HomeMy WebLinkAboutContract No. 2015-2663allpffmo
Covenant Number: COMMON COVERAGE DECLARATIONS
CMC 37961 Coverage is Provided by:
THE LEAGUE OF MINNESOTA CITIES
Previous Covenant Number: INSURANCE TRUST
CMC 36768 (Herein called LMCIT)
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Item 1. CITY and MAILING ADDRESS
!N °'jI_NN I-,SO A
COLUMBIA HEIGHTS, CITY OF &
-I 11 LS
COLUMBIA HEIGHTS EDA HRA
590 40TH AVENUE NE
COLUMBIA HEIGHTS MN 55421 -3835
Item 2. COVERAGE PERIOD:
From: 06/01/2015 To: 06/01/2016 12:01 AM Standard Time at Mailing Address on
Common Coverage
Declarations
Item 3. THE COVERED PARTY IS: CITY
Item 4. COVERAGE PARTS:
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF
THIS COVENANT, LMCIT AGREES TO PROVIDE THE COVERED PARTY
WITH COVERAGES
SHOWN BELOW FOR WHICH A PREMIUM CHARGE IS STATED:
PROPERTY, CRIME, BOND, and PETROFUND
Premium
Property
$ 89,218
Additional Covered Loss or Damages
INCLUDED
Water and Supplemental Flood Coverage
INCLUDED
Crime
INCLUDED
Bond
$ 2,079
Petrofund
INCLUDED
EQUIPMENT BREAKDOWN
$ 8,550
MUNICIPAL LIABILITY
$ 141,445
Medical and Related Expense
NOT COVERED
AUTOMOBILE LIABILITY
$ 15,036
AUTOMOBILE PHYSICAL DAMAGE
$ 14,108
TOTAL $ 270,436
Item 5. GENERAL ANNUAL AGGREGATE DEDUCTIBLE: DOES NOT APPLY
Item 6. PREMIUM IS DUE AND PAYABLE: QUARTERLY
Item 7. FORMS APPLICABLE TO ALL COVERAGE PARTS: CCM(I 1/09)
Item 8. DECLARATIONS APPLICABLE:
DEC - 011(11/09) DEC - 012(11/14) DEC - 013(11/14) DEC - 016(11/14)
Executive Director, LMCIT
LMCIT DEC -011 (11/86) (Rev. 11/09)
COVENANT NUMBER: CMC 37961
COMMON CONDITIONS
ALL COVERAGE PARTS INCLUDED IN THIS COVENANT
ARE SUBJECT TO THE FOLLOWING CONDITIONS:
1. CANCELLATION AND NON- RENEWAL
a. The city shown in the Declarations may cancel this
covenant by mailing or delivering to LMCIT
advance written notice of cancellation.
b. LMCIT may cancel this covenant by mailing or
delivering to the city shown in the Declarations
written notice of cancellation at least:
(1) 10 days before the effective date of the
cancellation if LMCIT cancels for nonpayment of
premium; or
(2) 30 days before the effective date of the
cancellation if LMCIT cancels for any other reason.
c. LMCIT will mail or deliver its notice to the city
shown in the Declarations last mailing address
known to LMCIT.
d. Notice of cancellation will state the effective date of
cancellation. The coverage period will end on that
date.
c. If this covenant is canceled, LMCIT will send the
city shown in the Declarations any premium refund
due. If LMCIT cancels, the refund will be pro -rata.
If the city cancels, the refund may be less than the
pro -rata. The cancellation will be effective even if
LMCIT has not made or offered a refund.
f. If LMCIT decides not to renew this covenant,
LMCIT will mail or deliver to the city shown in the
Declaration written notice of the non - renewal not
less than 30 days before the expiration date.
g. If notice is mailed, proof of mailing will be
sufficient proof of notice.
2. CHANGES
This covenant contains all the agreements between
LMCIT and the city concerning the coverage afforded.
The city shown in the Declarations is authorized to make
changes in the terms of this coverage agreement with the
consent of LMCIT. The coverage terms can be amended
or waived only by endorsement issued by LMCIT and
made a part of this covenant or by acknowledgment by
LMCIT that an endorsement will be issued at a later date.
3. RATING AUTHORITY AND
EXAMINATION OF THE CITY'S BOOKS
AND RECORDS
LMCIT shall have full discretionary authority to
promulgate rates and establish the premium to be
charged for the coverage period under this covenant.
LMCIT may, at its discretion or at the city's request,
examine and audit the city's books as they relate to this
covenant during the coverage period and up to one year
thereafter and, accordingly, make any necessary
adjustments in premium. No premium adjustments will
be made after one year following the expiration of the
coverage period.
4. INSPECTIONS AND SURVEYS
LMCIT has the right, but it is not obligated to:
a. Make inspections and surveys at any time.
b. Give the city reports on the conditions it finds; and
c. Recommend changes.
Neither LMCIT s right to make inspections nor its
making any report thereon shall constitute any
undertaking on behalf of or for the benefit of the city or
others to determine or warrant that such property or
operations are safe or healthful or free from hazard or
are in compliance with any law, rule or regulation.
These conditions apply not only to LMCIT, but also to
any rating advisory, rate service, or similar organization
which makes inspections, surveys, reports, or
recommendations.
5. PREMIUMS
The city shown in the Declarations:
a. Is responsible for the payment of all premiums; and
b. Will be the payee for any return premiums.
LMCIT CCM (11/89 (Rev. 11/09) Page 1 of 3
COVENANT NUMBER: CMC 37961
6. TRANSFER OF THE CITY'S RIGHTS AND
DUTIES UNDER THIS COVENANT
The city's rights and duties under this covenant may not
be transferred without the written consent of LMCIT.
7. OVERLAP OF COVERAGE
In the event of a dispute between LMCIT and one or
more insurers as to which policy or coverage agreement
applies to a covered loss, LMCIT shall indemnify the city
for any legal or other expenses which are necessarily
incurred by the city in determining whether LMCIT or
the insurer(s) shall bear the loss. Such indemnification
shall be made only if it is determined that payment of the
loss shall be made under this covenant. If the loss is
shared by LMCIT and one or more insurers,
indemnification shall be made in the same proportion as
the loss payment. The city and LMCIT shall cooperate
in the development and execution of reasonable
procedures to resolve the dispute.
8. ASSESSISILITY
All cities in the joint coverage pool are jointly and
severally liable for all claims and expenses of the pool.
The amount of any liabilities in excess of assets may be
assessed to the members of the pool when a deficiency is
identified.
9. NUCLEAR HAZARD
LMCIT, under this covenant, does not cover any loss or
claim for damage that is caused in part or in total by
nuclear reaction or radiation, or radioactive
contamination, however caused.
10. CONCEALMENT OR FRAUD
This covenant is void if the city has intentionally
concealed or misrepresented any material fact or
circumstance relating to this covenant.
11. OTHER COVERAGE
a. Except as provided in paragraph b., this coverage is
excess over the following:
(1) Any liability insurance policy of another party
on which the covered party is an additional insured
or additional named insured.
(2) Any other valid and collectible insurance policy
or other coverage, whether such other policy or
coverage is primary, excess, contingent, or any other
basis, unless that policy or coverage is specifically
written to be excess over this covenant.
b. This coverage is primary for any of the following
losses:
(1) A covered loss of business personal effects, with
respect to any coverage provided under the
employee's homeowners' insurance or similar
coverage.
(2) A covered loss of contents or mobile property in
the city's care, custody and control that is used to
maintain the operations of the city, with respect to
coverage provided under an insurance policy of the
owner covering that property.
(3) A covered loss resulting from the city's
maintenance or use, including loading or unloading,
of any owned automobile that is not a trailer.
(4) A covered loss resulting from the city's
maintenance or use, including loading or unloading,
of any trailer the city does not own but which is
connected to an owned automobile.
(5) Any covered liability claim against a party who
has been added by endorsement as an additional
covered party under this covenant, unless that
endorsement specifically provides that this covenant
is excess.
(6) A covered loss to a covered automobile as
provided by the Municipal Automobile Physical
Damage Coverage.
(7) A covered loss to a builders risk property as
provided by Buildings in the Course of Construction,
Alteration or Repair Coverage.
12. RECOVERIES
Except as otherwise required by statute, any "net
recovery" from a third party on a covered loss will be
allocated between the city and LMCIT in proportion to
their respective shares of the total covered loss. "Net
recovery" means the total amount recovered from a third
party; minus the cost of obtaining that recovery; but "net
recovery" does not include amounts LMCIT recovers
from a reinsurer, The city's share of the covered loss
includes any applicable deductible; any amounts for
which the city is responsible under any co -pay
provisions; and any amounts which exceed the
applicable coverage limit.
