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Home My WebLink About08-24-20 BOT Agenda Packet �� } • � WESTLAKE ACADEMY BOARD OF TRUSTEES MEETING AGENDA { { 1500 SOLANA BLVD, BUILDING 7, SUITE 7100, WESTLAKE, TX 76262 � � � � ,� August 24, 2020 k��'�`"�� 5:00 PM VIA VIRTUAL MEETING In accordance with Order of the Office of the Governor issued March 16, 2020 and March 19, 2020, the Board of Trustees of Westlake Academy will conduct this virtual meeting at 5:00 p.m. on Monday, August 24, 2020 by video and telephonic conference in order to advance the public health goal of limiting face-to-face meetings (also called "social distancing") to slow the spread of the Coronavirus (COVID-19). There will be no public access to the physical location described above. A recording of the telephonic meeting will be made and will be available to the public in accordance with the Open Meetings Act. Instructions for public participation in the meeting by video conference and telephonic conference are as follows: Bv Video: By Telephone: http://bit.ly/tcbot082420 Local: (346) 248-7799 or Webinar ID: 942 2267 6813 Toll Free: (888) 788-0099 Passcode: 753159 Webinar ID: 942 2267 6813 Passcode: 753159 �ision Statement Westlake Academy inspires col%ge bound students to achieve their highest indi�idual potential in a nurturing environment that fosters the traits found in the IB Learner Pro�/e:Inquirers, Knowledgeable, Thinkers, Communicators, Principled, Open-Minded, Caring, Risk-takers, Balanced and Reflective Regular Session 1. CALL TO ORDER 2. CITIZEN COMMENTS: This is an opportunity for citizens to address the Board on any matter whether or not it is posted on the agenda. For those joining by videoconference: Any person desiring to make a public comment using a Windows computer must first press the '�Raise Hand" button on the screen. Alternatively, the AIt+Y keyboard shortcut may be used to raise or lower their hand. Any person desiring to make a public comment using a Mac computer must first press the��Raise Hand" button on the screen. Alternatively, the Option+Y keyboard shortcut may be used to raise or lower their hand. For those joining by teleconference: Any person desiring to make a public comment must first press star-nine (*9) on their telephone keypad to "Raise their hand" to speak. Persons joining the meeting by teleconference may mute and unmute their phones by pressing star-6 (*6). Westlake Academy BOT Agenda 08-24-20 Page 1 of 3 Citizens will be placed in a queue based on the order the hands were raised. The presiding ofFicer will recognize callers based on the order of the queue, where they will be asked to state their name and address. Individual citizen comments are normally limited to three (3) minutes; however, time limits can be adjusted by the presiding officer. The presiding officer may ask the citizen to hold their comment on an agenda item if the item is posted as a Public Hearing. The Board cannot by law take action nor have any discussion or deliberations on any presentation made to the Board at this time concerning an item not listed on the agenda. The Board will receive the information, ask staff to review the matter, or an item may be noticed on a future agenda for deliberation or action. 3. CONSENT AGENDA: All items listed below are considered routine by the Board of Trustees and will be enacted with one motion. There will be no separate discussion of items unless a Board Member or citizen so requests, in which event the item will be removed from the general order of business and considered in its normal sequence. a. Consider approval of the minutes from the meeting on June 8, 2020. b. Consider approval of Resolution 20-10, Awarding the bid for property/casualty insurance products and services to Box Insurance Agency for FY 2020-2021, and further authorize the Superintendent or designee to execute this agreement. 4. DISCUSSION ITEMS: a. Presentation and discussion of Resolution 20-11 to: (1) ratify the attestations concerning our ability to meet TEA's threshold requirements for remote synchronous instruction to Academy Students in grades 3-12; and (2) approve a plan for remote asynchronous instruction for grades K-2 and for any other grades/courses for which the Academy cannot meet the threshold requirements for synchronous instruction to ensure funding. 5. FUTURE AGENDA ITEMS: Any Board member may request at a workshop and/or Board meeting, under'�Future Agenda Item Requests", an agenda item for a future Board meeting. The Board Member making the request will contact the Superintendent with the requested item and the Superintendent will list it on the agenda. At the meeting, the requesting Board Member will explain the item, the need for Board discussion of the item, the item's relationship to the Board's strategic priorities, and the amount of estimated staff time necessary to prepare for Board discussion. If the requesting Board Member receives a second, the Superintendent will place the item on the Board agenda calendar allowing for adequate time for staff preparation on the agenda item. 6. BOARD RECAP / STAFF DIRECTION 7. AD)OURNMENT Westlake Academy BOT Agenda 08-24-20 Page 2 of 3 ANY ITEM ON THIS POSTED AGENDA COULD BE DISCUSSED IN EXECUTIVE SESSION AS LONG AS IT IS WITHIN ONE OF THE PERMITTED CATEGORIES UNDER SECTIONS 551.071 THROUGH 551.076 AND SECTION 551.087 OF THE TEXAS GOVERNMENT CODE. CERTIFICATION I certify that the above notice was posted at the Town Hall of the Town of Westlake, 1500 Solana Blvd., Building 7, Suite 7100, Westlake, TX 76262, on August 21, 2020, by 5:00 p.m. under the Open Meetings Act, Chapter 551 of the Texas Government Code. Todd Wood, Town Secretary If you plan to attend this public meeting and have a disability that requires special needs or translation services, please advise the Town Secretary 48 hours in advance at 817-490-5711 and reasonable accommodations will be made to assist you. Westlake Academy BOT Agenda 08-24-20 Page 3 of 3 Board of Trustees Item # 2 — Citizen Comments CITIZEN COMMENTS: This is an opportunity for citizens to address the Board on any matter whether or not it is posted on the agenda. For those joining by videoconference: Any person desiring to make a public comment using a Windows computer must first press the ��Raise Hand" button on the screen. Alternatively, the AIt+Y keyboard shortcut may be used to raise or lower their hand. Any person desiring to make a public comment using a Mac computer must first press the ��Raise Hand" button on the screen. Alternatively, the Option+Y keyboard shortcut may be used to raise or lower their hand. For those joining by teleconference: Any person desiring to make a public comment must first press star-nine (*9) on their telephone keypad to "Raise their hand" to speak. Persons joining the meeting by teleconference may mute and unmute their phones by pressing star-6 (*6). Citizens will be placed in a queue based on the order the hands were raised. The presiding officer will recognize callers based on the order of the queue, where they will be asked to state their name and address. Individual citizen comments are normally limited to three (3) minutes; however, time limits can be adjusted by the presiding officer. The presiding officer may ask the citizen to hold their comment on an agenda item if the item is posted as a Public Hearing. The Board cannot by law take action nor have any discussion or deliberations on any presentation made to the Board at this time concerning an item not listed on the agenda. The Board will receive the information, ask staff to review the matter, or an item may be noticed on a future agenda for deliberation or action. Board of Trustees Item # 3 — Consent Agenda CONSENT AGENDA: All items listed below are considered routine by the Board of Trustees and will be enacted with one motion. There