HomeMy WebLinkAboutBrown & Brown
Brown & Brown of Florida, Inc.
Miami Division
14900 NW 79th Court, Suite 200
Miami Lakes, FL 33016-5869
(305) 364-7800
Fax (305) 822-5687
August 18, 20 II
Alan J. Cohen
City Manger
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL
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Re: IFB 11-08-02 - Property & Casualty Comprehensive Insurance
Dear Manager Cohen,
Brown and Brown Insurance of Florida, Miami Division and the Preferred Governmental
Insurance Trust (PGIT) have had the privilege of providing insurance coverages and services to
the City of Sunny Isles Beach for over ten years. We are now pleased to provide the enclosed
response to the above captioned RFP.
/""". ,,-!n addition to the enclosed proposal, I believe it is important to highlight some of the following
,.., unique enhanced insurance coverages in our proposal that are not generally included in other
programs:
I. PGIT's Property insurance program provides full replacement value limits for the perils of
windstorm and hurricane on a "blanket" format without the inclusion of a potentially onerous
coinsurance penalty condition. This extraordinary feature virtually eliminates the possibility of an
underinsured or co-insured property insurance claim.
2. $5,000,000 Excess Flood Insurance is provided over and above the primary flood insurance
provided by the National Flood Insurance Program.
3. A $2,500 payment is offered for legal fees ands assistance for reporting potential employee
termination is also included as well as a $100,000 coverage limit for the defense of Non-
Monetary claims, such as ethics hearings and recall petitions.
We appreciate the opportunity to offer our proposal and look forward to continuing to protect the
assets and service the insurance needs of the City of Sunny Isles Beach.
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CITY OF SUNNY ISLES BEACH
IFB 11-08-01
Property & Casualty Comprehensive Insurance
TABLE OF CONTENTS
1. Company Information Pages 2 - 3
2. Qualifications Pages 4 - 5
3. Staffing Pages 6
4. Approach/Methodology Pages 7 - 8
5. Cost of Services/Coverages Pages 9 - 43
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6. References Pages 44 - 46
7. Online Account Mgmt Demo Pages 47
8. Contract Forms / Affidavit Pages 48 - 58
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Brown & Brown of Florida - Miami Division
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Proposal No. 1 I -08-0 I
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Company Information:
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Brown & Brown Insurance of Florida - Miami Division
Please refer to enclosed 2010 Brown & Brown Insurance Annual Report for
listing of various locations/states.
Internet Web Site Address: www.bbinsurance.com
Brown & Brown Insurance is a publicly held corporation - NYSE/BROo
Brown & Brown Insurance was founded in 1938 in Daytona Beach, Florida.
Corporate Home Office Address & Telephone: 220 South Ridgewood A veo
Daytona Beach, FL 32114
(386) 252-9601
Local Address & Telephone: 14900 NoW. 79 Court, Suite 200
Miami Lakes, FL 33016
(305) 364-7818
No Outstanding Litigation.
C Proof of Insurance - Certificate of Insurance enclosed.
As the incumbent Insurance Agent for the City of Sunny Isles Beach our services will continue
without any interruption.
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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OP 10: JW
ACORD. CERTIFICA TE OF LIABILITY INSURANCE I DATE llolMIDDNYYYI
~ 08/03/11
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If tho cortlflcato holdor Is an ADDITIONAL INSURED, tho pollcy(les) must be endorsed. If SUBROGATION IS WAIVED, subject to
tho torms and condItions of tho policy, cortaln pollclos may roqulre an endersement. A statement on this certlllcate does not confer rights to tho
certlncale holder In lieu of such endorsemenlls'l.
PRODUCER 386.252-9601 ,,9I1TACT
Brown & Brown of Florida, Inc. NAME:
D'gtona Beach Office -. . " O' 386-239-5729 1'..tJ8N,To EkI': -. .' _.~- ...-- Ir~ No"
P. . Box 2.412. ~s:
Da~ona Beach, FL 32.115-2.412. 1[~~~lU' BROWN.3
M. ecker Youngman
INSURERlSI AFFOHOINO COVERAGE NAIC.
INSURE[) BROWN & BROWN OF FLORIDA INC INSURER A: Travelers PrOD & Cas of Amer 25674
POBOX 2412 INSURER B: National SuretV"CorDoratlon 21881
DAYTONA BEACH, FL 32115 INSURER c: Charter Oak Fire Ins 26616
INSURER 0 ,XL Sneclaltv Ins Co 37885
INSURER E: Executivo Risk Indemnltv 36181
INSURER F:
COVERAGES
CERTIFICATE NUMBER'
REVISION NUMBER'
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOlWlTHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT 'MTH RESPECT TO Vv'HICH 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.
I'r~~ TYPE OF INSURANCE PDUCY NUMBER 1,r.!:M%.~ ~gg~~ U~~TS
GElIERAL LIABILITY ~=i" S 1,000,000
-
A ~ ==rtl.ERClAL GENERAl LIAbILITY TC2JGLSA9527B874-11 01/01/11 01/01/12 S 1,000,00
_ a.AlMS.I.4AOE [K) OCCUR 1.11:0 EXP 'An" MO 00"""') s 5,00
- PERSONAL & AT:N INJURY $ 1,000,00
- GENERAL AGGREGATE $ 2,1300,1313
lfiA~EnE LIMIT APflS PER: PROOUCTSoCOMP~PAGQ S 2,1300,1313
X POllCY ~,\lR; LOC S
AUTOMOBIlE LIABILITY COMBINED SINGLE LIMIT S 1,OOO,OOC
- (E. ....ddanI)
A - NN AUTO TC2JCAP9627B862.11 01/01/11 131/01/12
OODIL Y INJURY (Pel' pel"on) S
- AlL O'MlED AUTOS OODIL Y INJURY (Pel' oOCldll<lI) $
- SCHEll\JlED AUTOS PROPERTY DAMAGE
~ HlREDAUTOS (1'.. .rodonl) $
15.. IIQH.QVd'IED AlIros $
$
UMBRELLA lIAD ~ OCCUR EACH OCCURRENCE $ 10,01313,1313
- 10,OOO,OOC
EXCESS UAD ClAIMS.lMDE AGGREGATE $
B SUOOO031754039 131/01/11 01/01/12
- DEDUCTIBLE $
RETENTION . S
WORl<EIIS COMPEIlSAnON X STATU- I IOJ~'
C AND EMPLOYERS' IJAOIUTY YIP/ TC20UB9517B58011 131/01/11 01/01/12 1,000,130
AH'I PROPftIETORlPARTHEiVEXECUnvE D E.L. EACHACClOEIlT $
OFFJCEH/MEMBER EXCLUOED7 iliA
A IMandatory In NH} TRJUB9618B76111 01/131/11 01/01/12 E.L DISEASE. EA EMPLOYEE $ 1,000,00
gr~~p~~ ~~PE'RATIONS below E. L. C1SEASE -I'OUCY L1IolIT $ 1.000,000
0 INS AGENTS E&O ELU119910011 131/01111 131/01/12 EACH LOSS 5,000,000
E EMP DIS/FIDELlTY 82220236 04/28/10 01/01/12 BLANKET 25.000,00
8ESCRi5~OH OF OyERAroNS ILOX~~IlS I VlrlCLES ~n'o~ ACO~ lUkMdltlonal RHjarke S~'dUIA ~ 'l'.oro ljn~'Yv.CJUlrodl
fTY SUNN IS ES BE IS A ADD 0 AL I S ED ON T E GE ER IA I I
POLICY AS RESPECTS RFP.
CERTIFICATE HOLDER
CANCELLATION
CITYS88
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CITY OF SUNNY ISLES BEACH ACCORDANCE WITH THE POLICY PROVISIONS.
18070 COLLINS AVE
SUNNY ISLES BEACH, FL 33160 AUTHORIZEO REPRESE/ITA TIVE
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@ 1988-213139 ACORD CORPORATION. All rights rosorved.
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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Qualifications:
Brown & Brown Insurance of Florida - Miami Division has provided the insurance services
required by RFP to the City of Sunny Isles Beach since July 1, 2001.
Brown & Brown Insurance of Florida - Miami Division and Agent, Robert P. Hollander have
continuously surveyed, reviewed and provided insurance programs to protect the insurance
exposures of the City of Sunny Isles Beach for over ten years. As recent as August 10, 2011,
Robert P. Hollander and a safety/loss prevention representative of The Preferred Governmental
Insurance Trust (PGIT) surveyed all locations within the City of Sunny Isles Beach with the goal
of updating insurance exposures and to provide risk management, safety and loss prevention
services to the City of Sunny Isles Beach.
Brown & Brown Insurance of Florida - Miami Division and Agent, Robert P. Hollander have
continuously provided independent insurance services and advice to the City of Sunny Isles
Beach and it's various staffmemberso These services include claim reporting and coverage
explanations, review of independent contractor/vendor insurance agreements prepared by the
City Attorney/legal counsel and review of the various and numerous independent
contractor/vendor Celiificates of Insurance for the protection of the City of Sunny Isles Beach.
Brown & Brown Insurance of Florida - Miami Division and Agent Robert P. Hollander have
provided review of claim data with special attention to claim frequencies in order to establish the
most comprehensive and competitive insurance program to the City of Sunny Isles Beach.
Brown & Brown Insurance of Florida - Miami Division and Agent, Robert P. Hollander have
been dedicated to assisting the City of Sunny Isles Beach in the claim process, providing specific
assistance in legal counsel selection and subrogation process to pursue at-fault third party
reimbursementso
The PrefelTed Governmental Insurance Trust (PGIT) has also provided services and insurance
services to the City of Sunny Isles Beach since July 1,2001. PGIT is non-profit and self
governed with several hundred public entity members and over 120 municipality members
throughout the State of Floridao The Board of Trustees is comprised of elected public officials
who work wisely and diligently to set policy, keeping Preferred as the premier public entity
insured of its kindo The Risk Advisory Board is composed of full-time risk managers from the
membershipo This Board is uniquely equipped to monitor and kelp improve products and
services - it serves as the voice of the membership and works in synergy with the administrator
for maximum efficiency.
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
~- PGIT provides customized, comprehensive safety management programs using state of the
~ art techniques. Services offered are as follows:
Identification and analysis of risk exposures, loss trends and job hazards.
Recommendation and implementation of safety control measures.
Specialized education and training programs from recordkeeping to first aid, from drug-free
policies to defensive driving, from ergonomics to lifting safety.
Safety consultant on-call.
Self-inspection program development.
Accident investigation trainingo Prompt, in-depth detailing of workplace injuries and
occurrenceso
Complete resource libraries consisting of safety and loss control documents, inspection forms,
safety briefs, checklists, videos and presentations.
E-tools, including library resources, forms, and a member forum to post questions and
suggestionso
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The exclusive Preferred Academy, providing an amazing range of education and training in
person and on the webo
Preferred's claims administrator is The Preferred Governmental Claim Services (PGCS).
With more than 25 years in claims experience PGCS is Florida's foremost governmental
third-party administration company. PGCS provides the following additional services:
24/7 claim repOliing by fax, email or online.
24/7 online access fro claim status and adjuster notes, loss runs, trend analysis and data charts.
Access to trained nurses for direction to initial medical facility.
Catastrophic adjustment teams.
In-depth claim review via quarterly meetings.
Dedicated subrogation unit to pursue at-fault third party reimbursements.
Special investigation unit (SID) for fraudulent claims.
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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Staffing:
The administrator for the Preferred Governmental Insurance Trust is Public Risk Underwriters of
Florida (PRU). PRU's team of underwriters' vast insurance expertise enhances the actuarial and
scientific data used to underwrite individual risks within the trust.
Brown and Brown of Florida - Miami Division is comprised of approximately 80 insurance
professionals. The cornerstone of our business philosophy is to provide impeccable service to our
clientele based on immediate and constant communication of all requests and issues involving
the individual customer.
The Brown & Brown Insurance of Florida - Miami Division agent for the City of Sunny Isles
Beach since July 1,2001 is Robert P. Hollander. Robert P. Hollander has over forty years of
experience in the insurance industry all in South Floridao Robert P. Hollander is an Executive
Vice President of Brown & Brown and is a graduate of The University of Miami and New York
College of Insuranceo
Robert P. Hollander is past President of the Independent Insurance Agents of South Florida and
past Chairman of both the A ventura Marketing Council and A ventura Hospital and Medical
Center.
Robert Po Hollander's responsibilities to the City of Sunny Isles Beach are to analyze the City's
insurance exposures and negotiate the appropriate insurance coverages for these exposures at the
most competitive insurance premiums. Robert P. Hollander provides various risk management
advices to the City and is available 24/7 to the City's staff for any insurance related issue.
The Brown & Brown of Florida - Miami Division, Senior Account Manager for the City of
Sunny Isles Beach is Mercy Garcia. Mercy Garcia has serviced the day to day need of the City of
Sunny isles Beach for over ten years and has in excess of 25 years experience in the insurance
industry. These services include but are not limited to claim reporting, issuance of certificates of
insurance to third parities, billing issues with PGIT and other insurance carriers as well as
responding to any communication form City personnel.
Brown & Brown of Florida- Miami Division
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Proposal No. 11-08-0 I
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Approach/Methodology:
Brown & Brown Insurance of Florida - Miami Division's approach and methodology for The
City of Sunny Isles Beach is to continue the plan of service that has been implemented for the
past ten years. We will continue to evaluate insurance exposures unique to the City of Sunny
Isles Beach as is evidenced by the recent inspection of all City properties on August 10, 2011.
It is the responsibility of Brown & Brown Insurance to offer risk management options to the City
Manager and staff to implement the most efficient and practical plan of insurance. Deductibles
and other self-insurance options are evaluated and presented based on the City's claim history
and budget.
Brown and Brown of Florida - Miami Division will continue negotiate with PGIT and PRU to
establish the most competitive premium options that can be made available to the City of Sunny
Isles Beacho The excellent working relationship with PGIT, PRU and Brown and Brown of
Florida - Miami Division provides for the ability to meet any requested timeline or deadline. In
addition, Brown & Brown of Florida - Miami Division also has the highest standard or
relationship with the various carriers that provide coverages that not included in the PGIT
program such as Flood, City Manager Bond, Accident Medical, Yacht, Plate Glass, Storage Tank
Liability and potential Builders' Risk insurance.
Please refer to the enclosed PGIT Municipality Excess-of-Loss Structure outlining the various
insurance carriers involved and their respective financial ratings.
Brown & Brown Insurance of Florida - Miami Division will continue to monitor the City's
National Council of Compensation Insurance (NCCI) individual experience to implement a
"light duty back to work program" limiting workers' compensation claims to medical only status,
thus making every effort to avoid the onerous surcharges applied to loss time or "indemnity"
claims. The Safety and Risk Control Services identification of risk exposures relating to work
related injuries and accident investigation will also add in the control of workers' compensation
premIUms.
