HomeMy WebLinkAboutAgr 2003-07-01 (Bay Cities JPA)
MEMORANDUM OF COVERAGE
FOR THE
CALIFORNIA AFFILIATED RISK MANAGEMENT AUTHORITIES
(CARMA)
TABLE OF CONTENTS
SECTION I - COVERAGE........... ....... ........ ................. ...... .............. .... ....... ............. ........................ 1
SECTION II - DEFINITIONS..... ......... .... .... ....................... .............. ........... .......... .... ....... ..,.......... .... 1
SECTION III - DEFENSE AND SETTLEMENT ............................................................................ 7
SECTION IV - CARMA'S LIMIT OF COVERAGE........................................................................ 7
SECTION V - COVERAGE PERIOD AND TERRITORy............................................................. 8
SECTION VI - EXCLUSIONS...... ......... .................... ...................................................................... 8
SECTION VII - CONDITIONS........................................................................................................ 15
FORM NUMBER -CARMA 200~m-l OGL
MEMORANDUM OF COVERAGE
FOR THE
CALIFORNIA AFFILIATED RISK MANAGEMENT AUTHORITIES
(CARMA)
In consideration of the payment of the deposit premium, the Authority agrees with the Covered
Parties as follows:
SECTION I - COVERAGE
The Authority will pay up to the Limit of Coverage those sums for Ultimate Net Loss in excess of
$1,000,000 that the Covered Parties payout of their own funds, unless otherwise provided herein, as
Damages because of Bodily Injury, Property Damage, Personal Injury, or Public Officials Errors
and Omissions as those terms are herein defined and to which this agreement applies, caused by an
Occurrence during the Coverage Period, except as otherwise excluded.
This Memorandum of Coverage does not provide insurance, but instead provides for pooled risk
sharing. This Memorandum is a negotiated agreement amongst the Members of the Authority and
none of the parties to the Memorandum is entitled to rely on any contract interpretation principles
that require interpretation of ambiguous language against the drafter of such Memorandum. This
Memorandum shall be applied according to the principles of contract law, giving full effect to the
intent of the Members of the Authority, acting through the Board of Directors in adopting this
Memorandum of Coverage. As the Authority is not an insurer, it has no obligation to provide
"Cumis" counsel to a Covered Party in disputed coverage situations under Civil Code 92860.
SECTION II - DEFINITIONS
1. "Aircraft" means a vehicle designed for the transport of persons or property principally in the
aIr.
2. "Authoritv" means the California Affiliated Risk Management Authorities.
3. "Automobile" means a land motor vehicle, trailer, or semi-trailer.
4. "Bodilv Iniurv" means bodily injury, sickness, disease, or emotional distress sustained by a
person, including death resulting from any of these at any time. Bodily Injury includes
Damages claimed by any person or organization for care, loss of services, or death resulting
at any time from the Bodily Injury.
5. "Coveraf!e Period" means that term prescribed for coverage by the Authority as set forth in
the Declarations page.
6. HCovered Indemnity Contract" means that part of any contract or agreement pertaining to
the Covered Party's routine governmental operations under which the Covered Party
assumes the tort liability of another party to pay for Bodily Injury or Property Damage to a
third person or organization. This definition applies only to tort liability arising out of an
Occurrence to which this agreement applies. Tort liability means a liability that would be
imposed by law in the absence of any contract or agreement.
7. "Covered Party" means:
(a) A Member of the Authority. This includes all entities named in its Declarations page,
including any and all commissions, agencies, districts, authorities, boards (including
the governing board), or similar entities coming under the Member's direction or
control, or for which the Member's board members sit as the governing body, except
a hospital board or commission, regardless of how such body is denominated.
(b) A member of a joint powers authority (JP A) which is a Member of the Authority
herein, which participates in said JP A's liability program. This includes ail entities
named in its Declarations page, including any and all commissions, agencies,
districts, authorities, boards (including the governing board), or similar entities
coming under the Member's direction or control, or for which the Member's board
member sits as the governing body, except a hospital board or commission,
regardless of how such body is denominated.
(c) Any person or Member identified as a Covered Party in a certificate of coverage to
third parties duly issued by the Authority for Occurrences during the Coverage
Period identified in the certificate of coverage, the person or Member is a Covered
Party only for Occurrences arising out of the described activity.
(d) Any person who is an official, employee, or volunteer of a person or Member
covered by (a), (b), or (c) herein, whether or not compensated, while acting in an
official capacity for or on behalf of such person or Member, including while acting
on any outside board at the direction of such person or Member, except a hospital
board or commission, regardless of how such a body is denominated.
(e) The Authority itself and its Board of Directors individually.
(f) With respect to any Automobile owned or leased by a Member, or loaned to or hired
for use by or on behalf of the Member, any person while using such Automobile and
any person or organization legally responsible for the use thereof, provided the actual
use is with the express permission of the Member, but this protection does not apply
to:
1. Any person or organization, or any agent or employee thereof, operating an
Automobile sales agency, repair shop, service station, storage garage, or public
parking place, with respect to an Occurrence arising out of the operation thereof;
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11. The owner or any lessee, other than the Member, of any Automobile hired by
or loaned to the Member or to any agent or employee of such owner or
lessee.
(g) No person or Member is a Covered Party with respect to the conduct of any current
or past partnership, joint venture, or joint powers authority that is not shown as a
named Covered Party in the Declarations; however, for any person (1) who is an
official, employee, or volunteer ofa Member covered by (a) or (b) herein, (2) who
participates in the activities of the partnership, joint venture, or joint powers
authority (or any separate agency or Member created under any joint powers
agreement by the named Member), and (3) who is acting for or on behalf of a
Member covered by (a) or (b) herein at the time of the Occurrence, then coverage is
afforded by this agreement. Such coverage will be in excess of and shall not
contribute with any collectible insurance or other coverage provided to the other joint
powers authority, agency, or Member.
(h) Notwithstanding sections (d) and (e) above, the defense and indemnity 'coverage
afforded by this agreement to a past or present official, employee, or volunteer of a
Member (including a member entity of a Member joint powers authority) is not
broader than the Member's duty to defend and indemnify its official, employee, or
volunteer pursuant to California Government Code Section 815, 815.3, 825 to 825.6,
995 to 996.6, inclus,ive, and any amendments thereof. If the Member which employs
the official, employee, or volunteer is not obligated under the California Government
Code to provide a defense, or to provide indemnity for a claim, or if said Member
refuses to provide such defense and/or indemnity to said official, employee, or
volunteer, then this agreement shall not provide any such defense or indemnity
coverage to said official, employee, or volunteer. All immunities, defenses, rights,
and privileges afforded to a Member under California Government Code Section
815,815.3,825 to 825.6, 995 to 996.6, inclusive, and any amendments thereof, shall
be afforded to the Authority to bar any defense or indemnity coverage under this
agreement to that Member's official, employee, or volunteer.
8. "Dam" means any artificial barrier, together with appurtenant works, which does or may
impound or divert water, and which either (a) is 25 feet or more in height from the natural
bed of the stream or watercourse at the downstream toe of the barrier, or from the lowest.
elevation of the outside limit of the barrier, if it is not across a stream, channel, or
watercourse, to the maximum possible water storage elevation; or (b) has an impounding
capacity of 50 acre-feet or more.
Any such barrier which is not in excess of6 feet in height, regardless of storage capacity, or
which has a storage capacity not in excess of 15 acre-feet, regardless of height, shall not be
considered a Dam.
No obstruction in a canal used to raise or lower water therein or divert water there from, no
levee, including but not limited to, a levee on the bed of a natural lake the primary purpose
of which levee is to control floodwaters, no railroad fill or structure, no road or highway fill
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or structure, no circular tank constructed of steel or concrete or of a combination thereof, no
tank elevated above the ground, no water or waste water treatment facility, and no barrier
which is not across a stream channel, watercourse, or natural drainage area and which has the
principal purpose of impounding water for agricultural use or storm water detention or water
recharging or use as a sewage sludge drying facility shall be considered a Dam. In addition,
no obstruction in the channel of a stream or watercourse which is 15 feet or less in height
from the lowest elevation of the obstruction and which has the single purpose of spreading
water within the bed of the stream or watercourse upstream from the construction for
percolation uriderground shall be considered a Dam. Nor shall any impoundlnent
constructed and utilized to hold treated water from a sewage treatment plant be considered a
Dam. Nor shall any wastewater treatment or storage pond exempted from State regulations
and supervision by Water Code Section 6025.5 be considered a Dam.
9. "Damaf!es" means compensation in money recovered by a third party for loss or detriment it
has suffered through the acts of a Covered Party. Damages include (1) attorney fees not
based on contract awarded against the Covered Party, (2) interest on judgments, or (3) costs,
for which the Covered Party is liable either by adjudication or by compromise' with the
written consent of the Authority, if the fees, interest, or costs arise from an Occurrence to
which this coverage applies.
10. "Defense Costs" means all fees and expenses incurred by any Covered Party, caused by and
relating to the adjustment, investigation, defense, or litigation of a claim to which this
coverage applies, including attorney's fees, court costs, and interest on judgments accruing
after entry of judgment. Defense Costs shall include adjusting expenses of a third party
claims administrator that are specifically identifiable with a claim subject to this coverage.
Defense Costs shall include reasonable attorney fees and necessary litigation expenses
incurred by or for a party other than the Covered Party, that are assumed by the Covered
Party in a Covered Indemnity Contract where such attorney fees or costs are attributable to a
claim for Damages covered by this Memorandum. Defense Costs shall include fees and
expenses relating to coverage issues or disputes that arise after a written denial of coverage,
between any Covered Party named in the Declarations and the Authority, if the Covered
Party named in the Declarations prevails in such dispute. Defense Costs shall not include
the office expenses, salaries of employees and officials, or expenses of the Covered Party or
the Authority, or attorney fees or costs awarded to a prevailing plaintiff against the Covered
Party.
11. "Limit of Coveraf!e" shall be the amount of coverage stated in the declaration page or
certificate of coverage, or sublimits as stated therein for each Covered Party per Occurrence,
subject to any lower sublimit stated in this Memorandum. For each Occurrence, there shall
be only one Limit of Coverage regardless of the number of claimants or Covered Parties
against whom a claim is made. In the event that a structured settlement, whether purchased
from or through a third-party, or paid directly by the Covered Party in installments, is
utilized in the resolution of a claim or suit, the Authority will pay only up to the an10unt
stated in the Declarations or certificate of coverage in present value of the claim, as
determined on the date of settlement, regardless of whether the full value of the settlement
exceeds the amount stated in the Declarations or certificate of coverage.
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12. "Medical Malvractice" means tbe rendering of or failure to render any of the following
servIces:
(a) Medical, surgical, dental, psychiatric, psychological counseling, x-ray, or nursing service or
treatment or the furnishing of food or beverages in connection therewith; or any services
provided by a health care provider as defined in Section 6146 (c), (2), (3), of the California
Business and Professions Code.
(b) Furnishing or dispensing of drugs or medical, dental, or surgical supplies or appliances.
Medical Malpractice does not include emergency medical services or first aid administered by
employees, nor does it include advice or services rendered by a 911 emergency dispatcher.
13. "Member" shall mean any organization that is a party to the Agreement creating the California
Affiliated Risk Management Authorities.
14. "Nuclear Material" means Source Material, Special Nuclear Material, or Byproduct Material.
"Source Material". "Svecial Nuclear Material", and "Bvvroduct Material" have the meanings given
to them by the Atomic Energy Act of 1954 or in any law amendatory thereof.
15. "Occurrence" means:
(a) With respect to Bodily Injury or Property Damage: an accident, including continuous or
repeated exposure to substantially the same generally harmful conditions, which results in
Bodily Injury or Property Damage neither expected nor intended from the standpoint of the
Covered Party. Loss of use of tangible property that is not physically injured shall be deemed
to occur at the time of the Occurrence that caused it.
(b) With respect to Personal Injury: an offense described in the definitions of those terms in this
coverage agreement.
(c) With respect to Public Officials Errors and Omissions: any actual or alleged misstatement or
misleading statement or act or omission as described in the definitions of the term in this
coverage agreement.
16. "Personal In;urv" means injury arising out of one or more of the following offenses:
(a) False arrest, detention or imprisonment, or malicious prosecution;
(b) Abuse of legal process;
(c) Wrongful entry into, or eviction of a person from, a room, dwelling, or premises that a person
occupIes;
(d) Publication or utterance of material, including continuous or repeated, that slanders or libels a
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person or organization or disparages a person's or organization's goods, products or services,
or oral or written publication of material that violates a person's right of privacy;
(e) 'Discrimination or violation of civil rights; and
(f) Injury resulting from the use of reasonable force for the purpose of protecting persons or
property .
17. "Pollutants" means any solid, liquid, gaseous or thermal irritant or contaminant, including, but not
limited to, smoke, vapor, soot, fumes, acids, alkalis, chemicals, airborne particles, or fibers and waste.
Waste includes materials to be recycled, reconditioned, or reclaimed. The term Pollutants as used
herein does not mean potable water, agricultural water, water furnished to commercial users, or water
used for fire suppression.
18. "Provertv Damaf!e" means:
(a) Physical injury or destruction of tangible property, including all resulting'loss of use of that
property; or
(b) Loss of use of tangible property that is not physically injured or destroyed.
19. "Public Officials Errors and Omissions" means any (including continuous or repeated) actual or
alleged misstatement or misleading statement or act or omission by any Covered Party (individually
or collectively) arising in the course and scope of their duties with the Covered Party or claimed
against them solely by reason of their being or having been public officials or employees, and which
results in damage neither expected nor intended from the standpoint of the Covered Party. All c1ain1s
involving the same misstatement or misleading statement or act or omission or a series of contiguous
or interrelated misstatements or misleading statements or acts or omissions will be considered as
arising out of one Occurrence.
20. "Retained Limit" means the amount, identified in the applicable Declaration or certificate, of Ultimate
Net Loss for which the Covered Party pays out of its own funds, unless otherwise provided herein,
before the Authority is obligated to make payment, subject to the following:
(a) For each Occurrence, there shall be only one Retained Limit regardless of the nUlnber of
claimants or Covered Parties against whom a claim is made.
(b) Payment of the Retained Limit shall be apportioned among the Covered Parties in accordance
with their proportionate shares of liability. If the payment is for a settlement, the Retained
Limit shall be apportioned among the Covered Parties, in accordance with the respective
parties' agreed upon or court-determined share of liability. In the event that the
apportionment requires court determination, the Covered Parties will pay all costs of the
Authority in seeking such determination, including its attorney's fees in proportion to the
court's determination of liability.
21. "Ultimate Net Loss" means the sums actually paid by the Covered Parties comprising the total of all
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Defense Costs and all Damages.
SECTION III - DEFENSE AND SETTLEMENT
The Authority shall have no duty to assume charge of investigation or defense of any claim. However, the
Authority, at its own expense, shall have the right to assume the control of the negotiation, investigation,
defense, appeal, or settlement of any claim the Authority determines, in its sole discretion, to have reasonable
probability resulting in an Ultimate Net Loss in excess of the applicable Retained Limit. The Covered Party
shall fully cooperate in all matters pertaining to such claim or proceeding.