LMCIT CCM (11/89 (Rev. 11/09) Page 2 of 3
COVENANT NUMBER: CMC 37961
13. TRANSFER OF RIGHTS OF RECOVERY
AGAINST OTHERS TO LMCIT
Except as provided below, if any person or organization
to or for whom LMCIT makes payment under this
covenant has rights to recover damages from another,
those rights are transferred to LMCIT to the extent of
LMCIT's payment. That person or organization must do
everything necessary to secure our rights and must do
nothing before or after a loss to impair them.
a. The city may waive the city's rights against another
party in writing prior to a covered loss or damage
but this does not apply to a covered loss or damage
as provided by the Municipal Bond Coverage or
Municipal Crime Coverage. The city does not need
to notify LMCIT in writing.
b. The city may waive the city's rights against another
party in writing after a covered loss or damage as
provided by the Municipal Property Coverage, only
if at the time of loss that party is one of the
following:
(1) Another covered party covered by this covenant
(2) Another entity
(a) Owned or controlled by the city; or
(b) That owns or controls the city.
14. DUTY TO COOPERATE
The city, or other covered party, including its officers,
employees or agents, shall fully cooperate with LMCIT
in the processing and investigation of claims under this
covenant. In addition, the city, or other covered party,
including its officers, employees or agents, shall not take
any action nor do anything that would impair or
prejudice the investigation or processing of any claim, or
LMCIT's defense of any claim or suit. If the city, or
other covered party, including its officers, employees or
agents fails to cooperate or takes any action or does
anything that impairs or prejudices the investigation or
processing of any claim, or LMCIT s defense of any
claim or suit, LMCIT shall have the right to withdraw
coverage with respect to such claim or suit or to modify,
cancel or not renew coverage. Notwithstanding the
above, nothing herein shall be construed to apply to a
legitimate response by the city, a covered party, or any
of its officers, employees and agents, to a request for
information made as part of a legal proceeding or
pursuant to other statutory or legal obligation; nor shall
it be deemed to apply to an action brought by a covered
party, or any of its officers, employees or agents against
the city or another covered party.
15. COVENANT EXPIRATION DATE
Covenant expires on the expiration date unless the city
has requested that coverage be extended and LMCIT has
sent a written confirmation of the extension to the city.
16. RIGHT TO OFFSET
Notwithstanding any other provision of this covenant to
the contrary, if the city fails to make timely payment of
amounts owed to LMCIT, including premiums, penalties,
deductibles, co -pays, premium audit adjustments or
retrospective rating plan charges, LMCIT, in addition to
other remedies available to it, shall have the right to
retain and offset any amounts owed to the city and apply
the amounts so retained against the unpaid and overdue
amounts. Amounts owed to the city, which are subject
to an offset include, but are not limited to, dividends,
premium audit adjustments, retrospective rating plan
adjustments, and claims payments owed to the city by
LMCIT.
LMCIT CCM (11/89 (Rev. 11/09) Page 3 of 3
Covenant Number: MUNICIPAL PROPERTY, CRIME, BOND, PETROFUND,
CMC 37961 and EQUIPMENT BREAKDOWN DECLARATIONS !
Coverage is Provided by:
THE LEAGUE OF MINNESOTA CITIES r
INSURANCE TRUST
(Herein called LIVMCIT)�l l�(.) lti
Item 1. CITY: COLUMBIA HEIGHTS, CITY OF &
Item 2. COVERAGE PERIOD:
From: 06/01/2015 To: 06/01/2016 12:01 AM Standard Time at Mailing Address
on Common Coverage Declarations
Item 3. THE COVERED PARTY IS: CITY
Item 4. COVERAGE:
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF
THIS COVENANT, LMCIT AGREES TO PROVIDE THE COVERED PARTY WITH COVERAGES
SHOWN BELOW FOR WHICH A LIMIT IS STATED:
Item 5. COVERAGE PART ONE — PROPERTY
Section I — Property General Limit of Coverage Per Occurrence $ 66,041,704
This general limit is subject to the sublimity as described in Section VI, Limits of
Coverage and Valuation, and the specific property limit.
Terrorism loss occurrence - shared limit $ 50,000,000
This limit is subject to the provisions of the Terrorism Losses - Special Pool Limit
Endorsement ME079(11/09)
Section II — Additional Covered Loss or Damages
1. Loss of Revenue, Extra Expense and Expediting Expense
2. Demolition and Debris Removal
(Direct Physical Damage to Covered Property)
(No Direct Physical Damage to Covered Property)
3. Leasehold Interest
4. Accounts Receivable
5. Valuable Papers and Records
6. Utility Services
7. Green Building Expenses
8. Asbestos Clean up, Abatement and Removal
9. Pollutant Cleanup and Removal
10. Errors
11. Rental Reimbursement
12. Arson Reward
13. Extraordinary Expense
14, Data Security Breach Expenses
$ 5,000,000. Per Occurrence
25% of the Estimated Replacement Cost
of the Covered Property
$ 50,000.
Per Occurrence
$ 500,000.
Per Location
$ 500,000.
Per Location
$ 500,000.
Per Location
$ 100,000.
Per Occurrence
1 % of the Contract Cost but not to
exceed $100,000.
Per Location
$ 250,000.
Per Location
$ 250,000.
Per Location
$ 500,000.
Per Occurrence
$ 250,000.
Annual Aggregate
$ 5,000.
Per Fire Loss
$ 250,000.
Annual Aggregate
$ 250,000.
Annual Aggregate
Section IV - Water and Supplemental Flood Coverage $ 500,000. Per Occurrence
$ 500,000. Annual Aggregate
LNICIT DEC - 012(11 /86)(Rcv.11/14) Pagel of 3
COVENANT NUMBER: CMC 37961
( -I 1'It S
Item 6. REFER TO SCHEDULE OF COVERED PROPERTY FOR THOSE LOCATIONS INCLUDED IN THE
Item 7
Item 8.
SECTION I COVERAGE; THE SCHEDULE OF COVERED MOBILE PROPERTY FOR THE MOBILE
PROPERTY INCLUDED IN THE SECTION I COVERAGE AND THE SCHEDULE OF COVERED
PROPERTY FOR THOSE LOCATIONS INCLUDED IN SECTION IV COVERAGE.
DEDUCTIBLE (Deductible applies per occurrence subject to General Annual Aggregate Deductible, if any,
shown on Common Coverage Declarations):
COVERAGE PART ONE — PROPERTY $ 1,000 Per Occurrence
COVERAGE PARTS, FORMS, SCHEDULES AND ENDORSEMENTS APPLICABLE TO THIS
COVERAGE.
MPCBP(11 /14) PM- 100(11/03) ME079(11/09) ME063(11/01)
MPCBP- 115(11 /05) MPCBP- 209(11/05) PM- 109(11/07)
Item 9. MORTGAGE HOLDER (if applicable):
Item 10.
Item 11
Item 12.
COVERAGE PART TWO — CRIME
LIMIT OF COVERAGE PER OCCURRENCE $ 250,000
DEDUCTIBLE (Deductible applies per occurrence subject to General Annual Aggregate Deductible, if any,
shown on Common Coverage Declarations):
COVERAGE PART TWO — CRIME
$ 1,000 Per Occurrence
COVERAGE PARTS, FORMS, SCHEDULES AND ENDORSEMENTS APPLICABLE TO THIS
COVERAGE.
ME063(11 /01) MPCBP(11 /14)
LMCIT DEC- 012(11/86)(Rcv.11/14) Page 2 of3
COVENANT NUMBER: CMC 37961
Item 13.
Item 14.
COVERAGE PART THREE — BOND
r?1�
J.C.Ai,;t,1 , I
LIMIT OF COVERAGE PER OCCURRENCE: $ 300,000
DEDUCTIBLE (Deductible applies per occurrence subject to General Annual Aggregate Deductible, if any,
shown on Common Coverage Declarations):
COVERAGE PART THREE - BOND $ 1,000 Per Occurrence
COVERAGE PARTS, FORMS, SCHEDULES AND ENDORSEMENTS APPLICABLE TO THIS
COVERAGE.
MPCBP(11 /14) ME063(11 /01)
Item 15. COVERAGE PART FOUR — PETROFUND (Claims made)
LIMMITS OF REIMBURSEMENT BENEFIT MAXIMUM
REIMBURSABLE COSTS AND DEFENSE COSTS
EACH TANK RELEASE $ 250,000
REIMBURSABLE COSTS AND DEFENSE COSTS
AGREEMENT TERM AGGREGATE $ 250,000
DEDUCTIBLE: COVERAGE PART FOUR - PETROFUND NOT APPLICABLE
Item 16. COVERAGE PARTS, FORMS, SCHEDULES AND ENDORSEMENTS APPLICABLE TO THIS
COVERAGE.
