentation. e 45 minutes (LMCIT Workshop 1989 Running Time: Approximately ( p ) 10/90 • • NSRS Videotape Library Page Seven PUBLIC WORKS PU 19. KEEPING MAINTENANCE & INSPECTION RECORD S (PUBLIC WORKS ( (NSRS #14) With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust How can something so boring be so important? This presentation discusses the importance of keeping good, sound maintenance and records and suggests wa s to keep inspection r rds an y p these records in as easy a manner as possible. Running Time: Approximately 15 minutes (LMCIT Workshop 1988) 20. TRAFFIC SIGNS & MARKINGS (NSRS #15), With: Donald Anderson Transportation Technology Transfer Center North Dakota State University This presentation uses slides and discussion to illustrate traffic sign and marking fundamentals to help minimize your liability exposure and promote traffic safety for the motoring public. Running Time: Approximately 60 minutes (LMCIT Workshop 1988) 21. INSPECTING YOUR STREETS. SIDEWALKS, ETC. (NSRS #16), With: Dou g Holm, Loss Control Consultant North Star Risk Services and Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust This presentation uses slides taken from actual situations existing in Minnesota cities to illustrate conditions existing with streets, sidewalks and other public ways which can lead to liability exposures and claims. Also included is a discussion un - practical loss control measures you can use to eliminate or minimize these exposures. Running Time: Approximately 50 minutes (LMCIT Workshop 1988) 10/90 • NSRS Videotape Library Page Eight 22. "SNOWBOUND!" (NSRS #29), With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust If your governmental entity is involved with services related to snow removal, snowplowing and related operations, this informa- tion applies to you. Some of the questions answered include: "How do I establish a snowplowing/snow removal policy?" and "How do I convey this in a positive way to the public?" This presen- tation also includes discussion of actual claims relating to snow removal and snowplowing activities and how you can learn from these claim circumstances. Running Time: Approximately 35 minutes (LMCIT Workshop, 1990) 23 . "GIVE ME A LIFT!" (NSRS #30), With: Ellen Longfellow, Staff Attorney League of Minnesota Cities Insurance Trust Claims relative to liability for handling of wastewater and for sewer backups occur all too often in governmental entities. This presentation is designed to provide you with helpful information concerning prevention of these types of claims and how you can more effectively structure a defense when these types of claims are made. Included is some discussion relative to operation and maintenance of wastewater lift station equipment. Running Time: Approximately 27 minutes (LMCIT Workshop, 1990) PARKS AND RECREATION 24. PARRS & RECREATION HAZARD RECOGNITION & CONTROL (NSRS #17) With: W. Michael Everist, Loss Control Consultant North Star Risk Services, Inc. How can something designed for fun present so many hazards? In this presentation learn how to recognize and control many of those hazards relating to parks and recreation facilities and programs. Running Time: Approximately 45 minutes (LMCIT Workshop 1989) 10/90 • NSRS Videotape Library Page Nine 25. "WHO'S IN CHARGE HERE?!" (NSRS #31), With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust Many governmental entities find themselves in situations where they are asked to provide public facilities, either on a rental or free basis, to the public. This can include facilities ranging from ice arenas to public park and ball field areas. This presen- tation will provide you with some helpful information concerning how you can most effectively manage this potential liability exposure and includes information concerning those situations where there may be serving or consumption of alcohol. Running Time: Approximately 50 minutes (LMCIT Workshop, 1990) 26. "THIS OLD PARK" (NSRS #32), Produced By: North Star Risk Services, Inc. Loss Control Department, in cooperation with the Cities of Eagan, Minnesota and Roseville, Minnesota Parks and Recreation Departments and the Minnesota Recreation and Parks Association In September, 1990, „a workshop was conducted at a park in the City of Eagan, Minnesota. This workshop was designed to provide "front line” parks maintenance personnel with an opportunity to observe hidden hazards which can represent liability exposures and main- tenance problems for these persons. This videotape was produced to illustrate how this workshop was conducted and some of the information related in the workshop so that you can create your own workshop environment for effective training of your parks maintenance personnel. Running Time: Approximately 58 minutes I. - 10/90 • NSRS Videotape Library Page Ten LAW ENFORCEMENT/POLICE LIABILITY 27. LAW ENFORCEMENT LIABILITY ISSUES (NSRS #18) With: Donald Davis, Chief of Police City of Brooklyn Park, Minnesota From the perspective of a law enforcement agency administrator, this presentation deals with a multitude of liability exposure concerns facing law enforcement agencies today. Included are discussions on the establishment, use and maintenance of a Policy & Procedure Manual, as well as "hot topics" on pursuit driving, use of force and weapons, and stun gun usage. Running Time: Approximately 120 minutes (LMCIT Workshop 1988) 28. LAW ENFORCEMENT PUNITIVE DAMAGES (NSRS 419), With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust As a law enforcement officer, how are you personally exposed to punitive damages? How does LMCIT's coverage fit in when it comes to p unitive damages? These and other questions pertaining to law enforcement punitive damages are addressed in this presentation. Running Time: Approximately 15 minutes (LMCIT Workshop 1988) 29 . POLICE PURSUIT POLICY AND PROCEDURE (NSRS #20) Presented By: The Minnesota Board of Peace Officer Standards and Training Minnesota law requires certain policies and issues involving police pursuit to be addressed by October, 1989. This video involves presentations by P.O.S.T. director Bill Carter and authorities from the legal and law enforcement communities to help you establish and refine this critical policy and procedural area. I Running Time: Approximately 120 minutes (NSRS 8/89) 10/90 111 NSRS Videotape Library Page Eleven 30. EPILEPSY: A POSITIVE I.D. (NSRS #21), Produced By: Epilepsy Education, University of Minnesota This award winning video is designed to help first responders (police, firefighters, paramedics) and other professionals recognize the most common epileptic seizures, administer first aid and recognize epilepsy medication. Emphasis is placed on the fact that complex partial (psychomotor) seizures can be easily mistaken for drunkenness or drug abuse. This could be a valuable training tool to help your first responders do a more effective job. Running Time: Approximately 22 minutes FIRE SERVICE 31. "WHERE'S THE BOOYA?! " (NSRS #33). With: Janet Coleman, Staff Attorney League of Minnesota Cities Insurance Trust Fire departments are often involved in a variety of fund-raising activities to support their operations. This tape provides information on how you can minimize your exposure to liability while conducting these types of activities. Information includes discussion surrounding liquor liability exposures and use of public facilities and premises for conducting fund-raising activities. Running Time: Approximately 12 minutes (LMCIT Workshop, 1990) 32. "THE FIREFIGHTER 500" (NSRS #34) With: Tom Grundhoefer, Staff Legal Counsel League of Minnesota Cities Insurance Trust Firefighters responding to emergency calls, especially in their own personal vehicles, can be exposed to significant levels of liability and injury potential. This presentation outlines the - kinds of exposures firefighters need to be aware of and the restrictions placed upon firefighters while they are responding on an emergency basis. Running Time: Approximately 16 minutes (LMCIT Workshop, 1990) 10/90 411 411 NSRS Videotape Library Page Twelve 33 . "THE FEW. THE PROUD. THE FIREFIGHTERS (NSRS #35) With: Jack Hennen, Staff Attorney League of Minnesota Cities Insurance Trust and Brenda Piatz, Legal Assistant League of Minnesota Cities Insurance Trust Fire service operations, especially those which are on a volunteer basis, may find themselves in awkward situations in the process of recruiting and "hiring" firefighters. This presentation is de- signed to assist fire departments in doing the most efficient job possible in this recruitment process while minimizing potential liability exposures associated with discrimination and employment practices. Running Time: Approximately 30 minutes (LMCIT Workshop, 1990) ENVIRONMENTAL IMPAIRMENT/POLLUTION LIABILITY 34. UNDERGROUND STORAGE TANKS - A TELECONFERENCE (NSRS #23) This video was produced in conjunction with a statewide tele- conference held on October 11, 1989. Panel members from the legal, governmental,_ industry, insurance and Pollution Control Agency standpoints discuss the "new" rules, regulations and issues facing owners and operators of underground storage tanks (UST's) in the 1990's. 35. WHAT IT MEANS TO YOU (NSRS #24) S.A.R.A. , Title III, Emergency Planning, Community Right-to-Know Act . These are all terms which have caused no small amount of confusion as local governments make efforts to comply with the requirements of this law. This video, produced by the E.P.A. , outlines the basic introduction to this law and describes, in a nontechnical manner, the provisions and scope of the law that can have far-reaching effects on communities and their citizens. Running Time: Approximately 18 minutes 10/90 . !/` S . . 4`.%;.° North Star Risk Services, Inc. VIDEOTAPE LOAN ORDER FORK TITLE OF VIDEOTAPE: (from title p title descri tion form - be sure to include the title number shown after the title! ) YOUR NAME: YOUR TITLE: YOUR ORGANIZATION: COMPLETE MAILING ADDRESS: YOUR PHONE NUMBER: _( ), MAIL THIS FORM TO: North Star Risk Services, Inc. Loss Control Services 1401 West 76th Street, Suite 500 Minneapolis, Minnesota 55423 *Attention: L. C. Video NOTE: In order to provide requested videos to as many requesting parties as possible, we ask that you order only one videotape at a time and keep the videotape for a maximum of 14 days. Feel free to make copies of this blank order form for subsequent videos you - would like to order. Thank you! • 1401 West 76th Street,Suite 500 ■ Minneapolis,Minnesota 55423 • (612)861-8600 • PS(612)861-8643 A Member of Beridey Risk Management Services Group • CITY OF OAK PARK HEIGHTS A MINNESOTA STAR CITY October 22, 1991 TO: Council/City Maintenance FROM: Parks Commission SUBJECT: Parks Commission Update 1). Resurface Swager Park Tennis Court. Confirmed by Commission. 2) . Install Picnic Shelter in Valley View Park (Size and number of tables still under consideration - will be confirmed). 3). Brekke Park walkway to restrooms - consensus is leaning toward engineering work-up for facility at deck level. 4) . Wal-Mart Park Contribution - stay with ordinance - settin g precedence is important regarding future development. 5). Handicap curb cut from parking lot to sidewalk at Brekke Building. City crew will handle per Jeff Kellogg. 6) . Both Ball Fields (Infields) will be re-worked next spring - proper aggregate to be installed and weed free. 7) . Jeff to make contact with DNR regarding culvert length, grade and size for Dixon farm road in Valley View Park. 8). Jeff to secure quotes for ball players bench fencing for both fields (North Star Risk Letter 1991). Thank Y ou Dick Seggelke DS:jad 14168 North 57th Street • Box 2007 • Oak Park Heights, Minnesota 55082-2007 Phone: 612-439-4439 • Fax: 612-439-0574 • • RECEIVED SEA' 6iggi North Star Risk Services, Inc. GLOrri September 3, 1991 a"))11/;1- Ms. LaVonne Wilson Administrator-Treasurer CITY OF OAK PARK HEIGHTS P.O. Box 2007 Oak Park Heights, Minnesota 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. POLICE OPERATIONS 1-8/91 The Police Policy and Procedure Manual should include comprehensive policies on squad cars driving without lights for emergency situations. The city's legal counsel should review all such wording on a periodic basis as the Policy and Procedure Manual is updated. 2-8/91 We are very concerned about the potential for police officers individually engaging in the practice of contracting out their services to private entities on an individual basis. These entities, such as schools and dance halls, should be contracted directly with the city, which would then assign a police officer to that entity. The city's legal counsel should be involved in writing and/or reviewing the legal contract, which should include proper hold-harmless arrangements written in favor of the city. 3-8/91 Consideration should be given to qualifying with a "P" for pass rather than a number score. We are concerned that this procedure will help take away a • 1401 West 76th Street,Suite 500 • Minneapolis,Minnesota 55423 • (612)861-8600 • FAX(612)861-8643 '° A Member of Berkley Risk Management Services Group �/ 11 • City of Oak Park Heights September 3, 1991 Page Two plaintiff argument for negligent shooting. The city should be in consultation with the city's legal counsel for the development of such policies. CITY HALL 4-8/91 As I reviewed the new addition on the city hall, I did note the city has gone to extra expense of placing fire doors within the building. The purpose of these fire doors is to help control the spread of smoke and fire, thus protecting the rest of the building. I did note a number of these doors propped open, thus negating their usefulness. Strong consideration should be given to removing the door props so the doors can remain properly closed in an emergency situation. CITY PARK 5-8/91 It is recommended that a review be accomplished of all city owned and/or maintained playground facilities to determine that these facilities are arranged with appropriate impact absorption material under all playground equipment. This could consist of at least twelve inches of sand or other material with similar impact absorption capability. This material should extend throughout the base of the playground equipment and an area of at least eight to ten feet out surrounding the equipment where potential falls from equipment could occur. This material should be well maintained. 6-8/91 In order to provide a means of communication to users of the ice rink facility, it is recommended that appropriate advisory signage be placed at the ice rinkS to adequately advise and warn users of the area concerning the operation of the area. This advisory signage should be placed outside in an area conspicuous to users of the facility while not creating an obstruction in itself which could be a hazard to skaters. Common types of advisories that we have observed on rink signage can include: hours of rink operation, requirements for separation of hockey activity from pleasure skating activity (either by separation of the rink areas or by skating • times for each activity) and use of appropriate personal protective equipment for persons engaged in hockey activity. Comments can also be made indicating the appropriate behavior expected of users of the facility. • • City of Oak Park Heights September 3, 1991 Page Three We highly recommend the city consult with appropriate legal counsel concerning the size, high visibility coloring and placement of this advisory signage. The League of Minnesota Cities Insurance Trust legal staff is also a resource to you in this regard. 7-8/91 In order to help protect youngsters using the playground, I would recommend the city place a shroud over the bearing on the tire swing. We are concerned that youngsters can get fingers pinched within this bearing and sustain an injury. These bearing shrouds are available through a playground manufacturer/ distributor. BALL FIELD 8-8/91 A minimum 15 foot wide warning track should be installed in the outfield on high use baseball fields to assist in warning the outfielder he or she is nearing the outfield fence. 