If the Authority assumes the control of the handling ofa claim, the Covered Parties shall be obligated to pay
at the discretion of the Authority any sum necessary for the defense and settlement of a claim, or to satisfy
liability imposed by law, up to the applicable Retained Limit.
No claim shall be settled for an amount in excess of the Retained Limit without the prior written consent of
the Authority, and the Authority shall not be required to contribute to any settlement to which it has not
consented. '
SECTION IV - CARMA'S LIMIT OF COVERAGE
Regardless of the number of(1) Covered Parties under this Memorandum, (2) persons or organizations who
sustain injury or damage, or (3) claims made or suits brought, the Authority's liability is limited as follows:
(a) With respect to coverage provided, the Authority's liability for anyone Occurrence shall be
limited to the Ultimate Net Loss that is in excess of $1,000,000, which shall be the Covered
Party's Retained Limit, but then only up to the sum set forth in the Declarations as the
Authority's limit of liability for anyone Occurrence. In the event that a structured settlement,
whether purchased from or through a third-party, or paid directly by the Covered Party in
installments, is utilized in the resolution of a claim or suit, the Authority will pay only up to
the amount stated in the Declarations or certificate of coverage in present value of the clain1,
as determined on the date of settlement, regardless of whether the full value of the settlement
exceeds the amount stated in the Declarations or certificate of coverage.
(b) The Limit of Coverage for any additional Covered Party as defined in Section 2, Paragraph 4,
Subparagraph (c), subject to the per Occurrence limitation above, shall not exceed the lin1it
stated in its additional Covered Party certificate regardless of the limit which applies to the
Member.
Nothing contained herein shall operate to increase the Authority's limit of liability under this Memorandun1.
SECTION V - COVERAGE PERIOD AND TERRITORY
This agreement applies to Bodily Injury, Property Damage, Personal Injury, or Public Officials
Errors and Omissions that occurs anywhere in the world during the Coverage Period identified in
the applicable declaration or certificate of coverage.
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SECTION VI - EXCLUSIONS
This agreement does not apply to:
1. With respect to Pollution:
(a) Any liability arising out of the actual, alleged, or threatened discharge, dispersal,
seepage, migration, release, or escape of Pollutants anywhere in the world.
(b) Any loss, cost or expense arising out of any governmental direction or request that
the Authority, the Covered Party or any other person or organization test for,
monitor, clean-up, remove, contain, treat, detoxify, neutralize, or assess the effects of
Pollutants; or
(c) Any loss, cost, or expense, including but not limited to costs of investigation or
attorneys' fees, incurred by a governmental unit or any other person or organization
to test for, monitor, clean-up, remove, contain, treat, detoxify, or neutralize
Pollutants.
However, this exclusion shall not apply to Bodily Injury or Property Damage caused by a
Covered Party's response to contamination caused by a third party unrelated to a Covered
Party. Response includes clean up, removal, containment, treatment, detoxification, and
neutralization of Pollutants. In addition this exclusion does not apply to direct and
immediate Bodily Injury or Property Damage arising out of operations involving the use,
application, or spraying of any pesticide at or from any site or location not owned or
controlled by the Covered Party on which the Covered Party or any contractors or
subcontractors working directly or indirectly on behalf of the Covered Party, are performing
operations if the operation(s) performed meet all standards of any statute, ordinance,
regulation, or license requirement of any federal, state, or local government which apply to
those operations.
(d) The exclusions set forth in (a), (b), or (c) above do not apply if said discharge,
dispersal, release, or escape of Pollutants meets all of the following conditions:
1. It was accidental and neither expected nor intended by the Covered Party;
and
11. It was demonstrable as having commenced on a specific date during the term
of this policy; and
iii. Its commencement became known to the Member within seven (7) calendar
days; and
IV. Its commencement was reported in writing to the Authority within forty (40)
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calendar days of becoming known to the Member; and
v. Reasonable effort was expended by the Member to terminate the discharge,
dispersal, release, or escape of Pollutants as soon as conditions permitted.
(e) The exclusions set forth in (a), (b), or (c) above do not apply if said discharge,
dispersal, release, or escape arises from materials being collected as part of any drop
off or curbside recycling program implemented and operated by the Covered Party,
unless the materials have been stored by the Covered Party or parties for a
continuous period exceeding ninety (90) days.
(f) Nothing contained in this agreement shall operate (to provide any coverage with
respect to:
1. Any site or location principally used by the Covered Party, or by others in
the Covered Party's behalf, for the handling, storage, disposal, dumping,
processing, or treatment of waste material; except as provided in Section VI,
paragraph 1, subparagraph ( e)
11. Any fines or penalties;
111. Any clean-up costs ordered by the Superfund Program, or any federal, state,
or local governmental authority. However, this specific exclusion (c) shall
not serve to deny coverage for third party clean-up costs otherwise covered
by this endorsement simply because of the involvement of a governmental
authority;
IV. Acid rain; or
v. Clean-up, removal, containment, treatment, detoxification, or neutralization
of Pollutants situated on premises the Covered Party owns, rents, or occupies
at the time of the actual discharge, dispersal, seepage, migration, release, or
escape of said Pollutants.
2. Claims, including attorney's fees or salary or wage loss claims, by any potential, present, or'
former employee or official of the Covered Party, arising out of, but not limited to, a
violation of civil rights or employment-related practices, policies, acts, or omissions,
including termination, coercion, demotion, evaluation, reassignment, discipline, defamation,
harassment, humiliation, or discrimination directed at that person. This exclusion extends to
claims of the spouse, child, unborn child or fetus, parent, brother, or sister of that person as a
consequence of injury to the person at whom any of the employment-related practices,
policies, acts, or omissions described above are directed.
3. Bodily Injury to:
(a) An employee of the Covered Party arising out of and in the course of:
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1. Employment by the Covered Party; or
11. Performing duties related to the conduct of the Covered Party's business; or
(b) The spouse, child, Unborn child or fetus, parent, brother, or sister of the employee as
a consequence of paragraph (1) above.
This exclusion applies to any obligation to share Damages with or repay someone else who
must pay Damages because of the injury. However, this exclusion does not apply to liability
assumed under contract.
4. Any obligation under any workers' compensation, unemployment compensation, or disability
benefits law or any similar law.
These exclusions 2, 3 and 4 apply whether the Covered Party may be liable as an employer
or in any other capacity. '
5. Claims arising out of ownership, maintenance, management, supervision, or the condition of
any hospital.
6. Claims because of Bodily Injury, Personal Injury, or Property Damage arising out of
ownership, maintenance, management, supervision, or the condition of any airport.
7. Claims arising out of any professional Medical Malpractice:
(a) Committed by a doctor, osteopath, chiropractor, dentist, or veterinarian; or
(b) Committed by any health care provider, as defined in Business & Professions Code
Section 6146(c)(2), working for any hospital or hospital operated out-patient, in-
patient, or other clinic at the time of the occurrence giving rise to the loss.
8. Claims arising out of the hazardous properties of Nuclear Material.
9. Claims arising out of:
(a) Land use regulations or planning policies, annexation, or eminent domain by
whatever name called, no matter how or under what theory such claims are alleged.
Notwithstanding this exclusion, coverage is provided for the following:
(1) Property Damage resulting from weather conditions, such as rainfall,
overflow of watercourses or flooding, wind, snow, hail, or ice, acting
upon or with the Covered Party's property or equipment;
(2) Property Damage resulting from the accidental failure of Covered
Party's property or equipment;
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(3) Property Damage resulting from negligent design or maintenance of
a public work or public improvement;
(4) Property Damage resulting from inadequate design of a public work
or public improvement; and
(5) Resultant Property Damage that is neither expected nor intended
from the standpoint of the Covered Party.
With respect to Property Damage resulting from exception (1) of exclusion 9,
notwithstanding what is stated in the applicable declarations, the Limit of Coverage
for claims described in this exception to the exclusion will be subject to a sub limit of
$2,500,000 per occurrence, and to an aggregate limit of $2,500,000 per Member.
With respect to Property Damage resulting from exceptions (4) and (5) of yxclusion
9, notwithstanding what is stated in the applicable declarations, the Limit of
Coverage for claims described in this exception to the exclusion will be subject to a
sub limit of $500,000 per occurrence, and to an aggregate limit of $1,000,000 per
Member.
Notwithstanding (1) through (5) above, this agreement shall not apply to any claim
arising out of the design, construction, ownership, maintenance, operation, or use of
any water treatment plant or waste water treatment plant, no matter how or under
what theory such claim is alleged, unless it is a claim based upon the accidental
failure of the equipment utilized or contained within the water treatment plant or
waste water treatment plant.
(b) The initiative process, whether or not liability accrues directly against any Covered
Party by reason of any agreement to which a Covered Party has entered.
10. Property Damage to:
(a) Property owned by the Covered Party;
(b) Property rented to or leased by the Covered Party where it has assumed liability for
damage to or destruction of such property, unless the Covered Party would have
been liable in the absence of such assumption of liability; and
(c) Aircraft or watercraft in the Covered Party's care, custody, or control.
11. Claims arising out of the ownership, operation, use, maintenance, or entrustment to others of:
(a) any Aircraft or (b) any watercraft being used for commercial purposes. Ownership,
operation, use, or maintenance as used herein does not include static displays of aircraft in a
park or museum setting.
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12. Claims arising out of the failure to supply or provide an adequate supply of gas, water,
electricity, or sewage capacity when such failure is a result of-the inadequacy of the Covered
Party'sfacilities to supply or produce sufficient gas, water, electricity, or sewage capacity to
meet the demand.
This exclusion does not apply if the failure to supply results from direct and immediate
accidental injury to tangible property owned or used by any Covered Party to procure,
produce, process, or transmit the gas, water, electricity, or sewage.
13. Claims arising out of the ownership, maintenance, or use of any trampoline or any other
rebound tumbling device.
14. Claims arising out of a Covered Party's sponsored or controlled skateboard activities or
facilities unless those activities or facilities are covered by the Member joint powers
authority .
15. Claims arising out of bun gee jumping or propelling activities sponsored or controlled by the
Covered Party.
16. Claims arising out of a failure to perform or breach of a contractual obligation.
17. Claims arising out of liability assumed under any contract or agreement, except liability that
would be imposed by law in the absence of the contract or agreement, or when such
assumption is the subject of a duly issued Certificate of Additional Covered Party; but such
assumption is covered only up to the Limit of Coverage stated in the certificate. This
exclusion does not apply to liability assumed in a contract or agreement that is a Covered
Indemnity Contract, provided the Bodily Injury or Property Damage occurs subsequent to
the execution of the contract or agreement.
18. Fines, assessments, penalties, restitution, disgorgement, exemplary or punitive Damages.
This exclusion applies whether the fine, assessment, penalty, restitution, disgorgement,
exemplary or punitive damage is awarded by a court or by an administrative or regulatory
agency. Restitution and disgorgement as used herein refer to the order of a court or
administrative agency for the return of a specific item of property or a specific sum of
money, because such item of property or sum of money was not lawfully or rightfully'
acquired by the Covered Party.
19. Ultimate Net Loss arising out of relief, or redress, in any form other than money Damages.
20. Claims arising out of the manufacture of, mining of, use of, sale of, installation of, removal
of, distribution of or exposure to radon, asbestos, asbestos products, asbestos fibers, asbestos
dust, or other asbestos containing materials, or:
(a) Any obligation of the Covered Party to indemnify any party because of such claims,
or
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(b) Any obligation to defend any suit or claims against the Covered Party because of
such claims.
21. Claims for injury or Damages caused by intentional conduct done by the Covered Party with
willful and conscious disregard of the rights or safety of others, or with malice. However,
where the Covered Party did not authorize, ratify, participate in, consent to, or have
knowledge of such conduct by its past or present employee, elected or appointed official, or
volunteer, and the claim against the Covered Party is based solely on its vicarious liability
arising from its relationship with such employee, official, or volunteer, this exclusion does
not apply to said Covered Party.
22. Claims arising out of partial or complete structural failure of a Dam.
23. Claims by any Covered Party against its own past or present elected or appointed officials,
employees, volunteers, or additional covered parties where such claim seeks Damages
payable to the Covered Party.
24. Claims arising out of oral or written publication of material, if done by or at the direction of
the Covered Party with knowledge of its falsity.
25. Claims arising out of liability imposed on any Covered Party under any
uninsured/underinsured motorist law or Automobile no-fault law.
26. Th~ cost of providing reasonable accommodation pursuant to the Americans with
Disabilities Act, Fair Employment and Housing Act, or similar law.
27. Refund or restitution of taxes, fees, or assessments.
28. Claims for refund, reimbursement, or repayment of any monies to which a Covered Party
was not legally entitled.
29. Claims arising in whole or in part out of the violation of a statute, ordinance, order, or decree
of any court or other judicial or administrative body, or rule oflaw, committed by or with the
knowledge or consent of the Covered Party.
30. Claims arising out of estimates of probable cost or cost estimates being exceeded or faulty
preparation of bid specifications or plans including architectural plans.
31. Under Public Officials Errors and Omissions Coverage:
(a) Bodily Injury, Personal Injury, or physical injury to tangible property, including all
resulting loss of use of that property.
(b) Benefits payable under any employee benefit plan.
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SECTION VII - CONDITIONS
1. Covered Partv's Duties in the Event of Occurrence. Claim. or Suit
The following provisions are conditions precedent to being afforded coverage under this
Memorandum. The Covered Party's failure to comply with any of these provisions shall void
the coverage provided herein.
( a) The Covered Party shall notify the Authority within 30 days upon receipt of notice of
a claim, or the establishing of a reserve on any claim or suit (including multiple
claims or suits arising out of one Occurrence), such claim or reserve amounting to
fifty percent or more of the Retained Limit; Title 42 USC 1983 cases in which a
complaint has been served and with reserves of twenty- five percent or more of the
Retained Limit; or regardless of reserve, any claim involving:
1.
11.
111.
IV.
v.
V1.
Vll.
viii.
IX.
X.
XL
One or more fatalities,
Loss of a limb or amputations,
Loss of use of any sensory organ,
Spinal cord injuries (quadriplegia or paraplegia),
Third degree burns involving ten percent or more of the body,
Serious facial disfigurement,
Paralysis,
Closed head injuries,
Loss of use of any sensory organ,
Serious loss of use of any body function, or
Long-term hospitalization.
Writt~n 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 Covered Party and of
available witnesses, shall be given to the Authority or any of its authorized agents as
soon as possible.
(b) Ifa claim is made or suit is brought against the Covered Party and such claim or suit'
falls within the descriptions in paragraph (a) above, the Covered Party shall be
obligated to forward to the Authority every demand, notice, summons, or other
process received by it or its representative.