MPCBP(11 /14) ME063(11/01)
Item 17. EQUIPMENT BREAKDOWN COVERAGE
EQUIPMENT BREAKDOWN LIMIT: $ 64,514,250
DEDUCTIBLE: $ 1,000 ANY ONE ACCIDENT
Item 18. COVERAGE PARTS, FORMS, SCHEDULES AND ENDORSEMENTS APPLICABLE TO THIS
COVERAGE.
BM- 200(11/13) BM-212 (11/01) PM-100 (11/03) ME063(11/01)
LMCIT DEC -012(11 /86)(Rev.11/14) Page 3 of 3
LMCIT PREMIUM BREAKDOWN
DATE: 07/09/2015 Coverage Period: 06/01/2015 -
06/01/2016
ME
CITY OF: COLUMBIA HEIGHTS, CITY OF &
COVERAGE AVERAGE RATE AMOUNT OF COVERAGE
PROPERTY (Per $100 Coverage)* $ 64,514,250
EQUIPMENT BREAKDOWN COVERAGE $ 64,514,250
MOBILE PROPERTY(Per $100 Coverage):
SCHED.OVER 25,000
UNSCHED.25,000 & LESS
MUNICIPAL LIABILITY
AUTO LIABILITY & PHYSICAL DAMAGE
CRIME - INSIDE /OUT /FORGERY
BONDS
.37221 $ 1,305,711
$ 221,743
SEE ATTACHED
*SEE ATTACHED
$ 250,000
$ 300,000
PREMIUM
$ 81,805
$ 8,550
$ 4,860
$ 2,553
$ 141,445
$ 29,144
$
$ 2,079
*These AVERAGE RATES are to be used TOTAL PREMIUM: $ 270,436
for ESTIMATES of PREMIUM ALLOCATION ONLY
07/20 PREPARED BY: --
SCHEDULE of VEHICLES - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
VEH#
YR
TRADE NM
MODEL
- ID -
LIAB
PHYD
HNO
HIRED /NONOWNED
$
64
$
001
1992
CHEV C15
CARGO VAN
6628
$
132
$
43
002
1995
FORD LS9000
ENGINE #1
0058
$
24
$
820
003
1985
FORD L9000
ENGINE #4
0591
$
24
$
419
004
1990
FORD
RESCUE #1
8732
$
128
$
445
005
2001
FORD
EXPEDITION
7504
$
81
$
54
006
1996
DCT
TRAILER
1554
$
$
33
007
1999
FORD
TAURUS
8304
$
81
$
54
008
1998
HAULMARK
TRAILER
9274
$
$
33
009
2001
FORD
TAURUS
2755
$
81
$
54
010
2001
SMART
TRAILER
8129
$
$
38
011
1999
FORD
VAN
5266
$
81
$
54
012
1994
CHEV 3/4 T
PICKUP
6180
$
132
$
49
013
2002
FORD F -450
TRUCK
7309
$
132
$
82
014
1996
FORD F -250
TRUCK
7963
$
132
$
42
015
1998
CHEV 3/4 T
PICKUP
3335
$
132
$
62
016
1994
FORD
F700 TRUCK
9182
$
150
$
105
017
2001
STERLING
POTHOLE
5864
$
150
$
237
018
1991
DCT
TRAILER
9194
$
$
33
019
2001
STERLING
DUMP TRUCK
1859
$
150
$
191
020
1998
FORD K7511
DUMP TRUCK
1035
$
150
$
128
021
1996
FORD
L8000
8927
$
150
$
215
022
1996
KIEFER
TRAILER
3408
$
$
33
023
1996
FORD
CLUB WAGON
1223
$
132
$
40
024
1995
FORD
F -250
5539
$
132
$
65
025
2002
FORD E450
AMBULANCE
5524
$
128
$
361
026
2000
FELLING TILT
TRAILER
3183
$
$
33
027
2002
FORD
TAURUS
7193
$
309
$
91
028
2001
FORD F450
TRUCK
5813
$
132
$
72
029
2003
FORD F450
TRUCK
3212
$
132
$
80
030
1999
TILT
TRAILER
0251
$
$
33
031
2004
FORD F450
TRUCK
1096
$
132
$
81
032
2004
FORD E250
VAN
3288
$
132
$
40
033
2004
SPARTAN
LADDER TRK
7328
$
24
$
2,038
034
2004
FORD F250
PICKUP
9439
$
132
$
49
035
2005
FORD
CROWN VICT
2694
$
81
$
54
036
2004
FORD F -350
PICKUP
9438
$
132
$
49
037
1998
FORD L800
LIFT TRUCK
7601
$
150
$
122
038
2006
INT'L 4300
JETTER
6095
$
150
$
483
039
2006
FORD F350
TRUCK
6584
$
132
$
54
040
2007
FORD
CROWN VICT
7203
$
81
$
54
041
2007
FORD
CROWN VICT
9245
$
81
$
54
SCHEDULE of VEHICLES - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
VEH#
YR
TRADE NM
MODEL
- ID -
LIAB
PHYD
042
2006
FORD F350
TRUCK
6583
$
132
$
54
043
2006
FORD F350
TRUCK
6585
$
132
$
54
044
2003
FORD E350
VAN
6293
$
1,504
$
138
045
2007
FORD
CROWN VICT
7454
$
81
$
54
046
2007
FORD F150
PICKUP
6537
$
132
$
38
047
2008
FORD
ESCAPE
3873
$
81
$
54
048
2008
FORD
TAURUS
0604
$
81
$
54
049
2009
FORD F250
PICKUP
6730
$
132
$
52
050
2008
DODGE
CHARGER
6209
$
309
$
91
051
2008
FORD F350
PICKUP
7926
$
132
$
126
052
2001
FORD
ECONOLINE
3879
$
132
$
33
053
2009
DODGE
CHARGER
1732
$
309
$
91
054
2008
CONTRAIL
TRAILER
2244
$
$
33
055
2009
INT'L
DUMP TRUCK
6984
$
150
$
348
056
2008
ELGIN EAGLE
SWEEPER
9263
$
150
$
550
057
2008
FORD
TRUCK
8623
$
150
$
365
058
2009
INT'L
DUMP TRUCK
3631
$
150
$
180
059
2009
CHEV
IMPALA
3599
$
309
$
91
060
2009
ROYAL CARGO
TRAILER
1990
$
132
$
33
061
2009
FORD
CROWN VIC
5132
$
81
$
54
062
2011
INT'L
CHASSIS
8723
$
150
$
187
063
2010
FORD
CROWN VIC
5350
$
309
$
91
064
2010
FORD
CROWN VIC
5351
$
309
$
91
065
2010
FORD E150
VAN
8000
$
132
$
49
066
2011
FORD F250
PICKUP
6263
$
132
$
72
067
2010
CHEV
IMPALA
0877
$
309
$
91
068
2011
FORD
CROWN VIC
7014
$
309
$
91
069
2011
FORD
CROWN VIC
7015
$
309
$
91
070
2011
ELGIN
SWEEPER
2199
$
150
$
589
071
2012
CHEV
TAHOE
0324
$
24
$
117
072
2007
FORD
ESCAPE
9394
$
309
$
91
073
2012
CHEVROLET
SUBURBAN
8301
$
81
$
54
074
2009
LINCOLN
MKS
0243
$
309
$
91
075
2013
INT'L
DUMP
5856
$
150
$
210
076
2013
FORD
INTERCEPTO
6911
$
309
$
91
077
2013
FORD
INTERCEPTO
6912
$
309
$
91
078
2013
FORD
INTERCEPTO
7266
$
309
$
91
079
2013
FORD
INTERCEPTO
3226
$
309
$
91
080
2012
AZTEX
FLOAT TRAI
1643
$
$
33
081
2013
FORD
VAN
4796
$
132
$
74
082
2014
FORD
F250
0264
$
132
$
79
083
2014
INT'L
7500
3928
$
150
$
1,121
084
2014
CHEV
IMPALA
9728
$
309
$
91
SCHEDULE of VEHICLES - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
VEH#
YR
TRADE NM
MODEL
- ID -
LIAB
PHYD
085
2014
FORD
EXPLORER
6232
$
309
$
91
086
2014
FORD
EXPLORER
6233
$
309
$
91
087
2015
FORD
PICKUP
6358
$
132
$
79
088
2015
FORD
VAN
8484
$
132
$
85
089
2015
TOYOTA
HIGHLANDER
6178
$
309
$
91
090
2106
INTERNATIONL
4300
3721
$
150
$
333
091
2015
DODGE
CHARGER
1395
$
309
$
91
TOTAL VEHICLES $ 15,036 $ 14,108
TOTAL AUTO PRM $ 29,144
MUNICIPAL LIABILITY - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
PREMIUM
-- HAZARD -- BASIS
EXPENDITURES $ 27,181,405.00
NO FAULT SEWER BACKUP - $10,000 7,243.00
FIREWORKS 1.00
LAND USE 8,055.00
SEWER BACKUP 7,243.00
EMPLOYMENT 134.00
POLICE DEPARTMENT 26.00
ADVANCED
PREMIUM
$ 20,249
$ 8,835
$ 225
$ 27,590
$ 22,863
$ 22,126
$ 39,557
TOTAL LIABILITY $ 141,445
MUNICIPAL PROPERTY - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
LOC
BLD
COV
DESCRIPTION
COVERAGE
PREMIUM
001
001
BLD
965 40TH AVENUE
NE
13,497,173
18,958
APARTMENT BLDG.