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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Municipality Excess Insurance Structure 10-11
Statutary I
Limits S12S,DDD,DDD Limit I
L aYl'!'ell progl:mn Higher Limits Available
with the fellowing participating S2 ODD ODD Per 0 ccurr en ce Limit
carriel'S: Higher Limits
Aspen Available
Star liullrance A.XIS Speri.,lty Sl,DDD,DDD Per
Endurance Amel'ican Occurrence Limit
Company Essex Insurance Co Star In suranc e
Lancashire UK Company Illlliml Hm'bor
Lexin~ton Insurance
Lloyds Star Star Company
l\lax Re
Mentpelier Re Insurance Insurance
Swiss Re CompmlY Company
$75,000,000
(Excess over Tower 1 & Towl'!" 2)
$50,000,000 $50,000,000
AWAC AWAC
$350,000 Arch Specialty Ar ch Sp ecialty $350,000
ll' on sh. or e Ironsbore
Lib l'!"ty 1\.Illtllal Lexington Lexington Indian Harb er
In Slll' mle e Lloyds LloYI}s Insurance
Company Princeton E &S Princeton E&S Compan)O
RSUI RSUI
United National $100,000 $100,000 $100,000
Retention Retl'!ltion Retl'!ltion
$75,000 (Towl'!' I) (Towl'!' 2) $75,000
Retention $25,000 Retention
Retention
Warkers' Praperty Autamabile General L iIW Enfarcem en t Public Officials .I-
Campensatian Inland Marin e Liability Liability Liability Emplayment
Autamabile PD Practices
Financial Ratings of Carriers Listed Above - Rated by A.M. Best
. Star Insurance Co A-IX
. Aspen Insurance Co AXV
. AXIS Specialty AXV
. Endurance American AXV
. Essex Insurance Co AXlll
. Lancashire UK AXlll
. Lexington AXV
. Lloyd's AXV
. Max Re
. Montpelier Re A-XIV
. Swiss Re AXV
. Indian Harbor Insurance AXV
. Liberty Mutual AXV
. AWAC
. Arch Specialty AXV
. 1ronshore AXlll
. Princeton E&S AXV
. RSU1 A Xli
. United National AX
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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CITY OF SUNNY ISLES BEACH
PROPOSAL NOo 11-08-01
18070 Collins Avenue
Sunny Isles Beach, FL 33160
COMMERCIAL INSURANCE PROPOSAL
October 1st, 2011 - 2012
Prepared
By
ROBERT HOLLANDER
SENIOR VICE PRESIDENT
Brown & Brown Miami Lakes
Tel. 305-364-7800 - Fax 305-822-5687
Date Prepared
August 11, 2011
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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INTRODUCTION OF THE ACCOUNT SERVICING TEAM
BROWN & BROWN MIAMI
~ Commercial Insurance (Property & Casualty) Primary Contacts
. Robert Hollander Direct TeI.305-364-7818
Senior Vice President
rhollander@bbmia.com
. Mercy Garcia
Account Manager
mgarcia@bbmia.com
~ Commercial Lines
. Denise Newman, CIC
Vice President - Commercial Lines Accounts Manager
dnewman@bbmia.com
~ Marketing (Property & Casualty)
. Marcel McSweeney, AAI
Vice President - Marketing Manager
mmcsweeney@bbmia.com
~ Surety Division (Bonds)
. Mayra Rodriguez
marodriguez@bbmia.com
~ Employee Benefits (Life, Health, Disability, Pension)
. Judy Menendez
Benefits Manager
jmenendez@bbmia.com
~ Personal Lines (Automobile, Home, Boat etc)
. Markelyne Almarales
Personal Lines Manager
malmarales@bbmia.com
BrO&,ll
~rown
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14900 NW 79th Court, Suite #200
Miami, Florida 33016
Phone 305-714-4400 0 Fax. 305-714-4400
Toll Free 800-432-8844
www.bbmia.com
Brown & Brown of Florida - Miami Division
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Direct Tel. 305-364-7804
Direct Tel. 305-714-4519
Direct Tel. 305-364-7803
Direct Tel. 305-714-4527
Direct Tel. 305-714-4506
Direct Tel. 305-714-4430
Proposal No. 11-08-01
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COMMERCIAL PROPERTY COVERAGE SECTION
INSURER (*)
Preferred Governmental Insurance Trust, Not Rated by A.M. Best
COVERAGE LIMITS (*)
35,713,210 Building & Contents Limit, per attached schedule - Blanket
*
Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend
the adequate limit of protection. Higher limits may be available. Please let us know if a quote is
desired.
COVERAGE TERMS AND CONDITIONS
Covered Losses Special Perils Coverage Including Flood & Mechanical Breakdown
Valuation
Replacement Cost
Coinsurance
Nil
Deductible
o $5,000 All perils per occurrence except as stated below:
o 5% Named Windstorm Deductible Per Occurrence subject to a
minimum of $20,000 (*)
Exclusions
Exclusions include, but are not limited to, the following:
War and Terrorism (**)
Earthquake
(*) This Wind & Hail Deductible can be reduced to a lower deductible
through the purchase of a Windstorm Deductible "Buy-Back" policy
which is available in the Excess & Surplus Lines market. The annual
cost is approximately $15.00 PER $100 of coverage (the amount of
buy-down).
(**) See Premium Summary Page for an option to include Terrorism
Coverage as outlined in the Federal Terrorism Act 2002
Brown & Brown of Florida- Miami Division
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Proposal No. 11-08-0 I
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PROPERTY COVERAGE EXTENSIONS
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO THE
POLICY DOCUMENT
COVERAGE
LIMIT
Accounts Receivable
$250,000
$500,000
$1,000/$5,000
$500,000
Additional Expense
Animals
Loss of Business Income
Debris Removal
$250,000
Expediting Expense
$5,000
Demolition, Ordinance, and Increased
Cost of Construction
$500,000
Fire Department Charges
$25,000
$10,000/$20,000
Fungus Cleanup Expense
Lawns, Plants, Trees and Shrubs
$25,000
$2,000,000
$25,000/$50,000
$25,000/$50,000
$10,000
$100,000
$250,000
$250,000
$250,000
New Locations
Personal Property of Employees
Pollution Cleanup Expense Limit
Recertification
Service Interruption Coverage
Transit
Errors and Omissions
Preservation of Property
Flood Limit - Per Occurrence and Aggregate
Excess of NFIP (whether purchased or not) - $5,000 Deductible
$5,000,000
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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Description Year Built Effo Date Building Value
Unit /I ........................ ~T~;:;;;D;;'i;; .........C~~t~~t~"i,i:;-iii~......... Total Insured Value
Address Canst Type
Roof Shape I Roof PItch Roof Covering I Covering Replaced I Roof Yr BIt
Water Pumps 1989 10101120111 $600'0001
001 19160 tl Bay Road ........................ $600,000
Sunny Isles Beach, fL 33160 251. 10101/2012. $0
Pump/Lift
I Station I I
City Hall and Parlllng Garage 2(J(}1 10101120111== 518'501'05~
002 18070 Collins Avenue ..-.-................. ...-....-........- -................-.....-.-............... $19.501,050
Sunny Isles Beach, FL 33160 1010112012 51,000,000
131. FR
Fl.1t I Low (< 10) I 2004 I 2004
3000 Gallon Diesel Fuel Tank 2004 10101120111== 520'0~L
003 18070 Collins Avenue .....22)".:.oii.... $20,0()(
Sunny Isles Beach. FL 33160 Ground 1010112012 $
I liquid I [
Storage Tank
Storage Lockers. Contenls Only (3 units, $5,000 each) 2005 10101/2011 50
004 301 Sunny Istes lllvd ..--.............-... -...................... ...................------......-.... 515,0()(
Sunny Isles Beach, FL 33160 1010112012 $15,000
151. MFR
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Samson Park Restrooms 2000 10/01120111== 55o'000L
005 17425 Collins Ave -......-..-.. ............--....... ----......-. $50,000
Sunny Isles Beach, FL 33160 1010112012 $0
131. FR
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Northslde Ocean 2 Reslrooms 2005 1010112011 $50,000
006 19141 Colllns Ave --.---- -.-.-.-.--.-. ---.-- $50,000
Sunny Isles Beach, FL 33160 10/01/2012 $0
119. JM
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Pier Park Restrooms 2006 10/01120111== 550'0001
007 16501 Collins Ave ....-........-..... $50,000
Sunny Isles Beach, FL 33160 131. FR 10/01/2012 SO
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Community Center 2007 1010112011 53,000,000
008 18115 N.Bay Road -._---- ----.---.-.--_. ._---._-~--- $3,200.000
Sunny Isles Beath. FL 33160 1010112012 $200,000
131. FR
Flat I low (< 10) I 2007 I 2007
Gynaslum 2007 10101/20111== $2.000'0001
009 18115 N.Bay Road _...-~_..- $2,050,000
Sunny Isles lleach, FL 33160 131. FR 1010112012 $50,000
Dome I High (> 301 I 2007 I 2007
48 X Bus Shelters ($8,000 each) 1010112011 5384,000
010 VarIous locatfons wilhln lhe Cily of Sunny Isle; ........--.--- --..-.---- .....-.......-.-...........--$0 $384,000
Sunny Isles Beach, FL 33160 1010112012
111.MtlC
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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Description Year Ilullt Eff. Date Ilulldlng Value
Unit 1/ .-..................... .............u......... .........Coni";;;;.ls.\iaijjo......- Total Insured Value
Address Const Type Term Date
Roof Shape I I(oor ~itcn ICOOI Lovering I Covering Ileplaced I Roof Yr lilt
Parking Garage 2010 10/0112011 $7,500,000
011 19200 Collins Avenue ............_-......... ......----.-- .....-.-.---...-........................- $7,500,000
Sunny Isles Beach, FL 33160 10/0112012 $0
131 - FR
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Skate Park 10/01/2011 $80,000
012 17200 Collins Avenue .....-........-....... ......................- .....................................--....... $80,000
Sunny Isles Beach, FL 33160 10/01/2012 $0
131 - FR
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Skate Park. Bleachers and Picnic Tables 10/01/2011 $6,100
013 17200 Collins Avenue .____n_nO .--.---- --------.----.......... $6,IOC
Sunny Isles Beach, FL 33160 10/0112012 $0
1520 HC
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Skate Park 0 Shade Structure 10/01/2011 $ 100,000
014 17200 Collins #\venue ....-......-.-..- ...--.-..- .........-.-...-.......--.--.---- $100,000
Sunny Isles Beach, FL 33160 10/01/2012 $0
1520 HC
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Heritage Park - Playground 10/01/2011 $267,000
015 19200 Collins Avenue ......-..--..-- .. ._ ,._..............................n..._... $267,000
Sunny Isles Beach, FL 33160 10/01/2012 $0
119. JM
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Heritage Park - Pavilion 10/0112011 $75,000
016 19200 Collins Avenue ......u._....._._ ---. --'---"-'-"..--.---..--.. $75,000
Sunny Isles Beach, fL 33160 10/0112012 $0
111-MtlC
I I I
Heritage Park 0 Interactive Water feature 10/01/20111 $175,000
017 19200 Collins Avenue .....................-.. ,oo,oiiim(jlz ...........................................$( $ 175,000
Sunny Isles Beach, FL 33160 251 .
Pump/lift
I Station I I
Golden Shores Community Palk - Playground 10/01/2011 $67,000
0111 191 Terrace 6: Atlantic Avenue ........................ -....-......---... ....................................-........ $67,000
Sunny Isles Beach, FL 33160 10/0112012 $C
1190 JM
I I I
Golden Shores Community Park. Aluminum fence 10/0112011 $5.3OC
019 191 Terrace Ct Atlantic Avenue .nn............__.. ........................ ..............--...........-.-.....-... $5,3OC
Sunny Isles Beach, FL 33160 10/0112012 $C
152 - He
I I I
Senator Gwen Margolis Park- Bathroom Buildi"lg 10/01/20111 $100.OOC
020 178151/. Bay Road ..............-........ ....loilii.,io.12 .............................-...........$( $100,000
Sunny Isles Beach, FL 33160 111-MNC
I I I
Brown & Brown of Florida - Miami Division
14
Proposal No. 11-08-0 I
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Descrlplfon Year Built Efr. Date Building Value Totallosured Value
Unit /I ~...__................ '-Tcr;ii-"O'ato '.------.Contcii"is.Vaiua-..-.--..
Address Canst Type
Hoof Shapa I Roof Pitch Roof LOVering I loVerlng Replaced I Hoof Yr Illt
Senator Gwen Margolis Park- Shade Structure 10/01/2011 $65,000
021 17815 N. Day Road .......-....-......... ...............n.___. -.--...........---...................... $65,000
Sunny Isles Beilch, FL 33160 10/01/2012 $0
1190 JM
I I I
Senator Gwen Margolis Park- Playground Equipment 10/0112011 $75,000
022 17815 N. Bay Road n"n.__.__.____.._... ._.n.___.n..__._ -.-.--.......-.......--.........._-........ $75,000
Sunny Isles Beilch, FL 33160 10/01/2012 50
119 - JM
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Samson Oceanfront Park - Shade Structure 10/01/2011 $35,000
023 17425 ColUns Avenue ........................ ..................- .........................................-... $35,000
Sunny Isles Beilch, FL 33160 10/01/2012 $0
119- JM
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Samson Oceanfront Park - Playground Equlpnl?nt 10/0112.011 $55,000
024 17425 ColUns Avenue -.....-------.- 0..__- ------------------- 555,000
Sunny Isles !leach, FL 33160 10/0112.012 50
119.JM
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Town Cenler Park - Bathroom Building 10/0112.011 $65,000
025 1 noo Collins Avenue ........................ ......------ .............................................. $65,000
Sunny Isles !leach, FL 33160 10/0112012 $0
111 'MIlC
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Town Center Park. Shade Structure 10/01/2011 $60,000
026 17200 Collins Avenue ---.....-......-.. ......- ................................................. $60,00<:
Sunny Isles !leoch, FL 33160 10/0112012 $C
1190 JM
I I I
Town Cenler Park - Fence 10/0112011 $40,000
027 1 noo Collins Avenue ---.-- -'- -.........--..--...--.....-.--.-..- $40,O()(
Sunny Isles !leilch, FL 33160 10/0112012 $C
152-IK
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Town Center Park - Skate Park Shelter 1010112011 $95'OOL
028 17200 Collins Avenue .-.-.......-. .......-..............-.............................. 595,O()(
Sunny Isles Beach, FL 33160 10/0112012 $
119 - JM
I I T
!lella Vlstil BilY Pilrk - Dock 10/0112011 $115,000
029 500 Sunny Isles Blv<l -----.- ---- ....................-............................ $115,000
Sunny Isles Beach, FL 33160 257 - 10/0112012 50
Waterfront
I Structures I I
Pellcan Cornrnunlly Park - Shade StlUcture 10/0112011 $45,000
030 18115 N, Bay Road ......~_..n.......... ......----- ............................................... 545,000
Sunny Isles Beach, fL 33160 1010112012 $0
152. HC
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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Description Year Built Eff. Data Building Value
Unit II --.....-.-.... -..-..-. ---..._.C'onto;;is-v~iU;;--" Total Insured Value
Address Canst Type Term Dale
Rool~l1ape I Ilooll'l:ch Roof Covering I Covering Replaced I Roof Yr Bit
Lifeguard TowerslSunny Isles Beach. 5@30,OOO each 10/0112011 $ 150,000
031 17200 Collins Avenue ._n......__.__...._. ----------- .......un....n..............._............ $150,000
Sunny Isles Beach, FL 33160 10/01/2012 $0
152. HC
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Parking Meters 0 Various locaUons 0 6@$10,OOOeach 10/01120111== $60,000
032 Various locations ........................ ........-............... ................................-...-..-..... $60,000
Sunny Isles Beach, FL 33160 10/0112012 $0
152. HC
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Public Works Compound. 8 Trallers@S4,5oo each f1 Tools 10/01/2011 $36'0001
t\ r_.,'__.._.. _{"AI C'1\n ...........