will be no separate discussion of items unless a Board member or citizen so requests, in which event the item will be removed from the general order of business and considered in its normal sequence. a. Consider approval of the minutes from the meeting on June 8, 2020. b. Consider approval of Resolution 20-10, awarding the bid for property/casualty insurance products and services to Box Insurance Agency for FY 2020-2021, and further authorize the Superintendent or designee to execute this agreement. f�� # # $ � � � � � ��'' MINUTES OF THE WESTLAKE ACADEMY BOARD OF TRUSTEES MEETING ]une 8, 2020 In accordance with Order of the Office of the Governor issued March 16, 2020 and March 19, 2020, the Westlake Academy Board of Trustees conducted its regular meeting at 5:00 p.m. on Monday, June 8, 2020 by video and telephone conference in order to advance the public health goal of limiting face-to-face meetings (also called "social distancing") to slow the spread of the Coronavirus (COVID- 19). There was no public access to the physical location described above. A recording of the telephonic meeting was made and is available to the public. PRESENT: President Laura Wheat and Trustees: Greg Goble, Rick Rennhack, Alesa Belvedere, and Rajiv Trivedi. Council Member Carol Langdon joined the videoconference at 5:18 p.m. ABSENT: None OTHERS PRESENT: Superintendent Amanda DeGan, Deputy Town Manager Noah Simon, Assistant Town Manager]arrod Greenwood, Town Attorney Stan Lowry, Town Secretary Todd Wood, Director of Information Technology Jason Power, Director of Finance Debbie Piper, Director of Facilities&Public Works Troy Meyer, Director of Communications Ginger Awtry, Communications Manager Jon Sasser, Business Manager Marlene Rutledge, Executive Director Dr. Mechelle Bryson, PYP Principal Rod Harding, Dr. James Owen, and Registrar Kim Gardner. Regular Session 1. CALL TO ORDER President Wheat called the Board of Trustees meeting to order at 5:02 p.m. 2. CITIZEN COMMENTS President Wheat provided a brief summary of instructions to the public for citizen comments. No one addressed the Board. Board of Trustees Minutes 06/08/20 Page 1 of 4 3. ITEMS OF COMMUNITY INTEREST President and Trustee Reports on Items of Community Interest pursuant to Texas Government Code Section 551.041: The Board of Trustees may report on the following items: (1) expression of thanks, congratulations or condolences; (2) information about holiday schedules; (3) recognition of individuals; (4) reminders about upcoming Board of Trustee events; (5) information about community events; and (6) announcements involving imminent threat to public health and safety. Graduation: Director of Communications Ginger Awtry provided an update on this item. She stated that a great deal of positive feedback had been received about the event, and this would not have been possible without the hard work provided by the municipal and academic staff. She noted that the graduates and their families were very happy that they were able to be together for this event. Independence Day Holiday: The municipal ofFices will be closed for the Independence Day Holiday on ]uly 3rd. There will be no interruption with trash and recycling services, and collections will occur on the regular Friday schedule that week. Westlake Academy Employee Receives Award: Ms. Amy Hess was recently awarded the University of Chicago Outstanding Educator Award. This award is for educators who have made an outstanding impact on the lives of students, and nominations are received by the university from students who are graduating. Ms. Awtry noted that Dr. James Owen had received a nomination for this award as well. 4. CONSENT AGENDA: All items listed below are considered routine by the Board of Trustees and will be enacted with one motion. There will be no separate discussion of items unless a Board Member or citizen so requests, in which event the item will be removed from the general order of business and considered in its normal sequence. a. Consider approval of the minutes from the meeting on May 4, 2020. b. Consider approval of Resolution 20-06, renewing membership with the Region 11 Benefits Cooperative for the 2020-2021 school year. c. Consider Resolution 20-07, verifying the completion of four (4) cybersecurity training programs for all Westlake Academy employees and elected officials, as required by HB 3834 for all local government employees and elected officials through a certified training program. MOTION: Trustee Goble made a motion to approve the Consent Agenda. Trustee Rennhack seconded the motion. The motion carried by a vote of 5-0. 5. PRESENTATION AND DISCUSSION ITEMS. a. Discussion regarding staff actions and associated items related to COVID-19. Superintendent Amanda DeGan provided information on this item. She began by stating that prior to the closure of the municipal offices on March 17t", some information was Board of Trustees Minutes 06/08/20 Page 2 of 4 being received from the State of Texas as to what school operations might look like in the fall. Staff worked diligently to develop a distance learning process from scratch in a very short period of time. Students were moved to the distance learning platform following spring break with great success. During this time, Westlake enacted an Emergency Order providing the Superintendent with additional authority during the pandemic and creating the requirement that the Superintendent update the Board of Trustees on any policies that have been changed or suspended. During this time, the policy pertaining to the grading scale has been altered, changing it to a pass/fail system. Additionally, the required notarized affidavit to show residency has been suspended. Facilities: Several deep cleanings have occurred on campus. Public Works and Facilities Director Troy Meyer was asked to provide additional information. He stated that efforts have been made to thoroughly clean after individuals have been in the buildings, and general cleaning occurs on a daily basis. Committees have been formed to address some of the operational changes that may be necessary when school re- opens. COVID-19 Planning: Superintendent DeGan then spoke about the planning efforts that have been made with COVID-19. She stated that she has participated in many discussions with local and state officials, including Superintendents from other school districts to discuss strategies and ensure compliance with state and local requirements. These meetings have resulted in positive and fruitful relationships with many other entities that will prove to be valuable in the future. At this time, it is not known whether schools will open regularly in the fall, continue distance learning exclusively, or offer a hybrid of the two approaches. It is anticipated that additional TEA guidelines will be released in the coming weeks. Budget: During this time, staff has continued to work on the FY 20/21 municipal and academic budgets. Superintendent DeGan indicated that efforts are being made to identify monetary savings for the current year and next year. On June 22"d, a more in- depth budget discussion will take place. b. Discussion of the Distance Learning Academic Overview. Executive Director Dr. Mechelle Bryson provided an update on this item. She began by stating that our distance learning program has worked very well, and many compliments have been received. She stated that it was necessary to change the learning goals and processes to accommodate distance learning and set reasonable expectations for students. This program has been designed to be in alignment with Westlake Academy's Vision, Values, and Mission. During the most recent submission of the PEIMS report, it was determined that 98% of students were engaged in the learning process and were successful. Dr. Bryson praised the efforts of the teaching staff and their ability to'�pivot" onto a new platform for instruction. Some of the areas that staff will review in preparation for the fall is grading, teaching new material, and vertical articulation. A staff survey and student survey will be conducted to receive valuable feedback and determine where distance learning can be improved and become more robust. Board of Trustees Minutes 06/08/20 Page 3 of 4 c. Discussion of Senior Activities/Graduation Overview. Dr. Bryson provided an update on this item. She stated that a great deal of positive feedback had been received from students and parents. The leadership of Westlake Academy felt that it was very important that our graduating seniors were properly honored and recognized. There is interest in carrying some elements of the graduation ceremony, parade, and the awards ceremony forward in future years. 