002
001
BLD
590 40TH AVENUE
NE
4,304,740
1,967
CITY HALL
002
001
CNT
590 40TH AVENUE
NE
393,337
239
CITY HALL
003
001
BLD
637 38TH AVENUE
NE
4,297,577
3,563
MUNICIPAL SERVICE CENTER
003
001
CNT
637 38TH AVENUE
NE
262,470
335
MUNICIPAL SERVICE CENTER
004
001
BLD
637 38TH AVENUE
NE
142,210
361
TANKS AND PUMPS
005
001
BLD
820 40TH AVENUE
NE
2,296,844
1,632
LIBRARY
005
001
CNT
820 40TH AVENUE
NE
1,720,112
1,630
LIBRARY
006
001
BLD
4025 VAN BUREN STREET
3,137,145
2,601
PARKING RAMP
007
001
BLD
4700 STINSON BOULEVARD
867,373
330
WATER TOWER- 250,000
GALLONS
008
001
BLD
5225 UNIVERSITY
AVENUE NE
514,061
1,348
LIQUOR STORE
008
001
CNT
5225 UNIVERSITY
AVENUE NE
178,981
794
LIQUOR STORE
009
001
BLD
530 MILL STREET
3,314,012
2,046
MURZYN HALL
009
001
CNT
530 MILL STREET
921,962
764
MURZYN HALL
010
001
BLD
SULLIVAN PARK
107,448
931
RESTROOMS
010
001
CNT
SULLIVAN PARK
15,267
132
RESTROOMS
011
001
PIO
EDGEMORE PARK
18,180
135
PARK
012
001
BLD
GAUVITTE PARK
74,897
648
WARMING HOUSE
013
001
PIO
GAUVITTE PARK
19,578
145
PARK
014
001
PIO
HILLTOP PARK
25,172
186
PARK
015
001
BLD
HUSET PARK
62,573
541
WARMING HOUSE
MUNICIPAL PROPERTY - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
LOC
BLD
COV
DESCRIPTION
COVERAGE
PREMIUM
016
001
BLD
HUSET PARK
15,801
195
PRESS BOX (FIELD #5)
017
001
PIO
HUSET PARK
84,566
628
PARK
018
001
BLD
KEYES PARK
74,897
648
WARMING HOUSE
019
001
PIO
KEYES PARK
19,578
145
PARK
020
001
PIO
LABELLE PARK
20,978
156
PARK
021
001
PIO
LABELLE CIRCLE TERRACE
20,978
156
VARIOUS
022
001
BLD
LOMIANKI PARK
52,670
456
WARMING HOUSE
023
001
BLD
MCKENNA PARK
74,897
648
WARMING HOUSE
024
001
PIO
MCKENNA PARK
19,578
145
PARK
025
001
BLD
OSTRANDER PARK
74,897
648
WARMING HOUSE
026
001
PIO
OSTRANDER PARK
41,953
311
PARK
027
001
BLD
PRESTEMON PARK
53,197
460
WARMING HOUSE
028
001
PIO
PRESTEMON PARK
138,202
1,026
PARK
029
001
BLD
RAMSDELL PARK
74,897
648
WARMING HOUSE
030
001
PIO
RAMSDELL PARK
20,978
156
PARK
031
001
BLD
SILVER LAKE BEACH
84,272
729
BEACH HOUSE
032
001
BLD
637 38TH AVENUE NE
361,528
471
MSC BROWN BUILDING
032
001
CNT
637 38TH AVENUE NE
21,056
42
MSC BROWN BUILDING
033
001
PIO
SULLIVAN PARK
51,743
384
PARK
034
001
BLD
4400 RESERVOIR BLVD
130,517
77
PUMP STATION #2
034
001
CNT
4400 RESERVOIR BLVD
284,264
202
PUMP STATION #2
035
001
BLD
4633 IVANHOE PLACE
170,652
101
PUMP STATION #3
MUNICIPAL PROPERTY - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
LOC
BLD
COV
DESCRIPTION
COVERAGE
PREMIUM
035
001
CNT
4633 IVANHOE PLACE
284,264
202
PUMP STATION #3
036
001
BLD
4640 CHATHAM ROAD
45,717
27
LIFT STATION #1 (CHATHAM)
036
001
CNT
4640 CHATHAM ROAD
36,849
26
LIFT STATION #1 (CHATHAM)
037
001
BLD
330 ARGONNE DRIVE
36,869
22
LIFT STATION #2
037
001
CNT
330 ARGONNE DRIVE
36,849
26
LIFT STATION #2
038
001
BLD
4101 STINSON BLVD
85,325
32
LIFT STATION #3 (SILVER LAKE)
038
001
CNT
4101 STINSON BLVD
47,377
22
LIFT STATION #3 (SILVER LAKE)
039
001
BLD
721 51ST AVENUE NE
184,346
70
LIFT STATION #4 (SULLIVAN)
039
001
CNT
721 51ST AVENUE NE
52,642
24
LIFT STATION #4 (SULLIVAN)
040
001
BLD
HUSET PARK
221,215
576
GARAGE
040
001
CNT
HUSET PARK
13,687
54
GARAGE
041
001
BLD
637 38TH AVENUE NE
269,671
351
MSC - BLUE BLDG
042
001
BLD
637 38TH AVENUE NE
53,091
69
MSC - SALT SHED
043
001
PIO
CITYWIDE
1,032,171
192
VARIOUS
044
001
PIO
559 MILL STREET
42,174
313
VARIOUS
045
001
PIO
4633 IVANHOE PLACE
38,367
284
VARIOUS
046
001
BLD
4950 CENTRAL AVENUE NE
3,266,714
6,107
LIQUOR STORE
046
001
CNT
4950 CENTRAL AVENUE NE
1,173,694
3,723
LIQUOR STORE
047
001
BLD
2105 37TH AVENUE
2,429,046
4,541
LIQUOR STORE
047
001
CNT
2105 37TH AVENUE
807,099
2,560
LIQUOR STORE
048
001
PIO
637 38TH AVE NE
74,169
440
MSC
049
001
PIO
4400 RESERVOIR BLVD
52,995
369
PUMP HOUSE #2
MUNICIPAL PROPERTY - COLUMBIA HEIGHTS, CITY OF &
COVENANT Number: CMC 37961
COVENANT Period: 06/01/2015 TO 06/01/2016
LOC BLD COV DESCRIPTION
050 001 PIO 4101 STINSON BLVD
LIFT STATION #3
051 001 PIO 530 MILL STREET
MURZYN HALL
052 001 BLD SULLIVAN PARK
SHELTER
053 001 PIO 40TH & CENTRAL NE
VARIOUS
054 001 BLD SILVER LAKE BEACH
SHELTER
055 001 BLD HUSET PARK
SHELTER
056 001 BLD 825 41ST AVE NE
PUBLIC SAFETY BUILDING
056 001 CNT 825 41ST AVE NE
PUBLIC SAFETY BUILDING
057 001 PIO JACKSON POND
STORM WATER RETENTION POND
058 001 BLD 40TH AVENUE
PARKING RAMP
059 001 PIO 39TH AVE /JEFFERSON ST NE /HUSET PKWY.
