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<br />\ <br />i <br /> <br />TERMS & CONDITIONS <br /> <br />1. Please review the quote carefully, as coverage terms and condItions may not encompllSs all requested coverages indicated In the <br />appliclltlon. <br />2. Renewal quote is subject to review and acceptance bV PGIT Board of Trustees <br />3. The Coveraee Asreement shall be 25" minimum earned ISS of the first dllV of the .Coverage Period". <br />4. Total premium is late if not paid in full withIn 30 days of inception, unless otherwise stated. <br />5. DeletIon of any coverage presented, Package and/or Workers' Com~nsatlon, wID result In re-prlclni of account <br />6. The PGIT Property program Is a shared limit. Ttle nmits purchased are II per occurrence limit lInd In the event an occurrence exhaust the <br />limit PUrdtllSed by PGlT on behlllf of the members, pavmentto ycu for a covered loss will be reduced pro-rata based on the amounts of <br />covered loss by all members affected by the occurrence. <br />7. Coverage Is not bound until confinnatlon Is received from a 6censed representative of Public Risk Undenvriters. <br /> <br />Additional terms and conditions, induding but not limited to: <br /> <br />~e is subject to recapt of the foIlowln9 Information by 10/30/2011 <br />a) Signed first page of the PGIT Application (Florida Fraud Statement) <br />b) IIitIaIed and sfgned PGlT POL/EPU Application <br />c) SIgned UMform <br />d) SIgned Signature page <br /> <br />1. please review the quote carefully, as coverage terms and conditions may not encompass all requested coverages Indicated In the <br />application. <br />2. Quote subject to review and acceptance by PGIT Board of Trustees <br />3. The Coverage Agreement premium shall be pro-rated as of the first day of coverage from the minimum pollcV premium. <br />4. Down payment Is due at inception <br />5. The Trust requires that the Member maintains valid and current certificates of workers' compensation Insurance on all work performed by <br />persons other than Its employees. <br />6, If NCCI re-promulgates a mod, we will honor the mod as promulgated. If the mod changes during the fund year, we reserve the right to <br />apply a correct mod back to the inception date of the Coverage Agreement. <br />7. Quote was prepared using payrolls supplied by your agency. <br />8. Safety and Drug Free program credits (if applicable) are subject to program requirements, <br />9. Payrolls are subject to final audit. ' <br />10. Deletion of any coverage presented, Package and/or Workers' Compensation, will result in Re-prlcing of account.011. Coverage Is not bound until confirmation Is received from a Ucensed representative of Public Risk Underwriters. <br /> <br />ADOmONAL TERMS AND CONOmONS, INCLUDING BUT NOT LIMITED TO: <br /> <br />Quote Is subJect to receipt of the foliO'.'mg Information by 10/30/2011: <br /> <br />. SIgned PGIT we Application <br />. S"1gI1€d Drug Free and Safely Program Applications <br /> <br />Brown & Brown of Florida - Miami Division <br /> <br />41 <br /> <br />Proposal No. 11-08-01 <br />