6. COUNCIL RECAP / STAFF DIRECTION President Wheat said she is looking forward to seeing the report showing the next steps that will be taken as fall approaches. 7. FUTURE AGENDA ITEMS None. 8. AD)OURNMENT There being no further business before the Board, President Wheat asked for a motion to adjourn the meeting. MOTION: Board Member Trivedi made a motion to adjourn the Board of Trustees meeting. Board Member Rennhack seconded the motion. The motion carried by a vote of 5-0. President Wheat adjourned the meeting at 6:36 p.m. APPROVED BY THE TOWN COUNCIL ON AUGUST 24, 2020. ATTEST: Laura Wheat, Board President Todd Wood, Town Secretary Board of Trustees Minutes 06/08/20 Page 4 of 4 �x��Y�� f �. h�':� :.. � '� ��}�'�F estlake Academy Board of Trustees �� s�.�� TYPE OF ACTiON Regular Meeting - Consent Westlake Board Meeting Monday, August 24, 2020 ToPrc: Consider a Resolution awarding the bid for property/casualty insurance products and services to Box Insurance Agency for FY 2020-2021, and further authorize the Superintendent or designee to execute this agreement. STaFF CoNTaCT: Todd Wood, Town Secretary Blair Wilson, HR Generalist Strategic Alignment Vision, Value, Mission Perspective Curriculum Outcome Ob'ective People,Facilities,& Attract,Recruit& Personal Responsibility Technology P�'P�MYP/DP Retain the Highest Quality Workforce Strategic Initiative Outside the Scope of Identified Strategic Tnitiatives Time Line - Start Date: September 1, 2020 Completion Date: August 31, 2021 Funding Amount: $155,740 Status - Funded Source - General Fund EXECUTIVE SUMMARY (INCLUDING APPLICABLE ORGANIZATIONAL HISTORY) Bids have been solicited and received for Westlake Academy's annual insurance renewal. The insurance policies contained in this package include Property, General Liability, Umbrella Liability, Workers Compensation, Auto, Crime, International Travel, Cyber Liability, and a Student Accident policy. Box Insurance Agency was the only submission that was received by the bidding deadline. This was also the only bid containing all lines of coverage. This quote reflects an overall price decrease of$105 from FY 2019-2020. It should be noted that liability quotes are quoted as all inclusive, or as sub-policies to the General Liability policy. These include coverage for Directors & Officers, Employers Legal Liability, Employment Practices Liability, Employee Benefits Liability, and Educator's Legal Liability. Changes in cost for these policies from FY 19-20 and FY 20-21 are as follows: • Property premiums have increased industry-wide, largely from wind and hail damage claims throughout Texas. This policy has increased by 4.4%. • The Workers Compensation policy decrease is due to lower claims, reducing our experience modifier from 1.37 to 1.01. The Workers Compensation policy has decreased by 13.2%. • Auto insurance has decreased by 11.2%due to lower vehicle replacement values and favorable claims history. • The General Liability and Umbrella Liability policies reflect minimal increases under 3% that are typical when adjusted for inflation. • The Student Accident policy, International Travel policy, Crime policy, and Cyber Liability Insurance policies did not increase. RECOMMENDATION Staffrecommends awarding the bid for Westlake Academy's property/casualty insurance products and services to Box Insurance Agency for FY 2020-2021. The total cost for this recommendation is $155,740.00. ATTACHMENTS Insurance Proposal from Box Insurance Agency, inclusive of Forms 2270 and 1295 Resolution Exhibit"A": Recommended Bid—Box Insurance AN INSURANCE PROPOSAL PREPARED FOR : Westlake Academy 1500 Solana Blvd Building 7, #7200 Westlake, TX 76262 PRESENTED BY: Dustin Parker& Adam Syswerda BOX I NSURANCE AGENCY I ZOO S. MAIN STREET, STE. I 6OO Grapevine, TX 76051 August 3 I, 2020 DISCLAIMER- The abbreviated outlines of coverages used throughout this proposal are not intended to express any legal opinion as to the nature of coverage. They are only visuals to a basic understanding of coverages. Please read your policy for specific details of coverages. This proposal does not constitute a binder of insurance. Coverage may be bound based on the terms outlined and chosen by signing and dating on the last page of this proposal. ♦ �ox INSURANCE AGENCY 2020-2021 Westlake Academy Proposal Submittal Format 1. Box Services 2. Index 3. Questionnaire 4. Property 5. General Liability: (Education Liability Package Included) 6. Auto 7. Umbrella 8. Crime 9. Workers Compensation 10. International Travel 11. Student Accident 12. Cyber Liability 13. Premium Summary 14. Required Documents a. Agent Current License b. Copy of E&0 Certificate of Insurance c. Completed and Signed Felony Conviction Notice Form d. Completed and Signed Non-Collusion Certification Form e. Completed and Signed Conflict of Interest Questionnaire f. Completed and Signed W-9 Form g. Completed and Signed Form 2270 12QQ S. Main Street, Suite 1600 � Graper►ine, TX 76051 � Phone: 817-865-1801 � www.baxinsurance.com �� `� � �� REQUEST FOR PROPOSAL � � .. . � �- �'��,:�� PROPOSAL FOR: Property, Liability,Workers Compensation,Auto, and Student Accident Insurance POSTED DATE: August 2,2020 EFFECTIVE DATES: September 1,2020 to August 31,2021 PROPOSAL DUE DATE: August 17,2020 PROPOSAL DUE TIME: 2:00 PM CST CONTACT: Todd Wood,Purchasing Agent E-mail: twood@westlake-tx.org Electronic proposals subject to the Terms and Conditions of this REQUEST FOR PROPOSAL and other provisions,must be received by the Purchasing Agent at twood@westlake-tx.org before the closing time and date shown above. The Town will retain late bids;however,they will not be opened nor considered in the evaluation of the bid. Bids may be withdrawn at any time prior to this deadline. Bids may not be altered, amended, or withdrawn after the official opening without the recommendation and approval of the Purchasing Agent. The undersigned agrees if the bid is accepted,to furnish any and all items upon which prices are offered, at the price(s) and upon the terms and conditions contained in the specifications. The period for acceptance of this proposal shall be 60 calendar days. THE UNDERSIGNED, BY SIGNING BELOW, YOU SIGNIFY THAT YOU HAVE READ THE ENTIRE DOCUMENT AND AGREE TO THE TERMS AND CONDITIONS THEREIN. BY SIGNING BELOW, YOU ALSO CERTIFY THAT IF A TEXAS ADDRESS IS SHOWN AS THE ADDRESS OF THE PROPOSING VENDOR, THE VENDOR QUALIFIES AS A TEXAS "RESIDENT BIDDER" AS DEFINED IN RULE 1 TAC 111.2. Com an Name and Address Com an 's Authorized A ent: Box Insurance Agency Adam Syswerda 1200 S. Main St. Suite 1600 Si nature Grapevine, TX 76051 Name and Title T ed or Printed Federal ID Number(TIN) or SSN and Name Adam Syswerda, Vice President Telephone No. g17-865-1806 Date August 7, 2020 Fax No. Email address: 817-424-1404 adam@boxinsurance.com Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 1 of 38 Request for Proposal —Westlake Academy Property, Liability, Workers Compensation, and Student Accident Insurance