Oll Lehman Causeway with access off of Collins Avenue .....................-. ........-...........- .-.......-.----..---..---.- $72,000
Sunny Isles Beach, FL 33160 191 0 Mobile 10/01/2012 $36,000
I Off1ca I I
33 Dccoraliva Light Poles 10/01/2011 $66,000
03-1 Atlantic Isles ........................ .......-........--.. ....-.......-- $66,000
Sunny Isles Beach, FL 33160 2430 10/01/2012 $0
ElectrIcal
I Equipment I I
Retatllluildfng 10/011201'1== $419,760
Ol5 287 Sunny Isles Illv'" .............-..- $419,760
Sunny Isles Beach, FL 33160 10/0112012 $0
lI1-/I,UC
Flat I Low (< 10) I I 1954
I Total:1 $34,412,210 I $1,301,000 I $35,713.210
Brown & Brown of Florida - Miami Division
16
Proposal No. 11-08-01
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INLAND MARINE COVERAGE
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO THE
POLICY DOCUMENT
INSURER (*)
Preferred Governmental Insurance Trust, Not Rated by A.M. Best
COVERAGE LIMITS (*)
$ 266,619 Contractor's I Mobile Equipment
$ 600,000 Electronic Data Processing Equipment
$ 387,137 FineArts
$ 754,000 Other Inland Marine
$ 50,000 Rented, Borrowed, or Leased Equipment
$ 1,000,000 Valuable Papers
$ 306,400 Watercraft - Not Hull Coverage, Limited to Property Perils Only
$ 3,364,156 TOTAL VALUES
Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend the
adequate limit of protection. Higher limits may be available. Please let us know if a quote is desired.
COVERAGE TERMS AND CONDITIONS
Covered Losses Special Perils Coverage
Valuation Actual Cash Value
Coinsurance N/A
Deductible Per Attached Schedule
Exclusions Exclusions include, but are not limited to, the following:
War and Terrorism (**)
Flood
Earthquake
(**) See Premium Summary Page for an option to include Terrorism
Coverage as outlined in the Federal Terrorism Act 2002
Brown & Brown of Florida - Miami Division
17
Proposal No. 11-08-01
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Item # Description Serlalllumber Classification Code err. uate Value Deductible
Term Date
001 Unscheduled Items Contractofs I Mobile 10/0112011 $100,000 $5,00(
Equipment 10/01/2012
002 2005 Yamaha Kodiak 400 A TV Contrac!ofs I Mobile 10/01/2011 $7,060 $5,00(
Equipment 10/01/2012
003 2009 Polaris Ranger ATV Contrac!ofs I Mobile 10/01/2011 $8,600 $5,00(
Equipment 'U/u,ILUI<
004 2006 Yamaha ATV Contractofs I Mobile 10/0112011 $9,478 $5,00(
Equipment 10/01/2012
005 2005 Yamaha Kodiak 400 ATV Contractofs I Mobile 10/01/2011 $8,918 $5,00(
Equipment
006 2005 Yamaha ATV Contractofs I Mobile 10/01/2011 $7,088 $5,00(
Equipment 10/0112012
007 2005 Yamaha ATV Contractofs I Mobile 10/0112011 $7,088 $5,00(
Equipment
008 2005 Bobcat Loader Contrac!ofs I Mobile 10/0112011 522,299 $5,00(
Equipment 10/0112012
009 Yamaha Kodiac ATV Contrac!ofs I Mobile 10/01/2011 57,088 $5,00(
Equipment
010 Segw;r.; Human Transporter 2006 Contrac!ofs I Mobile 10/0112011 $5,000 $5,00(
Equipment 10/01/2012
011 Yamaha Kodiac ATV 5Y4AJ07Y24AO Contractofs I Mobile 10/01/2011 57,000 $5,00(
21825 Equipment
012 Yamaha A TV 5Y4AJ15Y15AOO Contractofs I Mobile 10/0112011 $8,000 $5,00(
1663 Equipment 10/01/2012
013 YamahaA1V 5Y4AJl5Y15AOO Contrac!ofs I Mobile 10/01/2011 $8,000 $5,00(
4564 Equipment IV/UI/LUIL
014 YamahaATV JY4AM03YS6CO Contrac!ofs I Mobile 10/01/2011 $8,000 55,00(
63960 Equipment 10/01/2012
015 Yamaha Rhino 5Y4AJI5YOSAOO Contractofs I Mobile 10101/2011 $10,000 $5,00(
4029 Equipment IV/Ull LUlL
016 Yamaha Rhino 5Y4AM16Y68A0 Contractofs I Mobile 10/0112011 510,000 $5,001
02734 Equipment 10/0112012
017 Yamaha Rhino 5Y4AM23Y69AO Contractofs I Mobile 10/0112011 510,000 $5,001
03863 Equipment
018 Yamaha Kodiac400ATV 5Y4AJl5Y4SAOO Contractofs I Mobile 10/01/2011 58,000 $5,001
1162 Equipment 10/01/2012
019 Yamaha Kodiac 400 A 1'1 5Y4AJ15Y05AOO Contrac!ofs I Mobile 10/01/2011 $8,000 55,001
4029 Equipment 10/0112012
020 Unscheduled Items Electronic Data Processing 10/0112011 5600,000 55,001
Equipment 10/0112012
021 China D'MelWare Set Fine.A.rts 10/01/2011 510,137 55,001
10/0112012
022 Butterffy Sculpture Fine.A.rts 10/0112011 520,000 $5,00(
10/0112012
023 Fisherman Sculpture Fine.A.rts 10/0112011 $3,500 $5,00(
10/01/2012
024 Sculpture - "Fanlly" Fine .A.1ts 10/01/2011 $ 190,000 $5,00(
10/0112012
025 Pelican Sculpture Fine.A.rts 10/01/2011 $3,500 $5,00(
10/01/2012
Brown & Brown of Florida - Miami Division
18
Proposal No. 11-08-0 I
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Item1t Description Serial Number Classification Code ~rr. uate Value Deductible
Term Date
026 Sculpture - . Rising Horizons. Fine'!'.rts 10/01/2011 $ 160,000 $5,OOC
10/0112012
027 Unscheduled Items O"J1er Inland Marine 10/01/2011 $754,000 $5,OOC
10/0112012
028 Unscheduled Items Rented, Borrowed, Leased 10/01/2011 $50,000 $5,OOC
Equipment
029 Unscheduled Items Valuable Papers 10/0t /2011 $ 1 ,000,000 $5,OOC
10/0112012
030 2000 Polaris Genesis Jet Ski Watercraft 10/01/2011 $3,000 $5,OOC
lU/UIIlU1L
031 2005 Yamaha FXI40 Jet Ski "/atercraft 10/0112011 $8,600 $5,OOC
10/01/2012
032 Yamaha Jetski, Model #FY1800K ....atercraft 10/01/2011 $12,000 $5,001
lUlU II LOU
033 2005 Yamaha FXI40 Jet Ski Watercraft 10/0112011 $8,600 $5,001
10/0112012
034 2006 25' Foot Commander ram Police Vessel inclu<f:11!l all Watercrat'l 10/01/2011 $160,000 $5,OOC
accessories on file I'IlTrust
035 2011 Yamaha Jelski. Model FYI800K Watercraft 10/01/2011 $12,000 $5,OOC
10/0112012
036 2005 Yamaha PWC Jel Ski ....atercraft 10/01/2011 $8,600 $5,OOC
037 1993 Fountain 27' Natercraft 10/0112011 525,000 $5,OOC
10/0112012
038 2005 Yamaha PWC Jet Ski Watercrat'l 10/0112011 $8,600 $5,OOC
039 Yamaha Jetski FX 140 YAMA13661405 ....atercraft 10/01120tl 510,000 $5,OOC
10/01/2012
040 Yamaha Jetski FX 140 YAMA27281405 Watercraft 10/0112011 510,000 $5,OOC
041 Yamaha Jet Ski YAMA27301405 Watercraft 10/01/20t 1 510,000 $5,OOC
10/01/2012
042 Yamaha Jet Ski YAMA28921405 Watercraft 10/0112011 510,000 $5,OOC
043 Police Boat FG070041A393 "'atercraft 10/0112011 510,000 55,OOC
10/01/2012
044 Boat SAMA17811606 Watercraft 10/0112011 510,000 $5,OOC
10/01120t2
045 Yamaha YFM660FWA Contracto(s I Mobile 10/0112011 $7,000 $5,OOC
Equipment 10/0112012
I Total I 53,3601,156
Brown & Brown of Florida - Miami Division
19
Proposal No. 11-08-01
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COMMERCIAL CRIME COVERAGE
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FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO THE
POLICY DOCUMENT
INSURER (*)
Preferred Governmental Insurance Trust, Not Rated by A.M. Best
COVERAGE LIMITS (*)
Limit
Deductible
Covera~e
$
$
$
$
250,000
250,000
250,000
250,000
5,000
5,000
1,000
1,000
Employee Dishonesty - Per Loss
Forgery & Alteration
Theft, Disappearance or Destruction
Computer Fraud
* Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend the
adequate limit of protection. Higher limits may be available. Please let us know if a quote is desired.
COVERAGE PROVIDED
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Employee Dishonesty - Blanket Basis
This coverage is used to insure against loss of money, securities or other property belonging to
you, or for which you are liable, that is caused by employee dishonesty. It pays for anyone loss
caused by one or more employees up to the face amount stated on the form. Only the actual
loss sustained in the policy period is included for coverage (progressive or continuous loss over
multiple years outside the policy period is excluded)
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Forgery or Alteration
This coverage is used to insure against loss resulting from forgery of checks, drafts, notes or
other similar written promises prepared by you or your agent. It does not cover dishonest acts of
employees, which must be insured by Employee Dishonesty coverage.
Theft, Disappearance and Destruction
This coverage is used to insure against loss of money and securities caused by theft,
disappearance or destruction while located inside or outside your premises. It also covers
damage to premises resulting from actual or attempted theft. It insures only money and
securities and not other types of property.
Computer Fraud
This insurance will cover loss or damage to money, securities, and other property due to
computer fraud. Computer fraud is defined as "theft of property by and directly related to the
use of a computer."
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Brown & Brown of Florida - Miami Division
20
Proposal No. I 1-08-01
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COMMERCIAL LIABILITY COVERAGE
INSURER (*)
Preferred Governmental Insurance Trust, Not Rated by A.M. Best
GENERAL LIABILITY COVERAGE (*) - Ratable payroll of $6,404,870
$
$
$
$
$
$
$
$
$
$
$
5,000,000
Included
5,000,000
Included
50,000
2,500
5,000,000
5,000,000
1,000/5,000
1,000,000
2,500
General Aggregate Limit
Products & Completed Operations Aggregate Limit
Bodily Injury and Property Damage Limit
Personal Injury & Advertising Injury Limit
Fire Damage Legal Liability Limit
Medical Payments
Employee Benefits Liability Limit per Person
Retroactive Date 10/01/2000
Employee Benefits Liability Aggregate Limit
Retroactive Date 10/01/2000
No Fault Sewer Backup Limit
Herbicide & Pesticide Aggregate Limit
General Liability Deductible Per Occurrence
LAW ENFORCEMENT LIABILITY COVERAGE (*) Rated on 48 total officers
$
$
$
$
5,000,000
5,000,000
5,000,000
2,500
Law Enforcement Liability Limit - Per Person
Law Enforcement Liability Limit - Per Occurrence
Law Enforcement Liability Limit - Aggregate
Law Enforcement Liability Deductible Per Occurrence
PUBLIC OFFICIALS LIABILITY COVERAGE (*) - Ratable payroll of $10,129,624
$
$
$
$
$
$
5,000,000
5,000,000
2,500
100,000
2,500
5,000
Public Officials Liability Limit - Per Claim
Public Officials Liability Limit - Aggregate
Public Officials Liability Deductible Each Claim
Non-Monetary Damages - Aggregate
Pre-Termination - per employee
Pre-Termination - annual aggregate
EMPLOYMENT RELATED PRACTICES LIABILITY COVERAGE (*) - Rated on 160 employees
$
$
$
5,000,000
5,000,000
2,500
Employment Related Practices Liability Limit - Per Claim
Employment Related Practices Liability Limit - Aggregate
Employment Related Practices Liability Deductible Each Claim
Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend the
adequate limit of protection. Higher limits may be available. Please let us know if a quote is desired.
Exclusions include, but are not limited to the following:
War, Mold, Fungus, Bacteria, Silica, Lead, Pollution, Asbestos, Copyright or Patent
Infringement and Nuclear Liability.
Brown & Brown of Florida - Miami Division
21
Proposal No. 11-08-0 I
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SPECIAL NOTE REGARDING ADDITIONAL INSUREDS
General Liability coverage provided to a named insured (you) by an insurer could be modified to
extend to other parties. These other parties are commonly referred to as additional insureds.
Modifications (endorsements) to the named insured's policy could be used to provide similar
benefits enjoyed by the named insured to the additional insured. Because of changes to these
endorsements, the additional insured may no longer enjoy the same benefits. Under these new
endorsements, liability that is based on the sole negligence of the additional insured may no
longer be covered. The State of Florida's Office of Insurance Regulation approved changes to
these policy endorsements effective July 1, 2004.
The absence of insurance coverage and the agreement to contractual terms may not free you of
the responsibility to pay on behalf of the additional insured liability arising out of their sole
negligence.
Florida law allows you to assume liability on behalf of another party by way of a contractual
agreement. In fact, the law allows you to assume the liability for suits that may be the result of
the sole negligence of the other party in the contract. In other words, contractually you would be
accepting and paying for claims that may arise from situations that are not even your fault.
While we are not necessarily aware of the individual contracts you may have entered into, we
feel it is our duty to notify you that there is a possibility you could have a claim that is not
covered by insurance. Our recommendation to you would be to have your contracts reviewed
by your attorney to determine if you have assumed such liability and what your legal options
are.
Brown & Brown of Florida - Miami Division
22
Proposal No. 11-08-0 I
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BUSINESS AUTOMOBILE COVERAGE
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO
THE POLICY DOCUMENT
INSURER (*)
Preferred Governmental Insurance Trust, Not Rated by A.M. Best
COVERAGE LIMITS (*)
$ 5,000,000
$ Statutory
$ 2,500
$ 100,000
$ 5,000,000
$
$
50,000
2,500
Bodily Injury & Property Damage Liability - Any Auto
Personal Injury Protection - Autos Subject to PIP Law
Medical Payments - per person- All Owned Autos
Uninsured Motorists Coverage (Non Stacked) - All Owned Autos
Hired & Non-Owned Automobile Liability - Hired/Non-Owned Autos
Hired Auto Physical Damage - Hired Autos
Auto Liability Deductible - Each Accident
Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend the
adequate limit of protection. Higher limits may be available. Please let us know if a quote is desired.
COVERAGE PROVIDED
· Coverage only applies to vehicles that are owned/titled or leased in the corporate
name, or business name in case of a partnership, that is specifically listed. If a
business owned vehicle is furnished for personal use, an extension of coverage form
may be required for proper protection.