MONUMENT
060 001 PIO 3965 JEFFERSON ST - RUSSET PARK
PORTABLE RESTROOM SPECIALTY UN
061 001 PIO 721 -51ST AV- SULLIVAN PARK
PORTABLE RESTROOM SPECIALTY UN
062 001 PIO 4956 JOHNSON ST - RAMSDELL PARK
PORTABLE RESTROOM SPECIALTY UN
063 001 PIO 4301 STINSON BLVD - SILVER LAKE PARK
PORTABLE RESTROOM SPECIALTY UN
COVERAGE PREMIUM
11,780 82
70,566 524
84,272 1,042
30,836 228
27,916 345
84,272 1,042
10,322,105 5,502
577,793 410
8,427 59
4,875,158 4,042
63,183 585
2,600 49
2,600 49
2,600 49
2,600 49
TOTAL PROPERTY 81,805
MOBILE PROPERTY - COLUMBIA HEIGHTS, CITY OF &
LOC BLD COV DESCRIPTION
001
1991
LEE BOY PAVER #60 -042
002
1998
WILDCAT SNOW BLOWER - LOADER #9277
003
2007
JOHN DEERE TRACTOR W /BROOM #5648
004
1994
CASE FRONT END LOADER #0770
005
1999
HENKE REVE 12 FOOT PLOW /WING ATTA
006
1990
JCB 1400 TRACTOR /BACKHOE #8917
007
2000
CAT 428 TRACTOR /BACKHOE #1795
008
1993
FORD 3930 FARM TRACTOR #3655
009
2010
TRACKLESS MTV TRACTOR W /EQUIPMENT
010
1998
MCQUEEN MT TRACKLESS TRACTOR #1475
011
2004
BOMAG ROLLER #9591
012
2005
TRACKLESS LEAF LOADER
013
2007
TORO 580D LAWN MOWER #0152
014
CAT SHD STEER LOADER MDL 247B2 #5909
015
2007
CAT 938G11 LOADER #2454
COVERAGE
61,847
71,977
58,648
170,611
# 35,189
79,974
133,290
47,984
M 138,622
117,295
37,322
30,923
101,300
44,786
175,943
TOTAL MOBILE PROPERTY 1,305,711
CMC 37961 Mortgagee /Additional Insured /Lienholders
001 SAINT PAUL FESTIVAL & HERITAGE FOUNDATION
ATTN: PARADES
429 LANDMARK CENTER
75 WEST 5TH STREET
SAINT PAUL, MN 55102
N014
RE: PARTICIPATING IN THE WINTER CARNIVAL PARADE.
002 CITY OF NORTHFIELD
ATTN: ELIZABETH WHEELER
801 WASHINGTON STREET
NORTHFIELD, MN 55057
N014
RE: DEFEAT OF JESSE JAMES DAYS CELEBRATION
003 DEFEAT OF JESSE JAMES COMMITTEE, INC.
PO BOX 23
NORTHFIELD, MN 55057
N014
RE: DEFEAT OF JESSE JAMES DAYS CELEBRATION
004 ANOKA COUNTY & ANOKA COUNTY HRA
ATTN: KATE THUNSTUM, CDBG COORDINATOR
2100 3RD AVENUE
ANOKA, MN 55303
N014
RE: ANOKA COUNTY CDBG PROGRAM
005 US BANK NATIONAL ASSOCIATION ATIMA
EP- MN -WS3C
ATTN: CORPORATE TRSUT SERVICES
60 LIVINGSTON AVE
ST.PAUL, MN 55107
RE: 2105 37TH AVE NE, 4950 CENTRAL AVE NE
N181
006 CENTRAL PLAZA ASSOCATION
2227 UNIVERSITY AVENUE
ST. PAUL, MN 55114
N014
RE: USE OF CENTRAL PLAZA DURING
007 CARMAX
12800 TUCKAHOE CREEK PKWY
RICHMOND, VA 23238
N014
RE: USE OF PROPERTY AT
CMC 37961 AUTO ADDL INSRDSILEINHOLDERS
Loc /bld no. TYP
073 22 001 R NORTHEAST BANK 8301
77 NE BROADWAY
MINNEAPOLIS, MN 55413
073 22 002 S EXECUTIVE LEASING LLC 8301
9700 63RD AVENUE NORTH
SUITE 250
MAPLE GROVE, MN 55368
Covenant Number: MUNICIPAL LIQUOR LIABILITY
LLC 3071 Coverage Is Provided By:
THE LEAGUE OF MINNESOTA CITIES
Previous Covenant Number: INSURANCE TRUST
LLC 2909 (Herein called LMCIT)
Item 1
Item 2.
Item 3
Item 4.
Item 5
Item 6.
CITY and MAILING ADDRESS:
COLUMBIA HEIGHTS, CITY OF &
COLUMBIA HEIGHTS EDA HRA
590 40TH AVENUE NE
COLUMBIA HEIGHTS MN 55421 -3835
LOCATION (S) OF COVERED PREMISES:
1. 4950 CENTRAL AVENUE NE
2. 2105 37TH AVENUE NE
3. 5225 UNIVERSITY AVENUE NE
COVERAGE PERIOD:
From: 06/01/2015
COVERAGE LIMITS:
Municipal Liquor Liability Limit:
To: 06/01/2016
0
�.1�4iiIl1
iNNI
12:01 AM Standard Time at
Mailing Address Indicated Above
$ 1,000,000 Per Occurrence/Per Covered Premises
$ 1,000,000 Annual Aggregate /Per Covered Premises
MUNICIPAL LIQUOR LIABILITY DEDUCTIBLE: $------ Per Occurrence
PREMIUM: 10,298
Item 7. FORMS AND ENDORSEMENTS APPLICABLE TO AGREEMENT:
ME091(11/11) MLLC(11 /10)
4�� �/-
Executive Director, LMCIT
LMCIT DEC -021 (11/97)
ENDORSEMENT #
COVERED PARTY COVENANT NUMBER EFFECTIVE DATE
COLUMBIA HEIGHTS, CITY OF
&
LLC 3071
IT IS HEREBY UNDERSTOOD AND AGREED THAT MUNICIPAL LIQUOR LIABILITY,
FORM ME09I(I I /11) IS AMENDED TO ADD THE FOLLOWING:
LOCATION (S) OF COVERED PREMISES:
4. MURZYNE HALL
530 MILL STREET NE
All other terms and conditions remain unchanged.
%iG9
Executive Director, LMCIT
LMCIT ME091 (11 /11) Page I of 1
COVENANT NUMBER: LLC 3071
Various provisions in this covenant restrict coverage.
Read the entire coverage agreement carefully to
determine rights, duties and what is and is not covered.
Throughout this covenant the word "city" refers to the
first "city" shown in the Declarations. The word
LMCIT refers to the League of Minnesota Cities
Insurance Trust.
The words "city" and "covered party" are defined
under SECTION II - WHO IS COVERED.
Other words and phrases that appear in italics have
special meaning, as given in SECTION IV-
DEFINITIONS.
A. COVERAGE AGREEMENT
1. LMCIT will pay on behalf of the "covered
party" all sums which the "covered party" shall
become legally obligated to pay as damages by
reason of selling any alcoholic beverage at or from
a covered premises, as provided by the Minnesota
Civil Damages Act (M.S. 340A.801 - 340A.802)
or any other law governing liability for illegal
sales of alcoholic beverages at or from a covered
premises if the following conditions are met:
a. The occurrence which is the basis for such
damages must have taken place during the
coverage period; and
b. The occurrence which is the basis for such
damages must have taken place in the
coverage territory.
2. LMCIT will have the right and duty to defend
any such claim or suit seeking damages. LMCIT
may, at its discretion, investigate any actual or
potential claim; and unless the "city" has given
notice as provided in SECTION VI- CONDITIONS,
6, LMCIT may settle any claim or suit.
3. The amount LMCIT will pay for damages is
limited as described in SECTION III - LIMITS OF
COVERAGE.
B. EXCLUSIONS
This coverage does not apply to:
1. Any obligation for which the "covered party"
or any carrier as its insurer may be held liable
under any workers' compensation, unemployment
compensation, disability benefits, or under any
similar law.
2. Damages arising from the sale of alcoholic
beverage(s) if the sale occurred while the "covered
party's" license, permit or authority by law is
suspended, expired, canceled or revoked.
3. Damages for which the "covered party" is
liable by reason of the assumption of liability in a
contract or agreement, but this exclusion does not
apply to liability for damages which the "covered
party" would have in the absence of the contract or
agreement.
1. "City" means the "city" or other governmental agency;
body or entity first named in the Declarations. Unless
specifically named in the Declarations, "city" shall not c. Municipal power agency;
include any of the following:
a. Gas, electrical or steam utilities commission;
d. Municipal gas agency;
e. Welfare or public relief agency;
b. Port authority, housing and redevelopment
authority, economic development authority, area or f. School board; or
municipal redevelopment authority or similar
LMCIT MLLC (11 -97) (Rev. 11/10)
Page 1 of 6
COVENANT NUMBER: LLC 3071
g. Joint powers entity; but a joint planning board
created pursuant to an orderly annexation
agreement or joint resolution between the city and
a township is deemed to be a covered joint powers
entity under this agreement.
2. For purposes of Coverage A, "covered party"
means:
a. The "city ", and any other entity named in the
Declarations;
b. For actions within his duties as such, any
present or former:
(1) Member of the "city" council;
(2) Member of a "city" board, commission, or
committee which is not excluded by the
definition of "city ";
(3) Elected or appointed official of the "city';
(4) Employee of the "city ";
(5) Volunteer person or organization while
acting on behalf of the "city" and subject to
the "city's" direction and control;
(6) Other authorized person or agent of the
"city" while acting on behalf of the "city ", but
excluding independent contractors;
(7) "City" relief association and its members,
officers, and employees.