Table of Contents ...............................................................2 Acknowledgement of Receipt ....................................................3 Questionnaire ....................................................................4 General Requirements and Instructions .......................................5 Policy Requirements and Limits ...............................................8 Property Insurance, Fire and Extended Equipment Coverage .........8 General Liability, EPLI, EBLI, ELLI, D&O Insurance ...............10 Automobile and Physical Damage Insurance ...........................12 Umbrella Liability Insurance .............................................14 Crime Insurance .............................................................16 Workers Compensation Insurance.........................................18 International Travel Insurance .............................................20 Student Accident Insurance..................................................22 Cyber Liability Insurance .................................................24 Proposal Submittal Format....................................................26 Exhibit "A" - Property Schedule.............................................27 Felony Conviction Notice Form..............................................28 Non-Collusion Statement......................................................29 Conflict of Interest Questionnaire ...........................................30 W-9 Form .......................................................................32 Form2270 .......................................................................32 Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 2 of 38 ACKNOWLEDGEMENT OF RECEIPT THIS FORM MUST BE COMPLETED AND RETURNED PRIOR TO THE SUBMISSION OF ANY BID FOR THIS REQUEST FOR PROPOSAL. Please fill in the requested information below as acknowledgement that you have received the Request for Proposal noted above. If your firm is interested in participating, please complete this sheet and return by email to: Todd Wood Westlake Academy twood@westl ake-tx.org Name of Firm: Box Insurance Agency 1200 S. Main St. Suite 1600 Address: City/State/Zip: Grapevine, TX 76051 Phone: (817 ) 865-1806 Fax: ( ) E-Mail: Sharon@boxinsurance.com Name: (Print) Adam Syswerda Title: Vice President Signature: Date: $�5/2020 X Yes, our company does have an interest in responding. No, our company does not have an interest in responding. Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 3 of 38 QUESTIONNAIRE 1. Who will have primary responsibility for Westlake Academy's account? Dustin Parker 18 a. Number of years in the insurance business: b. Insurance background: CEO of Box Insurance 4 c. Number of schools or public entities serviced: Adam Syswerda 2. Who will be the back-up person for Westlake Academy's account? a. Number of years in the insurance business: � b. Insurance background: Vice President 4 c. Number of schools or public entities serviced: 4. Westlake Academy will expect the following annual reports from its agents: a) Summary of premiums and losses by coverage. b) Forecast of insurance market status prior to renewal. c) Insurance policy abstracts (summaries). d) Prior to future renewals, report containing suggested coverage or rating enhancements for the upcoming year. e) Following future renewals, a report detailing all material policy changes. f) Risk management services. 5. Please attach a copy of the following documents: a)A copy of the current license. b)A certificate for agenYs error and omission coverage insured for at least$1 million limit. Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 4 of 38 General Requirements and Instructions A. Information 1. The information contained in these specifications is confidential and is to be used only in connection with preparing a proposal for the following insurance services or insurance coverages: Commercial Property— Fire & Extended Coverage Commercial General Liability School Professional Liability Auto Liability& Physical Damage Workers' Compensation Commercial Umbrella Liability Crime International Travel Liability Student Accident Liability Cyber Liability 2. The effective dates of the policy period for all proposals is September 1, 2020 through August 31, 2021. 3. Westlake Academy reserves the right to accept or reject all or any part of the proposals, waive minor technicalities, and award the proposal to best serve the interest of the Academy. The Academy also reserves the right to waive or dispense with any of the formalities contained herein. 3. Proposals are to be submitted on the basis of the specifications contained herein. Alternate proposals will also be considered, provided the alternatives are clearly explained. All deviations from the specifications must be clearly identified and explained. 4. The information contained in these specifications is to be basis for proposal responses. After receipt of proposal, additional information needed may be requested via e-mail at: twood@westlake-bc.org. 5. The information contained herein is believed to be accurate and up-to-date but is not intended to be an express or implied warranty. 6. No telephone, fax, or mailed proposals will be accepted. Proposals may only be accepted if delivered by email to twood@westlake-tx.org. 7. Vendors are cordially invited view the opening of received proposals but are not required to attend. Due to the closures of Town of Westlake facilities associated with COVID-19 at the time of this proposal being issued, bid openings will occur virtually. A link will be posted on the Town of Westlake Bidding page no later than August 12, 2020. B. LEGAL 1. All parties submitting proposals are expected to comply with federal, state and local insurance laws and regulations relative to the preparation and submissions of insurance proposals. Specifically, the services to be provided are expected to be in compliance with the Americans with Disabilities Act (ADA), insurance laws and insurance regulations. All proposals that are submitted will be presumed to be in compliance with all applicable laws. C. COMMUNICATION 1. Proposals should reference "RFP 20-001 — Westlake Academy Property & Liability Insurance". Proposer is required to provide an electronic copy of proposals to: Todd Wood Westlake Academy twood @westl a ke-tx.o rg Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 5 of 38 D. COMMUNICATION WITH TOWN OF WESTLAKE/WESTLAKE ACADEMY MEMBERS Companies submitting proposals shall not discuss this RFP with employees of the Town of Westlake/Westlake Academy or members of the Town Council/Board of Trustees. If discussion is necessary, your company will be notified in writing. Failure to abide by this requirement may result in automatic disqualification. E.TIME FRAME 1. The RFP package will be available for download from our website at http://www.westlake-tx.orq. Vendors WILL NOT be notified of additional information/addenda postings. It is the vendor's responsibility to view the web page regularly, or prior to submitting a proposal response, to ensure that no addenda or additional information have been issued for the solicitation. 2. Proposals: must be delivered electronically via email to twood(a�westlake-tx.orq no later than 2:00 PM, Monday, August 17, 2020. 4. The parties submitting the selected proposals will be notified by August 19, 2020 of the Academy's decision. 5. The effective date for proposals is September 1, 2020. 6. Policies or coverage documents are to be provided to the Academy by October 1, 2020. The Academy reserves the right to not pay any premium until valid policies or coverage documents are received. F. PROPOSALS 1. Proposals must be clearly explained and identified. All costs, including optional programs, must be clearly separated and summarized. Exceptions to or deviations from the specifications must be explicitly identified. 