( c) The Covered Party shall cooperate with the Authority and upon its request assist in
making settlements, in the conduct of suits and in enforcing any right of contribution or
indemnity against any person or organization who may be liable to the Covered Party
because of Bodily Injury, Personal Injury, Property Damage, or Public Officials Errors
and Omissions with respect to which coverage is afforded under this agreement; and the
Covered Party shall attend hearings and trials and assist in securing and giving evidence
and obtaining the attendance of witnesses. The Covered Party shall not, except at its
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own cost, voluntarily make any payment, assume any obligation, or incur any expense
toward the settlement of any claim for which the Authority has accepted responsibility
and has so notified the Covered Party.
(d) As to any claim for which the Authority has accepted responsibility and has so
notified the Covered Party, if the Covered Party prevents settlement of the claim for
a reasonable amount, defined as the amount the Authority is willing to pay and the
claimant is willing to accept, and increases the Covered Party's potential liability for
Damages and continued Defense Costs, the Covered Party shall payor shall
reimburse the Authority for those Defense Costs incurred after the claim could have
been settled, and for any Damages awarded or settlement agreed upon in excess of
the amount for which the claim could have been settled.
(e) The Authority shall be entitled to complete access of the Covered Party's claim file,
the defense attorney's complete file, and all investigation material and reports,
including all evaluations and information on negotiations. The Covered Party shall
be responsible to report on the progress of the litigation and any significant
developments at least quarterly to the Authority, and to provide the Authority with
simultaneous copies of all correspondence provided to the Covered Party by its
defense attorneys and/or agents.
2. Bankruptcy or Insolvency
Bankruptcy or insolvency of the Covered Party shall not relieve the Authority of any of its
obligations hereunder.
3. Other Coverage
(a) Except as provided in 3(b), in order for coverage herein to apply, the Covered Party
must pay the full amount of its Retained Limit. Payment of the Retained Limit by the
Covered Party is required in addition to, and regardless of, any payment or payments
from any other source for or on behalf of that Covered Party. If insurance or any
other coverage with any insurer, joint powers authority or other source is available to
the Covered Party covering a loss also covered hereunder (whether on a primary,
excess or contingent basis), the coverage hereunder shall be in excess of, and shall'
not contribute with, such other insurance or coverage. This coverage shall be in
excess of, and shall not contribute with, any insurance or coverage which names a
Covered Party herein as an additional Covered Party or additional insured party,
where coverage is extended to a loss also covered hereunder.
(b) Commercial coverage purchased directly by a Covered Party for the sole purpose of
insuring all or a portion of its Retained Limit may be utilized to pay all, or a portion'
of, a Covered Party's Retained Limit.
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4. Severability of Interests
The term Covered Party is used severally and not collectively, but the inclusion herein of
more than one Covered Party shall not operate to increase the limits of the Authority's
liability or the Retained Limit applicable per Occurrence.
5. Accumulation of Limits
A claim which contains allegations extending to a duration of more than one Coverage
Period shall be treated as a single Occurrence arising during the first Coverage Period when
the Occurrence begins.
6. Termination
This agreement may be terminated at any time in accordance with the Bylaws of the
Authority.
7. Changes
Notice to any agent or knowledge possessed by any agent of the Authority or by any other
person shall not effect a waiver or a change in any part of this Memorandum of Coverage,
nor shall the terms of this Memorandum of Coverage be waived or changed, except by
endorsement issued to form a part of this Memorandum of Coverage.
8. Subrogation
The Authority shall be subrogated to the extent of any payment hereunder to all the Covered
Parties' rights of recovery thereof and the Covered Parties shall do nothing after loss to
prejudice such right and shall do everything necessary to secure such right. Any amounts so
recovered shall be apportioned as follows:
(a) The highest layer of coverage shall be reimbursed first and if there are sufficient
recoveries then the next highest layer shall be reimbursed until all recoveries are
used up.
(b) The expenses of all such recovery proceedings shall be paid before any
reimbursements are made. If there is no recovery in the proceedings conducted by
the Authority, it shall bear the expenses thereof.
9. Arbitration
Decisions by the Authority whether to assume control of the negotiation, investigation,
defense, appeal, or settlement of a claim, or whether or not coverage exists for a particular
claim or part ofa claim shall be made by the Board of Directors of the Authority.
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Any dispute concerning a decision of the Authority to deny coverage for all or part of a c1ailTI
shall not be subject to any court action, but shall instead be submitted to binding arbitration.
The Covered Party must exhaust the right to appeal to the Board of Directors before
requesting arbitration of a dispute.
Arbitration shall be conducted pursuant to the California Code of Civil Procedure.
Arbitration shall be conducted by a three-person panel. The Covered Party or parties shall
select one arbitrator and the Authority shall select one arbitrator, and the two arbitrators shall
select a third arbitrator upon mutual agreement. No arbitrator shall be employed or affiliated
with the Authority or the Covered Party or parties.
The selection of arbitrators shall take place within twenty (20) calendar days from the receipt
of the request for arbitration. The arbitration hearing shall commence within forty-five (45)
calendar days from the date of the selection of the arbitrators.
Each party shall bear the cost of its selected arbitrator and one-half the cost of the third
selected arbitrator. In addition, each party shall be responsible for its own costs and
expenses of arbitration.
Except for notification of appointment and as provided in the California Code of Civil
Procedure, there shall be no communication between the "parties" and the arbitrator(s)
relating to the subject of the arbitration other than at oral hearings.
The procedures set forth in California Code of Civil Procedure Section 1293.05 relating to
depositions and discovery shall apply to any arbitration pursuant to this paragraph 9.
Except as provided otherwise above, arbitration shall be conducted as provided in Title 9 of
the Code of Civil Procedure (commencing with Section 1280).
The decision of the panel of arbitrators shall be final and binding, and shall not be subject to
appeal.
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CALIFORNIA AFFILIATED RISK MANAGEMENT AUTHORITIES
(CARMA)
LIABILITY MASTER PROGRAM DOCUMENT
CALIFORNIA AFFILIATED RISK MANAGEMENT AUTHORITIES
(CARMA)
LIABILITY MASTER PROGRAM DOCUMENT
TABLE OF CONTENTS
A. LIABILITY PROGRAM............................................................ Page 1
B. COVERAGE PROVIDED... ... ... .... ..... ......... .... ........ ... ... .... ......... Page 1
C. DEFINITIONS........................................................................ Page 2
D. DEPOSIT PREMIUM ........ ...... ............................ ................... ... Page 3
E. ACTUARIALL Y SOUND yEARS................................................ Page 4
F. DIVIDENDS AND ASSESSMENTS.............................................. Page 4
G. ADMINISTRATION.................................................................. Page 5
H. CLAIMS AUDIT...................................................................... Page 6
1. MEMBERS PARTICIPATION ... ........ .... ... ......... ...... ......... ............ Page 6
J. AMENDMENTS TO THE PLAN ................................................. Page 10
K. SEVERABILITY ..................................................................... Page 10
L. SUBORDINATION ......... ......................................................... Page 10
M. DISPUTES ............................................................................. Page 10
CALIFORNIA AFFILIATED RISK MANAGEMENT AUTHORITIES
(CARMA)
LIABILITY MASTER PROGRAM DOCUMENT
A. LIABILITY PROGRAM
The Joint Powers Authority created by the California Affiliated Risk Management Authorities
(CARMA) offers participation in a risk sharing pool covering excess losses of affiliated joint powers
authorities and other public agencies in accordance with the Agreement adopted by the Members.
The assets of the pooled program shall be maintained at all times as the assets of the Members. Such
assets of the Members shall be held in trust for the Member and disbursed by CARMA on ,behalf of
the Member. Member assets may be di~bursed only on the authority of the Board, and no Member
shall have an individual right to exercise control over said assets except as provided in the Joint
Exercise of Powers Agreement creating CARMA.
B. COVERAGE PROVIDED
The Liability Program provides coverage for Bodily Injury and Property Damage, Personal Injury
and Public Officials Errors and Omissions under the terms and conditions set forth in the
M~morandum of Coverage. Initially, CARMA intends to provide coverage for a limit of$9,000,OOO
excess of $1 ,000,000 through a combination of pooling and purchasing of coverages. The type of
liability coverage, and/or limits of coverage, may be modified and changed upon Board approval.
The amount of coverage to be pooled or purchased is at the discretion of the Board.
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C. DEFINITIONS
1. "Assessment" shall mean an amount determined by the Board to be paid by each
Member as necessary to meet CARMA's obligations.
2. "Board" or "Board of Directors" shall mean the governing body of CARMA
composed of a representative of each Member.
3. "CARMA" shall mean the California Affiliated Risk Management Authorities, an
agency created by the Agreement.
4. "Devosit Premium" shall mean the annual dollar amount determined by the Board
which is payable by each Member as its established share of the funding required to
cover the financial obligations of this coverage program.
5. "Member" shall mean any organization that is a party to the Agreement.
6. "Management Contract" means that written agreement entered into between
CARMA and its administrator.
7. O.ff:Balance Ad;ustment" shall mean any difference in dollar amounts between the
Deposit Premium before adjustments for the experience modification and after.
8. "Prof!ram Year" shall mean a period of time determined by the Board, usually 12
months, into which this coverage program shall be segregated for purposes of
accounting and record-keeping.
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D. DEPOSIT PREMIUM
The Liability Program is funded through deposit premiums, and assessments (if necessary).
The Liability Program funding is determined as follows:
1. Deposit Premiums
On or before March 31 of each year, the Board shall adopt the deposit premium rate
for the next following program year.
Each Member shall pay a deposit premium to CARMA each program year. Such
deposit premiums shall consist of the amount needed to cover administrative
expenses, purchased insurance and/or reinsurance, and expected losses, plus a margin
for added confidence as determined by the Board.
Except for administrative expenses and purchased insurance and/or reinsurance, the
deposit premium shall be calculated for each Member by taking the Member's
expected annual payroll multiplied by the Board adopted rate per $100 of payroll and
then multiplied by the experience modification factor. An off-balance adjustment to
the calculation shall be made whenever the amount calculated for experience
modification varies from the amount calculated by the payroll/adopted rate. That
portion of the deposit premium for administrative expenses shall be spread dividing
40% of the Management Contract and 100% of all other administrative costs equally
and dividing the remaining 60% of the Management Contract using the uncapped
experience modification factor. Any purchased insurance and/or reinsurance shall be
spread based strictly on the rate per $100 of payroll for each Member.
2. Experience Modification Factor
The most recent six years of loss experience will be collected to determine the
experience modification for each program year. However, only the oldest four
years, years 3, 4, 5 and 6 will be used in the calculation. This will be accomplished
by utilizing the rolling six-year method, whereby the experience of the most recently .
completed program year for which data is available is added, and the oldest year is
dropped annually. Only the oldest four of the six years will be utilized in the
experience calculation.
The experience modification factor shall be calculated annually using the incurred
amount of each loss exceeding $100,000 limited to $500,000 per occurrence. Losses
shall be valued as close as possible to December 31 each year.
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The minimum experience modification factor shall be .75 for those Members with an
average loss rate better than the group average, and the maximum experience
modification factor shall be 1.25 for those Members that have an average loss
experience worse than the group average.
A credibility factor will be used in the experience modification calculation that will
be calculated by using the square root of the payroll of each Member divided by the
combined payroll of CARMA as a group. This factor will then be multiplied by the
deviation from the norm of the Member experience ratio. Finally, the sum of 1
minus the deviation calculation will be used to come up with the factored experience
modifier.
3. Rate Settine
The rates used for determining deposit premiums shall be set by the Board after
considering the recommendations of the actuary. Such rate shall ensure that
sufficient funds are collected by CARMA to cover administrative expepses and
expected losses, plus a margin for greater confidence as determined by the Board.
E. ACTUARIALL Y SOUND YEARS
The Board of Directors shall strive to maintain each program year actuarially sound and
assure that the Liability Program is actuarially sound as a whole. A deposit premium based
on the findings of an actuarial sound study shall be charged annually and allocated to the
Members in accordance with the individual Member's exposure. to loss.
To maintain'actuarial soundness, actuarial studies shall be performed every year, and action
shall be immediately taken by the Board of Directors to make up the deficit funding, if the
Liability Program as whole should be found to be actuarially deficient.
F. DIVIDENDS AND ASSESSMENTS
1. Dividends
Dividends may be declared and paid solely at the discretion of the Board after a
program year is at least 5 years old and reaches a 80% confidence level and provided
that the combined assets of the program years after the dividend shall equal or
exceed a 80% confidence level. Each share of the dividend declared shall be
allocated based on deposit premiums.
2. Assessments
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Assessments in the amount of and against a program year as determined by the
Board shall be levied on the Members at such time that an actuary finds that the
assets of the Liability Program, as a whole, do not meet the expected losses of the
'Program, inclusive of claims Incurred But Not Reported (IBNR) and Unallocated
Loss Adjustment Expenses (ULAE). Each Member's share of the assessment shall
be based upon the deposit premiums collected for the program year being assessed
provided that the amount of any assessment levied may not exceed 25% of the
deposit premium paid during the assessed program year. If such assessment is not
sufficient to relieve the pool of its actuarial deficit in the year of the assessment, such
assessment shall be levied each subsequent year until the actuarial deficit is relieved.
3. Freauencv of Dividends or Assessments
More than one dividend or assessment may be declared for each program year,
however, such dividend or assessment shall not occur more often than once every
fiscal year.
G. ADMINISTRATION
CARMA shall engage an administrator by written agreement to act as the Manager of
the Liability Program. The Manager shall:
1. General
a. use his/her best efforts to administer the Liability Program to achieve
the objectives and goals of the Liability Program and of CARMA;
b. administer the Liability Program in a manner that will provide claim
and cost accountability for each program year, separate and apart
from all other program years, and from other programs of CARMA;
2. Claims Administration
a. prepare, or cause to be prepared, a report annually which shows '
claims activity, paid claims, case reserves, obligated reserves, and
status of program funds of each program year;
b. obtain the services of a claims auditor to review claim activities of
Member and present the findings to the Board, provided the cost of
these services are within the approved annual budget;
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c. oversee performance of the Member's claims adjusters on the
handling of open claims which may penetrate the Liability Program,
including but not limited to:
(1) review, specifically, all open reportable claims and, if
necessary, recommend action on such claims;
(2) periodically, review Member's claim reports and relay
findings to the Board of any significant trends that may be
developing;
3. Financial and Actuarial
a. ensure dividend or assessment allocations for previous program
years, and rates and deposit premiums for each new program year are
calculated as set forth in this document;
b. obtain actuarial services and present the findings to the Board,
provided the cost of these services are within the approved annual
budget; and
c. evaluate and present to the Board the recommendations of the
actuarial studies with recommended actions where program years
are, or are likely to be, in the near future actuarially unsound.
H. CLAIMS AUDIT
The Board shall cause at least biennial claims audit to be made on each Member and a report of such
audit shall be filed with each Member. All costs of such claims audit shall be paid by CARMA and
shall be charged against the Members in the same manner as all other administrative costs.
I. MEMBERS PARTICIPATION
1. Eligibility and Application
a. Eligibility
(1) Only Members may participate in the Liability Program.
(2) The Member must initially commit to at least three full program
years of participation in the Liability Program.