(8) Person while acting in the administrative
capacity of medical director or medical
advisor to the "city" ambulance service.
c. With respect to a joint powers entity named in
the Declarations:
(1) The joint powers entity;
(2) While acting on behalf of the joint powers
entity, or with respect to liability arising out of
the activities of the joint powers entity, any
present or former:
(a) Governmental member of the joint
powers entity;
(b) Elected or appointed official of the
governmental member;
(c) Employee of the governmental
member;
(d) Other authorized person or agent of
the governmental member, but excluding
independent contractors.
1. The limits of coverage shown in the Declarations
and the rules below fix the most LMCIT will pay as
damages regardless of the number of:
a. "Covered Parties ";
b. Claims made or suits brought; or
c. Persons or organizations making claims or
bringing suits.
2. LMCIT shall not be obligated under this covenant
to pay any claim or judgment or to defend any suit
after the limit of LMCIT's liability has been exhausted
by payment of judgments or settlements or by tender
to any excess carrier or excess coverage including
excess coverage provided by LMCIT.
3. For any Annual Aggregate Limit shown in the
LMCIT MLLC (11 -97) (Rev. 11(10)
Declarations, the limit shall apply separately to each
consecutive annual period and to any remaining period
of less than 12 months, starting with the beginning of
the coverage period shown in the Declarations, unless
the coverage period is extended after issuance for an
additional period of less than 12 months. In that case,
the additional period will be deemed part of the last
preceding period for purposes of determining the
limits of coverage.
4. LMCIT's obligation to pay damages on behalf of
the "covered party" applies only to compensatory
damages in excess of any deductible amount stated in
the Declarations. The limit of liability shown as being
applicable to each claim shall be reduced by the
amount of the deductible. LMCIT may pay any part or
all of the deductible amount to effect settlement of any
claim or suit. Upon LMCIT's request, the "city" shall
promptly reimburse LMCIT for such part of the
Page 2 of 6
COVENANT NUMBER: LLC 3071
deductible paid by LMCIT.
5. Subject to the Annual Aggregate Limit shown in
1. Coverage territory means:
the Declarations, this covenant shall be construed to
provide at least the coverage required under Minn.
Stat. Sec. 340A.409.
a. The United States of America (including its
territories and possessions), Puerto Rico and
Canada;
b. International waters or airspace, provided the
injury or damage does not occur in the course of
travel or transportation to or from any place not
included in a. above; or
c. All parts of the world if:
(1) The injury or damage arises out of.
(a) Goods or products made or sold by'the
"city" in the territory described in a.
above; or
(b) The activities of a person whose home
is in the territory described in a. above, but
is away for a short time on the "city's"
business; and
(2) The "covered party's" responsibility to pay
damages is determined in a suit on the merits,
in the territory described in a. above or in a
settlement LMCIT agrees to.
2. Covered premises means the premises stated in the
Declarations. Covered premises does not mean any
premises acquired by the "covered party" or used by
the "covered party" for the sale or furnishing of
alcoholic beverages unless those premises are stated in
the Declarations or are included by endorsement to
this coverage agreement.
3. Damages means money damages for which the
"covered party" may be liable by reason of the
Minnesota Civil Damages Act (M.S. 340A.801-
340A.802) or any other law governing liability for
illegal sales of alcoholic beverages.
4. Joint powers entity means an operating entity
created by two or more governmental units entering
into an agreement as provided by statute for the joint
exercise of governmental powers. An
intergovernmental agreement will be deemed to create
a joint powers entity if the agreement establishes a
board with the effective power to do any of the
following, regardless of whether the specific consent
of the constituent governmental units may also be
required:
a. To receive and expend funds;
b. To enter contracts;
c. To hire employees;
d. To purchase or otherwise acquire and hold real
or personal property; or
e. To sue or be sued.
5. Occurrence means the injury which took place if
the liability for damages arising from such injury is or
is claimed to be imposed upon the "covered party" by
the provisions of the Minnesota Civil Damages Act
(M.S. 340A.801 - 340A.802).
6. Suit means a civil proceeding in which damages
to which this coverage applies are alleged. Suit
includes an arbitration proceeding alleging such
damages to which the "city" must submit or submit
with LMCIT's consent. Suit does not mean any
criminal proceeding against any "covered party" unless
damages are also alleged in that proceeding.
LMCIT will pay, with respect to any claim or suit
LMCIT defends:
LMCIT MLLC (11 -97) (Rev. 11/10)
1. All expenses LMCIT incurs.
2. The cost of bonds to release attachments, but only
Page 3 of 6
COVENANT NUMBER: LLC 3071
for bond amount within the applicable limit of
coverage. LMCIT does not have to furnish these
bonds.
3. All reasonable expenses incurred by the "covered
party" at LMCIT's request, to assist it in the
investigation or defense of the claim or suit,
including actual loss of earnings up to $200 a day
because of time off from work.
4. All costs taxed against the "covered party" in the
suit.
5. Pre judgment interest awarded against the
"covered party" on that part of the judgment LMCIT
pays. If LMCIT makes an offer to pay the applicable
limit of coverage, LMCIT will not pay any pre
judgment interest based on that period of time after the
offer.
6. All interest on the full amount of any judgment
that accrues after entry of the judgment and before
LMCIT has paid, offered to pay, or deposited in court
the part of the judgment that is within the applicable
limits of coverage.
This coverage agreement is subject to the following
conditions:
1. LIMITATIONS ON LMCIT'S DUTY TO
INDEMNIFY
LMCIT's duty to pay on behalf of or to indemnify a
"covered party" other than the "city" shall not apply to
any act or violation:
a. Which constitutes malfeasance in office; or
b. Which constitutes willful neglect of duty; or
c. Which constitutes bad faith; or
d. For which the "city" is not authorized to indemnify
any person by statute; or
e. Which constitutes dishonesty on the part of a
"covered party ".
The terms "malfeasance ", "willful neglect of duty ",
and "bad faith" shall be given the same meaning in this
covenant as given in the applicable statute with respect
to the "city's" duty to defend or indemnify its officers,
employees or agents.
2. "COVERED PARTY'S" DUTIES IN THE
EVENT OF OCCURRENCE, CLAIM OR
SUIT
a. In the event of a claim or suit, notice containing
particulars sufficient to identify the "covered party"
and also reasonably obtainable information with
respect to the time, place and circumstances thereof,
and the names and addresses of the injured and of
LMCIT MLLC (11-97) (Rev. 11110)
available witnesses, shall be given by or for the
"covered party" to LMCIT or any of its authorized
agents as soon as practicable. The "city" shall
promptly take, at its own expense, all reasonable steps
to prevent damages from arising out of the same or
similar conditions; provided that:
(1) A failure to take such preventative measures
shall not constitute a breach of this condition
unless LMCIT has requested the "city" in writing
to undertake such preventative measures; and
(2) Such expense shall not be recoverable under
this covenant.
Notice of damages or injury is not notice of a claim.
b. If claim is made or suit is brought against the
"covered party ", the "covered party" shall immediately
forward to LMCIT every demand, notice, summons or
other process received by him or his representative.
c. The "covered party" shall cooperate with LMCIT
and, upon LMCIT's request, assist in making
settlements, assist in the conduct of suits and assist in
enforcing any right of contribution or indemnity
against any person or organization who may be liable
to the "covered party" because of damages for which
coverage is afforded under this covenant; and the
"covered party" shall attend hearings and trials and
assist in securing and getting evidence and obtaining
the attendance of witnesses. The "covered party" shall
not, except at his own cost, voluntarily make any
payment, assume any obligation or incur any expense
other than for first aid to others at the time of accident.
Page 4 of 6
COVENANT NUMBER: LLC 3071
3. ACTION AGAINST LMCIT
No action shall lie against LMCIT unless as a
condition precedent thereto, there shall have been full
compliance with all of the terms of this covenant, nor
until the amount of the "covered party's" obligation to
pay shall have been fully determined either by
judgment against the "covered party" after actual trial
or by written agreement of the "covered party ", the
claimant and LMCIT.
Any person or organization or the legal representative
thereof who has secured such judgment or written
agreement shall thereafter be entitled to recover under
this covenant to the extent of the coverage afforded by
this covenant.
No person or organization shall have any right under
this covenant to join LMCIT as a party to any action
against the "covered party" to determine the "covered
party's" liability, nor shall LMCIT be impleaded by the
"covered party" or his legal representative.
Bankruptcy or insolvency of the "covered party" or of
the "covered party's" estate shall not relieve LMCIT of
any of its obligations hereunder.