2. Each party submitting a proposal is asked to screen their designated proposals for correctness and compliance with the specifications. 3. The contents of the proposals shall be kept confidential during the process of review. G. DISQUALIFICATION AND REJECTION OF PROPOSALS 1. Failure to comply with the requirements or the procedures set forth herein, or to satisfy the insurance and servicing criteria as set forth in the specifications, may result in disqualification. It is not intended that exceptions to the specifications will, in and of themselves, result in disqualification. H. SELECTION OF VENDOR 1. Westlake Academy reserves the right to reject any or all of the proposals, in whole or in part; to waive any informality in any proposal, and to accept the proposal which, in its discretion, is in the best interest of the Academy. An Academy insurance consultant may review proposals for completeness and for compliance with bid specifications. Proposals will be carefully evaluated for cost effectiveness, for coverage provisions, and for compliance with the coverage and servicing criteria contained in the specifications and in accordance with Texas Education Code 44.031 and any other pertinent laws. 2. The contract will be awarded to the responsible vendor who submits a superior but economical proposal based on the relative importance of the following selection criteria: Selection Criteria Maximum Points Coverage 35 Cost 35 Professional Qualifications 15 Service 15 Total 100 Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 6 of 38 I. TERMS OF AGREEMENTS 1. Westlake Academy desires to receive proposals for a one (1)year period, beginning on September 1, 2020 through August 31, 2021. 2. Westlake Academy reserves the right to terminate the agreement at the expiration of the budget period, during the term of the agreement or at the end of the anniversary date with sixty (60)days' notice. The agreement will be for current revenues only in accordance with Local Government Code Section 271.903 to terminate the agreement. 3. The agreement is to contain a cancellation provision that provides for sixty (60)days' notice of cancellation (except for non-payment) and sixty (60)days e for non-renewal or material change. J. QUALIFICATION OF INSURERS 1. Insurance companies must have a general policyholder's rating of A-VII or better as published by A.M. Best Company in the latest edition of its Key Rating Guide. Insurers shall be duly licensed and comply with all applicable insurance laws and requirements of the Texas State Board of Insurance. 2. Proposals will be accepted for intergovernmental risk sharing pools organized in accordance with article 4413(32c), Texas Interlocal Cooperation Act. Self-insured pools must include a current audited financial statement(Balance Sheet and Statement of Operations, including the auditor's opinion, and Reinsurance Provisions.) K. AGENT MINIMUM QUALIFICATIONS All agents submitting proposals for this insurance must meet the following minimum qualifications: 1. The agency must be licensed in Texas. 2. The agency must have insurance for agenYs errors and omissions liability with a limit of at least$1 million per occurrence. A certificate of the agent's E&O insurance must be included with the proposal. 3. The agency must have been in business for at least five (5)years. 4. The agency must assign a minimum of one qualified account representative. This representative must have a minimum of three (3)years of experience in commercial property and liability insurance lines, or hold the C.P.C.U. or A.R.M. designation. L. AUTHORIZED SIGNATURE 1. All proposal forms must be signed by persons who have legal authority to bind the insurer and administrator to the services that are proposed. M. Policy Requirements and Limits 1. All proposals must adhere to the specifications and limits as defined on the following pages for each insurance product. Any deviation or additional coverage(s)should be clearly explained. If the quote contains higher limits than specified, it should be listed separately as an alternate quote. Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 7 of 38 PROPERTY, FIRE, AND EXTENDED EQUIPMENT INSURANCE A. BACKGROUND INFORMATION 1. Please contact Purchasing Agent at twood@westlake-tx.org for loss runs. 2. Schedule of Buildings and Contents limits are located on page 25 as Exhibit"A". 3. Summarized property schedule with estimated replacement cost(limits), including desired deductibles and coinsurance as of September 1, 2020 is as follows: Description Limit Deductible Coinsurance Building Physical Property $43,845,000 $ 5,000 100°/o Building Personal Property $ 4,670,000 $ 5,000 100°/o Business Income and Extra Expense: $ 485,000 Total Property Limits $49,000,000 Note: Blanket Coveraqe at full replacement cost is required for all propertv quotes. B. Insurance coverage is to include the following: 1. Blanket coverage on all buildings, contents and auxiliary structures including on-site improvements. 2. Basis of Recovery is to be full replacement cost. 3. Automatic coverage on newly acquired property is to be included. 4. Coverage is to include extra expense and loss of revenue related to loss. 5. Coverage is to be for all risk, including theft of contents. 6. Quotes should include deductibles of$5,000 with 100% coinsurance. Deductibles for wind, hail, earthquake, and floods should be $50,000 or less with 100°/o coinsurance, if available. In the event a $50,000 wind/hail deductible (or lower) is not available, the lowest deductible available should be quoted. 7. Wind and hail deductibles may be accompanied by a "buy-down" reinsurance policy. This policy should be shown separately from the primary policy, including premiums. 8. Include a listing of endorsements, extensions, and exclusions. C. Quoted Coverage Provisions 1. Description Limit Deductible Coinsurance Building Physical Property $43,844,000 10,000 Agreed Value Building Personal Property $ 4,671,000 10,000 Agreed Value Business Income and Extra Expense: $ 485,000 10,000 Agreed Value 2. Is automatic coverage for newly acquired property provided: � Yes ❑ No If yes, please attach description. 3. Does coverage include equipment breakdown? � Yes ❑ No If yes, please attach description. 4. Is there additional deductible or exclusion for wind, hail or earthquake? g7 Yes ❑ No If yes, please attach description and/or provide additional proposal to cover this risk. D. Quotation 1. Property, Fire, and Extended Equipment Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ 91,955 2. Alternate Property, Fire, and Extended Equipment Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 8 of 38 E. INSURANCE COMPANY/RISK POOL INFORMATION Name of Company: The North River Insurance Company A. M. Best Rating/Size: A XIII Insurance Company:�7 Yes ❑ No Risk Pool: ❑ Yes ❑ No For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Wind/Hail Deductible is the greater of$100,000 or 2% Flood Limit is $5,000,000 with a $50,000 deductible Earthquake Limit is $5,000,000 with a $50,000 deductible Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 9 of 38 GENERAL LIABILITY INSURANCE A. BACKGROUND INFORMATION 1. All coverage in Section "B" must be included. Please contact Purchasing Agent at twood@westlake-tx.org for loss runs. 2. Estimated student count is 885. Grades K-8: 557 Grades 9-12: 328 3. Estimated number of full-time equivalent employees is 102. Total employees (including substitute teachers) is approximately 165. 4. Sports programs include: Football, basketball, volleyball, baseball, softball, track, cross country track, tennis, golf, softball, cheerleading, and soccer. B. Insurance coverage should include the following: 1. Incidental medical malpractice coverage for registered nurses administering first aid, dispensing prescribed medications, and maintaining students' health immunization records. 