9-8/91 Protective measures should be in place to protect the players not involved on the field of play from flying balls. One method would be to install an adequate protective fence in the dugout or player seating areas. 10-8/91 Consideration should be given to replacing the current bases with a safety style base. Many of these safety bases have tapered edges which can reduce the potential for leg and ankle injuries to ballplayers. GENERAL OPERATIONS 11-8/91 The city should be obtaining certificates of insurance from all insurance • providers as we discussed at the time of my last loss control service call. 12-8/91 I highly recommend the city develop an affirmative action sheet and incorporate • this form with the employment application form. This affirmative action sheet should be filled out by a prospective employee, separated from the employment application by a person other than the interviewer. The sheet should be kept on file. 13-8/91 Many cities have situations where other governmental entities, such as counties and the state, have rights-of-way which traverse portions of the city. It is important that an understanding be established between the city and these i • City of Oak Park Heights 1 September 3, 1991 Page Four other entities concernin g the responsibility for maintaining these structures and the responsibility for liability that may be associated with these structures. Hence, it is recommended the city establish written agreements with these other entities so that responsibility for design, engineering, maintenance and responsibility for liability is clear for sidewalks, curbs, gutters and roads which traverse the city. To provide you with some additional information in this regard, enclosed is a copy of an article written by Jack Hennen, League of Minnesota Cities Insurance Trust staff attorney, concerning this topic. This article was published in the Loss Control Quarterly section of the January, 1989 issue of Minnesota Cities magazine. Also, the LMCIT staff attorneys can be contacted directly for additional information in this regard. 14-8/91 In the event a major catastrophe would.strike the city, it is very important that .r- there is a written media policy for communication with the media, whether it I I z be the print media or the electronic media. This media policy usually indicates ' y a designated spokesperson, be it the city administrator, city legal counsel or department head. This person should then be schooled in dissemination of 8 information to the media. To assist you, we have rov_ided a videotape list which does have at least two videotapes dealing with this subject. The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. • • City of Oak Park Heights September 3, 1991 Page Five Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, _ J Douglas D. I-Iolm, CSP, MS Senior Loss Control Consultant North Star Risk Services, Inc. DDH:eab Enclosure cc: Mr. Dean McGowan FOREST LAKE INSURANCE AGENCY P.O. Box 188 Forest Lake, Minnesota 55025 These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. • • • January 3 , 1992 North Star Risk Services , Inc. 1401 West 76th Street, Suite 500 Minneapolis, MN 55423 Attention: Mr. Douglas Holm, CSP, MS Dear Doug: In response to your letter dated September 3, 1991, the following are answers to your recommendations for the City of Oak Park Heights loss control program: #1 The City Attorney and Police Chief are working on this project. Please refer to attached Exhibit "A" . #2 Our Police Chief does not consent to police officers individually engaging in the practice of contracting our their services to private entities on an individual basis. #3 Done. #4 All fire doors are kept closed during the day when the rooms are not in use. All fire doors are closed at 4 :30 p.m. daily and kept closed weekends and holidays. #5 Done. #6 Please refer to Exhibit "B" . #7 Ordered in 1991 . #8 Gravel will be installed Spring of 1992. #9 Will be ordered Spring 1992. #10 School District and ball teams furnish own bases. #11 Please refer to Exhibit "C" . • • Page two - North Star Risk Services, Inc. #12 Please refer to Exhibit "D" . #13 Discussed with City Attorney and Jack Hennen' s article forwarded. #14 Designated spokesmen for the City of Oak Park Heights in the event of a major catastrophe are Police Chief and Civil Defense Officer. Should you have further need for information or questions on the above, please do not hesitate to contact me. Sincerely, CITY OF OAK PARK HEIGHTS La Vonne Wilson City Administrator/Treasurer • • FILE COPY LAW OFFICES OF ECKBERG, LAMMERS, BRIGGS, WOLFF & VZERLING 1835 NORTHWESTERN AVENUE STILLWATER, MINNESOTA 55082 LYLE J. ECKBERG (612) 439-2878 JAMES F. LAMMERS FAX (612)439-2923 ROBERT G. BRIGGS PAUL A.WOLFF MARK J.VIERLING [ VICKI L.GIFFORD August 21, 1990 @ \�'"' :: • GREGORY G. GALLER 'i KEVIN K. SHOEBERG ji 1 MAR I R 1992 THOMAS J.WEIDNER • La Vonne Wilson, City Clerk/Administrator City of Oak Park Heights P. 0. Box 2007 Stillwater, Minnesota 55082 Re: City legal liabilities for employees using their private vehicles Dear La Vonne: The issues as presented to me are as follows: 1. Is the City liable to third parties for injuries sustained as a result of an accident caused by an employee of the City driving a privately owned vehicle in the course of that employee's employment? 2 . Is the City liable for the injuries sustained by the employee for an accident which involves a privately owned automobile used by the employee in the course of his or her employment? In regard to item 1, an employer is liable for the torts of its employees, if the employer expects to derive advantages from those acts being performed by the employee for the employer. The City may be liable for the negligence of its employee to a third party if that employee was acting within the scope of his or her employment at the time of the accident.. At that time the negligence of the employee may be imputed to the 'City. In the area of motor vehicle accidents, however, the no- fault insurance law has radically altered the principles of liability for the negligent operation of a motor vehicle. Liability for basic economic loss benefits is imposed on the owner of the vehicle and that person's insurance company (the employee) , up to a maximum of $20, 000.00 to medical expense loss and a total of $20, 000.00 for economic loss. The primary liability for these basic economic loss benefits to an injured driver and passengers in the motor vehicle or any pedestrian injured by the employee's motor vehicle is on • 1 • 410 La Vonne Wilson, City Clerk/Administrator August 21, 1990 Page 2 that employee or insurance company. The law limits liability for property damage and the liability for damages for non-economic detriment, and determines liability on the basis of respective negligence of the parties involved. Therefore, it is very important that the City require its employees to maintain automobile liability coverage on the automobiles they are using in the course of their employment. The law provides that all automobiles carry a very limited amount of automobile liability insurance. It is important to realize that to subject the City to legal responsibility for the negligent acts or wrongdoings of its employees, the relation of employer/employee must exist between the City and the person who committed the negligent act. Please realize every public corporation acts through its agents. Also, be aware that the City is as responsible for the negligent acts of its officers, as it is for those of its employees, if these officers are acting in the course of City duties. The tort liability of a city or an officer or employee of any city for a tort arising out of an alleged act or omission occurring in the performance of the duty may not exceed $200, 000 .00 for any single claim, or $600,000 .00 for any number of claims in a single occurrence. The total liability of the city on a claim against its employees or officers arising out of a single occurrence such as an auto accident may not exceed the above limits. In regard to item 2, an employee injured in the course of his or her employment with the City is covered by the Worker's Compensation Act. Any employee under the Worker's Compensation Act, M.S.A. Sec. 176 et seq. , as described in Section 176. 011, includes "any person performing services for another for hire" . Elected or appointed town or city officials of any government subdivision of a state are considered employees. Any officer of a political subdivision elected or appointed fora regular term of office or to complete an unexpired portion of a regular term shall be included only after the governing body of the political subdivision has adopted an ordinance or resolution to that effect. Injuries covered pursuant to the Worker's Compensation Act include any personal injury arising out .and in the course of employment and includes personal injury caused by an automobile accident as discussed above. Therefore, the City's liability to its employees for injuries sustained in the course of their employment is controlled and limited by the Minnesota Worker's Compensation Act. 110 • La Vonne Wilson, City Clerk/Administrator August 21, 1990 Page 3 Conclusion: to reduce the exposure of liability of the City of Oak Park Heights for an automobile accident by an employee while in the course of his employment by the City, the City should: 1. Require only necessary uses of the motor vehicle; 2 . Require the proof of statutory insurance coverage by the City employees; 3 . Require proof of a valid driver's license by that employee; 4 . Require a driver's license record check on all employees and history of automobile accident history from such employees; and 5. Require City employees using privately owned vehicles to maintain automobile insurance of policy limits of $100,000. 00 per claim and $300, 000. 00 per incident. Lastly, an employee injured during the operation of a motor vehicle will be compensated for their injuries in accordance with Minn. Stat. Sec. 176, Minnesota Worker's Compensation Act. Should you have any questions regarding the above, please let me know. Yours very truly, Thomas J. Weidner TJW:ks 411 410 NOV 14 1990 4!!■rliiS North Star Risk Services, Inc. November 12 , 1990 Ms. LaVon Wilson CITY OF OAK PARK HEIGHTS 14168 57th Street North Oak Park Heights, Minnesota 55082 Dear Ms. Wilson: Thank you for your October 30, 1990 response letter to my July 2, 1990 recommendation letter to you. I have reviewed your letter and did have several comments I would like to make to further assist you in your loss control efforts. With regard to recommendation R-1-89, I would highly urge the City to contact the League of Minnesota Cities Insurance Trust staff attorneys for their input into these signs. Ms. Ellen Longfellow, staff attorney, can assist you in critiquing the signs as well as the coloring and placement of the signs. I am not an attorney myself, however, the attorneys have indicated to me that any reference to "your own risk" can present great difficulties in court in trying to defend a claim. With reference to recommendation R-3-89, the most current guidelines are recommending a minimum of 12 inches of sand or pea gravel under the park and playground equipment. Perhaps additional material above the 6 to 8 inches could be budgeted in the not too distant future. (Reference National Safety Council) With reference to recommendation R-21-89, some other entities like counties and the state whose roads traverse the city do have reservations about developing a liability contract with cities. I do commend you for your attempt in this area to develop a written contractual agreement. To further assist you, I have enclosed an article by Jack Hennen, LMCIT staff attorney, who gives cities suggestions on how to deal with some of these other entities who have not been very cooperative in the past. • 1401 West 76th Street,Suite 500 ■ Minneapolis,Minnesota 55423 • (612)861-8600 • FAX(612)861-8643 A Member of Berkley Risk Management Services Group • 410 City of Oak Park Heights November 12, 1990 Page Two Again, thank you for your return letter. If I can be of any further assistance, please feel free to contact me. Sincerely, Douglas D. Holm, CSP, MS Loss Control Consultant North Star Risk Services, Inc. DDH:eab Enclosure cc: Mr. Dean McGowan FOREST LAKE INSURANCE AGENCY P.O. Box 188 Forest Lake, Minnesota 55025 These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. • • CITY OF OAK PARK HEIGHTS 14168 - 57th Street North -Box 2007 OAK PARK HEIGHTS, MINNESOTA 55082 439-4439 October 30, 1990 Mr. Douglas. D. Holm, MS, ASP Loss Control Consultant North Star Risk Services, Inc. 1401 West 76th Street, Suite 550 Minneapolis, MN 55423 Re : Recommendation letter of July 2, 1990 Dear Mr. Holm: With respect to the above-referenced please find the following responses: R-1-89 Parks Commission has agreed upon need for rule/warning sign controlling ice skaters. The sign will be posted on the outside of the skating rink and will read "Pucks and Sticks Inside Boards Only ! ! " "Skate at your own Risk". The Commission would like North Star to note that the City has Rink Attendants on duty to supervise activities at the rink. R-3-89 A 3/8 inch screen river wash, pea gravel a minimum of 6 to 8 inches deep and a minimum of 8 to 10 fee out from the "action area" of each piece of equipment has bee placed. R-5-89 Merry-go-rounds have been removed as of 10/90. R-16-89 Some schooling of this nature was included in water & sewer courses completed. R-17-89 & R-18-89 We are already doing these things. Please refer to conversation with Building Official, Mick Kaehler with your office if notes were taken. R-21-89 This has been discussed with MN Dept. of Transportation attorney; they know of no agreements with cities other than designating certain cities to perform certain maintenance functions. (Reference: State Statute 160.02, Subd. 9 and State Statute 169). 1-6/90 We are currently in the process of updating many of our employee policies for the City. Sexual harassment in the workplace is anticipated to be included by January 1, 1991. • • Mr. Douglas D. Holm October 30, 1990 Page 2 2-6/90 The City currently has a verbal agreement between the City and the police department. The city and police department (the chief) are working together with attorney Mark Vierling to put this agreement into writing. 3-6/90 The City Attorney, Mark Vierling and Council are working together on this. , Mr. Douglas, I hope that these responses are sufficient for your understanding. If we can be of further assistance relative any of the above, kindly contact us and we'll do our best to assist you. Sincerely, THE CITY OF OAK PARK HEIGHTS V LaVonne Wilson Administrator/Treasurer LW:j ad cc: City Attorney CITY OF. a '� OAK PARK HEIGHTS 14168 North 57th Street IVIEMO P.O. Box 2007 Oak Park Heights, MN 55082 TO: Jeff Kellogg DATE: 10-24-90 FROM: Julie Dietzmann SUBJECT:North Star Risk Letter (Ice Skating Rink Sign) ;RE ;O14 i t+►IN Jeff - Per Dick Seggelke's phone call of this morning he stated that you should have a note or something to that effect which states what will be placed on the warning sign at Brekke Park. Will you please give me a copy of that note or jot down the wording for me. Thanks a bunch! ! CC ( P vcK T t CKS A) S1tDE T30A DS 0 t- Y t $ ik IT i 1 / 'oche v W ` v &/ s k. d 1 i CITY O 411, , ..., OAK PARK HEIGHTS MEMO 14168 North 57th Street P.O. Box 2007 Oak Park Heights, MN 55082 Jeff Kellogg gg DATE: 10-24-90 FROM) Julie Dietzmann SUBJECT:North Star Risk Letter (Ice Skating Rink Sign) Jeff - Per Dick Seggelke's phone call of this morning he stated that you should have a note or something to that effect which states what will be placed on the warning sign at Brekke Park. Will you please give me a copy of that note or jot down the working for me. Thanksaa bunch3 ! � CITY 040 • OAK PARK HEIGHTS 1%4 E MO 14168 North 57th Street P.O. Box 2007 Oak Park Heights, MN 55082 (TO: Dick Seggelke DATE: 10-16-90 FROM: Julie Dietzmann SUBJECT: North Star Risk Letter RESOLUTION nick: Re; the ice skating rink sign which #ou have states has been agreed to be needed. You stated that this matter was going to be further discussed at your Dc*1. 