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(3) Any applicant wishing to become a Member must submit an
application with an application fee which shall be determined by the
Board, and provide a completed and signed Resolution obligating the
Member to participate for the required three (3) program years and
accepting the rules and regulations set forth in the governing
documents of CARMA. The Member requesting to participate in the
Liability Program shall submit at least five (5) years of liability loss
experience, complete an Exposure Analysis Questionnaire, and
provide copies of the last four (4) quarterly DE-6 or Federal 941
payroll reports of each of its members.
(4) The applicant shall provide the obligatory Resolution, the experience
information, and the DE-6 or Federal 941 payroll reports at least sixty
(60) days prior to the inception of the program year in which the
applicant will commence participation, or the date the applicant
desires coverage to begin.
(5) In the event the applicant is not accredited by the California
Association of Joint Powers Authorities (CAJP A), the applicant shall,
at its own expense, be evaluated by a consultant to be chosen by the
Board for an evaluation and recommendation.
b. Approval of Application
(1) The Board shall, from a review of the Resolution, other underwriting
criteria, and the advice of the Manager, determine the acceptability of
the exposures presented by the requesting applicant.
(2) The Manager shall advise, in writing, the requesting applicant of the
decision of the Board to accept or reject the request within ten (10)
working days after the decision.
c. Date of Membership
It is desirable that a new Member enter the Liability Program at the
commencement of a new program year. If the new applicant enters at any
other time, the deposit premium may be pro rated for the remainder of the
program year, and covered losses of the new Member which occur on or
after the date of membership will be paid; however, the new Member shall be
required to share losses for the pool for the entire program year, just as if it
had begun its membership in the pool at the beginning of the program year.
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2. Member Duties
a. Cooperation with CARMA
(1) Each Member shall provide a payroll report for the calendar year,
detailed by quarter, by February 1. Each Member shall also provide
copies its member's DE-6 or Federal 941 payroll report quarterly
within thirty (30) days after filing with the State.
(2) 'Each Member shall disclose the addition of any new member( s) to the
Program.
(3) Each Member shall cooperate with CARMA in the claim
management, loss control, underwriting, and actuarial activities of
CARMA.
b. Payment of Devosit Premiums and Other Charges
(1) Annual Billings - Each year, not later than June 1, CARMA shall bill
each Member for a Liability deposit premium for the next program
year. The annual billing shall be due and payable on July 1, and shall
be delinquent if not paid on or before the last working day in July.
(2) Assessment Billings - A Member may be billed an Assessment for a
program year. This billing is due and payable upon receipt and
delinquent if not paid on or before thirty (30) calendar days after
receipt. The date of receipt shall be determined as the date the billing
was presented in person to the representative of the Member or the
date the billing was posted in the U. S. Mail.
(3) Failure to Pay Billings. Penalties. or Interest - Failure to pay billings,
penalties, or the accrued interest shall be considered grounds for
removal of the Member from the Liability Program and may result in
expulsion of the Member from CARMA in accordance with the,
CARMA Agreement.
(4) Duties of Withdrawn or Expelled Members - Withdrawn or expelled
Members which have formerly participated in the Liability ProgrmTI
shall be required to pay all applicable billings for the program years
in which they participated. Delinquent billings shall be treated in the
same manner as set forth above as if the withdrawn or expelled
Member still participated in the Liability Program.
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3. Termination of Participation
a. V oluntary Termination
(1) A Member which has completed its mandatory three-year
commitment to CARMA may terminate participation in the next
Program Year by providing to CARMA, at least six months before
the initiation of the next Program Year, a written request to terminate
participation. Such termination from CARMA shall terminate the
Member's membership in CARMA pursuant to the Joint Powers
Agreement and Bylaws effective at the end of the current program
year.
(2) CARMA reserves the right to withhold from the sums due to the
withdrawing member, in addition to any other remedies available to
CARMA Bylaws, an amount sufficient to cover administrative costs
associated with such untimely withdrawal but not less than 10% of
the renewal premium contribution.
(3) A participating Member that has not completed its mandatory three-
year commitment to CARMA shall not be permitted, at its request, to
withdraw from CARMA prior to the end of its commitment period.
b. Involuntary Termination
(1) The Board may, by 2/3rds vote of the representatives of the Members
participating in this program, tern1inate future participation by a
Member for, but not limited to, the following reasons:
1. Declination to cover the Member by the entity providing
excess coverage;
11. Nonpayment of past premiums, assessments, retrospective
adjustments, or other charges;
111. Habitual late payment of premiums, assessments,
retrospective adjustments, and/or other charges;
IV. Failure to provide requested underwriting information;
v. Development of an extraordinarily poor loss history;
V1. Substantial change in exposures which are not acceptable in
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CARMA; and/or
Vll. Financial impairment which is likely to jeopardize
CARMA's ability to collect amounts due in the future.
(2) The Board may terminate future participation by a Member with or
without cause with 2/3rds vote of the representatives of the Members
participating in this Program.
(3) The President shall send a notice of termination to the Member at
least thirty (30) days prior to termination.
c. Termination of participation, whether voluntary or involuntary, does not
relieve the terminated Member of any benefits or obligations of those
Program Years in which the terminated Member participated. These
obligations include payment .of administrative overhead, assessments,
retrospective adjustments, continuing administration costs, or any other
amounts due and payable. When termination of participation, whether
voluntary or involuntary occurs, all positive account balances for that
Member, will be withheld from redistribution and applied to future years with
negative balances until such time as the Member's account balances for all
Program Years in which the Member participated are positive.
J. AMENDMENTS TO THE PLAN
The provisions of this Document may be amended or repealed by a two-thirds vote of the
representatives of the Members participating in the Program provided prior written notice has been
given to the Members.
K. SEVERABILITY
Should any portion, term, condition or provision of this document be decided by a court of ,
competent jurisdiction to be illegal or in conflict with any law of the State of California, or the
United States, or be otherwise rendered unenforceable or ineffectual, the validity of the remaining
portions, terms, conditions and provisions shall not be affected thereby.
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L. SUBORDINATION
If this Document is in conflict with the Joint Powers Agreement, Bylaws, and/or the Memorandum
of Coverage, the terms of the Master Program Document will be subordinate to the Joint Powers
Agreement, Bylaws, and/or the Memorandum of Coverage.
M. DISPUTES
Claims disputes between Members and CARMA will be resolved according to procedure as described
in the Memorandum of Coverage.
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EMPLOYMENT RISK MANAGEMENT AUTHORITY
(ERMA)
MEMORANDUM OF COVERAGE
FOR THE PERIOD JULY 1,2003, TO JUNE 30, 2004
EFFECTIVE JULY 1, 2003
MEMORANDUM OF COVERAGE
FOR THE
EMPLOYMENT RISK MANAGEMENT AUTHORITY
(ERMA)
TABLE OF CONTENTS
SECTION I - COVERAGE......... ......... ....... ........... ........................................ ..... ....... ....................... 1
SECTION II - DEFINITIONS........................................................................................................... 2
SECTION III - DEFENSE AND SETTLEMENT ........ ....... ........................... .................... .............. 10
SECTION IV - ERMA'S LIMIT OF COVERAGE........................................................................... 11
SECTION V - COVERAGE PERIOD AND TERRITORy............................................................. 12
SECTION VI - EXCLUSIONS....................... ................................................ .................................. 13
SECTION VII - CONDITIONS.... ...... .............. ......... ........................................ .............. ................. 16
FORM NUMBER ERMA 2003-1 EPL
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MEMORANDUM OF COVERAGE
FOR THE
EMPLOYMENT RISK MANAGEMENT AUTHORITY
(ERMA)
In consideration of the payment of the deposit premium, the Authority agrees with the Covered
Parties as follows:
SECTION I - COVERAGE
The Authority will pay up to the Limit of Coverage those sums on behalf of the Covered Party for
the Ultimate Net Loss, less the Retained Limit, that the Covered Party becomes legally obligated to
pay as Damages because of Wrongful Employment Practice, as that term is herein defined and to
which this Memorandum applies, caused by an Occurrence during the Coverage Period, except as
otherwise excluded.
This Memorandum of Coverage does not provide insurance, but instead provides for pooled risk
sharing. This Memorandum is a negotiated agreement amongst the Covered Parties of the Authority
and none of the parties to the Memorandum is entitled to rely on any contract interpretation
principles which require interpretation of ambiguous language against the drafter of such
Memorandum. This Memorandum shall be applied according to the principles of contract law, .
giving full effect to the intent of the Covered Parties of the Authority, acting through the Board of
Directors in adopting this Memorandum of Coverage.
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SECTION II - DEFINITIONS
1. HAuthoritv" means the Employment Risk Management Authority.
2. HClaim" means: (a) a written demand or notice which is made or brought by an Employee,
or an oral demand or notice by an Employee which is memorialized by the Covered Party in
writing within fifteen (15) days of the oral demand or notice, and (b) seeks or alleges
Damages or alleges other injury, harm, or invasion of rights, and (c) which contains an
allegation that a Wrongful Employment Practice or a series of Wrongful Employment
Practices has been committed during the Coverage Period. Claim includes a civil action, an
administrative proceeding or charge commenced before the Equal ElTIployment Opportunity
Commission or similar state or other agency having jurisdiction over the Covered Party, or
an alternative dispute resolution proceeding, or action brought by a person or entity acting on
behalf of an Employee of the Covered Party.
Claim does not include a Union Grievance, or any type of criminal proceeding.
A Claim shall be deemed to be made on the earliest date such written demand or notice is
received by a Covered Party.
3. "Coveraf!e Period" means that term prescribed for coverage by the Authority as set forth
in the Declarations page.
4. "Covered Partv " means:
(A) All entities named in the Declarations page, including any and all commissions,
agencies, districts, authorities, boards (including the governing board).
(B) Any person who is an Employee ofa Covered Party identified in Section (A) herein,
whether or not compensated, while acting in an official capacity for or on behalf of
such Covered Party, including while acting on any outside board at the direction of
such Covered Party.
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Covered Party shall not include any person, whether or not compensated, who is not
acting in the course and scope of his or her employment or whose conduct, as a
matter of law, is not within the course and scope of his or her employment by the
Covered Party at the time of the act or acts alleged in a Claim.
(C) Notwithstanding section (B) above, the defense and indemnity coverage afforded by
this Memorandum to a past or present Employee of a Covered Party is not broader
than the Covered Party's duty to defend and indemnify its Employee, pursuant to
California Government Code Section 815, 815.3, 825 to 825.6, 995 to 996.6,
inclusive, and any amendments thereof. If the Covered Party which employs the
Employee is not obligated under the California Government Code to provide a
defense or to provide indemnity for a Claim, or if said Covered Party refuses to
provide such defense and/or indemnity to said Employee, then this Memorandum
shall not provide any such defense or indemnity coverage to said Employee. All
immunities, defenses, rights, and privileges afforded to a Covered Party under
California Government Code Section 815, 815.3, 825 to 825.6, 995 to 996.6,
inclusive, and any amendments thereof, shall be afforded to the Authority to bar any
defense or indemnity coverage under this Memorandum to that Covered Party's
Employee.
5. "Damages" means compensation in money which a Covered Party is legally obligated to
pay as a result of a Claim. Damages include: (1) attorney fees not based on contract,
awarded against the Covered Party, (2) interest on judgments, or (3) costs for which the,
Covered Party is liable either by adjudication, or by compromise with the written consent of
the Authority, if the fees, interest, or costs arise from an Occurrence to which this coverage
applies.
Damages shall not include those sums determined to be owed by a Covered Party as contract
Damages, including but not limited to retroactive or prospective benefits, or any Damages
determined to be owing for breach of an express contract of employment or under an express
obligation to make payments in the event of termination of employment.
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Damages also shall not include sums paid pursuant to any judgment or agreement, whether
injunctive or otherwise, to undertake actions to correct past discriminatory or unlawful
conduct or to establish practices or procedures designed to eliminate or prevent future
discriminatory or other unlawful conduct, or any non-monetary relief.
6. "Defense Costs" means all fees and expenses incurred by any Covered Party, caused by and
relating to the adjustment, investigation, defense, or litigation of a Claim to which this
coverage applies, including attorney's fees, court costs, and interest on judgments accruing
after entry of judgment.
Defense Costs shall not include the office expenses, salaries of Employees, or ex?enses of
the Covered Party or the Authority. Defense Costs shall not include any fee or expense
relating to coverage issues or disputes between the Authority and any Covered Party, or
attorney fees or costs awarded to a prevailing plaintiff against the Covered Party. Defense
Costs shall not include investigation costs incurred by investigators or adjusting expenses
that were not approved by ERMA prior to the costs being incurred. Defense Costs are
included within, and are not in addition to, the applicable Limit of Cover.age.
7. HDiscrimination " means termination of the employment relationship, a demotion, a failure
or refusal to hire or promote, denial of an employment benefit, or the taking of any adverse
or differential employment action becauseofrace, color, creed, religion, age, sex, disability,
pregnancy, sexual orientation, national origin, AIDS, or other protected category or
characteristic established pursuant to any applicable federal, state, or local statute or
ordinance.
8. HEmplovee" means any person whose labor or services is engaged and directed by a
Covered Party, whether past, present or future, including a volunteer, official, or applicant
for employment. This includes part-time, seasonal, and temporary labor or services, as well
as any person employed in a supervisory, managerial, or confidential position. Employee
shall not include leased employees, independent contractors or subcontractors, agents, or
servants of any Covered Party, unless the Covered Party has the right to and does control
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and directJhe details of their work rather than the result of that work. Employee also shall
not include the spouse, child, unborn fetus, parent, brother, or sister of the Employee.
9. "Harassment" means:
(A) unwelcome sexual advances, requests for sexual favors, or other verbal, visual or
physical conduct of a sexual nature, including those which:
(1) are made a condition of employment with the Covered Party;
(2) are used as a basis for employment decisions by the Covered Party; or
(3) create a work environment by a Covered Party that interferes with
performance or creates an intimidating, hostile or offensive working
environment; or
(B) workplace conduct (i.e. Harassment of a non-sexual nature) committed by a
Covered Party in violation of law or because of any protected category or
characteristic which creates a work environment that interferes with perforn1ance, or
creates an intimidating, hostile, or offensive working environment.
10. "Limit of Coveraf!e II shall be the amount of coverage stated in the Dec~arations Page, or
sublimits as stated therein for each Covered Party per Occurrence, subject to any lower
sub limit stated in this Memorandum. The Limit of Coverage shall include the Covered
Party's Retained Limit. For each Occurrence, there shall be only one Limit of Coverage
regardless of the number of claimants or Covered Parties against whom a Claim is made. In
the event that a structured settlement, whether purchased from or through a third-party, or
paid directly by the Covered Party in installments, is utilized in the resolution of a Claim or
suit, the Authority will pay only up to the amount stated in the Declarations in present value
of the Claim, as determined on the date of settlement, regardless of whether the full value of
the settlement exceeds the amount stated in the Declarations.
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11. "Occurrence" means an act, policy, or course of conduct by the Covered Party during the
Coverage Period which results in a Claim for Wrongful Employment if the last act, policy or
course of conduct by the Covered Party, without regard to any review process or appeal
relating to such act, policy or course of conduct, occurred during the Coverage Period.