2. Coverage for the negligent act, error or omission of the Academy and/or its employees relative to the administration of employment practices and employee benefit programs. 3. Coverage is to include premises liability. 4. Persons to be covered are to include the Academy, school board members, employees, student teachers, school volunteers, or any authorized agent as designated by the Academy. 5 If coinsurance is quoted as an alternative to deductible, please list this figure separately. 6. Include a listing of coverage extensions, endorsements and exclusions. 7. If EPLI, EBLI, ELLI, and D&O coverage is not automatically included, please provide separate quote(s). Per Occurrence Aqqreqate Deductible General Liability $ 1,000,000 $ 2,000,000 $0 Products/Completed Operations $ 1,000,000 $ 2,000,000 $0 Personal &Advertising Injury $ 1,000,000 $ 1,000,000 $0 Damage to Rented Premises $ 1,000,000 $ 1,000,000 $0 Medical Expenses $ 10,000 $0 Employee Benefits Liability $ 1,000,000 $ 3,000,000 $1,000 Abuse & Misconduct Liability** $ 1,000,000 $ 1,000,000 $0 Educators Legal Liability'` *'` $ 1,000,000 $ 2,000,000 $10,000 Professional Liability—D&O* ** $ 1,000,000 $ 2,000,000 $10,000 Employment Practices Liability*** $ 1,000,000 $ 1,000,000 $10,000 * Retention shown as Deductible ** Retroactive Date 8/31/11 C. Quoted Coverage Provisions 1. Coverage Detail Per Occurrence Aqqreqate Deductible General Liability �1 nnn,nnn �g� Q�� Products/Completed Operations $1,000,000 �2gg�gg� Q�� Personal &Advertising Injury $1,000,000 �ppp�p�� n Damage to Rented Premises $1,000,000 �,ppp,ppp �n Medical Expenses �1n,000 �n Employee Benefits Liability $1.000.000 $ 3,000,000 ,�;000 Abuse & Misconduct Liability $1,000,000 $ 1,000,000 �p Professional Liability—D&O $1,000,000 $ 2,000,000 $10,000 Educators Legal Liability $1,000,000 $ 2,000,000 $10,000 Employment Practices Liability $1,000,000 $ 1,000,000 $10,000 Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 10 of 38 2. Please respond to the following questions as they relate to the Professional Legal Liability coverage proposed. Please specify if there are any SUB-LIMITS, otherwise it will be assumed full policy limits are available: a. Who are the "covered persons" or"named insureds?" b. Is Prior Acts coverage provided? If so, what is the retroactive date? c. Is corporal punishment/student discipline covered? d. Describe the terms available for"Extended Reporting/Discovery Period" coverage available when either the insured or insurer cancels or non-renews? How long is the reporting period and what is the cost? e. Does the policy cover non-pecuniary relief? If so, are there any sub-limits for either defense costs or damages? If sub-limits apply, please stipulate. f. Are board members/employees covered as they serve on other boards within the course and scope of their employment (i.e., would coverage extend to a superintendent as he/she served on a Special Education Cooperative)? g. Are claims alleging discrimination covered (e.g., 1983 Civil Rights violation)? If so, what is the Limit of Liability? h. Is sexual misconduct(i.e., harassment), sexual abuse and molestation covered? If so, are there sub-limits? i. Does the coverage pay on behalf of or indemnify? j. Are defense costs within limits or in addition to? k. Please explain the notice of claim provision and what constitutes a "demand." D. Quotation (Must include all coverages and limits from Section A) 1. General Liability, EPLI, EBLI, ELLI and D&O Quote—(Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): � 14,861 2. Alternate General Liability, EPLI, EBLI, EELI, and D&O Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ E. INSURANCE COMPANY/RISK POOL INFORMATION Name of Company: Utica National Insurance A. M. Best Rating/Size: A XII Insurance Company: � Yes ❑ No Risk Pool: ❑ Yes ❑ No For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 11 of 38 Automobile & Physical Damage Insurance A. BACKGROUND INFORMATION 1. Please contact Purchasing Agent at twood@westlake-tx.org for loss runs. 2. Current list of vehicles: 2006 Chevrolet Girardin Bus— 18 passengers 2010 Chevrolet Startrans Bus—20 passengers 2018 Blue Bird Bus—77 passengers 2019 Blue Bird Bus—77 passengers 4. All drivers have proper class endorsements and driving histories are reviewed annually. B. Insurance coverage is to include the following: 1. Liability Limits &Coverage Desired: Auto Liability must be as follows: Limit Per Deductible Bodily Injury& Property Damage $ 1,000,000 Accident $ 1,000 Personal Injury Protection $ 2,500 Person $ 0 Uninsured Motorist $ 1,000,000 Accident $ 0 Underinsured Motorist $ 1,000,000 Accident $ 0 Physical Damage Coverage Comprehensive ACV/Repair Loss $ 1,000 Vandalism ACV/Repair Loss $ 0 Collision $ 1,000,000 Accident $ 1,000 2. Basis of Recovery is to be full repair cost or actual cash value, where applicable. 3. Hired auto and non-owned auto is to be included. 4. Include a listing of additional coverages, extensions, and exclusions. C. Quoted Coverage Provisions 1. Coverage Detail Per Occurrence Aqqreqate Deductible Bodily Injury& Property Damage $ 1.000.000 Accident $ 1.000 Personal Injury Protection $ 2,500 parcnn �n Uninsured Motorist $ 1,000,000 Ar.cident � 0 Underinsured Motorist $ 1,000,000 Accident $ 0 Medical Expenses Physical Damage Coverage Comprehensive Physical Damage ACV/Repair Loss $ 1,000 Vandalism ACV/Repair Loss � Collision $ 1,000,000 Accident $ 1,000 2. Does coverage include automatic coverage for substitute or newly acquired vehicles?XYes ❑ No If yes, please describe: D. Quotation 1. Automobile Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ 5,029 2. Alternate Automobile Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 12 of 38 E. INSURANCE COMPANY/RISK POOL INFORMATION Name of Com an Utica National p Y� A XI I A. M. Best Rating/Size: Insurance Company: C� Yes ❑ No Risk Pool: ❑ Yes ❑ No For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 13 of 38 Umbrella/Excess Liability Insurance A. BACKGROUND INFORMATION 1. No claims since inception of coverage in 2003. 2. Coverage is to be in excess of all Liability limits. B. Insurance coverage is to include the following: 1. Liability Limits & Coverage: Limit Per Aqgreqate General Liability $ 5,000,000 Occurrence $ 5,000,000 Personal &Advertising Injury $ 5,000,000 Person/Org. $ 5,000,000 Wrongful Acts—Claims Made Basis $1,000,000 Occurrence $ 1,000,000 Aggregate Limit $ 5,000,000 Self-Insured Retention -$10,000 2. Include a listing of additional coverages and coverage extensions. 3. Include a listing of exclusions. C. Quoted Coverage Provisions 1. Coverage Detail Limit Per Aqqreqate General Liability � 5,�00,000 (�r.r.i�rrPnc:P $ 5,OO�,n�n Personal &Advertising Injury $ 5,000,000 Person/Org. $ 5,000,000 Wrongful Acts—Claims Made Basis $1,000.000 Occurrence $ 1,000.000 Aggregate Limit $ 5,000,000 Self-Insured Retention $10,000 2. Is prior acts coverage provided? �7 Yes ❑ No If yes, please give effective date(s)and explanation. D. Quotation 1. Umbrella Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ 7,138 2. Alternate Umbrella Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ E. INSURANCE COMPANY/RISK POOL INFORMATION Name of Company: Utica National Insurance A. M. Best Rating/Size: A XII Insurance Company: � Yes ❑ No Risk Pool: ❑ Yes ❑ No Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 14 of 38 For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 1 S of 38 Crime Insurance A. BACKGROUND INFORMATION 1. No claims since inception of coverage in 2003. 