· Automobile Liability
· Uninsured Motorists Coverage (Non-Stacked)
· Medical Payments
· Hired Automobile Liability
· Employers Non-Owned Automobile Liability
· Automobile Physical Damage (Coverage/Deductibles Per Schedule Overleaf)
Brown & Brown of Florida - Miami Division
23
Proposal No. 11-08-01
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Unit # Make ModeL/Description Department AL Eft Comp Oed Comp Eft Term Value
Qty Year VitI # Vehicle Type AL Term Coli Oed Coli Eft Coli Valuation I APD Rptd
TA'~ Tvne
001 Ford Crown Victoria Non Police 10101111 52,500 10101/11 10101/12 517,SOO
1 1998 2FAFP7IWOWXI23430 Private Passel1ger 10101/12 52,500 10101/11 10101/12 Actual Cashl 517,50
002 Ford Cra.'m Victoria Non Police 10101/11 52,500 10101/11 10101/12 517,500
1 1998 2FAFP71WTWX123425 Private Passel1ger 10101/12 52,500 10101/11 10101/12 Actual Cash I 517,50
003 Chevrolet S-10P/U Non Police 10101/11 52,SOO 10101/11 10101/12 515,000
1 1998 IGCCS19X7Vv8233354 Ught Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I 515,00
004 Ford Ranger Non Police 10101111 52,SOO 10101/11 10101/12 511,SOO
1 1999 lFTYR10V5XUB21491 Ught Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I 511,50
005 Ford F-350 Non Pol ice 10101/11 52,SOO 10101/11 10,'01112 519,000
1 1999 1 FDWF36L9XED59688 Medium Truck 10101/12 52,500 10101/11 10,'01/12 Actual Cash I S19,OOC
006 Ford Taurus Non Police 10101/11 52,500 10101/11 10101/12 517,500
1 1999 lFAFP52U5XA212681 Private Passenger 10101/12 52,500 10101/11 10101/12 Actual Cash I S17,50C
007 Ford Focus Non Police 10101/11 52,500 10101/11 10,'01/12 515,000
1 2000 lFAFP33P3YVl304289 Private Passenger 10101/ 12 52,500 10101/11 10101/12 Actual Cash I 515,00(
008 Ford T llUruS Non Police 10lDl/11 52,500 10101/11 10101/12 517,SOO
1 2000 1 F AFP5220YG 1308<;5 Private Passel1ger 10101/12 52,SOO 10,'01/11 10,'01/12 Actual Cash I S17,SO(
009 Ford Crown Victoria Non Police 10101/11 52,SOO 10101/11 10101/12 517,SOO
1 2000 2FAFP71WOYX140957 Prr..ate Passenger 10101/12 52,SOO 10101/11 10101/12 Actual Cashl S17.50(
010 Ford F-250 PIU Non Police 10101111 52,SOO 10101/11 10101/12 525,000
1 2001 lFTl~F21L21EB57977 Light Truck 10101/12 52.500 10101/11 10,'01/12 Actual Cash I S25,OO(
011 TRAILER Non Police 10lDl/11 52,500 10,'01/11 10101/12 55,000
1 2001 146UB 1217YM040808 Trai~er - NO CH ~1/12 52,SOO 10101/11 10101112 Actual Cash I 55,Om
012 TRAILER Non Police 10101/11 52,500 10101/11 10101112 55,000
1 2001 146UB1211M041457 Trai'er - NO CH ~1/12 52,500 10101/11 10,'01112 Actual Cash I 55,Om
013 Ford Explorer Non Police 10101/11 52,500 10101111 10101/12 529,000
1 2001 lF~U72El1ZA54350 Light Truck 10101/12 52,SOO 10,'01/11 10101/12 Actual Cash I S29,OOC
014 JET SKI TRAILER Non Police 10101111 52,500 10101/11 10101/12 57,000
1 2001 146DA 1413YM040808 Trai~er - NO CH ~1/12 52,500 10,'01/11 10101/12 Actual Cash I 57,OOC
015 Ford F ISO PIU Non Police 10101/11 52,500 10101/11 10101/12 S2O,000
1 2001 lFTZF172X'A'NB49773 Light Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I 520,OO(
016 Toyota Camry Non Police 10101/11 52,SOO 10101/11 10101/12 517,000
1 2003 4T1BF32K834056591 Private Passel1ger 10101/12 52,500 10101/11 10101/12 Actual Cash I 517,OOC
017 Ford F-350 4X4 Non Police 10101/11 52,500 10101/11 10101/12 525,000
1 2004 lFTSF31SX4EB72117 Medium Truck 10101/12 52,500 10.'01/11 10101/12 Actual Cash I 525,00C
018 Ford Explorer Non Police 10101/11 52,500 10101/11 10101/12 528,000
1 2004 1 FMZU72KX4UA82168 Ught Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I S28,00(
019 Ford Explorer Non Police 10101/11 52,500 10101/11 10101/12 528,000
1 2004 lFMZU72KI4UA82169 Ught Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I 528,OO(
020 Ford E-SSO Non Police 10101/11 52,500 10101/11 10,'01/12 527,000
1 2004 lFDAE55F93HBOO115 Heavy Truck 10101/12 52,500 10101/11 10,'01/12 Actual Cash I 527,Om
021 A TV TRAILER Non Police 10101/11 52,500 10,'01/11 10101/12 56,000
1 2004 lZJUT14X4M025518 Trai~er - NO CH ~1/12 52,500 10101/11 10,'01/12 Actual Cash I 56,Om
Brown & Brown of Florida - Miami Division
24
Proposal No. I 1-08-0 I
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Unit# Make ModeUOescription Department AL Eff Comp Oed Comp Eft Term Value
Qty Year VUl# Vehicle Type AL Tenn Coli Oed Coli Eff TColI Valuation I APO Rptd
Tune
022 Ford F-250 4X4 Non Police 10101/11 52,500 10101/11 10:01/12 524,000
1 2004 1 FTNF21L93EOS8701 Ught Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I 524,00
023 Chevrolet C5500 AEROUTE Non Police 10101/11 52,SOO 10101/11 10:01/12 533,000
I 2004 IGBE5V1254F518956 Bus <20 Pass, No 1110101112 52,500 10101/11 10:01/12 Actual Cash I 533,00
024 Che'.rrole! C5500 AEROUTE Non Police 10101/11 52,500 10101/11 10:01/12 533,000
1 2004 lGBE5V1284F518623 Bus <20 Pass, No 1110101/12 52,SOO 10:01/11 10101/12 Actual Cash I 533,00
025 ATVTRAILER Non Police 10101111 52,500 10101/11 10101/12 55,000
1 2005 lZJUTI8175M030168 TraHer - NO CHi ~1/12 52,500 10101/11 10101/12 Actual Cash I 55,00
026 TRAILER Non Police 10101/11 52,500 10101/11 10101/12 55,000
1 2005 Trailer - NO CHi ~1/12 52,SOO 10101111 10101/12 Actual Cash I 55,00
027 TRAILER Non Police 10101111 52,500 10:01111 10:01/12 55,000
1 2005 Trailer - NO CHi ~1/12 52,500 10101111 10:01112 Actual Cash I 55,00
026 SKI TRAILER Non Police 10101111 52,500 10:01/11 10101112 510,000
1 2005 lZJBE141X5M030169 Trai:er - NO CH ~1/12 52,500 10101/11 10:01112 Actual Cash I 510,00
029 SKI TRAILER Non Police 10101111 52,500 10101/11 10101/12 510,000
1 2005 lZJBE1465M030170 TraHer - NO CH ~1/12 52,500 10101/11 10101112 Actual Cash I 510,00
030 JETSKI TRAILER Non Police 10101111 52,500 10101/11 10101/12 510,000
1 2005 lZJBE20115M030167 Trai!er - NO CH ~1/12 52,500 10101111 10101/12 Actual Cash I 510,00
031 Ford Explorer Sport Trac Non Police 10101/11 52,500 10101/11 10101/12 57,000
1 2005 lFMZU77K45UB98914 Ught Truck 10101/12 52,SOO 10101111 10101112 Actual Cashl 57,00
032 Ford Ranger 4x4 Non Police 10101111 52,500 10101/11 10101/12 515,000
1 2005 lFTYRllE65PAS8377 Ught Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I 515,00
033 Ford Explorer Non Police 10101/11 52,500 10101111 10101/12 524,000
1 2005 1 FMZU72KXSUB05725 Ugh! Truck 10101/12 52,500 10101111 10101/12 Actual Cash I 524,00
034 Ford EXPEDITION Non Police 10101111 52,500 10:01/11 10101112 529,000
I 2005 1 FMFU 1625SLA6S079 Ught Truck 10101/12 52,500 10101/11 10101/12 Actual Cash I 529,00
035 Ford F-6S0 DUMP Non Police 10101/11 52,SOO 10101/11 10101/12 528,000
I 2005 3FR\VF65E36V167079 Heavy Truck 10101/12 52,500 10101111 10101/12 Actual Cash I 528,00
036 LOADER Non Police 10101/11 52,500 10101111 10101/12 510,000
I 2005 52S018616 TraHer - NO CH. ~1/12 52,500 10101111 10101112 Actual Cash I 510,00
037 Anderson TRAILER Non Police 10101111 52,500 10101111 10101112 56,000
1 2005 4YNBN18245C02&637 TraHer - NO CHi ~1I12 52,500 10101/11 10101112 Actual Cash I 56,00
038 WASHER/TRAIL Non Police 10101111 52,500 10101111 10101112 56,000
1 2005 NOVIN0200444887 Trailer - NO CHi ~1I12 52,500 10101111 10:01/12 Actual Cash I 56,00
039 Ford Explorer Non Police 10101111 52,500 10101/11 10101/12 525,000
1 2005 lFMZU64KI5UB58899 Ught Truck 10101/12 52,500 10101111 10:01/12 Actual Cash I 525,00
040 Ford F-150 4X4 Non Police 10101/11 52,500 10101/11 10:01/12 525,000
I 2006 lFTRF145X6NA63717 Ught Truck 10101/12 52,500 10101111 10:01112 Actual Cash I 525.00
041 Ford F-1SO 4X4 Non Police 10101111 52,500 10101111 10101/12 525,000
1 2006 lFTRF14616NA63718 Ught Truck 10101/12 52,500 10101/11 10101112 Actual Cash I 525.00
042 Ford Ranger4x4 Non Police 10101/11 52,500 10101/11 10101112 514,400
1 2006 lFTYR11E3BPA49220 Ught Truck 10101/12 52,SOO 10101/11 10101112 Actual Cash I 514,40
Brown & Brown of Florida - Miami Division
25
Proposal No. 11-08-0 I
c
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Unit# Make Model/Description Department AL Eft Comp Oed Comp Eft Term Value
Qty Year VIII # Vehicle Type AL Term Coli Oed Coli Eff Coli Valuation I APD Rptd
T___ Tvne
043 Ford Ranger 4x4 Non Police 10,"01111 52,500 10101/11 10101/12 514,400
1 2006 lFTYRIIE56PA49221 UghtTruck 10101112 52,500 10101/11 10101/12 Actual Cash I 514,40
044 Ford Explorer Non Police 10101/11 52,SOO 10101/11 10101/12 525,000
1 2006 1 FMEU72E2GUA93029 UghtTruck 10101/12 52,500 10101111 10101/12 Actual Cash I 525,00
045 Ford E450 Non Police 10101111 52,SOO 10101111 10101112 528,000
1 2006 IFDXE45P06HB23977 Bus <20 Pass, No ftlOlOl1l2 52,500 10101111 10101112 Actual Cash I 528,00
046 Sterling ELGIN Non Police 10101/11 S2,500 10101111 10101112 525,000
1 2007 49HAADBV17DX57959 TraHer - NO CHi ~1112 52,500 10101/11 10101/12 Actual Cash I 525,00
047 VT/ MIXER Non Police 10101111 52,SOO 10101111 10101112 515,000
1 2008 2S9U821108S132160 Trai!er - NO CHi ~1/12 52,500 10101/11 10101112 Actual Cash I 515,00
048 Ford F-SSO Non Police 10101/11 52,SOO 10101111 10,'01112 524,000
1 2008 lFDAF56R38EC75765 Medium Truck 10101112 52,SOO 10101111 10,'01112 Actual Cash I 524,00
049 GEM eL Non Police 10101/11 52,SOO 10101111 10101112 59,000
1 2008 5ASAK27448F047426 Private Passenger 10101112 52,500 10101/11 10101/12 Actual Cashl 59,00
050 GEM eL Non Police 10101/11 52,SOO 10101/11 10101/12 59,000
1 2008 5ASAK274X8F047429 Private Passenger 10101/12 S2,5OO 10101/11 10101/12 Actual Cash I 59,00
051 Ford E4SO Non Police 10101/11 52,500 10101/11 10101/12 528,000
1 2008 I FDXE45P87DA95189 Bus <20 Pass. No ftlOlOl/12 52,500 10101/11 10101112 Actual Cash I 528,00
052 Ford F-150 4X4 Non Police 10101/11 52,500 10101/11 10101112 528,000
1 2009 lFTRFI4879KC35833 Ught Truck 10101112 S2,5OO 10101/11 10101112 Actual Cash I 528,00
053 Ford F-150 4X4 Non Police 10101111 52,500 10101111 10101112 528,000
1 2010 lFTEVV1E82AFCI7296 Ugh! Truck 10101/12 52,500 10101/11 10101112 Actual Cash I 528,00
054 Ford Explorer Non Police 10101/11 52,500 10101111 10101/12 526,000
1 2010 I FMEU6FE9.A.UA34332 Ugh! Truck 10101112 52,500 10101/11 10101/12 Actual Cash I 526,00
055 BOAT TRAILER Police 10101111 52,500 10101/11 10101/12 54,000
1 1993 Trailer - NO CH ~1/12 52,500 10101111 10101/12 Actual Cash I 54,00
056 Ford Crown Victoria Police 10101111 52,500 10101/11 10101/12 517,SOO
1 199.; 2FAFP7IW3WXII3068 Police Car 10101112 52,SOO 10101111 10101/12 Actual Cashl 517,50
057 Ford Crown Victoria Police 10/01/11 52,SOO 10101/11 10101/12 517,SOO
1 1993 2FAFP7IV{7VlXI23425 Police Car 10101/12 52,SOO 10101/11 10101/12 Actual Cash I 517,50
058 Ford Crown Victoria Police 10101111 52,SOO 10101/11 10101/12 517 ,SOO
1 1993 2FAFP71W2W123428 Po'ice Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 517,50
059 Ford Crown Victoria Police 10101/11 52,500 10101/11 10101/12 517,500
1 1993 2FAFP71W3VlX123423 Police Car 10101112 52,500 10101111 10101/12 Actual Cash I 517,50C
060 UTL TV TRAILER Police 10101/11 S2,5OO 10101/tl 10101112 SS,OOO
I 1999 lE9AL10131L25274 Police Car 10101112 52,500 10101/11 10101112 Actual Cashl 55,00(
061 SMART TRAILER Police 10101/11 52,500 10101/11 10101112 56,000
I 1999 IK9B50813VVK118886 Police Car 10101112 52,500 10101/11 10101112 Actual Cash I 56,00(
062 Ford Crown Victoria Police 10101111 52,500 10101/11 10101112 517,SOO
I 1998 2FAFP71W2W123428 Police Car 10101112 52,SOO 10101/11 10101112 Actual Cash I 517,50(
063 Ford Taurus Police 10/01111 52,500 10101111 10101/12 516,000
1 2000 1 FAFP5222YG I 36866 Police Car 10101112 52,500 10101111 10101/12 Actual Cashl 516,00(
Brown & Brown of Florida - Miami Division
26
Proposal No. I 1-08-01
,....".