4. NO WAIVER OF IMMUNITIES
It is the express intent of the parties to this covenant
that the procurement of this covenant shall not waive
any immunities, limits, or defenses imposed by or
available under any statute or common law which is
applicable to any "covered party ".
5. CONSENT TO SETTLE
The "city" may prohibit LMCIT from settling any
claim or suit against a "covered party" without the
"city's" consent, as provided below:
a. At any time before LMCIT has offered or made a
settlement of a claim or suit, the "city" may notify
LMCIT that LMCIT may not settle the claim or suit
without the "city's" consent. The "city" must give a
separate notice for each claim or suit which the "city"
intends to prohibit LMCIT from settling without the
"city's" consent.
b. If the "city" notifies LMCIT that the claim or suit
may not be settled without the "city's" consent, the
"city" must designate an individual authorized to give
or refuse consent on the "city's" behalf. The "city's"
notice must include the name, address, and telephone
LMCIT MLLC (11 -97) (Rev. 11 /10)
number of the individual authorized to give or refuse
consent on the "city's" behalf.
c. If the "city" has notified LMCIT that the claim or
suit may not be settled without the "city's" consent,
LMCIT will notify the "city" of the terms and
conditions of any proposed settlement. If the "city"
does not consent to the proposed settlement, the "city"
must notify LMCIT within 14 days of the date the
"city" receives notice of the proposed settlement,
unless the "city" and LMCIT have mutually agreed to
a longer or shorter period. If within that time the "city"
does not notify LMCIT that the "city" does not consent
to the settlement, the "city" will be deemed to have
consented to the settlement.
d. If the "city" refuses to consent to a settlement
recommended by LMCIT, LMCIT will not be liable
for any excess amount. "Excess amount" means the
sum of all damages and legal defense costs for the
claim or suit minus the sum of:
(1) The amount of the settlement proposed by
LMCIT; and
(2) Any costs of defense incurred before the date
of the "city's" refusal. Any excess amount shall not
be included in the calculation of damages for
purposes of any applicable "Each Occurrence
Deductible" or "General Aggregate Deductible ".
e. If the "city" refuses to consent to a settlement
recommended by LMCIT, LMCIT may, at its sole
discretion, exercise either of the following options:
(1) LMCIT may pay to the "city" an amount equal
to the amount of the recommended settlement,
minus any applicable deductible. If LMCIT
makes such payment, LMCIT has no further duty
to defend or to indemnify the "city" or any other
covered party for this claim or suit, and the "city"
assumes any duty which LMCIT would otherwise
have had to defend and to indemnify any other
covered party.
(2) LMCIT may continue to defend the claim or
suit. If LMCIT elects to continue to defend the
claim or suit, the "city" must reimburse LMCIT
for any excess amount.
f. If the "city" refuses to consent to a settlement
recommended by LMCIT, the "city" must defend and
indemnify LMCIT for any claim or suit arising out of
the failure to settle the original claim or suit, including
Page 5 of 6
COVENANT NUMBER: LLC 3071
amounts the "city" may owe as a Medicare Secondary
Payer under federal law.
g. If the "city" refuses to consent to a settlement
recommended by LMCIT, and regardless of which of
the options LMCIT chooses to exercise under
subparagraph e. above, LMCIT as an agent of the
"city ", will continue to fulfill the mandatory Medicare
Secondary Payer reporting obligation under Section
111 of the Medicare, Medicaid, and SCRIP Extension
Act of 2007, if any, associated with the claim; but shall
have no payment obligation beyond the amount of the
recommended settlement amount. The "city" must
cooperate with LMCIT in providing LMCIT the
necessary information to allow LMCIT to fulfill the
reporting responsibility.
LMCIT MLLC (11 -97) (Rev. 11/10)
Page 6 of 6
Covenant Number: MUNICIPAL EXCESS LIABILITY DECLARATIONS
MEL 8540 Coverage is Provided by:
THE LEAGUE OF MINNESOTA CITIES
Previous Covenant Number: INSURANCE TRUST
MEL 8200 (Herein called LMCIT)
I_I A61 S)
j\AI NN ES() I
( PIIS
Item 1. CITY and MAILING ADDRESS:
COLUMBIA HEIGHTS, CITY OF &
COLUMBIA HEIGHTS EDA HRA
590 40TH AVENUE NE Claims Made
COLUMBIA HEIGHTS MN 55421 -3835
Item 2. COVERAGE PERIOD: 12:01 AM Standard Time at Mailing
Address Indicated on Item 1.
From: 06/01/2015 To: 06/01/2016
Item 3. RETROACTIVE DATE: 06/01/2007
Item 4. THE COVERED PARTY IS: CITY
Item 5. LIMITS OF COVERAGE:
Aggregate Limit $ 11000,000
Item 6. PREMIUM: 36,289
Item 7. FORM NUMBERS AND /OR ENDORSEMENTS FORMING A PART OF THE AGREEMENT AT ISSUE:
MELC(11 /14) UME- 49(11/03)
Executive Director, LMCIT
LMCIT DEC -017 (111196) (Rev. 11/14)
COVENANT NUMBER: MEL 8540
Various provisions in this covenant restrict coverage. covered. Words and phrases that appear in italics have
Read the entire coverage agreement carefully to special meaning, as given in SECTION III -
determine rights, duties, and what is covered and not DEFINITIONS, or in the underlying coverage.
Eye EA v - U
a. Subject to the terms, conditions, limitations,
and exclusions contained herein, LMCIT will
pay amounts in excess of what LMCIT is
obligated to pay under the terms of the
underlying coverage.
b. The amount that LMCIT will pay is limited as
described in SECTION II - LIMITS OF
COVERAGE.
c. LMCIT will only pay if the date of the claim is
on or after the retroactive date, if any, shown in
the Declarations.
d. Except as otherwise provided herein, this
coverage is subject to the same terms,
definitions, conditions and exclusions of the
underlying coverage.
2. EXCLUSIONS
In addition to the exclusions contained in the
underlying coverage, the following exclusions apply
to this coverage:
a. Any obligation to pay expenses under medical
and related expense coverage.
b. Any obligation imposed by law under any
automobile no- fault, uninsured motorist,
underinsured motorist, workers' compensation,
disability benefits, or unemployment
compensation or any similar law.
e. Any failure to supply claim.
d. Any mold claim.
e. Awards for attorney's fees pursuant to statute,
except for attorney's fees with respect to federal
civil rights suits or state human rights suits.
f. Any limited pollution liability claim except for
damages:
(a) Arising out of pesticide or herbicide
application operations;
(b) Arising from the accidental rupture,
backup, or overflow of the city's sanitary
sewer, storm sewer, or water supply
systems; or
(c) Caused by an actual, alleged, or threatened
discharge, dispersal, release or escape of
pollutants which took place entirely above
ground and not within or on the surface of
any lake, stream, surface water, or other
body of water, and in which any resulting
damages occurred entirely above ground
and not within or on the surface of any lake,
stream, surface water, or other body of
water.
g. Any outside organization claim.
h. Any claim for damages arising out of the
failure or bursting of any:
(a) Class I or Class 11 dam as classified by the
Commissioner of the Department of
Natural Resources pursuant to Minnesota
Rules §6115.0340; or
(b) Any dike, levee or similar structure.
This exclusion applies regardless of whether
underlying coverage exclusion o. in the
Comprehensive Municipal Coverage Form
CMC has been deleted or amended.
i. Any no -fault sewer back -up coverage claim or
no -fault water main break coverage claim.
LMCIT MELC (I 1 /86)(Rev. 11/14) Page 1 of
COVENANT NUMBER: MEL 8540
1. The Limits of Coverage shown in Item 5. of the
Declarations and the rules below fix the most
LMCIT will pay under the terms of this covenant
regardless of the number of
a. Covered parties;
b. Claims made or suits brought;
c. Persons or organizations making claims or
suits.
2. The Aggregate Limit is the most LMCIT will pay
under this covenant for the total of.
a. Damages and loss adjustment expenses
including defense costs and supplementary
payments for land use and special risk
litigation claims;
b. Damages and loss adjustment expenses
including defense costs and supplementary
payments for limited pollution liability
claims; and
c. Damages for all other claims to which this
covenant applies.
3. For all claims other than land use and special risk
litigation claims and limited pollution liability
claims,
a. Loss adjustment expenses including defense
costs and supplementary payments shall be
allocated between the underlying coverage and
this covenant in proportion to the amount of
damages paid under each respective covenant;
and
b. Loss adjustment expense paid by this covenant
shall be in addition to the Aggregate Limit.
Underlying coverage means the Comprehensive Coverage of the Workers Compensation and Employers
Municipal Coverage and Part Two - Employers Liability Liability Coverage as provided by LMCIT.