2. Copy of current policy declaration schedule is attached. B. Insurance coverage is to include the following: 1. Crime Limits & Coverage Desired: Sinqle Loss Limit Retention Employee Theft $ 250,000 $ 2,500 ERISA Fidelity $ 250,000 $ 0 Forgery or Alteration $ 250,000 $ 2,500 On Premises $ 250,000 $ 2,500 In Transit $ 250,000 $ 2,500 Money Orders/Counterfeit $ 250,000 $ 2,500 Computer Fraud $ 250,000 $ 2,500 Program/Restoration Expense $ 100,000 $ 2,500 Funds Transfer Fraud $ 250,000 $ 2,500 Claim Expense $ 5,000 $ 0 2. Include a listing of additional coverages and coverage extensions. 3. Include a listing of exclusions. C. Quoted Coverage Provisions 1. Coverage Detail Sinqle Loss Limit Retention Employee Theft �250,000 � 2,500 ERISA Fidelity $250 000 $ 0 Forgery or Alteration $250,000 $ 2 500 On Premises $ 250.000 $ 2.500 In Transit $ 250,000 $ 2.500 Money Orders/Counterfeit $ 250,000 $ 2,500 Computer Fraud $ 250,000 $ 2.500 Program/Restoration Expense $ 100,000 $ 2,500 Funds Transfer Fraud $ 250,000 $ 2,500 Claim Expense $ 5,000 $ 0 D. Quotation 1. Crime Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ 2,850 2. Alternate Crime Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ E. INSURANCE COMPANY/RISK POOL INFORMATION Travelers Casualty And Surety Company of America Name of Company: A. M. Best Rating/Size: A XV Insurance Company: � Yes ❑ No Risk Pool: ❑ Yes ❑ No Westlake Academy-FY 20/21 Comprehensive Insurance RFP Page 16 of 38 For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 17 of 38 Workers Compensation Insurance A. BACKGROUND INFORMATION 1. Please contact Purchasing Agent at twood@westlake-tx.org for loss runs. 2. Experience Modifier is currently 1.37. 3. Estimated FY 20-21 payroll schedule is below. 4. Estimated number of regular employees is 103 (excluding substitute teachers & part-time coaches.) B. Insurance coverage is to include the following: 1. Workers Compensation Limits & Coverage Desired: Limit Per Bodily Injury by Accident $ 1,000,000 Accident Bodily Injury by Disease $ 1,000,000 Policy Limit Bodily Injury by Disease $ 1,000,000 Employee 2. Estimated FY 17-18 payroll is as follows: Pavroll Code Annual Amount Emplovees 8868 $ 5,672,533 134 (includes substitute teachers) 8810 $ 328,000 7 9101 $280,400 7 Total Estimated Payroll: $6,280,533 3. Please include "Others States Coverage"where applicable, as an additional endorsement. 4. Please include "Terrorism Risk" as an additional endorsement. 5. Include a listing of additional coverage, extensions, and exclusions. 6. Include a Blanket Waiver of Subrogation. C. Quoted Coverage Provisions 1. Does coverage utilize a specific provider network? �7 Yes ❑ No If yes, please provide details. D. Quotation 1. Workers Compensation Insurance Quote (Attach complete coverage information) Annual Premium (09/01/2020 to 08/31/2021): $ 25,924 2. Alternate Workers Compensation Insurance Quote (Attach complete coverage information) Annual Premium (09/01/2020 to 08/31/2021): $ E. INSURANCE COMPANY/RISK POOL INFORMATION Name of Company: Accident Fund Insurance Company A. M. Best Rating/Size: A XII Insurance Company: � Yes ❑ No Risk Pool: ❑ Yes ❑ No Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 18 of 38 For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Enrolled in Accident Fund's National Dividend Plan Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 19 of 38 International Travel Liability Insurance A. BACKGROUND INFORMATION 1. No claims since inception of coverage in 2015. 2. Coverage is for employees engaged in overseas travel, no countries excluded. 3. Coverage should include Medical Assistance, Personal Assistance, and Travel Assistance for employees and students, based on 50 participants per year. B. Insurance coverage is to include the following: 1. Benefits Limit Per Aqqreqate Medical Expense Limit $ 50,000 Person $ 50,000 Dental Treatment $ 250 Tooth $ 500 Room and Board Average Semi Private Room rate ICU Room and Board Charges Twice the semi-private room rate Treatment of Pregnancy Treated as any other medical condition Preexisting Conditions Treated as any other medical condition Chiropractic Care $ 35 Visit $ 350 Emergency Medical Evacuation 100% Expenses Repatriation of Remains 100% Expenses Chaperone Replacement $ 2,000 Accidental Death & Dismemberment $ 10,000 Student Accidental Death & Dismemberment $ 50,000 Faculty Kidnap/Ransom $ 100,000 Event $ 100,000 Aggregate Limit $ 250,000 Benefit Max 2. All coverage is $0 deductible with 100°/o coinsurance. 3. Include a listing of additional coverages, coverage extensions, and AD&D schedule. 4. Include a listing of exclusions. C. Quoted Coverage Provisions 1. Coverage Detail Limit Per Aqqreqate Medical Expense Limit $ 50,000 Person $ 50,000 Dental Treatment $ 250 Tooth $ 500 Room and Board Average Semi Private Room rate ICU Room and Board Charges Twice the semi-private room rate Treatment of Pregnancy Treated as any other medical condition Preexisting Conditions Treated as any other medical condition Chiropractic Care $ 35 Visit $ 350 Emergency Medical Evacuation 100% Expenses Repatriation of Remains 100% Expenses Chaperone Replacement $ 2,000 Accidental Death & Dismemberment $ 10,000 Student Accidental Death & Dismemberment $ 50,000 Faculty Kidnap/Ransom $ 100,000 Event $ 100,000 Aggregate Limit $ 250,000 Benefit Max 2. Does coverage include evacuation/repatriation? �7 Yes ❑ No Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 20 of 38 D. Quotation 1. International Travel Insurance Quote (Attach complete coverage information) Annual Premium (09/01/2020 to 08/31/2021): $ �2,000 2. Alternate International Travel Insurance Quote (Attach complete coverage information) Annual Premium (09/01/2020 to 08/31/2021): $ E. INSURANCE COMPANY/RISK POOL INFORMATION CHUBB Name of Company: A. M. Best Rating/Size: AXV Insurance Company:�] Yes ❑ No Risk Pool: ❑ Yes ❑ No For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 21 of 38 Student Accident Insurance A. BACKGROUND INFORMATION 1. Coverage is for all K-12 students participating in school sponsored activities, including sports. Liability waivers are obtained on all participants in sports programs. 2. Estimated Student Enrollment Count: 885 Grades K-8: 557 Grades 9-12: 328 3. Estimated Sports Participation is as follows: Football (grades 9-10): 35 Football (grades 11-12): 26 All other sports (grades 9-10): 170 All other sports (grades 11-12): 180 4. Batting cages or trampolines are not within the scope of the program. B. Insurance coverage is to include the following: 1. Liability Limits & Coverage: Limit Deductible Accident Medical Expense $ 25,000 $ 0 Accidental Death Benefit $ 15,000 $ 0 Accidental Dismemberment $ 50,000 $ 0 AD&D Aggregate Limit $ 500,000 2. Include a table of benefit amounts & percentages for covered medical expenses. 3. Include a listing of additional coverages, coverage extensions, exclusions, and AD&D schedule. C. Quoted Coverage Provisions 1. Coverage Detail: Limit Deductible Accident Medical Expense � 25,000 � 0 Accidental Death Benefit $ 15.000 $ 0 Accidental Dismemberment $ 50,000 $ 0 AD&D Aggregate Limit $ 500,000 2. Is arranged transportation included, prior, during, and after sponsored events?: ❑ Yes ❑ No If yes, please give effective date(s)and explanation. D. Quotation 1. Student Accident Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ 5,943 2. Alternate Student Accident Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 22 of 38 E. INSURANCE COMPANY/RISK POOL INFORMATION Name of Company: Philadelphia lnsurance Company A XV A. M. Best Rating/Size: Insurance Company: �l Yes ❑ No Risk Pool: ❑ Yes ❑ No For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 23 of 38 Cyber Risk Liability (optional) A. BACKGROUND INFORMATION 1. Coverage is intended to supplement Cyber Liability Coverage(s)that are contained within other policies quoted, or offer additional coverage excluded within those policies. 2. This should be offered as a stand-alone policy which may be accepted or rejected by Westlake Academy, without affecting the pricing of other policies. 