All allegations by the same Employee in the same Claim shall be considered one Occurrence
for the purpose of the Limit of Coverage, and such Occurrence shall be deemed to exist on
the date of the allegation of the last act, policy, or conduct, in the event of an allegation of
multiple acts, policies, or course of conduct.
All Claims by all Employees arising from the same act, policy, or course of conduct by the
same Covered Party shall be considered as one Occurrence for the purpose of the Limit of
Coverage.
12. HRetained Limit" means the amount of Ultimate Net Loss, identified in the applicable
Declaration which the Covered Party becomes liable to pay before the Authority is obligated
to make payment.
For each Occurrence, there shall be only one Retained Limit regardless of the number of
claimants or Covered Parties against whom a Claim is made.
13. HRetaliation" means retaliatory treatment against an Employee of the Covered Party on
account of such Employee's exercise or attempted exercise of his or her rights under the law.
14. "Ultimate Net Loss" means the total of all Defense Costs incurred by the Covered Parties
and all Damages for which the Covered Parties are liable either by adjudication or by
compromise with the written consent of the Authority, arising from an Occurrence to which
this coverage applies.
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15. HUnion Grievance" means any labor negotiation with respect to wages or working
conditions, any union organizing effort or unfair labor practice charge within the jurisdiction
of the National Labor Relations Board.
16. HWorkplace Tort" means any of the following acts alleged to have been committed in
violation of law or because of any protected category or characteristic:
(A) actual or constructive termination of an employment relationship in a manner which
is alleged to have been against the law or wrongful, or in breach of an implied
employment contract or breach of the covenant of good faith and fair dealing in the
employment contract;
(B) allegations of negligent or wrongful evaluation, wrongful demotion, wrongful
discipline, failure to promote, failure to grant tenure, or wrongful deprivation of
career opportunity;
(C) allegations of misrepresentation or defamation made by an Employee which arise
from an employment decision to hire, fire, promote or demote;
(D) allegations of infliction of emotional distress, mental injury, mental anguish, shock,
sickness, disease or disability made by an Employee which arise from an
employment decision to hire, fire, promote or demote;
(E) allegations of false imprisonment, detention, or malicious prosecution made by an
Employee which arise from an employment decision to hire, fire, promote or demote;
(F) allegations of libel, slander, defamation of character, invasion of privacy made by an
Employee which arise from an employment decision to hire, fire, promote or demote;
and
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(G) other personal injury allegations made by an Employee which anse from an
employment decision to hire, fire, promote or demote.
Workplace Torts do not include Damages determined to be owing under a written contract of
e~ployment or obligation to make payments, including but not limited to severance
payments, in the event of the termination of employment.
Workplace Torts shall not include any allegations other than those set forth above.
17. HWronf!ful Emplovment Practice II means any actual or alleged Wrongful Termination,
Discrimination, Harassment, Retaliation, or Workplace Tort.
18. IIWronf!ful Termination" means termination of an employment relationship in a manner
which is alleged to have been committed in violation of law or because of any protected
category or characteristic or in breach of an implied agreement to continue employment.
Wrongful Termination shall not include Damages determined to be owing under an
express contract of employment or an express obligation to make payments in the event
of the termination of employment.
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SECTION III - DEFENSE AND SETTLEMENT
The Authority shall have no duty to assume charge of investigation or defense of any Claim.
However, the Authority shall have the right to assume the control of the negotiation, investigation,
defense, appeal, or settlement of any Claim the Authority determines, in its sole discretion, to have
reasonable probability of resulting in an Ultimate Net Loss in excess of the applicable Retained
Limit. The Covered Parties shall fully cooperate in all matters pertaining to such Claim or
proceeding.
If the Authority assumes the control of the handling of a Claim, the Covered Parties shall be
obligated to pay at the discretion of the Authority any sum necessary for the defense and s~ttlement
of a Claim, or to satisfy liability imposed by law up to the applicable Retained Limit.
No Claim shall be settled for an amount in excess of the Retained Limit without the prior written
consent of the Authority, and the Authority shall not be required to contribute to any settlement to
which it has not consented.
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SECTION IV - ERMA'S LIMIT OF COVERAGE
Regardless of the number of (a) Covered Parties under this Memorandum, (2) persons or
organizations who sustain injury or damage, or (3) Claims made or suits brought, the
Authority's liability is limited as follows:
With respect to coverage provided, the Authority's liability for anyone Occurrence
shall be limited to the Ultimate Net Loss which is in excess of the Covered Party's
Retained Limit, but then only up to the sum set forth in the Declarations as the
Authority's Limit of Covera!!e for anyone Occurrence. In the event that a structured
settlement, whether purchased from or through a third party, or paid directly by the
Covered Party in installments, is utilized in the resolution of a Claim or suit, the
Authority will pay only up to the amount stated in the Declarations in present value of
the Claim, as determined on the date of settlement, regardless of whether the full value
of the settlement exceeds the amount stated in the Declarations.
The Authoritv 's Limit ofCoveraf!e is composed of two layers. The first layer consists
of the Covered Partv's Retained Limit and then the Authoritv's pooled funds for a total
of $1.000.000. The second laver is reinsured. and is in the amount of $3 .000.000 per
Occurrence in excess of the first layer of $1.000.000 Ultimate Net Loss. regardless of
the number of Covered Parties. The reinsurer is liable for 100% of the amount by
which the Ultimate Net Loss exceeds $1.000.000 in anyone Occurrence per Covered
Partv. but shall not exceed $3.000.000 for Ultimate Net Loss for anyone Occurrence.
regardless of the number of Covered Parties. In addition. the reinsurer's liability shall
not exceed $6.000.000 Ultimate Net Loss in the aggregate per Covered Partv in anyone
CoverafJe Period regardless of the number of Occurrences. and shall not exceed
$6.000.000 Ultimate Net Loss in the aggregate in anyone Coveraf!e Period regardless
of the number of Occurrences or Covered Parties. With regard to class action suits. the
liability of the reinsurer shall not exceed $6.000.000 Ultimate Net Loss in the aggregate
regardless of the number of Occurrences or Covered Parties.
Nothing contained herein shall operate to Increase the Authority's Limit of
Coverage under this Memorandum.
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SECTION V - COVERAGE PERIOD AND TERRITORY
This Memorandum applies to Wrongful Employment Practice that occurs anywhere in the world
during the Coverage Period identified in the applicable Declaration.
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SECTION VI - EXCLUSIONS
This Memorandum does not cover:
1. Bodily Injury. We do not cover Claims:
(A) for bodily injury, sickness, disease or death of any person; or
(B) brought by the person's domestic partner, spouse, child, parent, brother or sister as a
result of such bodily injury, sickness, disease or death.
This does not apply to Claims for emotional distress, mental anguish or humiliation that arise
from a Wrongful Employment Practice.
2. Compliance with ADA Requirements. We do not cover any costs or expenses incurred to
make premises accessible to persons with disabilities as required by:
(A) the Americans with Disabilities Act of 1990;
(B) any similar federal, state or local law;
(C) any amendments to such laws; or
(D) any regulations promulgated under any such laws.
3. Contractual Liability. We do not cover the liability of others assumed by the Covered
Party in a contract or agreement. This does not apply to liability that the Covered Party
would have had in the absence of the contract or agreement.
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4. ERISA, C.OBRA and WARN Act Liability. We do not cover any liability imposed on the
Covered Party under:
(A) the Employee Retirement Income Security Act of 1974;
(B) the Comprehensive Omnibus Budget Reconciliation Act;
(C) the Worker Adjustment and Retraining Notification Act;
(D) any similar federal, state or local laws;
(E) any amendments to such laws; or
(F) any regulations promulgated under any such laws.
5. Fines, Multiplied Damages, or Non-Monetary Relief. We do not cover:
(A) fines, taxes, penalties, or liquidated Damages;
(B) the multiplied portion of any damage award that is subject to a multiplier;
(C) non-monetary relief; or
(D) any other uninsurable amounts.
6. Intentional Conduct Done with Willful and Conscious Disregard. We do not cover
Claims for injury or Damages caused by intentional conduct done by the Covered Party with
willful and conscious disregard of the rights or safety of others, or with malice. However,
where the Covered Party did not authorize, ratify, participate in, consent to, or have
knowledge of such conduct by its Employee, and the Claim against the Covered Party is
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based solely on its vicarious liability arising from its relationship with such Employee, this
exclusion does not apply to said Covered Party.
7. Intentional Violations of Laws and Orders. We do not cover Claims that arise out of a
Covered Party's intentional failure to comply with, or reckless disregard of, any law, order
or regulation relating to employment practices.
8. Prior Wrongful Employment Practices. We do not cover liability arising out of any Claim,
fact, circumstance, situation, transaction or event concerning a Wrongful Employment
Practice of which any Covered Party had received a prior Claim, or which was the subject of
any notice given under any insurance policy or coverage prior to the Covered Party
obtaining coverage under this Memorandum.
9. Property Damage. We do not cover Claims for damage to or destruction of any tangible
property, including loss of its use.
10. Strikes and Lockouts. We do not cover Claims that arise out of a lockout, strike, picket
line, replacement or other similar actions resulting from labor disputes or labor negotiations.
11. Ultimate Net Loss. We do not cover Ultimate Net Loss arising out of relief, or redress, in
any form other than money Damages or seeking only injunctive or non-monetary relief,
regardless of whether a prevailing claimant may be entitled to recover attorney's fees and
costs.
12. Workers' Compensation or Similar Law. We do not cover obligations under a workers'
compensation law, disability benefits or unemployment compensation law, or any similar
law. This exclusion does not apply to Retaliation or Discrimination for filing a workers'
compensation Claim or a Claim for disability benefits.
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SECTION VII - CONDITIONS
1. Covered Partv's Duties in the Event of Occurrence. Claim. or Suit
The following provisions are conditions precedent to coverage under this Memorandum. The
Covered Party's failure to comply with any of these provisions shall void the coverage
provided herein.
(A) The Covered Party shall notify the Authority within 30 days upon receipt of notice of
a written Claim by an Employee.
Written notice containing particulars sufficient to identify the c1aimant(s), the
Covered Party(ies), and also reasonably obtainable information with respect to the
time, place, and circumstances thereof, and the names and addresses of the Covered
Party and of available witnesses, shall be given to the Authority or any of its
authorized agents as soon as possible.
(B) Ifa suit is brought against the Covered Party, in addition to the information required
by subparagraph(A), the Covered Party shall be obligated to forward immediately to
the Authority every demand, notice, summons, or other process received by it or its
representative.
(C) The Covered Party shall cooperate with the Authority and upon its request assist in
making settlements in the conduct of suits and in enforcing any right of contribution
or indemnity against any person or organization who may be liable to the Covered
Party because of Wrongful Employment Practice with respect to which coverage is
afforded under this Memorandum; and the Covered Party shall attend hearings and
trials and assist in securing and giving evidence and obtaining the attendance of
witnesses.
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(D) The Authority shall be entitled to complete access of the Covered Party's Claim file,
the defense attorney's complete file, and all investigation material and reports,
including all evaluations and information on negotiations. The Covered Party shall
be responsible to report on the progress of the litigation and any significant
developments at least quarterly to the Authority, and to provide the Authority with
simultaneous copies of all correspondence provided to the Covered Party by its
defense attorneys and/or agents.
2. Bankruptcy or Insolvency
Bankruptcy or insolvency of the Covered Party shall not relieve the Authority of any of its
obligations hereunder.
3. Other Coverage
Ifinsurance or any other coverage with any insurer, joint powers authority or other source is
available to the Covered Party covering a loss also covered hereunder (whether on primary,
excess, or contingent basis), the coverage hereunder shall be in excess of, and shall not
contribute with, such other insurance or coverage.
This coverage shall be in excess of, and shall not contribute with, any insurance or coverage
which names a Covered Party herein as an additional Covered Party or additional insured
party, where coverage is extended to a loss also covered hereunder. In order for the
coverage herein to apply, the Covered Party must pay the full amount of its Retained Limit.
Payment of the Retained Limit by the Covered Party is required in addition to and despite
any payments from any other source for or on behalf of that Covered Party.
4. Severability of Interests
The term Covered Party is used severally and not collectively, but the inclusion herein of
more than one Covered Party shall not operate to increase the limits of the Authority's
liability or the Retained Limit applicable per Occurrence.
5. Termination
This Memorandum may be terminated at any time in accordance with the Bylaws of the
Authority.
6. Changes
Notice to any agent or knowledge possessed by any agent of the Authority or by any other
person shall not effect a waiver or a change in any part of this Memorandum of Coverage,
nor shall the terms of this Memorandum of Coverage be waived or changed, except by
endorsement issued to form a part of this Memorandum of Coverage.
7. Subrogation
The Authority shall be subrogated to the extent of any payment hereunder to all the Covered
Parties' rights of recovery thereof and the Co'vered Parties shall do nothing after loss to
prejudice such right and shall do everything necessary to secure such right. Any amounts so
recovered shall be apportioned as follows:
(A) The highest layer of coverage shall be reimbursed first and if there are sufficient
recoveries then the next highest layer shall be reimbursed until all recoveries are
used up.
(B) The expenses of all such recovery proceedings shall be paid before any
reimbursements are made. If there is no recovery in the proceedings conducted by
the Authority, it shall bear the expenses thereof.
8. Arbitration
Decisions by the Authority whether to assume control of the negotiation, investigation,
defense, appeal, or settlement of a Claim, or whether or not coverage ,exists for a particular
Claim or part of a Claim shall be made by the Board of Directors of the Authority. Any
dispute concerning such decisions shall be submitted to binding arbitration. The Covered
Party must exhaust all rights to appeal as established by the Bylaws prior to requesting
arbitration of a dispute.
Arbitration shall be conducted pursuant to the California Code of Civil Procedure.
Arbitration shall be conducted by a three-person panel. The Covered Party or parties shall
select one arbitrator and the Authority shall select one arbitrator, and the two arbitrators shall
select a third arbitrator upon mutual agreement. No arbitrator shall be employed or affiliated
with the Authority or the Covered Party or parties.
The selection of arbitrators shall take place within twenty (20) calendar days from the receipt
of the request for arbitration. The arbitration hearing shall commence within forty-five (45)
calendar days from the date of the selection of the arbitrators.
Each party shall bear the cost of its selected arbitrator and one-half the cost of the third
selected arbitrator. In addition, each party shall be responsible for its own costs and
expenses of arbitration.
Except for notification of appointment and as provided in the California Code of Civil
Procedure, there shall be no communication between the parties and the arbitrator( s) relating
to the subject of the arbitration other than at oral hearings.
The procedures set forth in California Code of Civil Procedure Section 1293.05 relating to
depositions and discovery shall apply to any arbitration pursuant to this paragraph 8.
Except as provided otherwise above, arbitration shall be conducted as provided in Title 9 of
the Code of Civil Procedure (commencing with Section 1280).
The decision of the panel of arbitrators shall be final and binding, and shall not be subject to
appeal.