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Unit# Make ModellDescriDtion Department AL Eff Comp Oed Comp Eft Term Value
Qty Year vm# Vehicle Type AL Term Coli Ded Coli Eff T:~~' Valuation I APD Rptd
Tvne
064 Ford Crown Victoria Police 10,'01/11 52,500 10,'01/11 10/01/12 517,SOO
1 2000 2FAFP71WOYX140957 Police Car 10101112 52,500 10/01111 10101112 Actual Cash I 517,50C
065 Ford Taurus Police 10,'01/11 52,500 10/01111 10101112 517,500
1 2000 2FAFP5826YA236352 Police Car 10101112 52,500 10101111 10/01112 Actual Cash I 517,50C
066 Ford F-350 PIU 4X4 Police 10101111 52,500 10,'01111 10101112 525,000
1 2000 lFTSVV31S9YEC57228 Police Car 10101/12 52,500 10101111 10101/12 Actual Cash I 525,00C
067 Buick Regal LS Police 10101/11 52,500 10101/11 10101/12 525,000
1 2000 2G4'AnB55K9Yl339105 Police Car 10101112 52,500 10101111 10101/12 Actual Cash I 525,OOC
068 Ford Explorer Police 10101111 52,500 10101/11 10101/12 528,000
1 2001 lF~U72E31ZAS4351 Police Car 10101112 52,500 10101111 10101112 Actual Cash I 528,OOC
069 Ford Crown Victoria Police 10101111 52,500 10101111 10101112 516,250
1 2001 2FAFP71WX1X121872 Police Car 10101112 52,500 10101111 10101/12 Actual Cashl 516,25C
070 Ford CrO'.'m Victoria Police 10101/11 52,500 10101/11 10101112 516,250
1 2001 2FAFP71V(81X121871 Police Car 10101/12 52,500 10101111 10101112 Actual Cash I 516,25C
071 Ford CrO'l'm Victoria Police 10101111 52,500 10101111 10101112 516,250
1 2001 2FAFP71V(81X121868 Police Car 10101112 52.500 10101111 10101112 Actual Cash I 516,25C
072 Ford CrO'Ml Victoria Police 10101111 52,500 10101111 10101112 516,250
1 2001 2FAFP71VVX1X121569 Police Car 10101112 52,SOO 10101111 10101112 Actual Cash I 516,25C
073 Ford CrO'.'m Victoria Police 10101111 52,500 10101111 10101112 516,2SO
1 2001 2FAFP71W61X121870 Police Car 10101112 52,500 10101111 10101112 Actual Cash I 516,25
074 Ford CrO'.'m Victoria Police 10101111 52,SOO 10101111 10101112 516,2SO
1 2001 2FAFP71V(41X121866 Police Car 10101112 52,500 10101111 10,'01112 Actual Cash I 516,25
075 Ford CrO'.'m Victoria Police 10101111 52,500 10,'01111 10,'01112 516,250
1 2001 2FAFP71W31X124015 Police Car 10101112 52,500 10,'01111 10101112 Actual Cash I 516,25
076 Ford CrO','IO Victoria Police 10101111 52,500 10101111 10101112 516,2SO
1 2001 2FAFP71W51X124016 Police Car 10101112 52,500 10/01111 10101112 Actual Cash I 516,25
077 Ford CrO'.'IO Victoria Police 10101111 52,500 10101111 10101112 516,250
1 2001 2FAFP71W71X124017 Police Car 10101112 52,SOO 10101111 10,'01112 Actual Cash I 516.2SC
078 Ford CrO'l'lO Victoria Police 10101111 52,500 10101111 10101112 516,2SO
1 2001 2FAFP71W91X124018 Police Car 10,'01112 52,500 10101111 10101112 Actual Cash I 516,25
079 Ford CrO'~m Victoria Police 10101111 52,SOO 10101111 10101/12 516,2SO
1 2001 2FAFP71W21X124023 Police Car 10101112 52,500 10/01111 10/01112 Actual Cash I 516.2SC
080 Ford CrO'.'IO Victoria Police 10101111 52,500 10101111 10101112 516,2SO
1 2001 2FAFP71W41 X 124024 Police Car 10101112 52.S00 10101111 10/01112 Actual Cash I 516,25
081 Ford CrO'l'lO Victoria Police 10,'01/11 52,500 10101111 10101112 516,2SO
1 2001 2FAFP71W61X124025 Police Car 10101112 52,SOO 10101111 10101112 Actual Cash I 516,25
082 Ford Explorer Police 10101111 52,500 10101111 10,'01112 524,000
1 2004 1 FMZU72K44UA82245 Police Car 10101112 52.500 10101/11 10101112 Actual Cash I 524,00
083 Ford Explorer Police 10,'01111 52,SOO 10101111 10101112 524,000
1 2004 1 FMZU72K44UAB2246 Police Car 10101112 52,500 10101111 10101112 Actual Cash I 524,00
084 Ford Explorer Police 10101/11 52,500 10101111 10101112 524,000
1 2004 lFMZU72K84UA82167 Police Car 10101112 52,500 10101111 10101112 Actual Cash I 524,00
Brown & Brown of Florida - Miami Division
27
Proposal No. 11-08-01
--...
......
/'"
'-'"
~
~
Unit# Make ModeUDescription Department AL Eft Comp Ded Comp Eft Term Value
Qty Year VIN# Vehicle Type AL Term Coli Ded Coli Eft Coli Valuation I APD Rptd
T___ Tune
085 Ford Explorer Police 10101/11 52,500 10101111 10101112 524,000
1 2004 1 FMZU72K64UA82247 Police Car lDlOl/12 52,500 10101/11 10101/12 Actual Cash I 524,00
086 Ford Cra-'m Victoria Police 10,'01111 52,500 10101111 10101112 517,000
1 2005 2FAFP71V{OSX141814 Police Car lDlOl/12 52,500 10101111 10101/12 Actual Cash I 517,00
087 Ford Cra-'m Victoria Police lDlOl/11 52,500 10101111 10101/12 517,000
1 2005 2FAFP71WOSX141815 Police Car lDlO1l12 52,500 lDlOl/11 10101/12 Actual Cash I 517,00
088 Ford CrO\'m Victoria Police lDlO1l11 52,500 10101/11 10101112 517,000
1 2005 2FAFP71W9SX141813 Police Car lDlO1l12 52,500 lDlOl/11 10101/12 Actual Cash I 517,00
089 Ford Explorer Police lDlO1l11 52,500 10101111 10101/12 529,000
1 2005 1 FMZU72K05UB05720 Police Car lDlO1l12 52,500 10101111 10101112 Actual Cash I 529,00
090 Ford Explorer Police lDlOl/l1 52,500 10101/11 10101112 529,000
1 2005 lFMZU72K25UB05721 Police Car lDlOl/12 52,500 10101111 10101/12 Actual Cash I 529,00
091 Ford Explorer Police lDlOl/l1 52,500 10101/11 10101/12 529,000
1 2005 1 FMZU72K45UB05722 Police Car lDlOl/12 52,500 10101111 10101/12 Actual Cash I 529,00
092 Ford Explorer Police 10/01111 52,500 10101/11 10101/12 529,000
1 2005 lF~AZU72K65UB05723 Police Car lDlOl/12 52,500 10101111 10101/12 Actual Cashl 529,00
093 Ford Explorer Police lDlOl/11 52,500 10101/11 10101112 529,000
1 2005 lF~AZU72K85UB05724 Police Car 10/01/12 52,500 10101111 10101112 Actual Cash I 529,00
094 Ford EXPEDITlON Police lDlO1l11 52,500 10101111 10101112 526,000
1 2005 lFMPU165X5LA66505 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 526,00
095 Ford F-150 4X4 Police 10101/11 52,500 10101111 10101112 526,000
1 2005 lFTVXl4555~lA84968 Police Car lDlOl/12 52,500 10101111 10101/12 Actual Cash I 526,00(
096 Chevrolet I MPLALA Police 10101111 52,500 10101111 10101112 525,000
1 2005 2Gl\....H52K259248321 Police Car 1DlOl/12 52,500 10101111 10101112 Actual Cash I 525,001
097 SMART TRAILER Police lDlOl/11 52,500 10101/11 10101/12 55,000
1 2005 2S9US11135S132322 Trai:er - NO CH ~1/12 52,500 10101/11 10101112 Actual Cash I 55,00(
098 Ford CrO\'m Victoria Police lDlOl/ll 52,500 10101/11 10101/12 525,140
1 2006 2FAFP71W96XI24978 Police Car lDlOl/12 52,500 10101/11 10101/12 Actual Cash I 525,141
099 Ford Cra.'m Victoria Police lDlOl/11 52.500 10101111 10101/12 525,140
1 2006 2FAFP71W76X124980 Police Car lDlOl/12 52,500 10101/11 10101/12 Actual Cash I 525,14C
100 Ford Cra.'m Victoria Police lDlOl/11 52.500 10101/11 10101/12 525,140
1 2006 2FAFP71W96X124981 Police Car 10101112 52,500 10101111 10101/12 Actual Cash I 525,14C
101 Ford Cra.'m Victoria Police lDl01/11 52,500 10101/11 10101/12 525,140
1 2006 2FAFP71W26X 124983 Police Car lDlOl/12 S2,500 10101/11 10101/12 Actual Cashl 525,14C
102 Ford CrO\'ITI Victoria Police lDlO1l11 52,500 10101111 10101/12 525,140
1 2006 2FAFP71W46X124984 Police Car lDlOl/12 52.500 10101111 10101/12 Actual Cash I 525.141
103 Ford CI'O\'ITI Victoria Police lDlOl/l1 52,500 10101/11 10101/12 525,140
1 2006 2FAFP71 W6<lX 124985 Police Car 10101/12 52,500 10101111 10101112 Actual Cashl 525,141
104 Ford CrO\'ITI Victoria Police lDlOl/l1 52,500 10101/11 10101/12 525,140
1 2006 2FAFP71W86XI24986 Police Car lDlOl/12 52,500 10101/11 10101/12 Actual Cashl 525,141
105 Ford Cra,'ITI Victoria Police lDlOl/11 52,500 10101111 10101/12 525,140
1 2006 2FAFP71W86X124979 Police Car lDlOl/12 52,500 10101/11 10101112 Actual Cash I 525,141
Brown & Brown of Florida - Miami Division
28
Proposal No. 11-08-0 I
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r
'--"
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Unit # Make Model/Description Department ALEft Comp Oed Comp Eft Term Value
Qty Year V1tl# Vehicle Type AL Term Coli Oed Coli Eft Coli Valuation I APD Rptd
Ta.n. Tvne
106 Ford Crown Victoria Police 10lOI/ll 52,500 10lO1111 10101112 S25,140
1 2006 2FAFP71WOOX124982 Police Car 10l01/12 52,500 10,'01111 10101/12 Actual Cash I 525,14
107 Chevrolet Impala Police 10l01/ll 52.S00 10,'01/11 10,'01112 517,000
1 2006 2Gl\~581469220371 Police Car 10l01l12 52,500 10101/11 10,'01112 Actual Cash I 517,00
108 UTL TV TRAILER Police 10101111 S2,500 10l01/11 10101112 58,000
1 2006 16HCB12126G08309a Trailer - NO CH ~1112 52,500 10,'01/11 10,'01/12 Actual Cash I 5.3,00
109 Utiliti UTL TV TRAILER Police 10l01l11 52,500 10/01111 10101112 55,000
1 2006 NiA Trailer - NO CH ~1I12 52,500 10101/11 10101112 Actual Cash I 55,00
110 Harley Da 'idson Road King Police 10101111 52,SOO 10,'01111 10101112 517,600
I 2007 I HOl FHMI97Y622630 Police Car 10l01/12 52,500 10101111 10101112 Actual Cash I 517,60
III Harley Da 'idson Road King Police 10,'01111 52,SOO 10101/11 10101/12 517,600
I 2007 IHOIFHMI67Y621094 Police Car 10101112 S2,500 10101111 10101112 Actual Cashl 517,60
112 Harley Da 'idson Road King Police 10101111 52,500 10101111 10101112 517,600
1 2007 IHDIFHMI67Y622200 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cashl 517,60l
113 Harley Da 'idson Road King Police 10101111 52,500 10101/11 10101/12 517,600
1 2007 IHOIFHMI67Y622743 Police Car 10101112 52,500 10101111 10101112 Actual Cash I 517,60
114 Harley Da 'idson Road King Police 10,'01111 52,500 10101111 10101/12 517,600
1 2007 IHDIFHMI27Y622078 Police Car 10,'01/12 52,500 10,'01111 10101112 Actual Cash I 517,60l
115 Harley Da 'idson Road King Police 10101111 52,500 10101111 10,'01112 517,600
1 2007 IHDIFHMI97Y622899 Police Car 10101/12 52,500 10101111 10,'01112 Actual Cashl 517,60C
116 Ford Crown Victoria Police 10,'01111 52,500 10101111 10101/12 526,245
1 2007 2fAFP71W57X155100 Police Car 10101112 52,500 10101111 10101/12 Actual Cashl 526,24
117 Ford CrO\'m Victoria Police 10101/11 52,500 10.'01111 10,'01/12 526,245
I 2007 2fAFP71vmXI55101 Police Car 10101112 52,500 10.'01111 10101/12 Actual Cashl 526,24
118 Ford Cra.'m Victoria Police 10,'01111 52,500 10101111 10101112 526,245
1 2007 2FAFP71W97X155102 Police Car 10101112 52,500 10101111 10,'01112 Actual Cash I 526,24:
119 Ford CrO\'m Victoria Police 10101111 52,500 10,'01111 10lO1112 526,245
1 2007 2fAFP71W07X 155103 Police Car 10101112 52,500 10,'01111 10101112 Actual Cash I 526,24:
120 Ford Cra.'m Victoria Police 10101/11 52,500 10101/11 10101112 526,245
I 2007 2FAFP71W27X155104 Police Car 10101112 52,500 10101/11 10101/12 Actual Cash I 526,24:
121 Ford Cra.'m Victoria Police 10101111 52,500 10101/11 IOlO1112 526,245
1 2007 2FAFP71W67X155106 Police Car 10101/12 52,500 10,'01111 10,'01112 Actual Cash I 526,24
122 Ford Cra.'m Victoria Police 10101/11 52,500 10lOl/11 10101112 526,245
1 2007 2FAFP71W87X155107 Police Car 10101112 52.500 10101/11 10101112 Actual Cashl 526,24:
123 Ford Cra.'JT1 Victoria Police 10101111 52,500 10101111 10101112 526,245
1 2007 2FAFP71W47X155105 Police Car 10101112 52,500 10101111 10,'01112 Actual Cash I 526,24:
124 Ford Cl"O\'m Victoria Police 10101/11 52,500 10101/11 10101112 526,245
1 2009 2FAHP71V79XI29519 Police Car 10101112 52,500 10101111 10101112 Actual Cash I 526,24
125 Ford CrO\'JT1 Victoria Police 10l01l11 52,500 10lOIIIl 10101112 526,245
1 2009 2FAHP71V39XI29520 Police Car 10101112 52,500 10lOlIIl 10101/12 Actual Cash I 526,24
126 Ford CrO\'JT1 Victoria Police 10101111 52,500 10101/11 10lO1/12 526,245
1 2009 2FAHP71V79XI29522 Police Car 10101112 52,500 10101111 10101112 Actual Cashl 526,24
Brown & Brown of Florida - Miami Division
29
Proposal No. 11-08-01
-
'-""
,.-
~
~ .......
