The URL can be used to link to this page

Home My WebLink About04-89 - Res. Washington Counties Risk Pool DeclarationRESOLUTION NO. 4-89 WHEREAS, on December 13, 1988, the Board of Mason County Commissioners signed an inter -local agreement creating Washington Counties Risk Pool and agreed to it's terms and conditions as a member county of the Risk Pool effective January 1, 1989. NOW, THEREFORE BE IT RESOLVED, that the Board of Mason County Commissioners accepts the following declarations and binders from the Washington Counties Risk Pool: 1. Liability Insurance Declarations Policy #8889®GL AL®PP-PO-MACO for General Liability, Auto Liability, Police and Jail Professional Liability and Public Officials Liability. Policy Period-12:01 a.m., January 1, 1989 until 12:01 a.m., October 1, 1989. (Attachment A) 2. Binder No. GL/AL 8812-1-CB for Bodily Injury and Property Damage for General Liability, Vehicle Liability and Law Enforcement Liability. (Attachment B) 3. Binder No. POE L8812®1®CB for Public Officials and Employees Liability. (Attachment C) BE IT FURTHER RESOLVED, that the Chairperson of the Board of Mason County Commissioners is authorized to sign the acceptance of these documents. DATED this 24th day of January , 1989. ATTEST: Clerk of the Board PROVED AS TO FORM: Deputy Prosecutor xc: File Auditor Prosecutor Risk Pool resoluteriskpool BOARD OF COUNTY COMMISSIONERS MASON COUNTY, WASHINGTON ommissioner Hunte ATTACHMENT A WASHINGTON COUNTIES RISK POOL JOINT SELF-INSURANCE POLICY LIABILITY INSURANCE DECLARATIONS POLICY NUMBER: 8889-GL-AL-PP-PO-MACO 1. DECLARATIONS: In consideration of the premiums paid by the named in- sured, the Washington Counties Risk Pool ("Pool") shall provide insurance as hereafter stated. The Pool shall pay losses subject to the limits of liability and to other terms and conditions of this policy and any en- dorsements attached hereto. 2. POLICY PERIOD: The policy period shall be from 12:01 a.m. on January 1, 1989 until 12:01 a.m. on October 1, 1989. 3. LIMITS OF COVERAGE: The Pool shall pay on behalf of the named in- sured up to Five Hundred Thousand Dollars ($500,000) that the named insured is legally obligated to pay per occurrence for general liability, automobile liability, police and jail professional liability and public officials errors and omissions liability. 4. MEMBER COUNTY COVERED: Mason County % Board of County Commissioners Courthouse Annex II, 411 North 5th Shelton, WA 98584 5. DEDUCTIBLE AMOUNT: 6. ADVANCE PREMIUM: 7. COVERAGES: A. GENERAL LIABILITY $5,000.00 per occurrence $158,364.45 1. Personal injury 2. Civil rights 3. Contractual liability 4. Independent contractors 5. Products and completed operations 6. Employee benefit liability 7. Employers' liability B. AUTOMOBILE LIABILITY 1. Uninsured motorist C. POLICE AND JAIL PROFESSIONAL LIABILITY D. PUBLIC OFFICIALS LIABILITY hazards ACCEPTED 't of Mason County By: Chair r rson Title: WASHINGTON COUNTIES RISK POOL Tr" -"IT nr'r T T,TI,TTTI'. 1T 10/01/88 - 10/01/89 4TTACHN1ENT B CORROON & BLACK, INC. To WASHINGTON COUNTIES RISK POOL, an Association of This is to certify that we have effected the following insurance for account of Mason County Loss, if any, Payable to Washington Counties Risk Pool or its member counties as their interest may appear. Amount or limit $ 4,500,000 Excess $500,000 Self -Insured Retention For the period commencing and ending on Binder No. Washington Combined Casualty Insurance - Per Occurrence December 1 , 1988 to December 1 , 1989 GL/AL8812-1-CB Counties (Pool) COMPANY AMOUNT PREMIUM INTERESTIS) INSURED International Surplus Lines Insurance Company Policy No. 531-001024-4 * Taxes & Fees $4,500,000 Excess $500,000 S.I.R. Included Insuring Agreement Per Occurrence Bodily Injury and Property Damage, per sample form and endorsements attached. Including, but not limited to: General Liability Vehicle Liability Law Enforcement Liability "The contract is registered and delivered as a surplus coverage under the insurance code of the State of Washington enacted In 1947. It Is not issued by an insurer regulated by the Washington State Insurance Commissioner and is not protected by any Washington State Guaranty Fund l.aw" 1CORROON AND B • INC. F3yi"_S.W E. R ,..•1$ $ Q___ Ir This document is intended for use as evidence that insurance described above has been effected, against which underwriters certificate or policy will be duly issued. Immediate advice must be given to Corroon & Black, Inc. of any discrepan- cies, inaccuracies or necessary changes. By CORROON & BLACK, INC. OAlk /4,), Walter E. Rippe! ATTACHMENT C CORROON & BLACK, INC. Binder No. POEL8812-1-CB To WASHINGTON COUNTIES RISK POOL, an Association of Washington Counties (Pool) This is to certify that we have effected the following insurance for account of Mason County Loss, if any, Payable to Washington Counties Risk Pool or its member counties as their interest may appear. Amount or limit $ 3,000,000 Excess $500,000 Self -Insured For the period commencing and ending on Public Officials and Employees Liability Insurance Per Claim Per Occurrence Retention December 1, 1988 to December 1, 1989 COMPANY AMOUNT PREMIUM INTEREST(S) INSURED International Surplus $3,000,000 Include( Insuring Agreement Lines Insurance Excess Company $500,000 Public Officials and Employees Policy No. 524-110416-3 per occurrence S. I . R. Liability Insurance - Claims Made per policy form and endorsements attached. "The contract is registered and delivered as a surplus coverage under the insurance code of the State of Washington enacted in 1947. It is not issued by an insurer regulated by the Washington State Insurance Commissioner and is not protected by any Washington . State Guaranty Fund Law" CORR B IfJC et Q, 'te lter E 01 * Taxes & Fees This document is intended for use as evidence that insurance described above has been effected, against which underwriters certificate or policy will be duly issued. Immediate advice must be given to Corroon & Black, Inc. of any discrepan- cies, inaccuracies or necessary changes. CORROON & BLACK, INC. By Qr1/-:-: Walter E. Rippe!