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
POOLED PROPERTY PROGRAM
MASTER PLAN DOCUMENT
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
MASTER PLAN DOCUMENT
FOR THE
PROPERTY PROGRAM
TABLE OF CONTENTS
ARTICLE I-GENERAL.................................................................................................................. 1
A. AUTHORITy..................................................................................................................... 1
B. PURPOSE.................. .................................... ................................................ ..................... 1
C. RESPONSIBILITY AND AUTHORITY. ......... ................................................................. 1
D. PROGRAM YEARS ..... ....... ................ ........ ....... ............ .................................................... 2
E. LIMITS OF LIABILITy..................................................................................................... 2
F. DEDUCTIBLES ..... ....... ..... ................................ ................................................................ 2
G. FINANCING THE PROGRAM .................... .................................... ...... ...... ........ ............. 2
H. AMEND MENTS TO THIS DOCUMENT......................................................................... 3
ARTICLE II -PREMIUMS AND ASSESSMENTS ................................................... ............. ........ 4
ARTICLE III-COVERAGE .............................................. .................. ............................................ 6
ARTICLE IV-ADMINISTRATION.. .... .... .......... .... ............. ...... .... ........... .... ....... ........ ...... ............ 7
ARTICLE V-PARTICIPATION ............... ........ ............... ......................... ......... ...... .................... 10
A. ELIGIBILITY AND APPLICATION.... ............ ...... ............... ....... ........ ...... ........ ............. 10
B. PARTICIPANTS' DUTIES........................ ............... .................................. ...................... 10
C. TERMINATION OF PARTICIPATION .......................................................................... 11
ARTICLE VI-DEFINITIONS...................................................................................................... 12
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
POOLED PROPERTY PROGRAM
MASTER PLAN DOCUMENT
ARTICLE I
GENERAL
A. AUTHORITY
1. The MPD for the Pooled Property Program is intended to be the primary operational
guide for the conduct of the Authority's Pooled Property Program.
2. AUTHORITY AND STANDARDS
The Authority's Pooled Property Program has been organized under authority
granted by, and shall be conducted in accordance with, the laws of the State of
California and the standards set forth by the California Association of Joint Powers
Authorities (CAJP A) in its accreditation standards for pooled programs.
B. PURPOSE
The Authority, as a part of its overall objectives, provides a Pooled Property Program which
has been designed to provide for the needs of its Member Entities for protection against
physical injury to the Member Entities' real and personal property, including contractor's
equipment.
C. RESPONSIBILITY AND AUTHORITY
1. The Board of Directors shall have the responsibility of establishing policies and
remaining informed as to the financial strength and viability of the Pooled Property
Program. The Board has the authority, within the parameters of the Agreement and
Bylaws of the Authority and this MPD, to act as needed to maintain and develop the
financial strength of the Pooled Property Program. The Board of Directors shall
have the authority to enter into insurance contracts for the insurance coverages
within the budgeted costs of such insurance.
2. The Executive Committee shall have the responsibility and authority to effect the
general policies established by the Board of Directors.
3. The Authority Administrator shall have the responsibility to manage the daily
activities of the Pooled Property Program and shall be given the authority to
Pooled Property Program Master Plan Document Page 1
implement the policies established by the Board. The Administrator shall report to
the Executive Committee and to the Board of Directors, as necessary.
D. PROGRAM YEARS
1. A program year is defined by the term of the coverage period, generally a period of
twelve (12) months. The program years generally will begin at 12:01 a.m. on July
1, and end at 12:01 a.m. on the following July 1 except the first program year which
will begin on May 15,2003.
2. The income and expenses of this Pooled Property Program shall be accounted for and
the funds maintained separately from any other program of the Authority. An
annual contribution may be charged to each participating Member Entity at the
inception of the program year to fund the losses and expenses anticipated during
that program year.
3. Any excess funds at the end of the program year shall be retained by the Pooled
Property Program to pay claims and expenses which may be incurred in the future.
E. LIMITS OF LIABILITY
The Board of Directors shall establish an initial limit of liability for the Pooled Property
Program which may be amended from time to time for subsequent program years. This limit
of liability shall apply to each real and/or personal property claim as described in the
Memorandum of Coverage for this Pooled Property Program.
F. DEDUCTIBLES
1. A deductible, applicable to claims incurred by each Member Entity, may be
established by the Board of Directors.
2. A deductible, applicable to purchased insurance and applying to each claim for loss,
shall be established by the Board of Directors based on the ability of the Pooled
Property Program to assume such deductibles for the participating Member Entities'
and the savings in premiums with such assumption of risk of loss.
G. FINANCING THE PROGRAM
1. A reserve fund shall be established and maintained to fund adverse loss history
which may develop during the program year.
2. The deposit premiums may be used to fund the claims against the Pooled Property
Program, pay premiums for purchased coverage for participating member cities, and
pay program administrative expenses for participating Member Entities. Any
remaining deposit premiums shall be a contribution to the establishment or
maintenance of the reserve fund.
Pooled Property Program Master Plan Document
Page 2
3. If the Board of Directors determines that the Pooled Property Program lacks
sufficient funds to complete a program year, the Board of Directors, upon a two-
thirds (2/3rds) vote of the Board of Directors present and voting at a regular or
special meeting, may assess the participating Member Entities based on property
values, an amount sufficient to fund incurred costs and the completion of the
program year, or may temporarily suspend the coverage under the Pooled Property
Program until such time as the Board of Directors may vote to terminate or continue
the Pooled Property Program pursuant to Article VLC. of the Bylaws.
H. AMENDMENTS TO THIS DOCUMENT
The provisions of this document may be amended from time to time by a two-thirds (2/3rds)
vote of the Board of Directors, provided prior written notice has been given to the members
of the Board of Directors. Any provision of this document which is so amended may be
modified or repealed by a majority vote of the Member Entities which participC\te in this
program. This action must be taken within thirty (30) days after notice of the amendment to
the MPD. The appeal process may be by mail with a majority of the Member Entities
signing the appeal notice. The repeal process may also be conducted at any subsequent
regular or special meeting of the Board of Directors.
Pooled Property Program Master Plan Document
Page 3
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
POOLED PROPERTY PROGRAM
MASTER PLAN DOCUMENT
ARTICLE II
PREMIUMS AND ASSESSMENTS
A. DEPOSIT PREMIUMS
1. Each year, the Authority shall include in the annual billing, as described in
the Authority's Bylaws, the deposit premium for this Pooled Property
Program. The due dates and delinquency dates are the same as tho~e for the
annual billing.
2. The annual deposit premium for each participating Member Entity shall be
calculated by multiplying the appropriate premium rate times the values of
the covered properties for each participating Member Entity, plus an
administrative charge and the expected costs of insurance.
3. The values of the properties to be used in the calculation of the deposit
premium shall be the values collected prior to the preparation of the annual
budget each program year.
4. Deposit premiums may be established and charged to the individual
Member Entities such that, with the addition of funds raised from other
sources and the balance in the Pooled Property Program, there shall be
sufficient funds to meet expected losses, other expected expenses, and
desired contributions to the reserve fun4.
B. INTEREST AND PENALTIES
1. Members with delinquent amounts due shall be assessed a penalty which
shall be 1 percent of the unpaid an10unt due and payable to the Authority 30
days after the initial invoice due-date. A penalty of another one percent shall
accrue after an additional 45 days. Interest shall accrue on all delinquent
amounts due and payable to the Authority at the rate of 10% per annum from
the due date of the billing until the date finally posted by the designated
financial institution. Each participant shall indemnify the Authority from
any expense resulting from its failure to pay the sum due on or before the due
date. The Board may elect to temporarily suspend coverage if a member
Pooled Property Program Master Plan Document Page 4
fails to pay its contribution. For the purpose of assessing interest, each part
of a calendar month shall be treated as a whole month.
C. ASSESSMENTS
1. Any other charges, including assessments, are due and payable in accordance
with Article XIV(7)(C) of the Bylaws.
Pooled Property Program Master Plan Document
Page 5
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
POOLED PROPERTY PROGRAM
MASTER PLAN DOCUMENT
ARTICLE In
COVERAGE
A. GENERAL DESCRIPTION
'1. The coverage provided under this Pooled Property Program shall be defined in a
Memorandum of Coverage, which shall be adopted by the Board of Directors. The
Board of Directors may alter or amend the limit of liability and deductibles
applicable to the program year under the Memorandum of Coverage prior to such
program year.
2. The Board of Directors may determine to provide coverage in excess of the limit of
liability established in the Memorandum of Coverage by obtaining excess coverage
attaching at the Pooted Property Program's limit of liability. This coverage may be
obtained from an insurance company, by participating in another pool established
under the Government Code as a joint powers agency, or offered through another
Pooled Property Program pooling procedure. If the coverage is purchased from an
insurance company, such insurance company shall have an A.M. Best Rating
Classification of A- or better and an A.M. Best financial rating of VII or better.
Pooled Property Program Master Plan Document
Page 6
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
POOLED PROPERTY PROGRAM
MASTER PLAN DOCUMENT
ARTICLE IV
ADMINISTRATION
A. RESPONSIBILITY AND AUTHORITY
1. RELATION TO AUTHORITY STRUCTURE
a. This Master Plan Document (MPD) is incorporated into the Bylaws of the
Bay Cities Joint Powers Insurance Authority. As such, it shall be treated as
one of the Authority's governing documents. The MPD shall have ,the same
effect as the Agreement, Bylaws, or Memorandum of Coverage; however,
any conflict between the MPD, the Agreement, Bylaws, or Memorandum of
Coverage for property shall be determined in favor of the Agreement,
Bylaws, or Memorandum of Coverage for property.
b. The Authority's Pooled Property Program has been organized under
authority granted by, and shall be conducted in accordance with the laws of
the State of California and the standards set forth by the California
Association of Joint Powers Authorities (CAJP A) in its accreditation
standards for pooled programs.
2. BOARD OF DIRECTORS
a. The Board of Directors retains unto itself the authority to:
(1) Establish policies for the Pooled Property Program;
(2) Approve the annual budget for the Pooled Property Program;
(3) Act as needed to maintain and develop the financial strength of the
Pooled Property Program;
(4) Terminate any Member Entity from the Pooled Property Program
pursuant to Article V(C); and
(5) Terminate the Pooled Property Program.
Pooled Property Program Master Plan Document
Page 7
3. EXECUTIVE COMMITTEE
a. The Authority's Executive Committee shall have the responsibility and
authority to' carry out and perform all functions of the Pooled Property
Program not otherwise reserved to the Board of Directors.
4. ADMINISTRATOR
a. The Administrator shall use his or her best efforts to administer the Pooled
Property Program so as to achieve the objectives and goals of the Pooled
Property Program and the Authority.
b. The daily operation of the Pooled Property Program shall be administered by
the Authority's Administrator who shall report to the Authority's Board
of Directors and Executive Committee.
c. The Administrator shall be assisted by the Authority's Board Secr~tary and
Finance Manager who shall provide the technical oversight of the Pooled
Property Program, maintenance of this document, and the accounting systems
which support this Pooled Property Program.
d. The Pooled Property Program shall be administered in a manner which will
provide claim and cost accountability for the Pooled Property Program and
each participating Member Entity, separate and apart from all other
programs of the Authority.
e. The Administrator shall:
(1) Assist the participating Member Entities in training their personnel
in the correct procedures for timely and accurately reporting of
claims;
(2) Accept loss notices and supporting documents;
(3) Evaluate and pay claims in accordance with the Memorandum of '
Coverage;
(4) Determine the possibility of recovery through subrogation and
coordinate such action with the Member Entity where appropriate;
(5) Act as liaison between the insurance broker, claims adjusting firm,
and the Member Entities;
(6) Prepare and submit a budget for each program year to the Executive
Committee for review and to the Board of Directors for approval
prior to the program year;
Pooled Property Program Master Plan Document
Page 8
(7) Prepare and submit an annual report to the Board of Directors;
(8) Recommend rates and deposit premiums for each new program
year in the manner described in Article II;
(9) Invoice participating Member Entities for deposit premiums and
other amounts due;
(10) Report to the Board of Directors any delinquent billings not paid and
outstanding in excess of 60 days; ,
(11) Prepare demands for payment on claims against the Pooled Property
Program;
(12) Present timely annual financial statements to the Board of-Qirectors
and the Executive Committee;
(13) Provide other services as may reasonably be requested by the Board
of Directors, the Executive Committee, or a Member Entity;
(14) Have the authority to engage outside legal counsel for the purpose of
providing an opinion regarding the scope of coverage provided under
this program, as necessary;
(15) Secure the services of an actuarial consultant, as necessal}'; and
( 16) Work with the Board of Directors in securing the services of a
claims adjusting firm.
5. CLAIM SETTLEMENT AUTHORITY
a. The Administrator and the claims adjusting firm shall review all claims
properly submitted and make a determination as to applicability of coverage'
and amount of the loss. Upon such determination, the Administrator shall
advise the Member Entity experiencing the loss and process a payment to
the Member Entity where appropriate.
b. Any decision of the applicability of coverage or amount of the loss by the
Administrator may be appealed to the Board of Directors within thirty (30)
days after notice of the decision to the Member Entity. The decision of the
Board of Directors shall be final.
Pooled Property Program Master Plan Document
Page 9
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
POOLED PROPERTY PROGRAM
MASTER PLAN DOCUMENT
ARTICLE V
PARTICIPATION
A. ELIGIBILITY AND APPLICATION
1. To participate in the Pooled Property Program, the applicant must be a member of
the Authority. All Member Entities are eligible for participation in the Pooled
Property Program.
2. An applicant may apply for participation at any time during a program year.
3. The applicant must apply for participation in the Pooled Property Program by
providing all information requested by the Administrator.
4. Upon receipt of the requested information, the Authority Administrator shall
prepare a quote for coverage for the applicant Member Entity.
5. Once the applicant Member Entity accepts the quote for coverage, a letter from the
applicant Member Entity shall be sent to the Authority Administrator indicating
the date on which the Member Entity is requesting coverage.
6. The applicant must commit to at least three full program years of participation' in the
Pooled Property Program.
B. PARTICIPANTS' DUTIES
1. Each participating Member Entity shall be responsible for providing the data '
required by the Authority to determine the values of covered properties. This data
shall be factual and provided in a timely manner.
2. After completion of the initial three-year period, a participating Member Entity who
requests withdrawal from the Pooled Property Program shall be obligated to remain
in the Pooled Property Program until the end of a program year.
3. A participating Member Entity requesting to withdraw from the Pooled Property
Program shall give written notice to the Authority at least six months prior to the
end of a program year.
Pooled Property Program Master Plan Document
Page 10
C. TERMINATION OF PARTICIPATION
1. A participating Member Entity shall be obligated to remain in the Pooled Property
Program until the end of the initial three-year period.
2. A participating Member Entity shall participate in the next program year unless:
a. At least six months prior to the end of the program year a request to
terminate participation is received from the participating Member Entity, or
b. At least thirty (30) days prior to the end of the program year a termination
notice has been sent to the participating Member Entity.
