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<br />....-... <br /> <br />t...,. <br /> <br />~ <br /> <br />'- <br /> <br />r" <br />.., <br /> <br />WORKERS' COMPENSATION COVERAGE <br /> <br />INSURER <br />Preferred Governmental Insurance Trust, Not Rated by A.M. Best <br /> <br />CLASSIFICATIONS & EXPOSURES <br />In computing a deposit premium the following classifications and payrolls were used: these <br />payrolls are auditable by the Company at expiration of your policy. <br /> <br />CODE <br /> <br />7382 <br />7720 <br />8810 <br />8820 <br />9015 <br />9102 <br />9402 <br />9410 <br /> <br />CLASSIFICATION <br /> <br />PAYROLL <br /> <br />224,400 <br />3,724,754 <br />3,003,556 <br />282,596 <br />827,978 <br />1,383,645 <br />50,391 <br />632,304 <br /> <br />Bus Drivers <br />Police Officers & Drivers <br />Clerical <br />Attorneys & Clerical <br />Buildings-Owner or Lessee <br />Park, NOC Employees & Drivers <br />Street Cleaning & Drivers <br />Municipal Employees NOC <br /> <br />Experience Modifier: 1.09 <br /> <br />Minimum Annual Premium: $2,000 <br /> <br />Net Deductible: $2,500 per Occurrence <br />(Claims under $2,500 will not be reported to NCCI and will not affect experience modification) <br /> <br />Drug-Free Credit Included <br /> <br />Safety Credit Included <br /> <br />Emplovers Liabilitv Limits (*) <br /> <br />Bodily Injury by Accident $1,000,000 Each Accident <br />Bodily Injury by Disease $1,000,000 Each Employee <br />Bodily Injury by Disease $1,000,000 Policy Limit <br /> <br />*Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend the <br />adequate limit of protection. Higher limits may be available. Please let us know if a quote is desired. <br /> <br />SPECIAL EXCLUSION <br />. Workers Compensation benefits for employees domiciled outside of Florida are excluded <br />from coverage. Coverage may be available at an additional premium, please advise if <br />you have the exposure and require a quotation. <br /> <br />Brown & Brown of Florida - Miami Division <br /> <br />32 <br /> <br />Proposal No. 11-08-0 I <br />