15th Mtg. Was this matter discussed? If so, whht was the resolution as to the wording? Please let me know at your first convenience so that I may forward the ififormation along to North Star in the form a letter. Thanks i Julie i CITY 00 • OAK PARK HEIGHTS MEMO 14168 North 57th Street P.O. Box 2007 Oak Park Heights, MN 55082 TO: / /DATE: s 2 ` ie 0 FROM: . ` SUBJECT: %( , RESOLUTION . 7W ,7 mss. C 0,7-,...",,.s-s,a-,/ //-4,4,.s. v,‘..s',rss ?" 7-,4'5 Ay c e>99.Sc - Al arm 7-6 116_ ' 'A..1 _ A/ar it �/t1YlNAi,' e� 1 II - � 6-f3 f Q ( Laik, V1Je/ North Star �, '�5h d Rt5, ,tr,, Risk Services, Inc. a Ltn -P" July 2, 1990 EI {/ U cam' • &Q.k.ED Ms. LaVon Wilson City of Oak Park Heights F 14168 57th Street North i Oak Park Heights, MN 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. - As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. PAST RECOMMENDATIONS SKATING RINK L S. R-1-89 The city should develop a rule/warning sign controlling - ,.�3 ice skaters. This sign P should be posted on the outside ?� of the skating rink. The sign oftentimes separates pleasure skaters from hockey players, addresses alcohol, and behavior. I would urge the city to consult with the city's legal counsel or LMCIT defense counsel in this area. • CITY PARKS R-3-89 It was noted that the city has done a great deal of work on impact material under equipment, however, not all playground equipment does at this stage have impact absorption underneath it. I urge the city to place a 3/8 inch screen river wash, pea gravel a minimum of 6 to 8 inches deep and a minimum of 8 to 10 feet out from the "action area" of each piece of equipment. R-5-89 A review of your playground equipment shows that you currently have some small merry-go-rounds. Because of the high liability potential and hazards associated )1)41' 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 v 0 - 4Lo, , _/ North Star Risk Services, Inc. July 2, 1990 Ms. LaVon Wilson RECEIVED JUL � `� City of Oak Park Heights 14168 57th Street North Oak Park Heights, MN 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. - As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. PAST RECOMMENDATIONS SKATING RINK { 4) 5. R-I-89 The city should develop a rule/warning sign controlling - 4.3 ice skaters. This sign should be posted on the outside // of the skating rink. The sign oftentimes separates pleasure skaters from hockey players, addresses alcohol, and behavior. I would urge the city to consult with the city's legal counsel or LMCIT defense counsel in this area. • CITY PAR S R-3-89 It was noted that the city has done a great deal of work on impact material under equipment, however, not Yt-S. all playground equipment does at this stage have impact absorption underneath it. /: I urge the city to place impact, 3/8 inch screen river wash, pea gravel a minimum of 6 to 8 inches deep and a minimum of 8 to 10 feet out from the "action area" of each piece of equipment.) R-5-89 A review of your playground equipment shows that you currently have some small merry-go-rounds. Because of the high liability potential and hazards associated le (Ale 11) 1401 West 76th Street, Suite 550 ■ Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 • • 111 Ms. LaVon Wilson July 2, 1990 Page 2 with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing ;material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the OP City is not in a position to increase the maintenance R�fr4' ' on merry-grounds, they should consider removing them 9Q from service. /p GENERAL OPERATIONS R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be S°F4(' schooled in the Minnesota Manual on Uniform Traffic SCoo).0 Control Devices. Subsequently, after the schooling, r all signs both permanent and construction should be set v,.�`'�' according to the manual on uniform traffic controls devices. t :1 ) R-17-89 I highly recommend the city to obtain a certificates of / insurance from the additional services providers we discussed at the time of my survey. R-18-89 I highly recommend the city required a "named additional insured" endorsement on certificates of insurance from contractors. It is sometimes very difficult to get a named additional insured endorsement from service providers. R-21-89 We recommend the city obtain a written contract covering the county and state roads which traverse the city limits. This oftentimes indicates the other entity has designed the roads, engineered the roads, maintained the roads and also liable for these roads. City may want to research an article by Mr. Jack Hennen, LMCIT staff attorney which appeared in January, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Hennen addresses this issue. NEW RECOMMENDATIONS 1-6/90 It is recommended that the City undertake more formal educational efforts for employees on the topic of sexual harassment in the workplace to assist in minimizing the potential for claims and losses in this area. The Government Training Service does offer a NO2 SI-P E RISK 410 Ms. LaVon Wilson July 2, 1990 8cp/— 8600 Page 2 with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the City is not in a position to increase the maintenance on merry-grounds, they should consider removing them from service. GENERAL OPERATIONS R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be pc5 schooled in the Minnesota Manual on Uniform Traffic Control Devices. Subsequently, after the schooling, all signs both permanent and construction should be set according to the manual on uniform traffic control devices. R-17-89 recommend the city to obtain a certificates of insurance from the additional services providers we discussed at the time of my survey. • -18-89 highly recommend the city required a "named � f► ��' additional insured" endorsement on certificates of IT �i(� �J insurance from contractors. It is sometimes very 1 tN difficult to get a named additional insured endorsement VV from service providers. R-21-89 We recommend the city obtain a written contract covering the county and state roads which traverse the city limits. This oftentimes indicates the other y entity has designed the roads, engineered the roads, �J maintained the roads and also liable for these roads. City may want to research an article by Mr. Jack Mennen, LMCIT staff attorney which appeared in January, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Mennen addresses this issue. NEW RECOMMENDATIONS 1-6/90 It is recommended that the City undertake more formal educational efforts for employees on the topic of sexual harassment in the workplace to assist in minimizing the potential for claims and losses in this area. The Government Training Service does offer a • CITY O> , 10 ' OAK PARK HEIGHTS MEVIO 14168 North 57th Street P.O. Box 2007 Oak Park Heights, MN 55082 (TO: •` ,.c+Y� G11Q9�1�1cJ (DATE: I©—17-90 FROM: t , i, I[IA,,n,0 ) SUBJECT: iv„,,, ;1,4n1) .&k-) Witt It ) RESOLUTION •-r)Z4 — j 0 rm L LI t0 j ah;-E-ir5 , _c, o) . A_LPi j 10 .7-Vm4-h LA A daij p-n J rte, --Pein j . , rud L,) 4-)1:0 rot, yotiii t Otrn ntif-A Jrnarrn A /1P i0 arm a/1an j -in riii- , +11 urn a OiJ V j 1 el if rturrn end 7? /c,e.¢ �)t 0-1. ., L CLn'rti- . aiti-"L' • 9,14J. CITY 0 OP kom1004", AA. , .---i--"" OAK PARK HIGH TS AMMO 14168 North 57th Street P.O. Box 2007 Oak Park Heights, MN 55082 -A. TO: ,41-0_,,01, -46/}1400 C 1 L rut ) FROM: I, If i ut pm 0 -I [DATE: SUBJECT: 1v"ci,-).0 j 4nA ) Li-H e 54 ) RESOLUTION 07ceiL - j 0 fin Pfti 1 8 , IA1(1 rh 1)' q /lei ) -A10111z) J\ ipti in -arnii-h h g r nauriuLncia-1 i Ern _9 (•./_5L- An.00 , fyindiv) -(-1--)1 a _v. , Ail . ,,, Jo-la 1 I. lb 1 IIII 1 if 1 A 01 A IP r 11 AI 4 1 a I i 11 4 Ofrn (L (yin-1)7O 8 i 1 pl i i qAtyrn1 ero ) ------ (,,0-4 - • _____ i4'Y • • ° Ms. LaVon Wilson July 2, 1990 Page 2 with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the City is not in a position to increase the maintenance on merry-grounds, they should consider removing them from service. GENERAL OPERATIONS R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be Q43:5 schooled in the Minnesota Manual on Uniform Traffic Control Devices. Subsequently, after the schooling, all signs both permanent and construction should be set according to the manual on uniform traffic control devices. R-17-89 I highly recommend the city to obtain a certificates of insurance from the additional services providers we '�''' discussed at the time of my survey. R-18-89 I highly recommend the city required a "named additional insured" endorsement on certificates of insurance from contractors. It is sometimes very difficult to get a named additional insured endorsement rA / from service providers. R-21-89 e recommend the city obtain a written contract . overing the county and state roads which traverse the ,ity limits. This oftentimes indicates the other _I 1 1 entity has designed the roads, engineered the roads, i ;# maintained the roads and also liable for these roads) 1 r4 J riv City may want to research an article by Mr. Jack Hennen, LMCIT staff attorney which appeared in January, '1 '1, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Hennen addresses this issue. NEW - ° • I I IATIONS 1-6/90 It is recommended that the City undertake more formal educational efforts for employees on the topic of sexual harassment in the workplace to assist in minimizing the potential for claims and losses in this e area. The Government Training Service does offer a _i,j -gf - 81..Discus4ed thoi,4 with MN Dept. o4 Tnanspontation a.tonney 6 they know o6 no agreements with cities othen than designating center-.n cities to pen4onm center-i.n maintenance 4unction4 . Re,6enence: State Statute - 160 . 02, Sub 9 and Statute #169 . • • September 20, 1990 Barb: Please review the highlighted portions of the attached letter from 11. North Star Risk Services, Inc. and prepare a response to them so that LaVonne may be able to prepare a formal response to them regarding the same. Thank you for your time and attention to these issues. - Julie 3 -G/96 -- e-ts-c---or ;to 9--a-e-4...J 1 ' / - I 7ee.-... estto-.....sd+' al 1/1/7 6L-161-4-441-V-■ i 7 _ 411 411 Ms. LaVon Wilson July 2, 1990 Page 2 with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the City is not in a position to increase the maintenance on merry-grounds, they should consider removing them from service. GENERAL OPERATIONS R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be 0 schooled in the Minnesota Manual on Uniform Traffic Control Devices. Subsequently, after the schooling, all signs both permanent and construction should be set according to the manual on uniform traffic control devices. R-17-89 I highly recommend the city to obtain a certificates of insurance from the additional services providers we �'' discussed at the time of my survey. R-18-89 I highly recommend the city required a "named additional insured" endorsement on certificates of insurance from contractors. It is sometimes very difficult to get a named additional insured endorsement from service providers. R-21-89 We recommend the city obtain a written contract covering the county and state roads which traverse the city limits. This oftentimes indicates the other entity has designed the roads, engineered the roads, maintained the roads and also liable for these roads. City may want to research an article by Mr. Jack Hennen, LMCIT staff attorney which appeared in January, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Hennen addresses this issue. NEW RECOMMENDATIONS • 1-6/90 It is recommended that the City undertake more formal educational efforts for employees on the topic of sexual harassment in the workplace to assist in Y minimizing the potential for claims and losses in this area. The Government Training Service does offer a • • Ms. LaVon Wilson July 2, 1990 Page 3 seminar on this subject which would be available to the City on request. In order for you to obtain additional information concerning such a seminar, I would recommend that you contact the Government Training Service at Minnesota Building, Suite 202, 46 East Fourth Street, St. Paul, Minnesota 55101. Their phone number is (612) 222-7409. They should be able to inform you as to the availability of such a program to suit your needs. 2-6/90 In order to provide a consistent approach in those situations where the City is responsible for snow plowing and snow removal, it is recommended that the City develop a formal, written policy dealing with the plowing and removal of snow along the public ways, sidewalks, etc. To assist you in this process, enclosed is some material which may provide you with some guideline elements of a snowplowing policy derived from information provided by the Transportation Technology Transfer Center at North Dakota State University. Typically, we see policies of this type addressing such things as the minimum amount of snow/sleet which would need to fall before the City would respond with plowing, sanding, chemical treatment and snow removal, which public ways are to be plowed first and which intersection areas and other public ways which are to be sanded and/or chemically treated. As with any formal policy/procedure format, we highly recommend the use of appropriate legal counsel to assist in putting such a policy together as well as for periodically reviewing the policy and keeping it up-to-date. As always, the League of Minnesota Cities Insurance Trust legal staff can also be resource of information in this regard. 3-6/90 The city should highly review past contracts including but not limited to snow plowing contracts as well as black top contract for current language including u neutral gender language, proper hold harmless as well as indemnification requiring the city name as an additional insured. The aforementioned can help to make the other entity "primary" in the event of a loss, thus protecting the city. 'mss" -. z?.ti« . .rte 7ahSt IIM North Star Risk Services, Inc. July 2, 1990 Ms. LaVon Wilson JUL City of Oak Park Heights RECEIVED 14168 57th Street North Oak Park Heights, MN 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. - As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. PAST RECOMMENDATIONS SKATING RINK 4) S. R-1-89 The city should develop a rule/warning sign controlling -- x3 ice skaters. This sign should be posted on the outside 7/ of the skating rink. The sign oftentimes separates pleasure skaters from hockey players, addresses alcohol, and behavior. I would urge the city to consult with the city's legal counsel or LMCIT defense counsel in this area. • CITY PARKS R-3-89 It was noted that the city has done a great deal of work on impact material under equipment, however, not all playground equipment does at this stage have impact absorption underneath it. I urge the city to place a 3/8 inch screen river wash, pea gravel a minimum of 6 to 8 inches deep and a minimum of 8 to 10 feet out from the "action area" of each piece of equipment. R-5-89 A review of your playground equipment shows that you currently have some small merry-go-rounds. Because of the high liability potential and hazards associated 14 (4 I/ 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 Ms. LaVon Wilson July 2, 1990 Page 2 with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the City is not in a position to increase the maintenance on merry-grounds, they should consider removing them from service. GENERAL OPERATIONS R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be schooled in the Minnesota Manual on Uniform Traffic Control Devices. Subsequently, after the schooling, all signs both permanent and construction should be set according to the manual on uniform traffic control devices. R-17-89 I highly recommend the city to obtain a certificates of } insurance from the additional services providers we �'" discussed at the time of my survey. e R-18-89 I highly hl recommend the city required ired a "named additional insured" endorsement on certificates of 0 insurance from contractors. It is sometimes very difficult to get a named additional insured endorsement from service providers. R-21-89 We recommend the city obtain a written contract covering the county and state roads which traverse the city limits. This oftentimes indicates the other entity has designed the roads, engineered the roads, 4 ;),)-) maintained the roads and also liable for these roads. City may want to research an article by Mr. Jack CO` Hennen, LMCIT staff attorney which appeared in January, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Hennen addresses this issue. NEW RECOMMENDATIONS 1-6/90 It is recommended that the City undertake more formal educational efforts for employees on the topic of sexual harassment in the workplace to assist in minimizing the potential for claims and losses in this area. The Government Training Service does offer a 4 4111 /o _30 -90 Ms. LaVon Wilson Jt J-01,40,3 July 2, 1990 Page 3 C460, oL Loo-ut seminar on this subject which p, -frn-b a ( QQJ . City on request. In order fox information concerning such a recommend that you contact the Service at Minnesota Building, Fourth Street, St. Paul, Minne number is (612) 222-7409. ThE inform you as to the availabi] suit your needs. 