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Unit # Make Model/Description Department Al Eft Comp Oed Comp Eff Term Value
Qty Year VIU# Vehicle Type Al Term Coli Oed Coli Eff T:~!!. Valuation I APO Rptd
Tvne
127 Ford Cra.'m Victorio Police 10101111 52,500 10101/11 10101/12 526,245
1 2009 2FAHP71V59X129521 Police Car 10101/12 S2,500 10/01/11 10101112 Actual Cash I 526,24
128 Ford Cra.'m Victoria Police 10101/11 52,500 10101/11 10101/12 S26,245
1 2009 2FAHP71V99Xl29523 Police Car 10101/12 52,500 10101111 10101/12 Actual Cosh I 526,24
129 Ford Explorer Police 10101111 52,500 10101/11 10101112 529,000
1 2009 1 FMEU73E69UA21432 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 529,00
130 Ford Explorer Police 10101111 52,500 10101/11 10/01/12 529,000
1 2009 1 FMEU73E49UA21431 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 529,00
131 Che'flOlet Tahoe Police 10101/11 52,500 10101111 10/01/12 541,000
1 2010 lGNUKAEOXAR109533 Police Car 10101/12 52,500 10101/11 10101112 Actual Cash I 541,OOC
132 Chevrolet Tahoe Police 10101111 52,500 10101/11 10101/12 541,000
1 2010 lGNUKAE04AR110760 Pollee Car 1(1'01112 52,500 10101/11 10101112 Actual Cash I 541,00C
133 Chevrolet Tahoe Police IOlO1111 52,500 10101111 10101/12 541,000
1 2010 1 GNUKA.E05AR 1 08676 Police Car 10101/12 52,500 10/01/11 10101112 Actual Cash I 541,00(
134 Ford Explorer Police 10101/11 52,500 10101/11 10101/12 531,000
1 2010 1 FMEU7DE4AUA30133 Police Car 10101/12 52,500 10101111 10101112 Actual Cash I 531,00(
135 Ford Explorer Police 10101/11 52,SOO 10101/11 10101112 531,000
1 2010 1 FMEU7DE8AUA30135 Police Car 10101/12 52,500 10101/11 10101112 Actual Cash I 531,00(
136 Ford Explorer Police IOlOI/11 52,500 10101111 10101/12 531,000
1 2010 1 FMEU70EXAUA30136 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 531,00(
137 Ford Explorer Police 10lDl/ll 52,500 10101111 10101/12 531,000
1 2010 lFMEU7DE1AUA30137 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 531.00e
138 Ford Explorer Police 10101111 52,500 10101111 10101/12 531,000
1 2010 lFMEU7DE6AUA30134 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cashl 531,00(
139 Ford CrO'o'm Victoria Police 10101111 52,500 10101/11 10101/12 517,000
1 2010 2FABP7BVXAX112562 Police Car 10101/12 52,500 10101111 10101112 Actual Cash I 517,OOC
140 Chrysler 300 Police 10101/11 52,500 10101/11 10101/12 527,000
1 2010 2C3CA4CD4AH140313 Police Car 10101/12 52,500 10101111 10101112 Actual Cashl 527,OOC
141 Chrysler 300 Police 10101111 52,500 10101111 10101112 527,000
1 2010 2C3CA4C02AH 140312 Police Car 10101/12 52,500 10101111 10101112 Actual Cashl 527,OOC
142 Dodge Charger Police 10101/11 52,500 10101/11 10101/12 S24,OOO
1 2010 2B3AA4CTOAH143981 Police Car 10101/12 52,500 10/01111 10101/12 Actual Cash I 524,OOC
143 Ford Explorer Police 10101111 52,500 10101/11 10101/12 529,900
1 2010 1 FMEU7DE3AUA30138 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 529.90C
144 Harley Oa 'idson Road King Police 10101/11 52,500 10101/11 10101/12 517,000
1 2003 lHOl FHMI97Y622630 Police Car 10101/12 52,SOO 10101/11 10101/12 Actual Cash I 517.00e
145 Harley Do . ide.oo Road King Police 10101/11 52,500 10101/11 10101/12 517,000
1 2003 lH01FHMI67Y621094 Police Car 10101112 52,500 10101/11 10101/12 Actual Cash I 517 ,DOC
146 Horley Do . idson Road King Police 10101/11 52,500 10101/11 10101/12 517,000
1 2003 1 HO 1 FHM 167Y622200 Po'ice Car 10101112 52,500 10101111 10101112 Actual Cash I 517,00e
147 Harley Do . ide.on Road King Police 10101111 52,500 10ml/11 10/01112 517,000
1 2003 1 HO 1 FHM 167Y622743 Po'ice Car 10101112 52,500 10101111 10101112 Actual Cashl 517,00(
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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Unit# Make ModeUDescription Department AL Eff Comp Oed Comp Eft Term Value
Qty Year Vltl # Vehicle Type AL Term Coli Oed Coli Eft T:~~ Valuation I APD Rptd
Tvne
148 Polaris Ranger Police 10101111 52,500 10/01/11 10101/t2 515,000
I 2010 4XATH76A9A2385214 Police Car 10101112 52,500 10/01/11 10101/12 Actual Cash I 515,OOC
149 Polaris Ranger Police 10101111 52,500 10101/11 10101/12 515,000
1 2010 4XATH76A2A2S35202 Pol ice Car 10101/12 52,SOO 10101/11 10101/12 Actual Cash I 515,OOC
150 Dodge Charger Police 10101/11 52,500 10/01/11 10101112 523,000
1 2010 2B3AA4CTOAH143931 Police Car 10101/12 52,SOO 10/01/11 10101/12 Actual Cashl 523,OOC
151 Ford EXPEDITION Police 10101/11 52,500 10101/11 10101/12 529,000
1 2003 lFMFK195X7LA74796 Police Car 10101/12 52,SOO 10101/11 10101/12 Actual Cash I 529,00
152 Volvo 540 Police 10101/11 52,500 10101/11 10101/12 530,000
1 2010 YVI332M58A2490264 Pol ice Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 530,OOC
153 Ford Crown Victoria Police 10101111 52,500 10101/11 10101/12 526,000
1 2011 2FABP7BV1BX121815 Police Car 10101/12 52,500 10101/11 10101112 Actual Cash I 526,OOC
154 Ford CrO\'m Victoria Police 10101/11 52,500 10101/11 10101/12 526,000
1 2011 2FABP7BV5BX121820 Pollee Car 10101/12 52,SOO 10101/11 10101/12 Actual Cash I 526,00(
155 Ford CrO\'m Victoria Police 10101/11 52,500 10101/11 10101/12 526,000
1 2011 2FABP7BVOBX121823 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 526,OOC
156 Ford crO\vn Victoria Police 10101/11 52,500 10101/11 10101/12 526,000
1 2011 2FABP7BV2BX121824 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cashl 526,OOC
157 Ford CrO\'m Victoria Police 10101/11 52,500 10101/11 10101112 526,000
I 2011 2FABP7BV4BXI21825 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 526,OOC
158 Ford Cra.vn Victoria Police 10/01/11 52,500 10101/11 10101/12 526,000
I 2011 2FABP7BVXBXI21831 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cashl 526,OOC
159 Ford Cra,vn Victoria Police 10101/11 52,500 10101111 10101/12 526,000
I 2011 2FABP7BV5BXI21834 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 526,00
160 Ford Cra,'m Victoria Police 10101/11 52,SOO 10101/11 10101/12 526,000
I 2011 2FABP7BV7BXI21835 Police Car 10101/12 52,500 10101/11 10101/12 Actual Cash I 526,00
161 Chevrolet Impala Police 10101/11 S2,SOO 10101/11 10101/12 524,575
I 2011 2G1V:GSEK4BI248040 Police Car 10101112 52,SOO 10101/11 10101/12 Actual Cash I 524,57
162 Harley Da ;d~.()Il Road King 10101/11 52,SOO 10101/11 10101/12 517,500
1 2011 lHD1FHMIOBB649739. Motorcycle m'o 1/12 52,500 10/01/11 10101/12 Actual Cash I 517,SO
163 Dodge Charger 10101/11 52,500 10101111 10101/12 524,809
I 2011 2B3CLICT1BH554295 Private Passenger 10101112 52,500 10101/11 10101/12 Actual Cash I 524,30
164 Big Dog Chopper 1010111 I 52,SOO 10101/11 10101/12 515,200
I 2006 5JllYBJ196WOO0570 Molorcycle 10101112 52,SOO 10101111 10101/12 Actual Cash I 515.20
165 Midwest Jetski Trailer 1010111 I 52,SOO 10101111 10101/12 51,300
I 200.3 IMDKNKKII8A411928 Trai!er - NO C~ ~1/12 S2,SOO 10101/11 10101/12 Actual Cash I 51,30
Total $3,430,379
APD $3,430,879
Rptd
Brown & Brown of Florida - Miami Division
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Proposal No. I 1-08-0 I
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WORKERS' COMPENSATION COVERAGE
INSURER
Preferred Governmental Insurance Trust, Not Rated by A.M. Best
CLASSIFICATIONS & EXPOSURES
In computing a deposit premium the following classifications and payrolls were used: these
payrolls are auditable by the Company at expiration of your policy.
CODE
7382
7720
8810
8820
9015
9102
9402
9410
CLASSIFICATION
PAYROLL
224,400
3,724,754
3,003,556
282,596
827,978
1,383,645
50,391
632,304
Bus Drivers
Police Officers & Drivers
Clerical
Attorneys & Clerical
Buildings-Owner or Lessee
Park, NOC Employees & Drivers
Street Cleaning & Drivers
Municipal Employees NOC
Experience Modifier: 1.09
Minimum Annual Premium: $2,000
Net Deductible: $2,500 per Occurrence
(Claims under $2,500 will not be reported to NCCI and will not affect experience modification)
Drug-Free Credit Included
Safety Credit Included
Emplovers Liabilitv Limits (*)
Bodily Injury by Accident $1,000,000 Each Accident
Bodily Injury by Disease $1,000,000 Each Employee
Bodily Injury by Disease $1,000,000 Policy Limit
*Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend the
adequate limit of protection. Higher limits may be available. Please let us know if a quote is desired.
SPECIAL EXCLUSION
. Workers Compensation benefits for employees domiciled outside of Florida are excluded
from coverage. Coverage may be available at an additional premium, please advise if
you have the exposure and require a quotation.
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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GOVERNMENT CRIME POLICY
CITY MANAGER POSITION BOND
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO THE
POLICY DOCUMENT
INSURER
Zurich Insurance Company, A.M. Best's Rated A+ XV
COVERAGE LIMITS
$ 1,000,000
$ 5,000
Limit of Insurance
Deductible
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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SPONSORED ACTIVITY ACCIDENT POLICY
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO THE
POLICY DOCUMENT
INSURER
Mutual of Omaha Insurance Company, A.M. Best's Rated A+ XV
COVERAGE LIMITS
Accident Medical Expense: Full Excess
Maximum Medical Benefit
Accident Medical Deductible (Corridor)
Loss Period
Benefit Period
Accidental Death & Specific Loss
Loss of Life Principal Sum
Single Dismemberment Principal Sum
Double Dismemberment Principal Sum
Loss Period
Brown & Brown of Florida - Miami Division
Rider OLJ8MS I 9130MS
$25,000
$100
Initial treatment received within 90 days
of injury
Benefits payable for 52 weeks from
accident date
Rider 1359MS-EZ
$10,000
$5,000
$10,000
Loss within 180 Days of Injury
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Proposal No. 11-08-01
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MARINE HULL COVERAGE SECTION
INSURER
RLllnsurance Company, A.M. Best's Rated A+ XI
COVERAGE LIMITS (*)
$
160,000
The Grey Pearl - 2006 25' Commander
*
Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend
the adequate limit of protection. Higher limits may be available. Please let us know if a quote is
desired.
COVERAGE TERMS AND CONDITIONS
Covered Losses American Institute Hull Clauses (All Risks) including theft of entire
vessel, subject to policy exclusions.
Valuation
Agreed Value
Deductible
o $2,500 All perils per occurrence
Exclusions
Exclusions include, but are not limited to, the following:
War and Terrorism (**)
Radioactive Contamination
U.S. Economic & Trade Sanctions
Absolute Silica
Mold, Mildew, Fungus
Chemical, Biological, Bio-Chemical & Electromagnetic Pollution,
Asbestos
Navigation Warranty Atlantic Intracoastal Waterway & Beach Front Waters of S Florida
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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GLASS COVERAGE
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO THE
POLICY DOCUMENT
INSURER
USPlate Glass Insurance Company, A.M. Best's Rated A- IV
COVERED PROPERTY
All exterior Glass as itemized in glass schedule dated 10/1/2011
COVERAGE
Breakage of glass by any means subject to standard policy exclusions
Excludes scratching and marring
Temporary Board-up limit
$100 per occurrence deductible
CLAIMS REPORTING
All claims must be submitted to a 24-hour hotline (1-800-SHATTER).
If a claim is presented that does not go through this service the amount recoverable will
be subject to the carriers "usual and customary limits".
Brown & Brown of Florida - Miami Division
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Proposal No. I I -08-0 I
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STORAGE TANK LIABILITY
FOR A FULL DESCRIPTION OF TERMS, DEFINITIONS AND CONDITIONS PLEASE REFER TO THE
POLICY DOCUMENT
***Effective 1/1/2012***
LIMITS OF LIABILITY (*)
$
$
$
$
5,000,000
5,000,000
5,000,000
Per Storage Tank Incident
Aggregate all Storage Tank Incidents
Aggregate all Legal Defense Expenses
5,000
Deductible Per Storage Tank Incident
Coverage Limits must be ultimately chosen by the Insured. We as Agents cannot recommend the
adequate limit of protection. Higher limits may be available. Please let us know if a quote is desired.
SCHEDULED ITEMS
2000 Gallon Diesel Above-Ground Storage Tank
4000 Gallon Unleaded Above-Ground Storage Tank
PRIMARY COVERAGE TERMS AND CONDITIONS
Claims-Made Form
Retroactive Date 1/1/2005
Covers Bodily Injury and Property Damage arising from a Storage Tank Incident
Corrective Action Costs
Legal Defense Expense
Exclusions include, but are not limited to the following:
Contractual Liability, Employers Liability, First Party Property Damage, Known
Conditions, War or Hostile Acts, Intentional Non-Compliance, Lead Based Paint and
Asbestos, Nuclear Hazard, Storage Tank Contents
CLAIMS-MADE FORM
This coverage will provide protection for only those claims reported or first made during the
policy period or during any previous period that is stated in the Prior Acts or Retroactive Date
option of your policy. This option allows you to keep coverage in force under consecutive
Claims-Made policies.
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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'--" PREMIUM SUMMARY
EXPIRING PREMIUM RENEWAL PREMIUM
COVERAGE INSURER 2010-2011 2011-2012
Commercial Package Preferred Governmental
Insurance Trust (PGIT)
Property Same as above 268,207.00 250,206.00
Inland Marine Same as above 20,070.00 21,867.00
Crime Coverage Same as above 1,996.00 1,634.00
General Liability Same as above 68,568.00 69,040.00
Public Officials Liability Same as above 12,359.00 16,277.00
Employment Practices Liability Same as above 5,954.00 9,934.00
Law Enforcement Liability Same as above 33,343.00 36,059.00
Automobile Liability Same as above 76,672.00 66,549.00
Automobile Physical Damage Same as above 14,752.00 15,200.00
Workers' Compensation Preferred Governmental 99,708.00 136,429.00
Insurance Trust (PGIT)
Zurich Crime Zurich Insurance Company 707.00 707.00
/- Activity Accident Mutual of Omaha 11,164.00 11,164.00
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Hull Coverage RLI Insurance Company 1,845.00 1,845.00
Glass Policy USPlate Glass Insurance 8,764.00 11,874.00
Storage Tank Liability (1/1/12) Illinois Union Insurance 1,712.00 1,712.00
TOTAL $ 625,821.00 $ 650,497.00
. This Coverage Agreement shall be 25% minimum earned as of the first day of the
"Coverage Period"
AUDITS
The General Liability and Automobile coverages are not subject to year-end audit or adjustment.
Therefore, there would not be any additional premiums for increased liability exposures or additional
vehicles purchased during the policy year.