The additional premium for the supplemental extended
reporting period will be a percentage the annual expiring
premium for SECTION I - LIABILITY COVERAGE.
Number of Years Since
Retroactive Date Shown
on Declarations Page
Additional Cost
1
50%
2
70%
3
80%
4
90%
5+
100%
LMCIT MELC (11 /86)(Rev. 11/14) Page 2 of 2
COVENANT NUMBER: MEL 8540
THIS ENDORSEMENT MODIFIES COVERAGE PROVIDED UNDER MUNICIPAL
EXCESS LIABILITY COVERAGE, SECTION III - DEFINITIONS:
The definition of Underlying coverage is amended to read:
Underlying coverage means the following coverages as provided by LMCIT.-
1. Comprehensive Municipal Coverage;
2. Part Two- Employers Liability Coverage of the Workers Compensation and Employers Liability
Coverage; and
3. Municipal Liquor Liability Coverage.
All other terms and conditions remain unchanged.
LMCIT UME- 49(11103) Page 1 of 1
Covenant Number: AGREEMENT DECLARATIONS
0NIL 12332 DEFENSE COST
REIMBURSEMENT AGREEMENT
Previous Covenant Number: Coverage Is Provided By:
OML 11153 THE LEAGUE OF MINNESOTA CITIES
INSURANCE TRUST
(Herein called LNICIT)
Item 1. COVERED PARTY and MAILING ADDRESS:
COLUMBIA HEIGHTS, CITY OF &
COLUMBIA HEIGHTS EDA HRA
590 40TH AVENUE NE
COLUMBIA HEIGHTS MN 55421-3835
Item 2. COVERAGE PERIOD:
From: 06/01/2015 To: 06/01/2016
Item 3. RETROACTIVE DATE: 06/01/2002
Item 4. THE COVERED PARTY IS: CITY
Item 5. DEFENSE COST REIMBURSEMENT LIMITS:
1. Agreement Term Annual Aggregate Per City Official:
2. Agreement Term Annual Aggregate:
Item 6. PREMIUM: $NO CHARGE
M I N N 1:S() I A
cl-1-11-Is
12:01 AM Standard Time at
Mailing Address Indicated Above
$50,000.
$250,000.
Item 7. FORMS AND ENDORSEMENTS APPLICABLE TO AGREEMENT:
ME063(11/01) OMLRA-1(11/14)
Executive Director, LNICIT
LMCIT DEC -019 (11/93) (Rev. 11/14)
COVENANT NUMBER: OML 12332
t 1
It is understood and agreed that city is amended to include:
COLUMBIA HEIGHTS ECONOMIC DEVELOPMENT AUTHORITY
COLUMBIA HEIGHTS HOUSING AND REDEVELOPMENT AUTHORITY
All other terms and conditions remain unchanged.
LMCIT ME063 (11 /95)(Rev. 11101) Page 1 of I
COVENANT NUMBER: OML 12332
DEFENSE COST REIMBURSEMENT AGREEMENT
I. DEFENSE COST REIMBURSEMENT LMCIT's requests for information, investigative data,
COVERAGE records, or any other material documentation.
LMCIT will reimburse a city official for 100 percent of
the defense costs incurred by the city official in
defending a covered lawsuit, if the following conditions
are met:
I. The date on which the covered lawsuit is
commenced must be within the term of this
agreement; and;
2. The date on which the occurrence giving rise to the
covered lawsuit must be on or after the retroactive
date, if any, shown in the Declarations.
A covered lawsuit is deemed to be commenced on the
date the city official is served notice of the lawsuit.
II. LIMITS
The Defense Cost Reimbursement Agreement Limit
is $50,000. This is the most LMCIT will reimburse
any one city official for defense costs for covered
lawsuits commenced during the term of this
agreement, regardless of the number of lawsuits, the
number of actual or alleged violations, or the date
the defense costs are actually incurred.
2. The Defense Cost Reimbursement Annual
Aggregate Limit is $250,000. This is the most
LMCIT will pay for defense costs under this
agreement for all city officials for covered lawsuits
commenced with the term of this agreement.
III. CONDITIONS AND EXCLUSIONS
The term of this Agreement shall be one year
beginning with the effective date stated in the
Declarations. Subsequent renewals of this
Agreement shall be treated as separate terms.
2. LMCIT shall have no duty to provide a defense to a
city official with respect to a covered lawsuit;
however, LMCIT shall have the right to intervene at
its expense in the investigation or defense of such
legal action.
3. The city or the city official shall give prompt notice
to LMCIT of any actual or threatened covered
lawsuit. The city and the city official shall at all
times cooperate with and promptly respond to
4. The city official will be reimbursed only for defense
costs incurred with respect to legal services actually
rendered and expenses actually incurred.
5. The city official shall have complete freedom to
choose an attorney licensed in the State of
Minnesota to provide the city official with legal
services with respect to which defense costs are
reimbursable under this Agreement.
6. It is the express intent of the parties to this
Agreement that, neither the city nor the city official,
waive any immunities, defenses, or limitations on
liability available under Minnesota statutes or
common law.
In the event that a city official makes a recovery of
defense costs from any third party, that recovery
shall be applied first to any defense costs which the
city official has incurred which have not been
reimbursed by LMCIT; and any remainder shall be
applied to reimburse LMCIT for any payment it has
made under this Agreement.
LMCIT may cancel this Agreement by mailing or
delivering written notice to the city at least:
a. Ten (10) days before the effective date of
cancellation for nonpayment of premium for the
city's covenant that provides the following
coverages:
Municipal Property, Crime, Bond and Petrofund
Coverage;
Equipment Breakdown Coverage;
Comprehensive Municipal Coverage;
Automobile Liability Coverage; or
Automobile Physical Damage Coverage.
b. Thirty (30) days before the effective date of
cancellation for any other reason.
If LMCIT decides not to renew this Agreement,
LMCIT will mail or deliver to the city written
notice of non - renewal not less than thirty 30
days before the expiration date.
9. It is mutually understood and agreed that the city and
all other LMCIT pool participants are jointly and
severally liable for all claims and expenses of the
LMCIT 0MLRA- 1(11 /93)(Rev.11/14) Page 1 of 2
pool. The amount of any liabilities in excess of
assets may be assessed to LMCIT pool participants
when a deficiency is identified.
IV. DEFINITIONS
1. `Bankruptcy lawsuit" means a lawsuit against a
city official for actions within his or her duties as
such, that arises from or is related to the actual,
pending, or threatened bankruptcy of the city.
2. "City" means the city or other governmental body
or entity first named in the Declarations. Unless
specifically named in the Declarations, city shall not
include a gas, electrical, or steam utilities
commission; port authority, housing and
redevelopment authority, economic development
authority, area or municipal redevelopment
authority, or similar agency; municipal power
agency; municipal gas agency; hospital or nursing
home board or commission; airport commission;
welfare or public relief agency; school board; or
joint powers entity; but the following are deemed to
be a covered joint powers entity under this
agreement:
a. A joint planning board created pursuant to an
orderly annexation agreement, pursuant to
Minnesota Statute 462.3585, or pursuant to a
joint resolution between the city and a
township; or
b. A joint airport zoning board created pursuant to
Minnesota Statute 360.063.
"City official" means any former or present elected or
appointed official of the city or any present or
former employee of the city. For the purposes of
this coverage, an independent contractor is not a city
official, except when serving as a member of a
committee, subcommittee, board or commmission of
the city, or when representing the city as a member
of a committee, subcommittee, board or
commission.
4. "Covered lawsuit" means an Open Meeting Law
lawsuit or a bankruptcy lawsuit.
"Defense costs" means reasonable and necessary
attorney fees, court costs, court reporter and
transcript fees, general witness and expert witness
fees and expense, and similar defense related costs.
Defense costs does not include any fines or
penalties, or any attorney's fees awarded to a
plaintiff in a suit charging a violation of the Open
Meeting Law.
6. "Joint powers entity" means an operating entity
created by two or more governmental units entering
into an agreement as provided by statute for the joint
exercise of governmental powers. An
intergovernmental agreement will be deemed to
create a joint powers entity if the agreement
establishes a board with the effective power to do
any of the following, regardless of whether the
specific consent of the constituent governmental
units may also be required:
a. To receive and expend funds;
b. To enter into contracts;
c. To hire employees;
d. To purchase or otherwise acquire and hold real or
personal property; or
e. To sue or be sued.
7. "LMCIT" means the League of Minnesota Cities
Insurance Trust.
8. "Open Meeting Law lawsuit" means a lawsuit
seeking penalties against a city official based on an
allegation that the city official has violated M.S.
Chapter 13D, commonly known as the Minnesota
Open Meeting Law.
LMCIT 0MLRA- 1(11 /93)(Rev.11/14) Page 2 of 2