2-6/90 In order to provide a consistent appsvcm:u in 4uuSC situations where the City is responsible for snow plowing and snow removal, it is recommended that the City develop a formal, written policy dealing with the plowing and removal of snow along the public ways, } sidewalks, etc. To assist you in this process, enclosed is some material which may provide you with some guideline, elements of a snowplowing policy derived from information provided by the Transportation Technology Transfer Center at North Dakota State University. Typically, we see policies of this type addressing such things as the minimum amount of snow/sleet which would need to fall before the City would respond with plowing, sanding, chemical treatment and snow removal, which public ways are to be plowed first and which intersection areas and other public ways which are to be sanded and/or chemically treated. As with any formal policy/procedure format, we highly recommend the use of appropriate legal counsel to assist in putting such a policy together as well as for periodically reviewing the policy and keeping it up-to-date. As always, the League of Minnesota Cities Insurance Trust legal staff can also be resource of information in this regard. 6/90 The city should highly review past contracts including but not limited to snow plowing contracts as well as black top contract for current language including w,1 neutral gender language, proper hold harmless as well n ( ' as indemnification requiring the city name as an 3 additional insured. The aforementioned can help to make the other entity "primary" in the event of a loss, thus protecting the city. , L4 Ms. LaVon Wilson July 2, 1990 Page 4 The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. ' .cerely, NJ:— Douglas D. m, MS, ASP Loss Control Consultant North Star Risk Services, Inc. DDH:EH Enclosure cc: Forest Lake Insurance Agency These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. • r • • North Star Risk Services, Inc. July 2, 1990 Ms. LaVon Wilson RECEIVED JUL City of Oak Park Heights 5 19,93 14168 57th Street North Oak Park Heights, MN 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. - As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. PAST RECOM4ENDATIONS SKATING RINK R-1-89 The city should develop a rule/warning sign controlling ice skaters. This sign should be posted on the outside of the skating rink. The sign oftentimes separates pleasure skaters from hockey players, addresses alcohol, and behavior. I would urge the city to consult with the city's legal counsel or LMCIT defense counsel in this area. • CITY PARKS R-3-89 It was noted that the city has done a great deal of work on impact material under equipment, however, not all playground equipment does at this stage have impact absorption underneath it. I urge the city to place a 3/8 inch screen river wash, pea gravel a minimum of 6 to 8 inches deep and a minimum of 8 to 10 feet out from the "action area" of each piece of equipment. R-5-89 A review of your playground equipment shows that you currently have some small merry-go-rounds. Because of 411 the high liability potential and hazards associated 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861:8600 • FAX (612) 861-8643 4 411 111 Ms. LaVon Wilson July 2, 1990 Page 2 with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the City is not in a position to increase the maintenance on merry-grounds, they should consider removing them from service. GENERAL OPERATIONS R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be schooled in the Minnesota Manual on Uniform Traffic Control Devices. Subsequently, after the schooling, all signs both permanent and construction should be set according to the manual on uniform traffic control devices. R-17-89 I highly recommend the city to obtain a certificates of insurance from the additional services providers we discussed at the time of my survey. R-18-89 I highly recommend the city required a "named additional insured" endorsement on certificates of insurance from contractors. It is sometimes very difficult to get a named additional insured endorsement from service providers. R-21-89 We recommend the city obtain a written contract covering the county and state roads which traverse the city limits. This oftentimes indicates the other • entity has designed the roads, engineered the roads, maintained the roads and also liable for these roads. City may want to research an article by Mr. Jack Hennen, LMCIT staff attorney which appeared in January, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Hennen addresses this issue. NEW RECOMMENDATIONS -6 90 It is recommended that the City undertake more formal 1 Y educational efforts for employees on the topic of sexual harassment in the workplace to assist in minimizing the potential for claims and losses in this area. The Government Training Service does offer a r !II 111 Ms. LaVon Wilson July 2, 1990 Page 3 seminar on this subject which would be available to the City on request. In order for you to obtain additional information concerning such a seminar, I would recommend that you contact the Government Training Service at Minnesota Building, Suite 202, 46 East Fourth Street, St. Paul, Minnesota 55101. Their phone number is (612) 222-7409. They should be able to inform you as to the availability of such a program to suit your needs. 2-6/90 In order to provide a consistent approach in those situations where the City is responsible for snow plowing and snow removal, it is recommended that the City develop a formal, written policy dealing with the plowing and removal of snow along the public ways, sidewalks, etc. To assist you in this process, enclosed is some material which may provide you with some guideline elements of a snowplowing policy derived from information provided by the Transportation Technology Transfer Center at North Dakota State University. Typically, we see policies of this type addressing such • things as the minimum amount of snow/sleet which would need to fall before the City would respond with plowing, sanding, chemical treatment and snow removal, which public ways are to be plowed first and which intersection areas and other public ways which are to be sanded and/or chemically treated. As with any formal policy/procedure format, we highly recommend the use of appropriate legal counsel to assist in putting such a policy together as well as for periodically reviewing the policy and keeping it up-to-date. As always, the League of Minnesota Cities Insurance Trust legal staff can also be resource of information in this regard. 3-6/90 The city should highly review past contracts including but not limited to snow plowing contracts as well as black top contract for current language including neutral gender language, proper hold harmless as well as indemnification requiring the city name as an additional insured. The aforementioned can help to make the other entity "primary" in the event of a loss, thus protecting the city. l . 410 . , Ms. LaVon Wilson July 2, 1990 Page 4 ill The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. eeely, //)7/./J Douglas D. m, MS, ASP Loss Control Consultant North Star Risk Services, Inc. DDH:EH III Enclosure cc: Forest Lake Insurance Agency These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. 1 • • North Star Risk Services, Inc. May 21, 1990 Mr. Richard Seggelke Council Member City of Oak Park Heights 14168 57th Street No. Box 2007 Stillwater, MN 55082 Dear Mr. Seggelke; In reference to your May 7, 1990 telephone call, we did discussed a number of loss control items with respect to the proposed foot path for the City of Oak Park Heights. A number of cities have developed foot path systems, however, the City should take into consideration the potential for liability hazards as well as perpetual maintenance of such a system well into the future. My understanding is that this path will be about 1/4 mile long. In addition to the recommendations which you will find submitted below, I would highly encourage you or the City Council to further research this topic through League of Minnesota Cities Insurance Trust staff attorneys as well as the City legal counsel for their input. For your consideration I have formulated the following recommendations based on the above data: 1-5/90 As in any city sidewalks or pedestrian rights-of-way, the City should be in position to undertake a comprehensive, formal maintenance, and inspection program for the system for not only the near future, but in the distant future as well. The final responsibility for proper maintenance of such path systems and walk ways rest with the municipality. This inspection program should then be fully documented. 2-5/90 It is my understanding that the proposed system would traverse through or near the ball field area. The city should be engineering controls protecting such path users in the ball field area. 411 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 ■ (612) 861-8600 • FAX (612) 861-8643 111 Mr. Richard Seggelke . Page 2 May 10, 1990 3-5/90 A determination should be made to determine if the path system is to be open for summer use only or an all season facility. If the later is decided upon, this decision will impact the surfacing material as well as winter maintenance considerations. 3-5/90 A determination will have to be made as to permitting only pedestrians, a combination of pedestrians and bicycle riders, as well as considerations for motorized vehicles. Often times, cities do prohibit motorized vehicles on such paths. However, we have had some conflicts of interest in other municipalities in deciding if young bicycle riders or more senior citizens will be able to utilize these paths. It will be difficult for both to use these paths at the same time. 4-5/90 I understand there maybe some slops or grades within the path system itself. A decision will have to be made as to providing a sloping trail system or a step and handrail system. You should also keep in mind handicapped accessibility to this path will be important. If the city does elect to go with a step and handrail system, the city should then be contacting engineers for exact engineering specifications for handrails and steps. 5-5/90 Signage is a very important tool for safety of the path system as well as for defense in the event of a loss. Therefore, we highly recommend the City consult with LMCIT staff attorneys for the exact wording of the signs, coloring of the signage placement, as well as height of the signage along the path system. Generally, we have seen these signs posted at the normal beginning of the path and at various locations down the path system. A consideration also should be given to stop signs if the path is to cross a street system. These signs should also be constructed to the applicable codes. I do hope this information will be of benefit to you and the City of Oak Park Heights. If you do have any further questions, please feel free to contact me. I'm generally in the office on the first workin g day da of the week. 410 ! • Mr. Richard Seggelke • gg Page 3 May 21, 1990 The long-term benefits and successes that can be enjoyed b a 1 n fi by g cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, Douglas D. Holm, MS, ASP Loss Control Consultant North Star Risk Services, Inc. DDH/eh cc: Forest Lake Insurance Agency These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. 110 liilL- 411 411 E 4sizo tse, North Star Risk Services, Inc. June 21, 1989 Ms. LaVonne Wilson City Administrator City of Oak Park Heights 14168 - 57th St. N. Box 2007 Stillwater, MN 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City' s participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. • As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. SKATING RINK: R-1-89 The City should develop .a rule/warning sign controlling ice skaters. This sign should posted on the outside of the Iff949/9#4; i ' skating rink. The sign oftentimes separates pleasure eifj .skaters from hockey players, addresses alcohol, and behavior. I would urge the City to consult with the City legal counsel or LMCIT defense counsel in this area. CITY PARKS: R-2-89 I would highly urge the City to document all safety r ` inspection and retain these records in file as submitted to 10'44 , ,`i ) the City on January 20, 1987 letter of recommendation. , ' R-3-89 It was noted that the City has done a great deal of work on impact material under equipment, however, not all o, playground equipment does at this stage have impact L,,J/tJ6//C��.0 absorption underneath it. I t rre; ,„ ;r>,*b' 'x m D9" :: lT. i e s `".-` ..a- �e f,'8 t.to 1 fe a ewait �4 e.. �� .