POLICY CHANGES
1. Total value of Property Insurance increased from $26,400,840 to $35,713,210.
2. Inland Marine values increased from $3,168,056 to $3,364,156.
3. Schedule of vehicles reduced from 168 to 165.
/"" 4. Workers' Compensation NCCI Experience Modification Factor increased from .86 to 1.09
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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PAYMENT SUMMARY
PAYMENT TERMS: COMMERCIAL PACKAGE
First Payment of $243,383.00 is due 10/01/11
Second Payment of $121 ,691.50 is due 12/15/11
Final Payment of $121 ,691.50 is due 3/16/12
PAYMENT TERMS: WORKER'S COMPENSATION
Deposit due on 10/1/11: $34,257.25
Nine (9) Equal Installments of $11 ,352.42 Beginning 11/1/11
PAYMENT TERMS: ALL OTHER LINES OF COVERAGE
Premiums must be paid in full to Brown & Brown Insurance
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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COMMISSION SCHEDULE
Brown & Brown Insurance of Florida - Miami Division
PGIT Package 10%
PGIT Workers Compensation 7%
Zurich Crime 15%
Activity Accident 10%
Hull Coverage 10%
Glass Coverage 18%
Storage Tank Liability 10%
All commissions are included in the premiums indicated. No additional fees are required.
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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TERMS & CONDITIONS
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1. Please review the quote carefully, as coverage terms and conditions may not encompass all requested coverages indicated in the
application.
2. Renewal quote is subject to re\'iew and acceptance by PGIT Board of Trustees
3. The Coverage Agreement shall be 2S'Yo minimum earned as of the first day of the "Coverage Pefiod".
4. Total premium is late if not paid in full within 30 days of inception, unless otherwise stated.
5. Deletion of any coverage presented, Package and/or Workers' Compensation, will result in re-pricing of account.
6. The PGIT Property program is a shared limit. The limits purchased are a per occurrence limit and in the event an occurrence exhaust the
limit purchased by PGIT on behalf of the members, payment to you for a covered loss will be reduced pro-rata based on the amounts of
covered loss by all members affected by the occurrence.
7. Coverage is not bound until confirmation is received from a licensed representative of Public Risk Underwriters.
Additional terms and conditions, including but not limited to:
Quote is subject to receipt of the follOWing information by 10/30/2011
a) Signed first page of the PGIT Application (Florida Fraud Statement)
b) Initialed and signed PGIT POL!EPLI Application
c) Signed ur., form
d) Signed Signature page
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1. Please review the quote cafefully, as coverage terms and conditions may not encompass all requested coverages indicated in the
application.
2. Quote subject to review and acceptance by PGIT Board of Trustees
3. The Coverage Agreement premium shall be pro-rated as of the first day of coverage from the minimum policy premium.
4. Down payment is due at inception
5. The Trust requires that the Member maintains valid and current certificates of workers' compensation insurance on all work performed by
persons othef than its employees.
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
apply a correct mod back to the inception date of the Coverage Agreement.
7. Quote was prepared using payrolls supplied by your agency.
8. Safety and Drug Free program cfedits (if applicable) are subject to program requirements.
9. Payrolls are subject to final audit.
10. Deletion of any coverage presented, Package and/or Workers' Compensation, will result in Re-pricing of account.
11. Coverage is not bound until confirmation is received from a licensed representative of Public Risk Underwriters.
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ADDmONAl TERMS AND CONDmONS, INCLUDING BUT NOT LIMITED TO:
Quote is subject to receipt of the following information by 10/30/2011:
. Signed PGIT we Application
. Signed Drug Free and Safety Program Applications
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Proposal No. 11-08-0 I
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IMPORTANT NOTICE
THIS BRIEF DESCRIPTION OF INSURANCE COVERAGE IS BEING PROVIDED AS AN ACCOMMODATION ONLY AND IS NOT
INTENDED TO COVER OR DESCRIBE ALL POLICY TERMS. FOR MORE COMPLETE INFORMATION ON THE SCOPE AND
LIMITS OF COVERAGE, PLEASE REFER TO THE POLICY DOCUMENT.
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Compensation. In addition to the commissions or fees received by us for assistance with the placement,
servicing, claims handling, or renewal of your insurance coverages, other parties, such as excess and
surplus lines brokers, wholesale brokers, reinsurance intermediaries, underwriting managers and similar
parties, some of which may be owned in whole or in part by Brown & Brown, Inc., may also receive
compensation for their role in providing insurance products or services to you pursuant to their separate
contracts with insurance or reinsurance carriers. That compensation is derived from your premium
payments. Additionally, it is possible that we, or our corporate parents or affiliates, may receive contingent
payments or allowances from insurers based on factors which are not client-specific, such as the
performance and/or size of an overall book of business produced with an insurer. We generally do not
know if such a contingent payment will be made by a particular insurer, or the amount of any such
contingent payments, until the underwriting year is closed. That compensation is partially derived from
your premium dollars, after being combined (or "pooled") with the premium dollars of other insureds that
have purchased similar types of coverage. We may also receive invitations to programs sponsored and
paid for by insurance carriers to inform brokers regarding their products and services, including possible
participation in company-sponsored events such as trips, seminars, and advisory council meetings, based
upon the total volume of business placed with the carrier you select. We may, on occasion, receive loans
or credit from insurance companies. Additionally, in the ordinary course of our business, we may receive
and retain interest on premiums you pay from the date we receive them until the date of premiums are
remitted to the insurance company or intermediary. In the event that we assist with placement and other
details of arranging for the financing of your insurance premium, we may also receive a fee from the
premium finance company.
Wholesale Broker/Managing General Agent: Preferred Governmental Insurance Trust
This intermediary is owned in whole or part by Brown & Brown, Inc., the parent company of Brown &
Brown Miami Division. Brown & Brown entities operate independently and are not required to utilize other
companies owned by Brown & Brown, Inc., but routinely do so. In addition to providing access to the
insurance company, the Wholesale Insurance Broker/Managing General Agent may provide additional
services including, but not limited to: underwriting; loss control; risk placement; coverage review; claims
coordination with insurance company; and policy issuance. Compensation paid for those services may be
up to 15% of the premium you pay for coverage, and any compensation paid for those services is derived
from your premium payment. The fee, if any, for the Wholesale Insurance Broker's/Managing General
Agent's services above is no fee.
Questions and Information Requests. Should you have any questions, or require additional
information, please contact this office at 1-800-432-8844 or, if you prefer, submit your question or request
online at [http://www.bbinsurance.com/customerinquiry.shtml]. 11555 N. Meridian Street, Ste 220 .
Carmel, Indiana 46032
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Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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NOTICE AND ACKNOWLEDGEMENT OF FINANCIAL CONDITION
Brown & Brown of Miami and its parent company, Brown & Brown, Inc. (collectively "Brown & Brown") do
not certify, warrant or guarantee the financial soundness or stability of any insurance carrier or alternative
risk transfer or pooling entity. We endeavored to place your coverage with an insurance carrier with an
AM. Best Company financial rating of "A-" or better.* While Brown & Brown cannot certify, warrant or
guarantee the financial soundness or stability of any insurance carrier or alternative risk transfer or
pooling entity or otherwise predict whether the financial condition of any such entity might improve or
deteriorate, we are hereby providing you with notice and disclosure of financial condition so that you can
make an informed decision regarding the placement of coverage. Accordingly, with receipt of this notice
you acknowledge the following with regard to the placement and any subsequent renewal of the coverage
indicated below:
Brown & Brown attempted to present other options for your insurance placement, including
quotations with insurance carriers holding an "A-" or better rating from AM. Best Company, but
we were unable to secure such a quote.
Coverage is being placed through Preferred Governmental Insurance Trust ("PGIT"), which
is as a Florida local government self-insurance fund established pursuant to Section 624.4622,
Florida Statutes, as such PGIT is not rated by the AM. Best Company.
PGIT is not subject to the protections afforded by any state guaranty fund or association.
The financial condition of insurance companies and other coverage providers including local
government self-insurance funds like PGIT may change rapidly and that such changes are
beyond the control of Brown & Brown.
You should review the financial and membership information from PGIT and agree to abide by
the conditions of membership established by PGIT.
You should consider the information provided, including the PGIT coverage quote and
coverage placement and review it with your accountants, legal counsel and advisors.
By: [NAME OF AUTHORIZED REPRESENTATIVE OF INSURED]
Named Insured: City of Sunny Isles Beach
Policy Number: TBD
Policy Period: 10/1/11 -12
Date of Notice:
* A.M. Best Rating Guide:
Rating for Stability: A++ to D = Highest to lowest rating
Rating for Assets/ Surplus: 15 to 1 - Largest to smallest
rating
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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REFERENCES
Due to other outstanding RFPs and Cones of Silence, Brown & Brown of Florida - Miami
Division has enclosed two reference letters. We will be in a position to obtain a third reference
letter at a later date.
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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FINANCE DEPARTMENT
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August 16, 20 II
Re: City of South Miami
Property, Liability and Automobile Insurances
Brown and Brown Insurance of Florida
To Whom It May Concern:
"Brown and Brown Insurance of Florida - Miami Division is currently providing Property,
Liability and Automobile insurances for the City of South Miami in cooperation with The
Preferred Governmental Insurance Trust. We have found that Brown & Brown
Insurance of Florida - Miami Davison has provided a very comprehensive and
competitive program with outstanding service to the City of South Miami".
If you should have any questions or need any additional information, please do not
hesitate to contact me 305-663-6343 or via cmail at ariverol@southmiamifl,govo The
City thanks you for your continued support.
(J~~<-e
Alfredo Riverol. CPA
Chief Financial Officer
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-0 I
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() F
KEY
1\ I S <: A Y j\J E
()fIice of the Village.' ~lal1ager
, i/I.~~I ( ,,/0,,/:1
lunl:lin II. ('''1'1.,". \ 1.11'"
\Ildl.ld 1:. 1,..11:. f ", \I.oll/'
\Ii,'h..d \\. I ),", ,.,
I f,!J'llll (;.tlc 1,1
H"hl..rl (rU"lll.ln
.\1;,1 r.1 1'. 11I1.1'.Il
1.11I1e:"'~' T. II II II II
1\lIgIlS! 170 21111
J if: I;:, \ I. Ill.." I"
( ., n,"', , "( :1111'00 1,.1, '1.1'
Ik: Referrall.eller
To Wholl1 II i'vla)' COI1l.:ern:
Please he advised the Village or Key Biscayne, FI is cllrrenlly insurcd t1111h:r the I'(;IT or
Prcli.:rred (iO\'l:nllllelllal InsuranCe Trust. 0111' insurance ;Igcnl lor l'(ilT is IlI'O\\"n a III I
Iho\\'n Insurancc-Miami.
Wc can rccommcnd (heir brokera!!e services and (he 1'(;1'1' program 10 other
lIlunicipalities looking lill' professional claims ser\'icc, CIIStolller scr\'ice, CllJllpClitiw
prcmiullls and risk cllllSlllt:llilln.
Should Yllllnccd 10 cOlllaclus, plcase call the Village Ill' Kcy Iliseaync i\lanager's oflice
a( (JIIS) ]()5-X919,
Sincerel\'.
90- .[0<
Gcnarll "Chip" Iglesins
Vi lIage :<'l:lIlagcr
HH \'\l'st ,\ldlllyrl' SIH.'CI . SlIill' llO . 1\1.')' IIh('aY'Il', l'Iorida 551.-j') . (50'l1 5(r'i-':;':;OIl . Fa.'\ l.iO':;) 5(,'l.l-)')5()
''l''''~'I' 111'11' '.iI'!-....'1., \. .11 ..\ 1I1I\'''"'',1I '1,1 "f ' 'II' 1'''',11'1 III ~~ tl:~H',. 'j , -J!II 1,1:',j'~ l' )
,,\\\\.I.,"\I,j"Ll\IW.II.:':II\
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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ONLINE ACCOUNT MANAGEMENT DEMO
The City of Sunny Isles Beach is currently enrolled in the Preferred Governmental
Insurance Trust (PGIT) online account management program.
Brown & Brown of Florida - Miami Division
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Proposal No. 11-08-01
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DELIVER TO:
City of Sunny Isles Beach
City Clerk
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Request for Proposal
SECTION 6
BID SUBMITTAL FORMS
OPENING: 10:00 A.M.
08/18/2011
PLEASE QUOTE PRICES F.Q,B. DESTINATION, LESS TAXES, DELIVERED IN
CITY OF SUNNY ISLES BEACH, FLORIDA
NOTE: City of Sunny Isles Beach is exempt from all taxes (Federal, State, and Local), Bid price should be
less all taxes. Tax Exemption Certificate furnished upon request.
Issued by:
Purchasing Agent
Date Issued:
07/29/2011
This Bid Submittal Consists of
Pages 20 through 23
Sealed bids are subject to the Terms and Conditions of this Invitation to Bid and the accompanying Bid
Submittal. Such other contract provisions, specifications, drawings or other data as are attached or
incorporated by reference in the Bid Submittal, will be received at the office of the City Clerk at the
address shown above until the above stated time and date, and at that time, publicly opened for
furnishing the supplies or services described in the accompanying Bid Submittal Requirement.
IFB 11-08-01
Property & Casualty Comprehensive Insurance
A Bid Deposit in the amount of 0% of the total amount of the bid shall accompany all bids
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A Performance Bond in the amount of 0% of the total amount of the bid will be required upon execution
of the contract by the successful Proposer and City of Sunny Isles Beach
Procurement AClent:
fvlarcanthony Tulloch
~K/'v ,(-J~";';;:.r M v"""'t ;/ ?M/.4
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Commoditv Code(s):
RETURN ONE ORIGINAL AND TWO COPIES OF BID SUBMITTAL PAGES AND AFFIDAVITS
FAILURE TO SIGN PAGE 23 OF SECTION 4 BID SUBMITTAL WILL RENDER YOUR BID NON-
RESPONSIVE
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PAGE 20 OF 2<1
BID No. 11-08-01
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SECTION 4
BID SUBMITTAL FOR:
ACKNOWLEDGEMENT OF ADDENDA
INSTRUCTIONS: COMPLETE PART lOR PART II. WHICHEVER APPLIES
PART I:
LIST BELOW ARE THE DATES OF ISSUE FOR EACH ADDENDUM RECEIVED IN
CONNECTION WITH THIS BID
Addendum #1, Dated
August 15, 2011
August 15, 2011
Addendum #2, Dated
Addendum #3, Dated
Addendum #4, Dated
Addendum #5, Dated
Addendum #6, Dated
Addendum #7, Dated
Addendum #8, Dated
PART II:
o NO ADDENDUM WAS RECEIVED IN CONNECTION WITH THIS BID
Miami Division
DATE: 8/18/11
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AUTHORIZED SIGNATURE:
TITLE OF 0
Executive Vice President
PAGE 21 OF 24
BID No. 11-08-01
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BID SUBMITTAL FORM
Bid Title: Property & Casualty Comprehensive Insurance
The undersigned Proposers proposes and agreeso if this Bid is acceptedo to enter into an agreement with The City of
Sunny Isles Beach in the form included in the Contract Documents to perform and fUll1ish all Work as specified or
indicated in the Contract Documents for the Contract Price and within the Contract Time indicated in this Bid and in
accordance with the other tenTIS and conditions of the Contract Documents.
The Proposers accepts all of the terms and conditions of the Advertisement or Invitation to Bid and Instructions to
Proposers, including without limitation those dealing with the disposition of Bid Security. This Bid will remain subject
to acceptance for 90 days after the day of Bid opening. The Proposers agrees to sign and submit the Agreement with
the Bonds and other documents required by the Bidding Requirements within ten days after the dale of the City's
Notice of A ward.
In submitting this Bid, the Proposer represents, as more fully set forth in the Agreement, that:
The Proposer has familiarized himself/herself with the nature and extent of the
Contract Documents, Work, site, locality, and all local conditions and Law and
Regulations that in any manner may affect cost, progress, performance, or
furnishing of the Work,
· The Proposer has studied carefully all reports and drawings of subsurface
conditions and drawings of physical conditions.
The Proposer has given the City written notice of all conflicts, errors,
discrepancies that it has discovered in the Contract Documents and the written
resolution thereof by City is acceptable to the Proposer.