3. The Board may initiate termination offuture participation for the following reasons:
a. Termination as a member of the Authority;
b. Non-payment of premiums, assessments, or other charges;
c. Frequent late payment of premiums, assessments, and/or other charges,
subject to interest and penalty charges;
d. Failure to timely provide requested underwriting information;
e. Consistent poor loss history relative to the pool;
f. Substantial change in exposures which are not acceptable in this program;
and/or
g. Financial impairment that is likely to jeopardize this program's ability to
collect amounts due in the future.
Pooled Property Program Master Plan Document
Page 11
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
POOLED PROPERTY PROGRAM
MASTER PLAN DOCUMENT
ARTICLE VI
DEFINITIONS
The words in bold print are defined in the Authority's governing documents.
Pooled Property Program Master Plan Document
Page 12
RESOLUTION NO. 7-2002/2003
RESOLUTION OF THE BOARD OF DIRECTORS
OF THE BAY CITIES JOINT POWERS INSURANCE AUTHORITY
ESTABLISHING ADMINISTRATOR'S DUTIES REGARDING THE
PROSPECTIVE MEMBER APPLICATION PROCESS
WHEREAS, the Authority Board of Directors desires to provide additional guidance to the
Authority Administrator regarding the prospective member application process;
NOW, THEREFORE, BE IT RESOLVED by the Board of Directors as follows:
1. In implementing the prospective member application process, the Authority
Administrator shall follow these procedures:
a. Upon request from an eligible entity (applicant), the Administnltor shall
obtain the necessary information from the applicant to prepare an initial price
indication for coverage.
b. The Administrator shall also send a letter with the prospective member
packet. This packet generally contains all the relevant documents such as
governance, budget, membership, program data, and services to be provided.
In addition, this letter will include an explanation of the Authority's process
for admission of prospective member districts as outlined in the Bylaws,
including the requirement for a $1,000 application fee which must be
submitted to further process the application. It will be described that the fee
is only refundable upon Board approval of admission as a new member.
c. Upon receipt of the $1,000 application fee, the Administrator may do the
following:
(l) Meet and explain fully the Authority's insurance and self-insurance
programs and respond to related inquiries of applicant;
(2) Advise applicants in compiling and submitting underwriting data to
the Authority;
( 3) Review all underwriting data and make recommendations to the
Authority Board of Directors regarding applications;
(4) Conduct a limited risk exposure review by the BCJPIA Risk Control
Manager; and
( 5) Send notification to the applicant upon acceptance/rejection from the
Authority Board of Directors.
3. These procedures may be amended from time to time by subsequent resolution of the
Authority Board of Directors.
4. If there is any inconsistency between any provisions of the Authority Joint Exercise
of Powers Agreement, Bylaws, master plan documents, or memoranda of coverage
(the "governing documents") and this Resolution, the provisions of the governing
documents shall prevail.
This Resolution of the Board of Directors was adopted this 8th day of May, 2003 in Emeryville,
California by a majority vote of the Board of Directors then present at a regular meeting of the
Board:
AYES 16
NOES 0
ABSTAIN 0
ABSENT 1
SIGNED:
PRESIDENT
ATTEST:
SECRETARY TO THE BOARD OF DIRECTORS
RESOLUTION NO. 8-2002/2003
RESOLUTION OF THE BOARD OF DIRECTORS
OF THE BY CITIES JOINT POWERS INSURANCE AUTHORITY
AMENDING THE BYLAWS DETAILING MANAGEMENT POSITIONS
WHEREAS, the Authority desires to amend its Bylaws to provide in detail those management
positions acceptable as representatives or alternate representatives to the BCJPIA Board of
Directors; and
WHEREAS, Article VI, Section I.A. of the Bylaws currently states the following: "Each director
shall be the Chief Administrative Officer of each Member Entity or his or her designee
which must be from within the ranks of management and from an appropriate area of
management. "
NOW, THEREFORE, BE IT RESOLVED by the Board of Directors as follows:
The Bay Cities Joint Powers Agency Bylaws, are hereby amended to define "appropriate area of
management" to mean the following the positions or their equivalent:
City Attorney
Assistant City Attorney
Financial Officer
City Administrator
City Manager
Assistant/Deputy City Manager
Human Resources Manager
Administrative Services Director
This Resolution of the Board of Directors of the Bay Cities Joint Powers Insurance Authority was
adopted this 8th day of May 2003 in Emeryville, California by a majority vote of the Board members
then present at a regular meeting of the Board.
AYES 16
NOES 0
ABSTAIN 0
ABSENT 1
SIGNED:
President
ATTEST:
Secretary to the Board of Directors
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
MASTER PROGRAM DOCUMENT
FOR THE
WORKERS' COMPENSATION PROGRAM (WCP)
ARTICLE I: GENERAL
A. AUTHORITY
1. The Workers' Compensation Program (WCP) Master Program Document of the Bay
Cities Joint Powers Insurance Authority (Authority), shall be treated as one of the
Authority's governing documents. However, any conflict between the WCP Master
Program Document, the Authority's Joint Exercise of Powers Agreement
(Agreement), or the WCP Memorandum of Coverage (MOC) shall be determined in
favor of the Agreement or the MOC.
2. The WCP Master Program Document is intended to be the primary source of
information, contain the rules and regulations, and serve as the operational guide for
the conduct of the WCP.
3 The WCP has been organized under authority granted by, and shall be conducted in
accordance with, the laws of the State of California; regulations prescribed by the
Department of Industrial Relations (DIR) and the State of California Audit Unit; and
the accreditation standards set forth by the California Association of Joint Powers
Authorities (CAJPA).
B. PURPOSE
The Authority, as a part of its overall objectives, has designed the WCP to provide for the
varied needs of its member cities in the area of workers' con1pensation liability.
C. PARTICIPATION
1. All member cities of the Authority may become a participant (Participant) in the
WCP, and are encouraged to do so. However, the terms and conditions which may be
imposed on a member city which desires to join the WCP may be different,
depending upon payroll, number of employees, the size of the city, its loss record,
and other pertinent information.
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D. GOVERNANCE
Each member city's appointed primary representative and one alternate representative shall
be the representative for the WCP. The member city will be entitled to one vote on all issues
or decisions that involve the WCP. It is expected, but not mandatory, that the primary
representative from each member city will be the individual designated as the member city's
appointee to the Governing Body and that the alternate representative(s) will be the
individual(s) designated as the member city's alternate representative on the Governing
Body.
E. GOALS AND OBJECTIVES
1. The Authority offers its member cities this WCP designed to provide coverage for
the liabilities imposed by the workers' compensation laws of California as well as
those imposed by common law upon employers.
2. The WCP shall provide workers' compensation coverage for the Participants utilizing
an optimum mix of risk retention and risk transfer. The WCP shall provide various
levels of retentions for the Participants, provide a risk sharing pool for losses above
individual retention levels up to the Authority's Self-Insured Retention (SIR), and
obtain excess coverage for the amount of the loss which exceeds the Authority's SIR.
Additionally, the WCP shall provide for the sharing of operating costs and payment
of the excess coverage by charging all Participants their share of such costs.
3. Although the WCP is provided to the Participants under those terms and conditions
which prevail at' the time of the Participant's joining the WCP, the Governing Body
shall have the right to alter, from time to time, the terms and conditions of the excess
coverage and the pooled underlying coverage in response to the needs and abilities of
the WCP and the participating cities, as well as in response to availability of
coverage from outside sources.
4. The Authority offers participation in a risk sharing pool, covering losses of
Participants in accordance with the Agreement adopted by the member cities. The
assets of the pooled program shall be maintained at all times as the assets of the '
Participants collectively. The assets may be disbursed only pursuant to the provisions
of this Master Program Document, and no Participant shall have an individual right
to exercise control over said assets except as provided in the Agreement.
5. The WCP will provide coverage for injuries and illnesses to the Participants'
employees under the terms and conditions set forth in the MOC. In addition to the
coverage provided by the MOC, the Authority may purchase excess insurance or
reinsurance. The amount of coverage to be pooled and/or purchased is at the
discretion of the Governing Body.
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ARTICLE II: PROGRAM ELEMENTS
A. PROGRAM YEARS
1. \ A program year is defined by the term of the coverage period, generally a period of
12 months. The WCP will have program years which begin at 12:01 a.m. on July 1
and end at midnight on the following June 30.
2. Each program year shall be accounted for separately. The income and expenses of
each program year shall be accounted for separately from any other program years'
income or expenses.
3. A program year shall not be closed until such time that the Governing Body
authorizes closure, being convinced that known claims for the year are all closed and
the probability of further claims being discovered is minimal. Any clo~ed years,
however, may be reopened if deemed necessary and approved by the Governing
Body.
B. RETAINED LIMITS
The WCP shall annually establish the limit of coverage for the pool. The underlying
coverage of the WCP shall provide Participants retained limits of $150,000, $250,000,
$350,000, and $500,000 per occurrence, or other limits as modified by resolut~on. The
Participants may annually select their retained limit as approved. The amount of each loss,
including expenses, which is less than the retained limit chosen by the applicable Participant,
shall be paid by the Participant.
C. DEPOSIT PREMIUMS
1. Annually, each Participant shall pay a deposit premium to the Authority for each
program year. Such Deposit Premiums shall consist of the amount needed to cover
excess insurance or reinsurance premiums (if any), administrative expenses and
actuarially-determined losses, plus a margin for added confidence as determined by ,
the Governing Body.
2. The deposit premium shall be initially calculated for each Participant by taking the
Participant's expected annual payroll, as determined by the State DE-6 form
provided by each Participant, multiplied by the Governing Body adopted rate per
$100 of payroll. After the end of the program year, adjustments from expected to
actual payroll shall be made. Debit adjustments shall be billed to the Participant, and
credit adjustments will apply to next year's billings. An annual audit of a
Participant's payroll may be conducted by the Authority.
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3. The deposit premium shall also include:
(a). All volunteers declared or otherwise required to be covered. The value of the
volunteers' service shall be based upon a flat rate per volunteer; and
(b). All other persons engaged in work that could make the Authority liable under
Part One (workers' compensation insurance) of the MaC. If the Participant
does not have payroll records for these persons, the contract price
remuneration for their services and materials may be used as the premium
basis. This paragraph will not apply if the Participant gives the Authority
proof that the employers of these persons lawfully secured their workers'
compensation obligations.
4. EXPERIENCE MODIFICATION
( a) Each member entity shall be evaluated each year for an experience
modification adjustment that shall be applied to the deposit premIum.
(b) The calculation of the adjustment shall include the actual loss experience of
the individual member entity as it relates to the average loss experience of
the group as a whole. Such loss experience shall not consider loss years that
are more than three years old. The criteria that shall be used is the
relationship of actual average loss experience over the period being rated as it
relates to the average payroll for the same period.
D. DIVIDEND AND ASSESSMENTS
1. DIVIDENDS
(a). Five years after the end of the program year, the first dividend calculation
shall be performed. Each year thereafter there shall be an additional dividend
calculation made until such time as the program year is closed. Any
dividends available to be declared and returned to the Participants will be at,
the discretion of the Governing Body.
(b). Calculation
1. Dividends are available to be declared only at such time as the WCP
has equity, with liabilities actuarially stated discounted at an 80%
confidence level. The calculated amount shall represent the maxin1um
dividend available to be declared.
11. This amount shall be reduced if the two succeeding years (after the
fifth year of the program year reaches eligibility) have negative
4
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equity, with liabilities actuarially stated at an expected confidence
level.
111. Each Participant's share of any refunds shall be allocated based upon
the method in which they were collected, beginning with the oldest
program year. However, until the last claim of a program year has
been paid and the program year has been closed, the program year
must maintain sufficient funds to satisfy the 80% confidence level
discounted requirement.
2. ASSESSMENTS
(1) Assessments may be levied for the risk sharing layer of any program year( s),
as approved by the Governing Body, on the Participants at such time that an
actuary finds that the assets of the WCP, as a whole, do not meet the
expected un discounted losses of the WCP. Each Participant' s sh~re of the
assessment shall be allocated based upon the deposit premiums collected for
the risk sharing layer of each respective program year being assessed. If such
assessment is not sufficient to relieve the pool of its actuarial determined
deficit in the year of the assessment, such assessment shall be levied each
subsequent year until the actuarial determined deficit is relieved. The timing
of payment shall be determined by the Governing Body at the time of
assessment.
(2) Equity, from the risk sharing layer, may be exchanged between eligible
program years if sufficient funds are available. The transfer of equity will be
performed such that the individual Participant's share of equity is separately
applied so as to maintain the integrity of each Participant's balance.
E. EXCESS COVERAGE
1. The Governing Body shall ensure that each program year is provided with excess
workers' compensation coverage for the Participants. It is the intent and purpose of
the Authority to continue to provide such coverage to the Participants, provided that
such coverage can be obtained, and the coverage is not unreasonably priced. This
coverage may be obtained from an insurance company, by participating in another
pool established under the Government Code as a joint powers authority, or offered
through another WCP pooling procedure. If the coverage is purchased from an
insurance company, such insurance company shall have an A.M. Best Rating
Classification of A- or better and an A.M. Best Financial Rating of VII or better or
their equivalents.
2. The Authority, through the WCP, shall provide, where economically practical, at
least $10,000,000 of total combined limits. Total combined limits is the maximum
this WCP will pay for each injury or illness, regardless of whether the liability arises
from Workers' Compensation Laws, Employer's Liability, or a combination ofthese.
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3. Premiums for such coverages shall be paid by the WCP from the proceeds received
as deposit premiums from the Participants.
4. The Governing Body may, from time to time, alter excess coverage based on
insurance market conditions, available alternatives, costs, and other factors. The
Governing Body shall place excess coverage with the two competing objectives of
security and minimizing costs to the WCP as a whole.
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ARTICLE III: ADMINISTRATION
A. GOVERNING BOARD
1. Discussion of developments and performance of the WCP may occur as part of any
scheduled Governing Body meeting.
2. The Governing Body retains unto itself the authority as consistent with the
Agreement.
3. The Governing Body shall have the responsibility and authority to carry out and
perform all functions, and make all decisions affecting the WCP, consistent with the
powers of the Authority and not in conflict with the Agreement, the Bylaws, or the
MOC. '
B. EXECUTIVE COMMITTEE
1. The Executive Committee shall have the responsibility and authority to carry out and
perform all other functions, and make all decisions affecting the WCP, provided that
such functions and decision are consistent with the powers of the Authority and are
not in conflict with the Agreement, the Bylaws, or the Memorandum of CoveFage.
2. The Executive Committee shall meet at least twice a year to review the developments
and performance of this WCP. The Executive Committee shall review, study, advise,
make recommendations to the Governing Body, or take any action which the
Committee believes to be in the best interests of the WCP and its member entities,
provided that such action is not prohibited by law or is not an action reserved unto
the Governing Body of Directors.
C. ADMINISTRATOR
The Administrator shall be responsible for:
1. The overall operation of the WCP;
2. Monitoring the status of the WCP and its operations, the development of losses, the
program's administrative and operational costs, service companies' performance, and
brokers' performance;
3. Assisting the Board in selecting brokers, actuaries, auditors, and other service
companIes;
4. PrOlTIoting the programs to prospective new Participants;
5. Preparing, distributing, and maintaining all records of the WCP, including its Master
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Program Document and MOC as these may be amended from time to time; and
6. Preparing Certificates of Coverage and Waivers of Subrogation as may be required
by the Participants in the WCP.