�� "action area" of each piece of equipment. ( At' 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 • • • 410 Ms. LaVonne Wilson City of Oak Park Heights June 21, 1989 Page Two R-4-89 There are a number of swing sets in the park system for ' your City. These swing seats should be a minimum of 18 f 0 inches apart and a minimum of' '" inches as measured from (� the swing set to the support posts (Ref: United States Consumer Product Safety Commission) . R-5-89 A review of your playground equipment shows that you L currently have some small merry-go-rounds. Because of the high liability potential and hazards associated with these yI L, merry-go-rounds, it is recommended that impact ab prbing / , material be built up to within -- a k- ry-go-round .4' tenance on this impact absorbing material should be kept up to reduce the possibility of individuals ett� cau ht underneath the round- merr - o Y g •` i 4 *oevr aunds_• thelycl cons1 e` M6ving them from service. • R-6-89 During my service call I did note there was a chain stretched across two posts in Valley View Park. LMCIT has �iTfiGd suffered losses in this area where people on motorized er�'c units have struck the chain and have been killed. Therefore, we highly urge the City to remove all such chains and cable systems. R-7-89 Again during our tour of Valley View Park system we could � not locate in any aground fault..AinterrUpt+e �sj in the electrical systems in the shelter areas. This should be y 1 e e / 0 reviewed by a certified/licensed electrician and if ground 1/1 fault interrupter systems have not been installed, they should be installed. R-8-89 Restraining backs or guardrails should be installed on the backs and sides of bleachers which extend more than four feet off the ground, measured from the topmost seat level to ground level. R-9-89 All new outfield baseball fences should conform to standard codes. Research has indicated that 6 to 8 foot high outfield fences reduce potentials for loss. Additionally, the fence fabric should be placed on the inside or the field side of the posts rather than on the outside of the posts. If an outside contractor is to install the fence, • the standard paperwork including certificates of insurance, named additional insured would of course be appropriate. • `mot North Star Risk Services, Inc. July 2, 1990 Ms. LaVon Wilson RECEIVED JUL ` � City of Oak Park Heights 14168 57th Street North Oak Park Heights, MN 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. - As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. PAST RECOMMENDATIONS SKATING RINK I, 5- R-1-89 The city should develop a rule/warning sign controlling -- �3 ice skaters. This sign should be posted on the outside I' of the skating rink. The sign oftentimes separates pleasure skaters from hockey players, addresses alcohol, and behavior. I would urge the city to consult with the city's legal counsel or LMCIT defense counsel in this area. CITY PARKS R-3-89 It was noted that the city has done a great deal of work on impact material under equipment, however, not all playground equipment does at this stage have impact absorption underneath it. I urge the city to place a 3/8 inch screen river wash, pea gravel a minimum of 6 to 8 inches deep and a minimum of 8 to 10 feet out from the "action area" of each piece of equipment. R-5-89 A review of your playground equipment shows that you currently have some small merry-go-rounds. Because of the high liability potential and hazards associated r 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 • Ms. LaVon Wilson July 2, 1990 Page 2 with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the City is not in a position to increase the maintenance on merry-grounds, they should consider removing them from service. GENERAL OPERATIONS R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be schooled in the Minnesota Manual on Uniform Traffic Control Devices. Subsequently, after the schooling, all signs both permanent and construction should be set according to the manual on uniform traffic control devices. R-17-89 I highly recommend the city to obtain a certificates of insurance from the additional services providers we discussed at the time of my survey. R-18-89 I highly recommend the city required a "named additional insured" endorsement on certificates of insurance from contractors. It is sometimes very difficult to get a named additional insured endorsement from service providers. R-21-89 We recommend the city obtain a written contract covering the county and state roads which traverse the city limits. This oftentimes indicates the other entity has designed the roads, engineered the roads, maintained the roads and also liable for these roads. City may want to research an article by Mr. Jack Hennen, LMCIT staff attorney which appeared in January, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Hennen addresses this issue. NEW RECOMMENDATIONS, 1-6/90 It is recommended that the City undertake more formal educational efforts for employees on the topic of sexual harassment in the workplace to assist in minimizing the potential for claims and losses in this area. The Government Training Service does offer a • • Ms. LaVon Wilson July 2, 1990 Page 3 seminar on this subject which would be available to the City on request. In order for you to obtain additional information concerning such a seminar, I would recommend that you contact the Government Training Service at Minnesota Building, Suite 202, 46 East Fourth Street, St. Paul, Minnesota 55101. Their phone number is (612) 222-7409. They should be able to inform you as to the availability of such a program to suit your needs. 2-6/90 In order to provide a consistent approach in those situations where the City is responsible for snow plowing and snow removal, it is recommended that the City develop a formal, written policy dealing with the plowing and removal of snow along the public ways, sidewalks, etc. To assist you in this process, enclosed is some material which may provide you with some guideline elements of a snowplowing policy derived from information provided by the Transportation Technology Transfer Center at North Dakota State University. Typically, we see policies of this type addressing such things as the minimum amount of snow/sleet which would need to fall before the City would respond with plowing, sanding, chemical treatment and snow removal, which public ways are to be plowed first and which intersection areas and other public ways which are to be sanded and/or chemically treated. As with any formal policy/procedure format, we highly recommend the use of appropriate legal counsel to assist in putting such a policy together as well as for periodically reviewing the policy and keeping it up-to-date. As always, the League of Minnesota Cities Insurance Trust legal staff can also be resource of information in this regard. 3-6/90 The city should highly review past contracts including "' but not limited to snow plowing contracts as well as black top contract for current language including neutral gender language, proper hold harmless as well as indemnification requiring the city name as an additional insured. The aforementioned can help to make the other entity "primary" in the event of a loss, thus protecting the city. 411 4IM Ms. LaVon Wilson July 2, 1990 Page 4 The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. ' 1 eeely, 7411°— Douglas D. m, MS, ASP Loss Control Consultant North Star Risk Services, Inc. DDH:EH Enclosure cc: Forest Lake Insurance Agency These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. • • • North Star Risk Services, Inc. May 21, 1990 Mr. Richard Seggelke Council Member City of Oak Park Heights 14168 57th Street No. Box 2007 Stillwater, MN 55082 Dear Mr. Seggelke; In reference to your May 7, 1990 telephone call, we did discussed a number of loss control items with respect to the proposed foot path for the City of Oak Park Heights. A number of cities have developed foot path systems, however, the City should take into consideration the potential for liability hazards as well as perpetual maintenance of such a system well into the future. My understanding is that this path will be about 1/4 mile long. In addition to the recommendations which you will find submitted below, I would highly encourage you or the City Council to further research this topic through League of Minnesota Cities Insurance Trust staff attorneys as well as the City legal counsel for their input. For your consideration I have formulated the following recommendations based on the above data: 1-5/90 As in any city sidewalks or pedestrian rights-of-way, the City should be in position to undertake a comprehensive, formal maintenance, and inspection program for the system for not only the near future, but in the distant future as well. The final responsibility for proper maintenance of such path systems and walk ways rest with the municipality. This inspection program should then be fully documented. 2-5/90 It is my understanding that the proposed system would traverse through or near the ball field area. The city should be engineering controls protecting such path users in the ball field area. 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 } . • 1 • I Mr. Richard Seggelke Page 2 May 10, 1990 3-5/90 A determination should be made to determine if the path system is to be open for summer use only or an all season facility. If the later is decided upon, this decision will impact the surfacing material as well as winter maintenance considerations. 3-5/90 A determination will have to be made as to permitting only pedestrians, a combination of pedestrians and bicycle riders, as well as considerations for motorized vehicles. Often times, cities do prohibit motorized vehicles on such paths. However, we have had some conflicts of interest in other municipalities in deciding if young bicycle riders or more senior citizens will be able to utilize these paths. It will be difficult for both to use these paths at the same time. 4-5/90 I understand there maybe some slops or grades within the path system itself. A decision will have to be made as to providing a sloping trail system or a step and handrail system. You should also keep in mind handicapped accessibility to this path will be important. If the city does elect to go with a step and handrail system, the city should then be contacting engineers for exact engineering specifications for handrails and steps. 5-5/90 Signage is a very important tool for safety of the path system as well as for defense in the event of a loss. Therefore, we highly recommend the City consult with LMCIT staff attorneys for the exact wording of the signs, coloring of the signage placement, as well as height of the signage along the path system. Generally, we have seen these signs posted at the normal beginning of the path and at various locations down the path system. A consideration also should be given to stop signs if the path is to cross a street system. These signs should also be constructed to the applicable codes. I do hope this information will be of benefit to you and the City of Oak Park Heights. If you do have any further questions, please feel free to contact me. I'm generally in the office on the first working day of the week. { i 110 Mr. Richard Seggelke Page 3 May 21, 1990 The long-term benefits and successes that can be enjoyed by a cooperative, self-insurance organization depend upon serious and careful consideration of loss control recommendations. In that context we ask that you keep us informed of the steps you take to address these loss control recommendations. Therefore, PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF HOW YOU INTEND TO RESPOND TO THESE LOSS CONTROL RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, Douglas D. Holm, MS, ASP Loss Control Consultant North Star Risk Services, Inc. DDH/eh cc: Forest Lake Insurance Agency These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. I • • North Star Risk Services, Inc. - LOSS CONTROL DEPARTMENT - LOSS CONTROL AND RISK MANAGEMENT INFORMATION AVAILABLE ON VIDEOTAPE (All are VHS Format) GENERAL INTEREST 1. SETTING UP A RISK MANAGEMENT PROGRAM (NSRS #1) With: Peter E. Potemkin, Manager of Safety Services, Texas Municipal League Self-Insurance Fund (PRIMAVISION) When it comes to your risk management efforts, have you asked yourself . . . "How do I get started?" and . . . "How do I put a risk management program together?" This presentation will help you find answers to these and many other questions concerning risk management program development from one of the country's recog- nized public entity risk management authorities. Running Time: Approximately 30 minutes 2. RISK MANAGEMENT FOR SMALL COMMUNITIES (NSRS #2) Produced By: Extension Service, USDA, PRIMA, and Oklahoma State University This presentation is designed to help you with your risk manage- ment efforts by providing an overview of risk management avenues involving areas such as public officials liability, roads and streets, contracts and agreements, law enforcement, parks and recreation employee safety, and environmental impairment liability. Presentations are given by actual city management persons who can relate to "real world" risk management needs. This is an excel- lent primer to beginning and ongoing risk management efforts. A risk management manual and support resources are also available. Running Time: App Vailtely SS-minutes. mmItKIAL PROVIDED BY: 0 3/90 NORTH S i k Sig SERVICES, INC. DEPARTMENT :140i 04 l` rE"( , SUITE 500 MI1V�Ir SOTA 55423 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 • Information Available on Videotape Page Two 3. A RISK MANAGEMENT ENDORSEMENT -- A VIEW FROM THE CITY (NSR #3) With: Frank Boyles, Assistant City Manager City of Plymouth, Minnesota Can a risk management program really work for my city? If you've asked yourself that question, you'll want to see this presenta- tion. Mr. Boyles reviews the risk management efforts undertaken by the City of Plymouth, Minnesota and how those efforts have paid off for them. A real "nuts-and-bolts" view of a working risk management program. Running Time: Approximately 60 minutes (LMCIT Workshop 1989) 4. INTERDEPARTMENTAL COMMUNICATION (NSRS #4) With: Jack Hennen, Staff Attorney, L.M.C.I.T. Does the right hand know what the left hand is doing? Effective communication between departments, cities and other governmental entities is essential to loss control and risk management. This presentation lays out the paths to effective communication between these parties and how it can benefit your risk management efforts. Running Time: Approximately 40 minutes (LMCIT Workshop 1989) 5. LIABILITY CLAIMS - DEALING WITH THE INJURED PARTY (NSRS #5), With: Jack Hennen, Staff Attorney, L.M.C.I.T. This presentation uses skits to llustrate desirable and not-so-desirable ways to communicate with persons who have suffered a loss . . . and who may become claimants later. Running Time: Approximately 30 minutes (LMCIT Workshop 1988) 6. DEALING WITH THE INJURED PARTY (& WITH POTENTIAL CLAIMANTS) (NSRS #6) With: Ellen Longfellow, Staff Attorney, L.M.C.I.T. This presentation uses skits and discussion to help you do a more effective job dealing with persons who may become claimants because of injuries or damages occurring in your city. Running Time: Approximately 20 minutes (LMCIT Workshop 1989) Information Available on Videotape P Page Three 7. DEALING WITH THE MEDIA (NSRS #7)_ With: Ellen Longfellow, Staff Attorney, L.M.C.I.T. Have you ever had to deal with questions from the media or do you get chills thinking about it? This presentation provides valuable information, in skit and discussion form, to help you more effectively deal with the media. Information is also provided relative to media relations involving open and closed meetings and data privacy considerations. Running Time: Approximately 30 minutes (LMCIT Workshop 1989) 8 . "A MEDIA RELATIONS SELF-DEFENSE COURSE" (NSRS #8) Presented by Bob Shaw, Public Sector Consultants This presentation lays out some sound principles for maintaining effective media relations without compromising your interests and the public interest. Originally geared toward law enforcement agency administrators, the ideas presented can be used by anyone in public life who may find themselves dealing with or covered by the media. Running time: Approximately 60 minutes 9. MANAGING YOUR CONTRACTS (NSRS #9), With: Kathleen Magrew, Legal Assistant City of Minnetonka, Minnesota Ms. Magrew discusses risk management and loss control measures relative to contract management, certificates of insurance, and relationships with independent contractors from the perspective of the legal department in an actual city operation. Also included is a discussion concerning inter-agency and inter-governmental relationships from a risk management viewpoint. Running Time: Approximately 30 minutes (LMCIT Workshop 1988) • • Information Available on Videotape Page Four CONTRACTS AND INSURANCE ISSUES 10. MUNICIPAL CONTRACTS & INSURANCE ISSUES -- A CITY ATTORNEY'S POINT-OF-VIEW (NSRS #10) With: George Hoff, City Attorney Here's a viewpoint from someone who's "in the trenches. " Mr. Hoff discusses the practical ways that cities can use contracts, certificates of insurance and related tools to maximize risk management in a city. Running Time: Approximately 30 minutes (LMCIT Workshop 1989) EMPLOYMENT AND PERSONNEL PRACTICES 11. EMPLOYMENT LIABILITY ISSUES (NSRS #11), With: Chris Harristhal, Attorney-At-Law Larkin, Hoffman, Daly & Lindgren, Ltd. If you're