This Bid is genuine and not made in the interest of or on behalf of any
undisclosed person, Firm or corporation and is not submitted in conformity with
any agreement or rules of any group, association, organization, or corporation;
the Proposer has not directly or indirectly induced or solicited any other
Proposers to submit a false or sham Bid; the Proposer has not solicited or
induced any person, firm or corporation to refrain from Bidding; and Proposer
has not sought by collusion to obtain for itself any advantage over any other
Proposers or over the City.
The City and the successful Proposer will establish completion times for each individual Work Item and
the successful Proposer agrees that the work will be completed within the time frames agreed upon and
stipulated in the individual Purchase Orders and/or Notice to Proceed,
PAGE 22 OF 24
BID No. 11-08-01
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FIRM NAME:
Brown and Brown Insurance of FL - Miami Division
Street Address:
14900 N.W. 79th Court Miami Lakes,Suite 200, FL 33016
Mailing Address (if different):
Telephone No. (305) 364-7818
Fax No, (305) 913-2518
Email Address:rhollander@bbmia.com
FEIN No. -1_--1-1-1-1-1-1_
SIGNATURE:
'ER AGREES TO ALL TERMS
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(SIGNATURE
PRINT NAME: Robert P. Hollander
TITLE:Executive Vice President
THE EXECUTION OF THIS FORM CONSTITUTES THE UNEQUIVOCAL OFFER OF PROPOSER TO BE BOUND
BY THE TERMS OF ITS PROPOSAL. FAILURE TO SIGN THIS SOLICITATION WHERE INDICATED ABOVE
BY AN AUTHORIZED REPRESENTATIVE SHALL RENDER THE PROPOSAL NON-RESPONSIVE. THE CITY
MAY, HOWEVER, IN ITS SOLE DISCRETION, ACCEPT ANY PROPOSAL THAT INCLUDES AN EXECUTED
DOCUMENT WHICH UNEQUIVOCALLY BINDS THE PROPOSER TO THE TERMS OF ITS OFFER.
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PAGE 23 OF 24
BID No. 11-08-01
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NON-COLLUSION AFFIDAVIT
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, Fl 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
STATE OF FLORIDA )
COUNTY oFMiami D~de
The undersigned being first duly sworn as provided by law, deposes, and says:
This Affidavit is made with the knowledge and intent that it is to be filed with the City of Sunny Isles Beach City Commission and that it will be
relied upon by said County, in any consideration which may give to and any action it may take wilh respect to this Bid.
The undersigned is authorized to make this Affidavit on behalf of,
Brown and Brown Insurance of Fl - Miami Division
(Name of Corporation, Partnership, Individual, etc.)
a, corporation
(Type of Business)
Florida
, formed under the laws of
(State)
of which he is Executive Vice President
(Sole Owner, Partner, President, elc.)
Neither the undersigned nor any person, firm, or corporation named in above Paragraph 10.2, nor anyone else to the knowledge of the
undersigned, have themselves sOlicited or employed anyone else to solicit favorable action for this Bid by the City, also that no head of any
department or employee therein, or any officer of the City of Sunny Isles Beach, Florida is directly interested therein.
This Bid is genuine and not collusive or a sham; the person, firm or corporation named above in Paragraph 10.2 has not colluded, conspired,
connived or agreed directly or indirectly with any proposers or person, firm or corporation, to put in a sham Bid, or that SUCh person, firm or
corporation, shall refrain from Bidding, and has not in any manner, directly or indirectly, sought by agreement or collusion, or communication
or conference with any person, firm or corporation, to fix the prices of said Bid or Bids of any other proposers; and all statements contained in
the Bid or Bids described above true; and further; neither the undersigned, nor the person, firm or corporation named above in Paragraph
10.2, has directly or indirectly submitted said Bid or the contents thereof, or divulged information or data relative thereto, to any association or
to any member or age thereof.
fl::AME ,d ~ ~
"~,4r~- /r,tfM VI'
TAKEN, SWORN AND SUBSCRIBED TO BEFORE ME this ~ day of Au. Art( S T
Personally Known ./' or Produced Identification
Executive Vice President
AFFIANT'S TITLE
,2011
Type of identification ,,/'
(Affix seal here)
NANCYE ELLEN BATIST~
Notary Public. State of Flonda
My comm. exp, Apr, 24. 2013
Comm. No. 00879107
DECEMBER 28. 2010
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PUBLIC ENTITY CRIMES
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach, FL 33160
Telephone: (305) 947-0606 Fax; (305) 949.3113
SWORN STATEMENT PURSUANT TO SECTION 287.133(3)(a)
FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES
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PUBLIC ENTITY CRIMES
Pursuant to the provisions of paragraph (2) (a) of Section 287.133, Florida State Statutes - "A person or affiliate
who has been placed on the convicted vendor list following a conviction for a public entity crime may not submit a
Bid on a Contract to provide any goods or services to a public entity, may not submit a Bid on a Contract with a
public entity for the construction or repair of a public building or public Work, may not submit Bids on leases of
real property to a public entity, may not be awarded to perform Work as a Contractor, supplier, Sub-Contractor, or
Consultant under a Contract with any public entity, and may not transact business with any public entity in excess
of the threshold amount Category Two of Sec. 287.017, FS for thirty six months from the date of being placed on
the convicted vendor list".
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THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER
OFFICIAL AUTHORIZED TO ADMINISTER OATHS.
11.1. This sworn statement is submitted to City of Sunny Isles Beach
byRobert P. HOllander
Lpnnt InClIVldual s name and htleJ
furBrown and Brown Insurance of FL- Miami Division
(pnnl name 01 entity subll1llllOg swam statement)
whose business address is: ,
14900 N.W. 79th Court, Suite 200, Miaml Lakes, FL 33016
and (if applicable) its Federal Employer Identification number (FEIN) is 59- 0691921
(If the entity had no FEIN, include the Social Security Number of the individual signing this sworn
statement: .)
11.2. I understand that a "public entity crime" as defined in Paragraph 287.133(1)(g), Florida Statutes, means a
violation of any state or federal law by a person with respect to and directly related to the transaction of
business with any public entity or with an agency or political subdivision of any other state or with the
United States, including, but not limited to, any Bid or Contract for goods or services to be provided to any
public entity or an agency or political subdivision of any other state of the United States and involving
antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misrepresentation.
11.3. I understand (hat "convicted" or "conviction" as defined in Para. 287.133{1 )(b), Florida Statutes, means a
finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any
federal or state trail court of record relating to charges brought by indictment or information after July 1,
1989, as a result of a jury verdict, non-jury trial, or entry of a plea of guilty or nolo contendere.
11.4. I understand that an "affiliate" as defined in Para. 287.133(1 )(a), Florida Statutes, means:
a.) predecessor or successor of a person convicted of a public entity crime; or
b.)
Any entity under the control of any natural person who is active in the management of the entity
and who has been convicted of a public entity crime. The term "affiliate" includes those officers,
directors, executors, partners, shareholders, employees, members, and agents who are active in
the management of an affiliate. The ownership by one person of shares constituting a controlling
interest in another person, or a pooling of equipment or income among persons when not for fair
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OlOCEMBER 28. 2010
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market value under an arm's length agreement, shall be a prime facie case that one person
controls another person. A person who knowingly enters into a joint venture with a person who
has been convicted of a public entity crime in Florida during the preceding 36 months shall be
considered an affiliate.
11050
I understand that a "person" as defined in Para. 287.133(1)(e), Florida Statutes, means any natural
person or entity organized under the laws of any state or of the United States with the legal power to
enter into a binding Contract and which Bids or applies to Bid on Contracts for the provision of goods or
services let by a public entity, or which otherwise transacts or applies to transact business with a public
entity. The term "persons" includes those officers, directors, executives, partners, shareholders,
employees, members, and agents who are active in management of any entity.
11.6.
Based on information and belief, the statement which I have marked below is true in relation to the entity
submitting this sworn statement. (Indicate which statement applies.)
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Neither the entity submitting this sworn statement, nor any of it's officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, nor any
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to Jury 1,
1989.
The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989.
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The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners,
shareholders, employees, members, or agents who are active in the management of the entity, or an
affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1,
1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of
Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer of the
State of Florida, Division of Administrative Hearings and (he Final Order entered by the Hearing Officer
determined that it was not in the public interest to place the entity submitting this sworn statement on the
convicted vendor list. (Attach a copy of the final order.)
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I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE
PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 11.1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND,
THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILEDo I
ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THE PUBLIC ENTITY PRIOR TO ENTERING INTO
A CONTRACT IN EXCESS OF THE THRESHOLD OUNT PRO OED IN SECTION 287.017, FLORIDA
STATUTES, FOR CATEGORY TWO OF ANY, CH IN E I~ / MATI ON CONTAINED IN THIS FORM.
By:
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(Si ture)
Rohprr P Hollander
(Printed Name)
Executive Vice President
(Title)
Sworn to and subscribed before me this 18 thday of Augus t
, 20~. by
NANCYE ELLEN BAt IS IA
(~ofillrY !fI\KJl~S'talMjir1RlKImE)
My comm. expo Apr. 24, 2013
Comm. No. DD879107
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Sig9ature: Notary Public - S~te of Florida
!tAM (J.vE h U(,V' /~ 1?-17' ff71
Print or Type Commissioned Name
Personally Known X
OR Produced Identification
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Type of Identification Produced
1011998
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EQUAL OPPORTUNITY /
AFFIRMATIVE ACTION
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach. FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
EQUAL OPPORTUNITY I AFFIRMATIVE ACTION STATEMENT
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The contractors and all subcontractors hereby agree to a commitment to the principles and
practices of equal opportunity in employment and to comply with the letter and spirit of
federal, state, and local laws and regulations prohibiting discrimination based on race,
color, religion, national region, sex, age, handicap, marital status, and political affiliation or
belief.
Signed:
//~
Executive Vice President
Title:
Firm:
Brown & Brown Insurance of FL - Miami Division
Address:
14900 N.W.79th Court, Suite 200
Miami Lakes, FL 33016
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CONFLICT OF INTEREST
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach. FL 33160
Telephone: (305) 947-0606 Fa.: (305) 949.3113
CONFLICT OF INTEREST STATEMENT
The award of any contract hereunder is subject to the provisions of Chapter 112, Florida State Statutes. Proposers must
disclose with their Bids, the name of any officer, director, partner, associate or agent who is also an officer or employee of the
City of Sunny Isles Beach or its agencies.
STATE OF FLORIDA
COUNTY OF Miami Dade
BEFORE ME, the undersigned authority, personally appeared Robert P. Hollander, who was duly sworn,
deposes, and states:
18.1. I am the
Rrown fir Rrown InsUJ::.al1.C.lliilh a
-Baytonn Dcnch-; FL
18,2, The above named entily is submilling a Bid for the City of Sunny Isles Beach, Bid No. I FB 11- 08 - ~kribed
as: Landscape Maintenance Services. The Affiant has made diligenl inquiry and provides the information contained in lhis
Affidavit based upon his own knowledge,
Executive Vice President
local office in M; i'lm; T,i'lkp.s. FI.
of
and principal office in
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18,3 The Affiant states that only one submillal for the above Bid is being submilled and that the above named entity has
no financial interest in other entitles submilling Bids for the same project.
18.4 Neither the Affiant nor the above named entily has directly or indirectly entered into any agreement, parlicipaled in
any collusion, or otherwise taken any action in restraints of free competitive pricing in connection wllh the entity's submillal for
the above Bid. This statement restricts the discussion of pricing data until the completion of negotiations if necessary and
execution of lhe Contract for this project.
18.5 Neither the entity nor its affiliates, nor anyone associated with them, is presently suspended or otherwise ineligible from
participation in conlract lelling by any local, State, or Federal Agency.
1B,6 Neither the entity, nor its affiliates, nor anyone associated with them have any potential conflict of interesl due to any
other clients, contracts, or properly interests for this project.
1 B, 7 I certify that no member of the entity's ownership or management is presently applying for any employee position or
actively seeking an elected position with the City of Sunny Isles Beach.
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1B.81 certify that no member of the entity's ownership or management, or slaff has a vested interest in any aspect of the City
of Sunny Isles Beach.
18.9 In the event thai a conflict of interest is identified in the provision of services, J, on behalf of the above named entity, will
immediately notify the City of Sunny Isles Beach.
Da)eJllt!)is 18~ pay of .August ,201~_20~1J? -r
L~.PGt11" ~&t!;,."w,..~ erA t'r/'vt' (/~ e~ ~h '''~
AFFIANT Print or Type Name and Title
Sworn to and subscribed before me this 18 t bay of
ex Personally I<nown OR
o Produced Identification ; Type of Identilicalion
~
Auqust
,201~ 2011
NOTARY PUBLIC STATE OF FLORIDA
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DECEMBER 28. 2010
NANCYE ELLEN BAilS f~
Notary Public, Stato of Flonda
My commo expo Apr. 24, 2013
Camm. No. 001379107
5017
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DISPUTE DISCLOSURE
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach. FL 33160
Telephone: (305) 947.0606 Fax; (305) 949.3113
DISPUTE DISCLOSURE FORM
Answer the following questions by placing a "X" after "Yes" or "No". If you answel' "Yes", please
explain in the space provided, or 011 a separate sheet attached to this form.
19.1. Has your firrn or any of Its officers, received a reprimand of any nature or been suspended by the
Department of Professional Regulations or any other regulatory agency or professional associations within the last
five (5) years?
YES
NO X
19.2. Has your firm, or any member of your firm, been declared in default, terminated or removed from a
contract or job related to the services your firm provides in the regular course of business within the last five (5)
years?
YES
X
NO
19.3. Has your firm had against it or filed any requests for equitable adjustment, contract claims, Bid protests,
or litigation in the past five (5) years that is related to the services your firm provides in the regular course of
business?
X
YES NO If yes, state the nature of the request for equitable adjustment, contract
claim, litigation, or protest, and state a brief description of the case, the outcome or status of the suit and the
monetary amounts of extended contract time Involved.
I hereby certify that all statements made are true and agree and understand that any misstatement or
misrepresentation of falsification of facts shall be cause for forfeiture of rights for further consideration of this Bid
for the City of Sunny Isles Beach,
Brown
Firm
Miami Division August18, 2011
Date
Robert P. Hollander, EVP
Print or Type Name and Title
DEcwaER 28. 2010
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ANTI-KICKBACK
City of Sunny Isles Beach
18070 Collins Avenue
Sunny Isles Beach. FL 33160
Telephone: (305) 947-0606 Fax: (305) 949-3113
ANTI-KICI<BACI( AFFIDAVIT
STATE OF FLORIDA )
)
COUNTY OF Miami Dade)
I, the undersigned, hereby duly sworn and deposed say that no portion of this sum herein Bid
will be paid to any employees of the City of Sunny Isles Beach or its elected officials as a
commission, kickback, reward or gift, directly or indirectly by me or any member of my firm or
by an officer of the corporation, ~,/
V.?
By: c~
Title:
The foregoing instrument was acknowledged before me this 18th day of
August , 20~, by Robert P. HOllander [name
of person], as Executive Vice President [type of authority], for
Brown & Brown of FL- Miami [name of party on behalf of whom instrument was
executed] .
AFFIX NOTARY STAMP HERE:
NANCYE ELLEN BArlBT~
Notary Public, State of Flonda
My comm, expo Apr, 24, 2013
Comm. No. I)D879107
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)(4.N'a~E G.U€N .84-77.>1;<}
Print or ype Commissioned Name
Personally Known x OR Produced Identification
Type of Identification Produced
DeCEl.l8En 28.2010
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