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<br />QUOTATION TERMS & CONDITIONS INCLUDING BUT NOT LIMITED TO <br /> <br />1. All coverages requested may not be offered in this quote. <br />2. Quote is subject to review and acceptance by PGIT Board of Trustees <br />3. PGIT is not protected by the Florida Guarantee Association in the event it becomes <br />unable to meet its claims payment obligations. <br />4. TRIA Coverage excluded for all property and inland marine exposures. <br />5. Deletion of any coverage presented, Package andlor Workers' Compensation, will <br />result in repricing of account. <br />6. Request to bind must be received in writing via email prior to the effective date of <br />coverage. If request is not received prior to that date there is no coverage and the <br />file is closed. <br />7. Coverage is not bound until confirmation is received from a licensed representative <br />of Public Risk Underwriters. <br />8. The Trust requires that the Member maintains valid and current certificates of <br />workers' compensation insurance on all work performed by persons other than its <br />employees. <br />9. If NCCI re-promulgates a mod, we will honor the mod as promulgated. If the mod <br />changes during the fund year, we reserve the right to apply a correct mod back to <br />the inception date of the Coverage Agreement. <br />10. Safety and Drug Free program credits (if applicable) are subject to program <br />requirements. <br />11. Workers' Compensation Payrolls are subject to final audit. <br /> <br />ADDITIONAL TERMS AND CONDITIONS INCLUDING BUT NOT LIMITED TO: <br />1. Quote is subject to receipt of the following information: <br />a. Signed first page of the PGIT Application (Florida Fraud Statement) <br />b. Latest Audited Financials <br />c. Initialed and Signed POLlEPLI application <br />d. Signed PGIT WC Application <br />e. Signed Drug Free and Safety Program Applications <br />f. Signed PGIT Participation Agreement <br />g. Signed UM Form <br />h. Signed Signature Page <br />2. Please note that Statutory PIP coverage is currently not being provided. However, <br />should Florida legislation decide to renew Statutory PIP coverage on October 1, <br />2007, coverage will be provided at no additional charge. <br /> <br />23 <br />Brown & Brown of Florida, Inc. <br />