an administrator concerned about such employment liability issues as sexual harassment in the workplace, hiring, discipline and termination practices, employment handbooks and manuals . . . then this video is a must for you. Chris Harristhal is an attorney specializing in employment liability issues and presents a comprehensive treatment on this wide-ranging topic. Running Time: Approximately 60 minutes (LMCIT Workshop 1989) 12. EMPLOYMENT PRACTICES LIABILITY & PERSONNEL ISSUES (NSRS #12) With: Shannon McCambridge, Attorney-at-Law Larkin, Hoffman, Daly & Lindgren, Ltd. Employment related issues such as hiring, disciplining and terminating often involve very complex legal issues as well. Ms. McCambridge presents a comprehensive approach to these concerns from an attorney's viewpoint -- with practical tools you can use in your own city. Running Time: Approximately 60 minutes (LMCIT Workshop 1989) 3/90 !II 411 Information Available on Videotape Page Five AUTOMOBILE AND EQUIPMENT OPERATIONS 13 . A VEHICLE & EQUIPMENT FLEET LOSS CONTROL PROGRAM (NSRS #13) With: Doug Holm, Loss Control Consultant North Star Risk Services, Inc. Most cities have thousands of dollars worth of vehicles and equipment on the road every day as well as valuable personnel operating them. Learn how to set up and operate a comprehensive fleet loss control program in this presentation. Running Time: Approximately 45 minutes (LMCIT Workshop 1989) PUBLIC WORKS 14. KEEPING MAINTENANCE & INSPECTION RECORDS (PUBLIC WORKS (NSRS #14) With: Jack Hennen, Staff Attorney, L.M.C.I.T. How can something so boring be so important? This presentation discusses the importance of keeping good, sound maintenance and inspection records and suggests ways to keep these records in as easy a manner as possible. Running Time: Approximately 15 minutes (LMCIT Workshop 1988) 15. TRAFFIC SIGNS & MARKINGS (NSRS #15) With: Donald Anderson, Transportation Technology Transfer Center, North Dakota State University This presentation uses slides and discussion to illustrate traffic sign and marking fundamentals to help minimize your liability exposure and promote traffic safety for the motoring public. Running Time: Approximately 60 minutes (LMCIT Workshop 1988) 3/90 • • Information Available on Videotape Page Six 16. INSPECTING YOUR STREETS, SIDEWALKS, ETC. (NSRS #16), With: Doug Holm, Loss Control Consultant North Star Risk Services and Jack Hennen, Staff Attorney, L.M.C.I.T. This presentation uses slides taken from actual situations existing in Minnesota cities to illustrate conditions existing with streets, sidewalks and other public ways which can lead to liability exposures and claims. Also included is a discussion on practical loss control measures you can use to eliminate or minimize these exposures. Running Time: Approximately 50 minutes (LMCIT Workshop 1988) PARKS AND RECREATION 17. PARKS & RECREATION HAZARD RECOGNITION & CONTROL (NSRS #17), • Everist, Loss Control Consultant With: W. Michael e , North Star Risk Services, Inc. How can something designed for fun present so many hazards? In this presentation learn how to recognize and control many of those hazards relating to parks and recreation facilities and programs. Running Time: Approximately 45 minutes (LMCIT Workshop 1989) LAW ENFORCEMENT/POLICE LIABILITY 18. LAW ENFORCEMENT LIABILITY ISSUES (NSRS #18) With: Donald Davis, Chief-of-Police City of Brooklyn Park, Minnesota From the perspective of a law enforcement agency administrator, this presentation deals with a multitude of liability exposure concerns facing law enforcement agencies today. Included are discussions on the establishment, use and maintenance of a Policy & Procedure Manual, as well as "hot topics" on pursuit driving, use of force and weapons, and stun gun usage. Running Time: Approximately 120 minutes (LMCIT Workshop 1988) 3/90 , • 410 Information Available on Videotapes Page Seven 19. LAW ENFORCEMENT PUNITIVE DAMAGES (NSRS #19) With: Jack Hennen, Staff Attorney, L.M.C.I.T. As a law enforcement officer, how are you personally exposed to punitive damages? How does LMCIT's coverage fit in when it comes to punitive damages? These and other questions pertaining to law enforcement punitive damages are addressed in this presentation. Running Time: Approximately 15 minutes (LMCIT Workshop 1988) 20. POLICE PURSUIT POLICY AND PROCEDURE (NSRS #20), Presented By: The Minnesota Board of Peace Officer Standards and Training Minnesota law requires certain policies and issues involving police pursuit to be addressed by October, 1989. This video involves presentations by P.O.S.T. director Bill Carter and authorities from the legal and law enforcement communities to help you establish and refine this critical policy and procedural area. Running Time: Approximately 120 minutes (NSRS 8/89) 21. EPILEPSY: A POSITIVE I.D. (NSRS #21), Produced By: Epilepsy Education, University of Minnesota This award winning video is designed to help first responders (police, firefighters, paramedics) and other professionals recognize the most common epileptic seizures, administer first aid and recognize epilepsy medication. Emphasis is placed on the fact that complex partial (psychomotor) seizures can be easily mistaken for drunkenness or drug abuse. This could be a valuable training tool to help your first responders do a more effective job. Running Time: Approximately 22 minutes 3/90 • • Information Available on Videotapes Page Eight ENVIRONMENTAL IMPAIRMENT/POLLUTION LIABILITY 22 . LOSS CONTROL AND RISK MANAGEMENT FOR MUNICIPAL FESTIVALS AND SPECIAL EVENTS (NSRS #22). With: Jack Hennen, Staff Attorney, L.M.C.I.T. There are literally hundreds of municipal festivals and special place in Minnesota cities eve events that tak e p ry year. There are Y also multitudes of risk management and loss control concerns that need to be addressed when planning and carrying out these events. This presentation provides valuable information to help you in this process. Running Time: Approximately 30 minutes 23 . UNDERGROUND STORAGE TANKS - A TELECONFERENCE (NSRS #23) This video was produced in conjunction with a statewide teleconference held on October 11, 1989 . Panel members from the legal, governmental, industry, insurance and Pollution Control Agency standpoints discuss the "new" rules, regulations and issues facing owners and operators of underground storage tanks (UST's) in the 1990's. 24. WHAT IT MEANS TO YOU (NSRS #24) S.A.R.A. , Title III, Emergency Planning, Community Right-to-Know Act These are all terms which have caused no small amount of confusion as local governments make efforts to comply with the requirements of this law. This video, produced by the E.P.A. , outlines the basic introduction to this law and describes, in a non-technical manner, the provisions and scope of the law that can have far-reaching effects on communities and their citizens. Running Time: Approximately 18 minutes 3/90 • • CITY OF OAK PARK HEIGHTS 14168 - 57th Street North -Box 2007 OAK PARK HEIGHTS, MINNESOTA 55082 439-4439 August 17, 1989 North Star Risk Services, Inc. 1401 West 76th Street, Suite 550 Minneapolis, MN. 55423 Attn: Douglas D. Holm Dear Mr. Holm: Please find below, the attention given to your loss control recommen- dations in your letter of June 21st. R- 1-89 Signs posted inside. Will be removed by kids, if posted out. R- 2-89 Done R- 3-89 To install new pea gravel shortly. Some equipment to be re- moved. R- 4-89 Done • R- 5-89 Removing. R- 6-89 Removed. R- 7-89 Not done. R- 8-89 None over 4' . R- 9-89 They are placed on the inside. R-10-89 Some cans were police evidence. New safety cans are in use. �- • • CITY OF OAK PARK HEIGHTS 14168 - 57th Street North -Box 2007 OAK PARK HEIGHTS, MINNESOTA 55082 439-4439 Page two — August 17, 1989 R-11-89 Removed. R-19-89 Done R-20-89 We have information from League of Cities. R-22-89 League of MN. Cities Research Dept. to send us copy of permit to excavate on City easements. R-23-89 Done Sincerely, a Vonne Wilson Administrator/Treasurer • • . 4r:"s North Star Risk Services, Inc. June 21, 1989 Ms. LaVonne Wilson City Administrator City of Oak Park Heights 14168 - 57th St. N. Box 2007 Stillwater, MN 55082 Dear Ms. Wilson: A routine loss control survey was recently conducted concerning the premises and operations for the City. This is in conjunction with the City's participation in the League of Minnesota Cities Insurance Trust Property and Casualty Program. We sincerely appreciate your efforts and assistance in completion of this loss control survey. As a result of this loss control survey, prompt attention should be given to these loss control recommendations, which will assist in minimizing the potential for loss. SKATING RINK: R-1-89'-- The City should develop a rule/warning sign controlling ice eji ,,Sskaters. This sign should posted on the outside of the `h ;, 4 , 9i•'" skating rink. The sign oftentimes separates pleasure "7' 1" skaters from hockey players, addresses alcohol, and behavior. I would urge the City to consult with the City legal counsel or LMCIT defense counsel in this area. tv iAra° . ITY PARKS: R-2-89 I would highly urge the City to document all safety inspection and retain these records in file as submitted to e City on January 20, 1987 letter of recommendation. R-3-89 It was noted that the City has done a great deal of work on filt impact material under equipment, however, not all playground equipment does at this stage have impact /1 � absorption underneath it. I urge the City to place a 3/8 nel ' inch screen river wash, pea gravel a minimum of 6 to 8 r ' r� I• (64 inches deep and a minimum of 8 to 10 feet out from the 1 1/ "action area" of each piece of equipment. 4111/ 61" 1401 West 76th Street, Suite 550 • Minneapolis, Minnesota 55423 • (612) 861-8600 • FAX (612) 861-8643 • r r • Ms. LaVonne Wilson City of Oak Park Heights June 21, 1989 Page Two R-4-89 T ere are a number of swing sets in the park system for your City. These swing seats should be a minimum of 18 inches apart and a minimum of 18 inches as measured from the swing set to the support posts (Ref: United States Consumer Product Safety Commission) . R-5-89 A review of your playground equipment shows that you currently have some small merry-go-rounds. Because of the high liability potential and hazards associated with these merry-go-rounds, it is recommended that impact absorbing material be built up to within two to three inches of the bottom of the merry-go-round. Maintenance on this impact absorbing material should be kept up to reduce the possibility of individuals getting caught underneath the merry-go-round. If the City is not in a position to increase the maintenance on merry-go-rounds, they should consider removing them from service. R-6-89 During my service call I did note there was a chain 1 stretched across two posts in Valley View Park. LMCIT has suffered losses in this area where people on motorized kA11. units have struck the chain and have been killed. Therefore, we highly urge the City to remove all such chains and cable systems. R-7-89 Again during our tour of Valley View Park system we could not locate in any ground fault interrupters in the electrical systems in the shelter areas. This should be reviewed by a certified/licensed electrician and if ground fault interrupter systems have not been installed, they should be installed. R-8-89 Restraining backs or guardrails should be installed on the 1,,41" backs and sides of bleachers which extend more than four feet off the ground, measured from the topmost seat level `� to ground level. R-9-89 All new outfield baseball fences should conform to standard codes. Research has indicated that 6 to 8 foot high outfield fences reduce potentials for loss. Additionally, the fence fabric should be placed on the inside or the field side of the posts rather than eoutside of the pos s. If an outside contractor is to install the fence, he standard paperwork including certificates of insurance, named additional insured would of course be appropriate. • III • Ms. LaVonne Wilson City of Oak Park Heights June 21, 1989 Page Three ,,✓s MAINTENANCE SHOP: R-10-89 My tour of the maintenance shop revealed that a number of old unapproved style gas cans were still in the shop. These type of cans should be removed from the premise. R-11-89 All used oil/grease waste rags and towels should be stored in a UL listed, all-metal container with self-closing lid or these types of materials should be removed from the premise at night. POLICE OPERATIONS: R-12-89 The Police Policy and Procedure Manual should include an updated version on the gun section which would include the u2' use of 9 millimeter weapons, as well as expanding the high speed pursuit policy. R-13-89 We highly recommend that police officers discontinue/the practice of contracting out services to private or public entities on an individual basis. These entities, such as schools and dance halls, should be contracting with the City, which would then assign a police officer to that entity. The City's legal counsel should be involved with writing and/or reviewing the legal contract with proper Hold Harmless Arrangements in favor of the City. GENERAL OPERATIONS: R-14-89 A more formalized approach should be established for the receiving and documentation of information regarding nonlaw enforcement related complaints and/or incidents. To assist I you, I am enclosing a sample copy of formats that you may be able to modify to suit your needs in this area. This information should be fully documented and retained in file. The information can also be used to prompt necessary, timely response to complaints and/or incidents. R-15-89 The City should obtain product liability insurance certificates from vendors and/or product manufacturers when the City purchases major pieces of equipment or higher hazard equipment where the potential of loss is greater than normal. This is to confirm that the company you are doing business with does have proper product liability insurance and has economic backing in the event of a loss. The City may want to consult with the City' s agent-of-record to assist in reviewing these documents for evidence of proper lines and limits of insurance coverage. r .. i • Ms. LaVonne Wilson City of Oak Park Heights June 21, 1989 Page Four R-16-89 Of those staff members who could be involved with setting both permanent traffic control regulating signs as well as a temporary construction signs should be schooled in the Minnesota Manual on Uniform Traffic Control Devices. Subsequently, after the schooling, all signs both permanent and construction should be set according to the manual on uniform traffic control devices. �L R-17-89 I highly urge the City to obtain a certificates of �,,y/! insurance from the additional service providers we discussed at the time of my survey. R-18-89 I highly recommend the City require a "named additional insured" endorsement on certificates of insurance from contractors. It is sometimes very difficult to get a named additional insured endorsement from service providers. R-19-89 I highly recommend the City obtain a motor vehicle of records on City drivers directly from the State of Minnesota. To assist you, I have included the address of the state for your convenience. Additionally, there are some guideline requirements which you may desire to modify when evaluating the sample guidelines which you may want to modify when evaluating such records. R-20-89 The City should educate all potential staff members that could be interviewing on the current legal requirements on interviewing questions. It is very important that the interviewers ask the appropriate questions utilizing the r appropriate phraseology. The City may want to contact their City legal consultant or may wish to contact LMCIT staff attorneys for their input. R-21-89 We recommend the City obtain a written contract covering the county and state roads which traverse the city limits. This oftentimes indicates the other entity has designed the 4j roads, engineered the roads, maintained the roads and also r'1p� /V � liable for these roads. City may want to research an article by Mr. Jack Hennen, LMCIT staff attorney which appeared in January, 1989 issue of The League Magazine and more specifically to the Loss Control Quarterly section which Mr. Hennen addresses this issue. . S III • Ms. LaVonne Wilson City of Oak Park Heights June 21, 1989 Page Five e4'1 1 R-22-89 We recommend the City develop a permit system for contractors working on private property who may have to .j .. excavate on City easement,; This permit system oftentimes requires a principle of the contractor company to sign the ,;(,),D I permit, the contractor promises to obey all OSHA .