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D. WORKERS' COMPENSATION PROGRAM MANAGER'S DUTIES
The Workers' Compensation Program Manager (WCPM), unless otherwise modified by
resolution, shall:
1. Generally, oversee all workers' compensation claims administration and management
and report to the Administrator;
2. Develop for Board approval of performance standards third party administrators;
3. Maintain files on all claims reported to the Authority;
4. Recommend to the Governing Body the setting of reserves for those cases that are
likely to penetrate to pooled funds;
5. Upon the reporting of each claim that has an expectation of exceeding the minimum
incurred loss threshold set by the Governing Body, review said claim for the
Authority and report said claims to the Governing Body at the next scheduled
meeting;
6. Review the progress of all reported claims for the Authority and, if directed by the
Governing Body, propose reserve changes, and/or take control and assume
settlement authority for the claim;
7. Recommend claim settlements to the Governing Body for approval;
8. Annually, prepare a detailed report on the WCP, showing the activity by program
year and the cumulative activity of all years, including number of claims, losses
which have been incurred by each Participant, and the losses which have been shared
through pooling;
9. Assist the Participants in training their personnel in the correct procedures for timely
and accurately reporting claims;
10. As required, provide advice and assistance to Participants;
11. Periodically review third party claims administrators' claims files. The review
should include the new indemnity claims reported, claims currently open and
reported twelve months prior, and those claims for which a Participant has requested
a specific review;
(a). Provide guidance to the claims adjuster on the management of problem or
complex claims;
(b). Advise, where needed, on the selection of legal representation in anticipation
of litigation;
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( c). Monitor and evaluate the effectiveness of the defense firms and the
management of the litigation;
(d). Monitor and evaluate the effectiveness of medical treatment as respects
claims costs, especially those involving complex medical issues;
( e). Evaluate, where needed, recommendations. for settlement of claims;
(f). Mediate differences, if any, between the claims adjuster and a Participant;
and
(g). Review the performance of the claims adjusters' personnel assigned to the
Authority's account with special emphasis in the handling of "open claims."
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ARTICLE IV: CLAIMS ADMINISTRATION
A. CLAIMS PROCEDURES MANUAL
1. A Workers' Compensation Claims Procedures Manual (Manual) including reporting
procedures, forms, and other vital information shall be adopted by the Governing
Body and provided to all Participants.
2. All Participants shall be held accountable for understanding and abiding by the
procedures stated in the manual, as well as any changes thereto.
B. CLAIMS AUDIT
1. At least once every two years, the adequacy of claims adjusting for both the
Authority and the Participants shall be examined by an independent au~itor who
specializes in claims auditing.
2. The Governing Body shall approve the claims auditor. The costs of such claiIns
audit shall be paid by the Authority.
3. The claims audit report shall address the issues of both adequacy of claims
procedures and accuracy of claims data. The report shall be filed with the Authority
and sent to each Participant.
C. CLAIM SETTLEMENT AUTHORITY
1. Participants - Each Participant shall have settlement authority for all claims,
including attorney fees and other costs, which do not exceed 100% of the
Participant's Retained Limit. The WCPM will review these claims from time to tin1e
and may offer hislher recommendation to the Participant's Third Party Administrator
(TP A) and the Participant regarding settlement.
2. The WCPM shall have settlement authority for all claims which exceed 100% of the '
Participant's retained limit, but only up to $50,000. The Executive Committee shall
have settlement authority above $50,000 and up to $250,000 above each Participants'
Retained Limit. The Governing Body shall have settlement authority above $250,000
up to the Self-Insured Retention of the Authority. The administrator and the WCPM
will ensure that the Participant is kept informed regarding these claims, and will take
into consideration the Participant's desires in any settlement process; however, the
Administrator and the WCPM shall keep the best interests of the Participants
paramount in any decision. Any claims settlement decision made by the
Administrator or WCPM may be appealed to the Governing Body within 30 days
after notice of the decision to the Participant. The decision of the Governing Body
shall be final.
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D. DISPUTES BETWEEN PARTICIPANTS AND ADMINISTRATOR OR WORKERS'
COMPENSATION PROGRAM MANAGER, OR COMMITTEE
1. Any matter in dispute between a participating Participant and the Administrator or
WCPM shall be heard by the Executive Committee whose decision may be appealed
to the Governing Body within thirty (30) days of the Committee's decision. The
decision of the Governing Body shall be final.
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ARTICLE V: PARTICIPATION
A. ELIGIBILITY AND APPLICATION
1. ELIGIBILITY
(a). The applicant city must commit to at least three full program years of
participation in this WCP.
(b). Any member of the Authority may apply to participate in the WCP by
providing an adopted resolution of its city council and such other
information/materials as may be required. The city's resolution shall commit
the applicant city to three full years of participation in the WCP, if accepted,
and consent to be governed for workers' compensation matters in accordance
with the Master Program Document, the approved MOC ~nd other
documents and policies adopted by the Governing Body. The resolution may
also state the retained limit desired by the applicant city.
(c). It is recommended that a city only enter the WCP at the commencement ofa
new program year. If a city chooses to enter the WCP at any other time, the
deposit premium for the remainder of the program year will be pro rated. The
new member city will begin coverage on the date that is mutually acceptable
to the city and the Governing Body; however, the new Participant will be
required to share losses with the other members of the WCP for the entire
program year. The application for participation shall be submitted at least 60
days prior to the date the city wishes coverage to begin to ensure that the
State Certificate of Consent to Self-Insure is received prior to the inception
date, and that the Governing Body may have adequate time to review and
evaluate the acceptability of the applicant.
2. APPROVAL OF APPLICATION
(a). The Governing Body shall, after reviewing the resolution and other
underwriting criteria, determine the acceptability of the exposures presented
by the applicant city.
(b). The Governing Body shall, after a review of the resolution and other
underwriting criteria, advise in writing, the applicant city of its decision to
accept or reject the request within 10 days after the decision has been made.
B. PARTICIPANTS'DUTIES
1. The Participants shall provide payroll, using the State DE-6 form, and all other
requested information in conformance with the policies adopted by the Governing
Body.
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2. The Participants shall disclose activities not usual and customary in their operation.
3. The Participants shall at all times cooperate with the Authority's Administrator,
WCPM, claims adjusting company, and loss control personnel, in regards to
underwriting activities of the Authority.
4. Each year the Authority shall bill Participants for a workers' compensation deposit
premium for the next program year. The billings shall be due and payable in
accordance with the Bylaws.
5. Billings may be made to Participants for a program year found to be actuarially
unsound. All billings for payments to bring a program year into an actuarially sound
condition are due and payable upon receipt.
6. Participants that have formerly participated in the WCP, but have withdrawn as a
Participant, shall be required to pay all applicable billings for the program years in
which they participated. Delinquent billings, together with penalties and interest,
shall be charged and collected from the Participant in accordance with the policies
adopted by the Governing Body.
7. Penalties and interest shall be charged against any amounts delinquent in accordance
with the policies adopted by the Governing Body.
C. TERMINATION
1. VOLUNTARY TERMINATION
(a). A Participant which has maintained its participation in the WCP for three full
program years, may terminate its participation if, at least six months before
the next program year, a written request to terminate participation is received
from the Participant.
(b). A Participant that has not maintained its participation in the WCP for three,
full program years shall not be permitted to withdraw from the WCP prior to
the end of its commitment period and shall be obligated for payment of
premiums for these three years.
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2. INVOLUNTARY TERMINATION
(a) The Governing Body may initiate termination of future participation for the
following reasons:
(i) Termination as a member of the Authority;
(ii) Declinati~n to cover the Participant by the entity providing excess
coverage;
(iii) Nonpayment of premiums, assessments, or other charges;
(iv) Frequent late payment of premiums, assessments, and/or other
charges, subject to interest and penalty charges;
(v) Failure to timely provide requested underwriting informa~ion;
(vi) Consistent poor loss history relative to the pool;
(vii) Substantial change in exposures which are not acceptable in this
WCP;
(viii) Financial impairment that is likely to jeopardize this WCP's ability to
collect amounts due in the future; and/or
(ix) Revocation of Certificate to Self-insure.
(b) The Governing Body shall have the authority, upon a two-thirds approval, to
authorize a termination notice be sent to a Participant. Such notice shall be
sent at least 60 days prior to termination.
3. Termination of participation, whether voluntary or involuntary, in future program
years does not relieve the terminated city of any benefits or obligations of those
program years in which the city participated. These obligations include payment of
assessments, retrospective adjustments, or any other amounts due and payable.
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ARTICLE VI: TERMINATION AND DISSOLUTION
The WCP may be terminated and dissolved any time during the first three years by the written
consent of all Participants, and thereafter by the written consent of two-thirds of the Participants.
However, this WCP shall continue to exist for the purpose of disposing of all claims, distributing
assets, and all other functions necessary to conclude the affairs of the WCP.
Upon termination of the WCP, all assets of the WCP shall be distributed only among the
Participants, including any of those parties which previously withdrew pursuant to Article V, in
accordance with and proportionate to their deposit premiums and assessments paid during the term
of participation. The Governing Body shall determine such distribution within six months after the
last pending claim or loss covered by the WCP has been finally resolved and there is a reasonable
expectation that no new claims will be filed.
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ARTICLE VII: AMENDMENTS
This Master Program Document may be amended or repealed by a two-thirds (2/3rds) vote of the
Participants' representatives of the Governing Body present and voting at the meeting provided prior
written notice, as provided within the Agreement, has been given to the Governing Body.
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BAY CITIES JOINT POWERS INSURANCE AUTHORITY
MASTER PROGRAM DOCUMENT
FOR THE
WORKERS' COMPENSATION PROGRAM
BAY CITIES JOINT POWERS INSURANCE AUTHORITY
MASTER PROGRAM DOCUMENT
FOR THE
WORKERS' COMPENSATION PROGRAM
TABLE OF CONTENTS
ARTICLE I: GENERAL.................. ....................... ..... ................. .................................................. 1
A. A UTH 0 RITY .......................................................................................................................... 1
B. PURPOSE ................. .......... .... .... ................ .................. .................. ............... ..........................1
C. PARTICIPATION..... ........... ...... ................. ........ ...... ....... ...... ........................... ......................1
D. GOVERNANCE.................... .... .............. ........... ........ ......... ...... ................... ...........................2
E. GOALS AND OBJECTIVES..................................................................................................2
ARTICLE II: PROGRAM ELEMENTS..................................................... .................................. 3
A. PROGRAM yEARS........... ........... ................ ........ ..... .......... ............................... ....... .............3
B. RETAINED LIMITS.................. ....... ....................................... ....................... ........................3
C. DEPOSIT PREMIUMS............................. ................ ....................................... ..... ..................3
D. DIVIDEND AND ASSESSMENTS........................................................................................4
E. EXCESS COVERAGE............................................................................................................5
ARTICLE III: ADMINISTRATION.. ........................... .......... ............... .......... ................. ....... ...... 7
A. GOVERNING BOARD........................................................................................................... 7
B. EXECUTIVE COMMITTEE ........... ....................................................................................... 7
C. AD MINI S TRA TO R ................................................................................................................1
D. WORKERS' COMPENSATION PROGRAM MANAGER'S DUTIES .................................9
ARTICLE IV: CLAIMS ADMINISTRATION........... .......... ............................... ........................ 11
A. CLAIMS PROCEDURES MANUAL ...................................................................................11
B. CLAIMS AUDIT ... ...... .......... ........... ............. .................. ..... .............. ........... .................. .... ..11
C. CLAIM SETTLEMENT AUTHORITy............................ ................ .................................. ..11
D. DISPUTES BETWEEN PARTICIPANTS AND GENERAL MANAGER OR WORKERS'
COMPENSATION PROGRAM MANAGER, OR COMMITTEE ..............................................12'
ARTICLE V : PARTICIPATION .......................... ..... ......... ......................................................... 13
A. ELIGIBILITY AND APPLICATION ........ ............................. ............................................. .13
B. PARTICIPANTS' DUTIES... ............. ........ ................... ..... ..... ......... .... ........ ...... ............. .... ..13
C . TERMINATION. . . . . . . . . . .. . . .. . . . . . . . . .. . .. . . . . .. . . .. .. .. . .. .. .. .. .. . . .. .. . . . . . . . . . . . .. .. . . .. .. . . .. .. . . . . . . . . . . . . . .. .. .. .. .. . . . . . . 14
ARTICLE VI: TERMINATION AND DISSOLUTION............................................................. 16
AR TI CLE VII: AMENDMENTS................................................................................................ 1 7
BCJPIA
LIABILITY COVERAGE SIR's
2003/2004
Retained Limits applicable to each member entity are as follows:
Member
Retained Limit
City of Albany
City of Berkeley
City of Brisbane
City of Emeryville
Town of Fairfax
City of Larkspur
Menlo Park
City of Mill Valley
City of Monte Sereno
City of Novato
City of Piedmont
City of Pleasanton
City of Redwood City
Town of San Anselmo
San Francisco Redevelopment Agency
City of Sausalito
City of Union City
$ 25,000
$ 250,000
$ 25,000
$ 10,000
$ 50,000
$ 250,000
$ 100,000
$ 100,000
$ 5,000
$ 250,000
$ 10,000
$ 100,000
$ 250,000
$ 100,000
$ 50,000
$ 50,000
$ 25,000
BCJPIA
WORKERS' COMPENSATION COVERAGE SIR's
2003/2004
Retained Limits applicable to each member entity are as follows:
Member
City of Albany
City of Belvedere
Belvedere/Tiburon JRC
City of Brisbane
City of Emeryville
Town of Fairfax
City of Larkspur
City of Menlo Park
City of Mill Valley
City of Nova to
City of Piedmont
City of Pleasant on
City of Redwood City
Town of San Anselmo
City of Sausalito
Town of Tiburon
Twin Cities Police Authority
City of Union City
Retained Limit
$ 150,000
$ 150,000
$ 150,000
$ 150,000
$ 250,000
$ 150,000
$ 150,000
$ 250,000
$ 150,000
$ 150,000
$ 150,000
$ 500,000
$ 350,000
$ 150,000
$ 150,000
$ 150,000
$ 150,000
$ 150,000
BCJPIA
EMPLOYMENT PRACTICES LIABILITY COVERAGE SIR's
(ERMA)
2003/2004
Retained Limits applicable to each member entity are as follows:
Member
Retained Limit
City of Albany
City of Brisbane
City of Emeryville
Town of Fairfax
City of Larkspur
City of Menlo Park
City of Mill Valley
City of Piedmont
City of Pleasanton
Town of San Anselmo
San Francisco Redevelopment Agency
City of Sausalito
City of Union City
$ 50,000
$ 50,000
$ 50,000
$ 50,000
$ 100,000
$ 75,000
$ 50,000
$ 50,000
$ 50,000
$ 50,000
$ 50,000
$ 50,000
$ 50,000