Ripon, CA 95366
City of Ripon
259 North Wilma Avenue
Proposed Insured:
Thank you very much for your submission. Based upon the information received and subject to the limitations outlined below, we are pleased to offer the following:
QUOTATION
Application #: POL0950226-05-REN
Coverage:
Form:
Insurer Information:
A+
If we are offering coverage on a surplus lines basis, the agent is responsible for handling of filings unless we note otherwise on this quotation. If we have provided terms using bid specifications or an application other than ours, the quote is subject to change pending review of a completed and signed PGU application.
Quotation / Indication valid until: 7/1/2024
Retro Date:
See coverage form PGU POL 2001 (04/2017) for terms, conditions and limitations Claims Made
01/01/2015
Filings / Taxes: PGU Not Responsible For Tax Filings
DBA: PGB Insurance Agency CA License #: 0F65220
Public Officials Management & Employment
Practices Liability
Best Rating:
A member of the AXA XL Group of Companies
Surplus Lines Insurer
Indian Harbor Insurance Company
4870 Sadler Road, Suite 102
Glen Allen, VA 23060 www.pgui.com
DBA:ÿPGBÿInsuranceÿAgencyÿCAÿlicenseÿ#:ÿ0F65220
Date: 05/10/2024
Public Officials Management & Employment Practices Liability Proposed Insured:
Public Officials Management & Employment Practices Liability City of Ripon
Limits Retentions Premium
each claim including LAE
$1,000,000 $5,000 $16,246.00
$1,000,000 $25,000 Included
$1,000,000
See Retentions Above Included
See Retentions Above Included
See Retentions Above Included
See Retentions Above Included
See Retentions Above Included
$50,000 $5,000 Included
$100,000
$25,000 $5,000 Included
Terms
Public Officials Management
Employment Practices Liability
Policy Aggregate
Features/Enhancements
Punitive Damages
Personal Injury
Third Party Wrongful Acts
Back Pay / Front Pay
Loss of Earnings
Non-Monetary Coverage - Defense Only
Non-Monetary Coverage - Defense Only Aggregate
Crisis Management
$245.00
Total Premium: $16,246.00
Policy Fee :
Premium, Fees and Taxes
Optional Increased Limits Additional Premium
5,000,000 CSL N/A
4,000,000 CSL N/A
3,000,000 CSL N/A
2,000,000 CSL N/A
Comments:
By purchasing this coverage, you will have the opportunity to register for our PGU Employer Resource Center that provides unlimited, specific, documented, and confidential advice from employment law attorneys. It also provides on-line training courses, including sexual harassment prevention, available for both supervisors and employees. As well as, on-line tools; a state-specific employee handbook builder, forms, posters, news, and more.
SUBJECTIVITIES - WE MUST BE PROVIDED WITH THESE ITEMS BEFORE COVERAGE CAN BE BOUND:
Proposed Insured:
Public Officials Management & Employment Practices Liability City of Ripon
Deadly Weapon Protection Insurance is available through Professional Governmental Underwriters, Inc. Please contact your underwriter if you are interested in additional information about this new product.
PGU 2002 04 17
IL MP 9104 0314 IHIC 03 14
PGU POL 2000 08 19
PGU POL 1045 04 17
PGU POL 1033 04 17
PGU POL 2001 04 17
PGU 1052 (POL) 04 17
Schedule of Policy Forms and Endorsements
In Witness
Public Officials and Employment Practices Liability Declarations Additional Insureds - Boards, Commissions or Units
Public Officials and Employment Practices Liability Insurance Policy Minimum Earned Premium Upon Cancellation
Defense Expenses Paid Within the Limits of Liability
PGU 1137 04 17 Federal Immigration and Nationality Act Coverage PGU 1133 01 22 US Professional Indemnity - Cyber Exclusion PGU 1140 11 23 Consumer Protection Laws Exclusion Endorsement XL-CASOP 11 10 Service of Process
Reminders:
Engineering Fee is non-refundable.
We will not cancel flat after inception date.
Applicable Forms: (Other forms may apply. Consult Underwriter for details.) Limits, retentions, terms and conditions quoted do not necessarily match those requested.
See attached Coverage Features attachment for additional information.
Backdating of coverage is not allowed.
A written request is required to bind coverage.
Minimum Earned Premium is the GREATER of $1,500 or 25% of annual premium.
This proposal contains a brief outline of coverages to be included in any policy that may be issued in the future.
This is only a summary and the Terms and Conditions of any policy will take precedence over any proposal.
PN CW 05 05 19
PN CW 02 01 19
PN CW 01 01 22
PN CA 05 01 20
PN CA 05 01 17
PN CA 02 01 17
Notice to Policyholders - U.S. Treasury Department's Office of Foreign Assets Control ("OFAC") Notice to Policyholders - Privacy Policy
Notice to Policyholders - Fraud Notice
Notice to Policyholder - California Surplus Lines Important Notice Notice to Policyholder - California Surplus Lines Notice Import Information to Policyholders - California