�V specifications, uniform traffic control laws and other irr ' applicable laws and codes pertaining to the excavation. //' LMCIT staff attorneys do have samples of such a permit on file. /- � = / R-23-89 During my tour of your City I did note there were a number of grated openings over the storm sewer system with oblong enings parallel to bicycle traffic flow. There have been osses associated with bicycles getting the narrow front tires caught in such grated openings. These openings should be placed at an angle other than parallel to bicycle traffic flow. You may want to contact transportation technology transfer center at the North Dakota State University at Fargo, ND for remedies to this situation. PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF YOUR HANDLING OF THESE RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, (11-:ecu.,...; 4- Douglas D. Holm, MS, ASP Loss Control Consultant North Star Risk Services, Inc. DDH/dk Enclosures cc: Forest Lake Insurance Agency y .° S !II Ms. LaVonne Wilson City of Oak Park Heights June 21, 1989 Page Six These recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regulation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. Ms. LaVonne Wilson City of Oak Park Heights June 21, 1989 Page Five R-22-89 We recommend the City develop a permit system for contractors working on private property who may have to excavate on City easement,S This 7'_ y permit system oftentimes -requires a principle of the contractor company to sign the permit, the contractor promises to obey all OSHA 4 / specifications, uniform traffic control laws and other t applicable laws and co d es ertainin to the excavation. P g dam" LMCIT staff attorneys do have samples of such a permit on file. R-23-89 During my tour of your City I did note there were a number of grated openings over the storm sewer system with oblong openings parallel to bicycle traffic flow. There have been losses associated with bicycles getting the narrow front tires caught in such grated openings. These openings 11 should be placed at an angle other than parallel to bicycle traffic flow. You may want to contact transportation technology transfer center at the North Dakota State University at Fargo, ND for remedies to this situation. PLEASE RESPOND WITHIN 60 DAYS OF YOUR RECEIPT OF THIS LETTER REGARDING THE STATUS OF YOUR HANDLING OF THESE RECOMMENDATIONS. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on a copy of this letter and return it in this envelope. Thank you for your continued efforts in the interest of loss control. We look forward to working with you. Sincerely, Douglas D. Holm, MS, ASP Loss Control Consultant North Star Risk Services, Inc. DDH/dk Enclosures ' cc: Forest Lake Insurance Agency A 0 CITY OF OAK PARK HEIGHTS 14168 - 57th Street North STILLWATER, MINNESOTA 55082 439.4439 January 20, 1987 North Star Risk Services, Inc. 1401 W. 76th St. St. 550 Minneapolis, MN. 55423 Attention: Mr. David Drugg Dear Mr. Drugg: In response to your letters dated November 17th and December 29, the following items have been or will be attended to: :12 In compliance Have Council appr�aval-Now requesting quotes`' '. #3 - To be completed :spring ' 87 #4 #5 — Have check lists - Will be kept on file #6 - Archery target is installed, on ',prvate property: #7 - In-compliance #8 - Course provided by Washington County in early February' - ' Officers to attend #9 In compliance - #l'O Approximately half completed , { �+ N «u am` ; r.. °. = , 1` .e u,'. ?',;,R .,:'�c i rR x Sorry, for the delay in answering (vacation .and .auditors) N Should you have further questions, ,please-do' not :hesitate:_t..:,‘, ,T to -contact me ,. Sincerely; CITY OF `OAK PARK HEIGHTS' L,,n �. uonne Wilson r" Administrator/Treasurer "< . ak ,,.-ce xY',- ' ! mss" NSRS • • North Star Risk Services, Inc. 1401 West 76th Street,Suite 550 Minneapolis,MN 55423 (612)861-8600 January 16, 1987 Ms. LaVonne Wilson City Clerk CITY OF OAK PARK HEIGHTS 14168 57th Street North Stillwater, MN 55082 RE: City of Oak Park Heights Dear Ms. Wilson: Our loss control department has sent to your city a list of recommendations for risk improvement purposes. We have not received a reply advising us that all recommendations have been complied with. If the rates of L.M.C.I .T. are to be held down to the lowest possible level , it requires the combined efforts of all member cities. In fairness to our other cities, it will be necessary that one or more of the following be instituted for those cities who do not comply with our loss control recommendations: 1. Higher premiums to compensate for the increased hazard. 2. The exclusion of specific exposures. 3. The use of higher deductibles without a reduction in premium. 4. Non-renewal or cancellation of specific coverages. If our records are in error, and your city has complied with all outstanding recommendations, please send us a note indicating when the recommendations were complied with. Your cooperation will be appreciated. Sincerely, (9 Qw•-orge O'Connor Underwriting Manager GOC:djw NSRS • • North Star Risk Services, Inc. 1401 West 76th Street,Suite 550 Minneapolis,MN 55423 (612)861-8600 December 29, 1986 Ms. LaVonne Wilson, City Clerk City of Oak Park Heights 14168 - 57th Street North Stillwater, MN 55082 Dear Ms. Wilson: On November 17, 1986, a letter was sent to your attention relating several loss control recommendations applying to the premises and operations of the City of Oak Park Heights. Would you please advise me of the current status of handling of these recommenda- tions? Thank you for your assistance! Si rvrely, O David L. Drugg Loss Control Manager North Star Risk Services, Inc. DLD/bjh cc: Forest Lake Insurance Agency NSRS • • North Star Risk Services, Inc. 1401 West 76th Street,Suite 550 Minneapolis,MN 55423 (612)861-8600 November 17, 1986 Ms. LaVonne Wilson, City Clerk City of Oak Park Heights 14168 - 57th Street North Stillwater, MN 55082 Dear Ms. Wilson: As a result of a recent loss control survey, prompt attention should be given to these recommendations which will assist in minimizing the potential for loss. LOCATION SURVEYED: Garage/Municipal Building, 14168 - 57th Street North • 186 The door leading to the boiler room area in the office section of the building should be kept closed at all times. This door would act as a potential fire cut-off. R-2-86 Emergency lighting equipment should be installed in the building, especially in the vicinity of the council chambers, due to the po- tential for public assembly in this area of the building. This emergency lighting would serve to illuminate pathways to exits in an emergency condition. GENERAL OPERATIONS R-3-86 A review of the various park areas within the city reveals that much of the playground equipment is not mounted within a base of impact 7 absorption material . This type of material could consist of 6 - 8" of sand or pea gravel to provide proper impact absorption for poten- tial falls from the playground equipment. R-4-86 Due to the potential for injury to users based on design factors, we highly recommend that the city remove the merry-go-round and spring mounted animal rides playground equipment. R-5-86 The City of Oak Park Heights should establish a system of documenta- tion of regular maintenance and safety checks on the playgroud equip- ment. A type of checklist could be used for this purpose, which would also be used to prompt appropriate action for maintenance and upkeep of the equipment. This documentation should be retained in file. RESEIVE� Nov �1 ly�'- . 4111 Page Two City of Oak Park Heights November 17, 1986 During the peak use seasons of the playground equipment, we recommend that these checks be done on at least a bi-weekly basis. R-6-86 Valley View Park has what appears to be an archery target installation located on the north side of the access road to the park. Due to the potential conflict between persons using this target, and traffic on the access road, this target facility should be moved to a more secure portion of the park area, away from other park activities, traffic, etc. V-7-86 As a reminder, the City of Oak Park Heights should accomplish a review of all contractual agreements, and other arrangements with contractors, sub-contractors, service providers, etc. that conduct operations for or on behalf of the city to determine that requirements are in force for providing certificates of insurance evidencing proper lines and limits of coverage to the city. Contractual arrangements should also include hold harmless agreements in favor of the City of Oak Park Heights, as well s a requirement for naming the city as an additional insured when- ever possible. The city's insurance agent and legal counsel can be of additional as- sistance in this area. R-8-86 As part of the appropriate training for police officers, a program should be established for periodic defensive driving training, and training in the operation of emergency vehicles in potential high speed and increased maneuver situations. We recommend that this training be updated at least every two to three years for each officer. -9-86 It would be desirable for the city to obtain and periodically update motor vehicle records for persons who are operating city owned vehicles N1 . and equipment. These records should be updated on an approximately an annual basis. R-10-86 A formal , written policy and procedure concerning the use of high speed motor vehicle pursuit should be established for the police department. To assist you, I am enclosing a copy of a sample policy statement in j this regard. Obviously, you would need to tailor your policy to reflect your particu- lar situation, and we highly recommend that you involve the city' s legal counsel in any final policy drafting. PLEASE REPLY WITHIN 45 DAYS REGARDING YOUR COMPLIANCE WITH THESE RECOMMENDATIONS. The recommendations are made for risk improvement purposes only. They were not made for the purpose of complying with the requirements of any law, rule or regu- 4111 411, Page Three City of Oak Park Heights November 17, 1986 lation. We do not infer or imply in the making of these recommendations that there are no other hazards and exposures in existence. We assume no liability for recommendations provided. The purpose of the recommendations is to assist in improving the risk exposure and to assist you with your loss control program. For your convenience, enclosed is a self-addressed envelope. Feel free to make your reply on this letter and return in this envelope. 1/11 , All/11 ncerely, ,De/d D,ru/ 04./° i� 99 Loss Control Manager North Star Risk Services, Inc. DD/bjh Enclosure cc: Forest Lake Insurance Agency • r y • 411 POLICE DEPARTMENT (c/-m-m NArn) , MINNESOTA 1111111■1111•111110 alit 1 January 1910 Subject: High Speed Motor Vehicle Pursuits and Emergency Operation of Police Vehicles BACKGROUND High speed pursuits are among the most emotionally charged and dangerous actions undertaken by police officers . An officer must be ready at all times to apprehend violators with the least amount of danger to himself and the general public. Wanton high speed driving invites criticism from citizens and subjects the officer and the department to potential liability. REFERENCES 169. 01 Definition of Authorized Emergency Vehicle 169 . 03 Emergency Vehicles; Application 169 . 17 Due Regard for Safety 169 .20 Fail to Yield to Emergency Vehicle 609 . 487 Fleeing a Peace Officer in a Motor Vehicle POLICY It is the policy of this agency to engage in high speed motor vehicle Pursuits ONLY when the necessity of immediate apprehension outweighs the level of danger created by the pursuit. PURPOSE The purpose of this order is to recodify and Promulgate standards to control high speed pursuits . This procedure serves to define factors which an officer must consider in determining whether to continue or to terminate a pursuit. It also serves as a standard for administrative review of the propriety of the action taken, and establishes authority for supervisory personnel to order termination of a pursuit. Only in most unusual situations will an officer be subject for criticism for termination of a pursuit. 411 411 Subject: High Speed Motor Vehicle Pursuits and Emergency Operation of Police Vehicles REQUIRED ACTION I. Officers must activate both the red lights and the siren to pursue another vehicle legally at speeds in excess of the posted limit. High speed motor vehicle pursuit is defined as : An active attempt by a police officer operating an authorized emergency vehicle and utilizing simultaneously all required emergency equipment, red lights and siren, to apprehend one or more occupants of another motor vehicle when the driver of the fleeing vehicle is resisting appre- hension by maintaining or increasing his speed, ignoring the officer, or attempting to elude the officer while driving at speeds in excess of the legal speed limits. Officers intending to stop a vehicle shall be within as close proximity as possible consistent with the safe operation of the police vehicle, before activating red lights and siren and attempting the stop. The violator' s temptation to evade a police contact would be greater in those instances where it appears he has an advantage created by longer than necessary distances between his vehicle and the pursuing squad at the time the officer first activates the red lights and siren. Failure to activate either red lights or siren of a police vehicle operated in excess of posted speed limits does not remove the officers conduct from the proscriptions of this order. All caveats and regulations addressed herein to pursuits also apply to operation of police vehicles in other emergency conditions . II. Initiation and Notification In the event an officer becomes involved in a pursuit when a vehicle fails to stop when signalled, the officer shall immediately notify the dispatcher giving the following information: A. A description of the pursued vehicle including: 1. License plate number; 2. Make of vehicle; 3 . Color B. The reason for the pursuit and/or crime involved. C. Present location, direction of travel, and route of pursuit - constantly updated. D. The location where the pursuit terminates . -2- Ilk• 411 ubject: High Speed Motor Vehicle Pursuits and Emergency Operation of Police Vehicles REQUIRED ACTION (cont'd) \� III. Supervisory Responsibilities Upon notification, the watch supervisor shall assume responsibility for the Pursuit and in the exercise of his discretion may order the immediate termination of the pursuit. "Th►'s caN ✓ARy *--10, o04 The watch supervisor may, at any time, order the termination cage of a pursuit when in his judgement the necessity of immediate or-De-yr. apprehension is outweighed by the level of danger created by the pursuit. This may be accomplished by direct communica- tion with the unit in pursuit or through the dispatcher. IV. Factors to be Considered in Initiation, Continuation, and Termination of Pursuits A. The pursuing officer and the watch supervisor must constantly consider the risks created by pursuit. They should not needlessly endanger other persons. Some of the factors to be considered when determining to initiate, continue, or terminate a pursuit are listed below. 1. The nature of the initial offense a. The pursuit of a suspect who is known to have committed a forcible felony obviously justifies more risks than the pursuit of a traffic or other misdemeanor violator. b. Although "fleeing a police officer in a motor vehicle" is a gross misdemeanor, it is important to remember that to allow someone, who initially may have committed only a misdemeanor or petty misdemeanor, to escape may be easier to justify than to justify causing property damage or personal injury that could occur during the pursuit. 2. Ability of the officer in pursuit The officer should not attempt to drive beyond his abilities . The pursuit should be abandoned when the hazards of the chase exceed the hazards of the violation. This decision should never reflect the element of any personal challenge to the officer. 3. Condition of pursuit vehicle Is the squad marked and equipped with red lights and siren? ?.?as the car designed to be driven as a pursuit vehicle? Are the tires suitable for high speeds? How fast can the car be driven safely? -3- 411 Subject: High Speed Motor Vehicle Pursuits and Emergency Operation of Police Vehicles REQUIRED .ACTION (cont'd) 4 . Time of Day High speed pursuits occurring during high level of business , school , or other activities are deemed more hazardous than those occurring during_ periods of low activity. 5 . Volume of Vehicular/Pedestrian Traffic Pursuits occurring during periods of heavy traffic flow are deemed more hazardous than those occurring at other times. Remember, the pursued vehicle is an even greater threat to the driving public and to pedestrians because unlike the police vehicle, the pursued vehicle is without warning devices. In addition, the operators of these vehicles generally have had less experience in high speed driving than the pursuing officers and are often in a panic- controlled mental state. 6 . Weather and Road Condition Inclement weather and/or poor road conditions will adversely affect the driver's ability to keen control and to drive safely at high speeds. 7 . Speeds Involved It is . impossible to drive above certain speeds on city streets and still maintain enough control to protect the public. The officer shall not drive above that steed at which he no longer can safely control his squad. If the violator drives in excess of the speed the officer feels he can control his squad, the safety of the officer and to the public shall override the necessity to apprehend the violator in most cases. 8. Location of Pursuit Pursuits through residential areas or along streets near or adjacent to schools and narks are deemed more hazardous than those in lightly populated areas . -4- 411 Subject) High Speed Motor Vehicle Pursuits and Emergency Operation of Police Vehicles REQUIPED ACTION (cont ' d) 9. Passengers in Squad Prior to initiating a pursuit, or during a high speed pursuit, extra caution must be used when NoN-pea 1oNN_ a passenger is riding in the squad. The safety "K► -A 9s" �� of a citizen ride-along should not preclude a kay Disc.otAcAy.o. pursuit, but it would be considered an additional risk factor. Also, the officer must consider the safety of any reserve officers riding as a partner. V. Pursuit Tactics A. Unmarked Vehicles Officers operating unmarked vehicles may engage in pursuit only when the fleeincr vehicle represents a serious, immediate , and direct threat to life or property. Whenever a marked unit becomes available to take over a. pursuit initiated bv .unmarked vehicle, then the unmarked vehicle will withdraw from active pursuit and will serve in a support function for the marked vehicle. B. Number of Police Vehicles Unless otherwise directed by the watch supervisor, no - more than two police vehicles will become actively involved in the pursuit. There shall be no caravanning of field units attempting to join or joining the pursuit. All other squads shall remain in their areas to be avail- able for normal calls for service. They should be alert to the pursuit progress and location in case the pursuit comes into their area at which time they may assist as necessary. C. Pursuit Initiated by an Outside Agency When a pursuit is initiated by a law enforcement agency of another jurisdiction, the initiating unit and juris- diction shall be responsible for the progress of the pursuit. (11111111111111officers shall not leave the city to assist in a pursuit without specific authorization of the watch supervisor. If a pursuit from another juris- diction enters this city, our units may actively join in the pursuit as long as they are needed. (They are not needed if there are already two or more squads directly behind the fleeing vehicle. ) -5- 411 410 Subject: High Speed Motor Vehicle Pursuits and Emergency Operation of Police olice Vehicle S REQUIRED ACTION (cont 'd) If the pursuit leaves the city, they shall then abandon the pursuit unless they have become the first or second unit directly behind the fleeing vehicle. Officers involved in a pursuit shall not attempt to pass another police vehicle unless it is disabled or they are requested to do so. Our units shall return to the city at the earliest possible opportunity. especially if a third agency has joined in the pursuit. At no time shall all police vehicles on duty leave the city at the same time in a high speed pursuit. It is the philosophy of this agency to assist other departments whenever possible. It must be remembered that our primary responsibility is to protect and to serve the City of immilimm. All action taken must be in the best interest of our responsibility to S /ry /vA,,,£) D. Interstate Highways Officer shall not pursue vehicles the wrong way (against traffic)- on an interstate highway. or any other controlled access highway. Officers may drive the wrong way down a freeway ramp to make a traffic stop on a vehicle going the wrong way down that ramp to prevent the vehicle from actually entering the main portion of the freeway. Officers may drive on the wrong side of any other divided roadway only when absolutely necessary and in so doing shall use extreme caution. E. Overtaking the Suspect In most cases, officers should not attempt to overtake or pass a fleeing suspect. To do so _places the officer in a highly vulnerable position. The pursuing officer should keep a safe distance from the suspect vehicle and merely attempt to keep the suspect in until the suspect voluntarily stops. In some exigent circumstances when the necessity of stopping the suspect outweighs the potential danger to the officer, the officer may use the rolling roadblock, in which the squad car gets in front of the car to be- stopr-ed and does not allow the suspect car to pass. The officer straddles both lanes and slows down. This will allow other pursuing cars to catch up and may cause the suspect to stop. F. Firearms An officer shall not shoot from a moving vehicle. -6- • 411 410 Subject: High Speed Motor Vehicle Pursuits and Emergency Operation of Police Vehicles REQUIRED ACTION (cont'd) G. Ramming Officers shall not halt or attempt to halt a suspect vehicle in a high speed pursuit by "vehicle contact tactics" using a police vehicle to strike the suspect vehicle. H. Roadblocks The use of a roadblock must be authorized by the watch supervisor. Stationary roadblocks and/or rolling roadblocks may be employed only when there is definite knowledge that the suspect fleeing (a) has committed a felony; (2) the violator constitutes an immediate and continuing serious hazard; and (3) all other efforts to effect the apprehension have failed. Roadblocks should not be employed when it is apparent that innocent persons would be endangered. Immediately advise all pursuing squads of the existence and exact location of the road- block. The improvised stationary roadblock generally consists of placing a police vehicle or hastily erected barricade across the roadway at some distance ahead of the fleeing vehicle to force a stop. There are several cases on record where improvised roadblocks of this tyre, due to lack of sufficient warning and/or poor location, have resulted in serious injury to police officers, innocent • persons, or to the violator. Therefore, each particular incident must be carefully evaluated and the hastily improvised roadblocks employed only as a last resort. The use of a roadblock must be directly associated with the seriousness of the crime for which the suspect is wanted. I. Traffic Control Devices Extreme care shall be used whenever disobeying traffic signs or signals, even where statutes specifically permit such conduct. Pursuit vehicles shall make use of all available warning devices to alert other motorists and pedeistrians . J. Reserve Officers No member of the police reserve shall drive a police vehicle in a high speed pursuit. No exigent circum- stances will prevail . -7- . • ' . 1 Subject: High Speed Motor Vehicle Pursuits and Emergency Operation of Police Vehicles REQUIRED ACTION (cont 'd) K. No member of this agency shall commandeer any vehicle for use in any pursuit or for use in any roadblock. L. No member of this agency (regardless of duty status or assignment) shall engage in an active pursuit, as defined in Required Action I of this policy, or in any other high speed attempt to apprehend or otherwise track, follow, or chase a subject while operating a non-departmental motor vehicle. VI . Termination A. A pursuit will be terminated under one of the following conditions: 1. The suspect stops and is apprehended. 2. The identity of the suspect has been established to a point that later apprehension can be accomplished, and there is no longer any need for immediate apprehension. 3. When, in the opinion of the officer of watch supervisor, the level of danger created by the pursuit outweighs the necessity for immediate apprehension. 4 . The pursued vehicle ' s location is no longer known. VII . Accountability These procedures are based upon recognition of the basic need for pursuit under certain circumstances . Great reliance is placed upon the individual officer and the watch supervisor in the application of their experience, common sense, and training. All members involved in vehicular pursuits will be held accountable for continuing a pursuit when circumstances indicate it should have been discontinued. A dead, disabled, or injured officer is of no use to himself, his family, or the department. Conversely, death by- auto collision is a heavy penalty for a traffic or misdemeanor offender to nay. If you pursue and the offender is thus inspired or frightened into fleeing, your actions could indirectly cause death to a violator whose original offense might normally result in a simple fine. -8- . i Subject- High Speed Motor Vehicle Pursuits %/1) and Emergency Operation of Police Vehicles dQ<, REQUIRED ACTION (cont 'd) Officers and/or supervisor will neither be criticized nor disciplined when their decision is to terminate rather than continue the pursuit, except where termination amounts to neglect of duty. EFFECTIVE DATE This order shall be effective upon publication. 1 J n Chief of Police I certify that I have read and fully understand this order. Signature • CITY OF OAK PARK HEIGHTS 14168 - 57th Street North STILLWATER, MINNESOTA 55082 439-4439 January 20, 1987 North Star Risk Services, Inc. • 1401 W. 76th St. - St. 550 • Minneapolis, MN. 55423 Attention: Mr. David Drugg Dear Mr. Drugg: In response to your letters dated November 17th and December 29, the following items have been or will be attended to: #1 - In compliance ' #2 Have Council approval-Now requesting qnotes #3 - To be completed :spring ' 87 #4 - VI #5 - Have check lists - Will be kept on file #6 Archery target is installed, on private property #7 In:-compliance #8 , —Course provided by Washington County in early February - - Officers to attend #9 - In compliance #1,0 - Approximately, half -;-completed .__. _ _ =• Sorry for the de lay in answering (vacations and auditors) . ..' Should you have further .questions, .please-do not ':hesitate to contact me Sincerely, -- CITY OF OAK PARK HEIGHTS a Vonne Wilson Administrator/Treasurer . ROA� SIGN a a +• GSIDE SIGN 1< / • vaA•_� RICT TOP . DISTRICT _� ^ -1 I I raw ( ' • • A\ - - --1---- j- sPcco WARNING SIGN LIMIT WITH ADVISORY ROADSIDE SIGN 50 SPEED PLATE OUSINESS OR z.—4 1 RURAL DISTRICT A •,r•RESIDENCE DISTRICT - .r 7, a\A A` VI II� _03_ s nAv — - • •• . I al ROADSIDE ASSEMBLY _ . RURAL DISTRICT 44 ( © 0 ••,V. WARNING SIGN ON ISLAND ` .. IN THE LINE uF TRAFFIC o,• i'• 4 YO R K:'. OVERHEAD � ' `�4/11/4 THIS MATERIAL PROVIDED BY: MOUNTING .� p.*41;:;::;:];-;% ,;�5�S NORTH STAR RISK SERVICES, INC• = fit LA-i'°'' LOSS CONTROL DEPARTMENT = . - } ' ��11:� I So" 1401 WEST 76TH STREET, SUITE 500 411A MINNEAPOLIS, MINNESOT, r— ' " (612) 861-8600 • ' • • ' �� '� .Y•• •4G i4.N• r Figure 2-7. Height and lateral location of signs—typical installations. 2A-9 Reference: Minnesota Manual on Uniform Traffic Control Devices, 1986 I �• - r i• Iii °c • w c E Q t"' c p ? ( cc 11-1 1 H m NIX C � N m '' QJW +a C d C7 m m Z � > c A. J a ,�' i In W Ev W O o o c >0 > p o 'c C O Ti t C t6 o > 2 I Q ` _ • ---- - ---1 d ce Z 7.- - m o i QY I 4C V o : y v F V W -(i• 3 1- 8 2 n-O __ o •. V Q m I m in cc al m O O d _� N LL. (7 — c E -- - - GL _ --, s+�-- F v ,r3, jr,,aPI72firr :„,,,,,-- ..., 0 .3 0 ; < ° ' s v ; - / r i A Q II - R"ST::i, y o . e i - r,1',',:, I Ct -q- t = O • • } s4 i . ..,,„...,. 1 ,1 o s a a. o \ w Hi ( - g U i=µ-1>ti g1- -.i6 our 1 (0 ; ye c es 0 Il ,: l ' CO ,r)-'---p,-,•.-;-.-,L of g; CO c,. _;!'_s-:t,. $A Rte, 421 o ! ` it W O 6. 0 ; . E.-c • C a r.. 4 I 1 0 Z ��dg - e X•CC v 3 i • • IIII uu -1(II league of minnesota cities GENERAL COMPLAINT FORMS (can be used by any department) The attached complaint forms may need to be amended or supplemented depending on the proposed use . Please consult your city attorney or organization' s attorney about using such forms. Ellen A. Longfellow LMCIT Staff Attorney THIS MATERIAL PROVIDED BY: Ill NORTH STAR RISK SERVICES, INC. 11414,:oiloi LOSS CONTROL DEPARTMENT 1401 WEST 76TH STREET, SUITE 500 MINNEAPOLIS, MINNESOTA 55423 (612) 861-8600 183 university avenue east, st paul, mmnesota 55101 [61 2) 227-5600 0 0 a m 3 m z a x m 0 m el a r 1 r s m � r t o "b ,• j f' rC-4,r "�' n • I I- ! i i ■ 1 1 t • I 1 f i Ai n c, -1 0 z --1 n 7z m z mo c, 3 m nzi W ,ca •• m ►-. v z --1 r • DATE : INCIDENT : A few minutes after 1 : 00 P .M . On October 29 , 1985 , I was informed by Peggy Schupp of ou • fice staff , that Mrs . Ervin Sthreder of 404 3rd Street No th h d - o report a blockage of her sewer line . At approx ' mat . - . . 1 . , Mr ., Noel Blais and myself checked the city s -were n -i, !t 'r e .;;.street manholes above and below the Schreder �.. ' ,'` �'' �D -o�und no blockage . This area of the city ' s sewers ^ - - -Wed by the, city maintenance staff during the week of July - - � �`, 1985 , during our routine maintenance of the collection system. BY : John B . O ' Malley Public Works Director City of Sartell I 40 • COMPLAINT MEMO DATE 19 TIME Complaint Received By Name of Caller Telephone Number Address of Caller Nature of Complaint Person Notified .; "4 PRPOSEs Date 1--7•. mli Receipt of Notification By Action Taken ///14/&.'bii: By ��s • CITY OF CHAMPL I N • UTILITY DEPARTMENT EMERGENCY CALL-OUT INFORMATION DATE: TIME OF CALL-OUT: • TYPE OF CALL: PROBLEM LOCATION: NAME (If applicable) : DETAILS OF PROBLEM: sA_ USE Fri R Eir ACTION TAKEN: GU11JE!/ aAll PURPOSES EQUIPMENT USED: • HOURS SPENT: EMPLOYEE (S) : , .. 6 • City of Complaint Form Date : Complaint : Address/Area : i. - , i , i- ! pLE Complaint/Address : USE FOR r"IDE . . L�NC , ONLY. Reported To : Date : Action Taken : 1 Date : Verification : Date : Follow-up : Date : Additional Action : Recorded By : ** All supporting data attache 0 • • COMPLAINT LOG DATE TIME NAME OF CALLER _ COMPLAINT ACTION TAKEN lk / .: , , w 1 . .. 1---iuZicE FOR GU/DEUNE PURPOSES