3. Coverage should include the following or the most equivalent limits and deductible available: B. Insurance coverage is to include the following: 1. Liability Limits & Coverage: Limit Deductible Liability Coverages Networks and information security $ 1,000,000 $10,000 Communications and media $ 1,000,000 $10,000 Regulatory defense expenses $ 500,000 $10,000 1 St Party coverage Crisis Management event expenses $ 500,000 $10,000 Security Breach remediation and $ 500,000 $10,000 notification expenses E-commerce extortion $ 500,000 $10,000 Business interruption and additional $ 500,000 24 Hours Expenses 2. Include coverage descriptions of each insuring agreement 3. Include a listing of additional coverages, coverage extensions, and exclusions. C. Quoted Coverage Provisions 1. Coverage Detail: Limit Deductible Liability Coverages Networks and information security $ 1,000,000 $10,000 Communications and media $ 1,000,000 $10,000 Regulatory defense expenses $ 500,000 $10,000 15t Party coverage Crisis Management event expenses $ 500,000 $10,000 Security Breach remediation and $ 500,000 $10,000 notification expenses E-commerce extortion $ 500,000 $10.000 Business interruption and additional $ 500.000 24 Hours expenses D. Quotation 1. Cyber liability Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ Included In the General Liability Pricing 2. Alternate Cyber liability Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2020 to 08/31/2021): $ Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 24 of 38 E. INSURANCE COMPANY/RISK POOL INFORMATION Name of Company: Utica National Insurance A. M. Best Rating/Size: A XII Insurance Company: � Yes ❑ No Risk Pool: ❑ Yes ❑ No For Alternate Quote(s): Name of Company: A. M. Best Rating/Size: Insurance Company: ❑ Yes ❑ No Risk Pool: ❑ Yes ❑ No F. LIST ANY DEVIATIONS OR ADDITIONAL INFORMATION: Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 25 of 38 PROPOSAL SUBMITTAL FORMAT Quotations should be clearly labeled, using the format below. Proposals using an alternate format should have all quotes clearly labeled by policy type, and include policy limits, details, and cost. All submissions must include the completed forms below. 1 —Completed Questionnaire 2 - Property Insurance, Fire and Extended Equipment Coverage Quote 3 - General Liability Quote (including D&O, EPLI, EBLI and ELLI coverage) 4 -Automobile Liability& Physical Damage Quote 5 - Umbrella Liability Insurance Quote 6 - Crime Insurance Quote 7—Workers Compensation Insurance Quote 8— International Travel Insurance Quote 9—Student Accident Insurance Quote 10—Cyber Liability& Cyber Security Insurance Quote 11 -AgenYs Current License, Copy of E&O Insurance Certificate 12 - Completed and signed Felony Conviction Notice Form 13 - Completed and signed Non-Collusion Certification Form 14 - Completed and signed Conflict of Interest Questionnaire Form 15 - Completed and signed W-9 Form 16 - Completed and signed Form 2270 Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 26 of 38 Exhibit "A" - Propertv Schedule 1. All buildings are located on 2600 JT Ottinger Road, Westlake TX, 76262. Blanket coverage is required for buildings and contents. Buildinq Sq. Footaqe Valuation Roof Type #1 15,600 12,285,000 100% concrete tile #2: 20,000 8,770,000 100% concrete tile #3 11,200 4,491,000 100% concrete tile #4: 8,400 5,681,000 80% concrete tile, 20%flat membrane #5: 1,500 45,000 Portable #6: 1,500 45,000 Portable #7: 1,500 45,000 Portable #8: 10,853 2,920,000 75% seam metal, 25%flat membrane #9: 9,698 3,533,000 25% concrete tile, 75%flat membrane #10: 19,820 5,895,000 75% seam metal, 25%flat membrane #11: 1,500 45,000 Portable #12: 1,500 45,000 Portable #13: 1,500 45,000 Portable 2. Contents: $4,671,000 3. Business Income and Extra Expense: $484,000 4. Total Property Limits $ 49,000,000 Westlake Academy—FY 20/21 Comprehensive Insurance RFP Page 27 of 38 Compliance Express TM Page 1 of 1 � �� — - � �. '� � . �' � � �, � � � f � � � ��i � �� ' ; �� , � 44 �� , ; � ,, �' �� y� � 4� � � �� IF� � � � — � ,. � � �=— - —�-� � �� General Lines Agency Life, Accident, Health and HMO, Property and Casualty BOX INSURANCE AGENCY INC 1200 SOUTH MAIN ST STE 1600 GRAPEVINE, TX 76051 is authorized to transact business as described above License No: 8774 Issue Date: 03-07-2000 Expiration Date: 03-07-2022 Generated by Sircon 207284647 �� .��;�r�r�., IS HEREBY AUTHORIZED TO TRANSACT BUSINESS �� 't �� IN ACCORDANCE TO THE LICENSE DESCRIPTION F ��: � SHOWN BELOW: �L:I'ARfx1EF�7'{]I� ��SURrti\C'L THIS IS TO CERTIFY THAT �,�<�;` General Lines Agency ''��`~ Life, Accident, Health and HMO, BOX INSURANCE AGENCY INC Property and Casualty 1200 SOUTH MAIN ST STE 1600,GRAPEVINE,TX 76051 Issue Date:03-07-2000 Expiration Date:03-07-2022 LICENSE NUMBER:8774 Generated by Sircon 207284647 https://www.sircon.com/ComplianceExpress/ServiceRequest/licPrnt.do?method=coll ectPay... 1/9/2020 At�� DATE(MM/DDIYYYY) a..�� CERTIFICATE OF LIABILITY INSURANCE a�ai�aoao THiS CERTIFICATE IS ISSUED AS A MATTER OF INFORMA710N ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICA7E OF iNSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATNE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. 1f SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s}. PRODUCER CONTACT NAME: Texas Insurance Professionals Services IriC. PHONE Fax PO BOX 700877 A!C No Ext• A/C No: E-MAIL Dallas, TX 75370 ADDRESS: INSURER S AFFORDING COVERAGE NAIC# INSURERA: L7MIC0 INSURED �NSURER e: Box Bonding Agency LLC dba Box Insurance Agency INSURERC: 1200 S. Main Street, Suite 1600 INSURERD: Grapevine, TX 76051 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED: NOTWITHSTANDWG ANY REQUIREMENT, TERM OR CONDITION OF ANY CON7RACT OR OTHER DOCUMEN7 WITH RESPECT TO WHICH 7H4S CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES pESCRIBED HEREIN IS SUBJECT TO AL� THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CIAIMS. INSR TYPE OF INSURANCE ADDL SUBR pOLICY NUMBER MMIDD�YY MMIDDY� LIMITS LTR ' COMMERCIALGENERALLIABIL�TY EACHOCCURRENCE $ A CLAIMS-MADE �OCCUR PREMISES Ea occurrence $ MED EXP(Any one person) S PERSONAL 8 ADV INJURY $ GEN'LAGGREGATELIMITAPPLIESPER�: GENERALAGGREGATE $ POLICY❑ PR� �LOC PRODUCTS-COMP/OPAGG $ JECT OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT g Ea accident ANY AU70 SODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ - AUTOS ONLY AUTOS HIRED NON-OWNED PROPER7Y DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident _ $ UMBRELLALIAB OCCUR � EACHOCCURRENCE $ EXCESSLIAB CLAIMS-MADE AGGREGATE $ OED RETENTION^� $ WORKERS COMPENSATION AND EMPLOYERS'LIABILITY Y!N STATUTE ERH ANYPROPRIETORIPARTNER/EXECUtIVE ❑ N�A E.L EACH ACCIDENT $ __ OFFICER/M EMB ER EXCLUDED? (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ __`_,_ If yes,describe under DESCRIPTION OF OPERATIONS beiow E.L.DISEASE-POLICY LIMIT $ Other 5330160 2/18/20 2/18/21 Each Loss;10,000,0 0 Agents & Brokers E&O Aggregate:li,000,0 0 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Addltlonal Remarks Schedule,may be attached if more space is required) Deductible: $50,000 Each Loss: 150,000 Aggregate: Loss Plus Litigation Named Insured : Box Bonding Agency, LLC dba Sox Insurance Agency Box Professional Insurance Agency LLC Box Home and Auto LLC CERTIFiCATE HOLDER CANCELLATtON Box Bonding Agency LLC dba Box Insurance Agency SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 1200 S. Main StYeet, Suite 1600 THE EXPtRATION DATE THEREOF, NOTICE WILL BE DELIVERED lN Grapevine, TX 76051 ACCORDANCEWITHTHEPOLICYPROVISIONS. AUTHORIZED REPRESENTATIVE c P�� O 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016f03) The ACORD name and logo are registered marks of ACORD .��5 � � � � � � � � '��w��" Town of Westlake Westlake Academy Human Resources Department FELONY CONVICTION NOTICE State of Texas Legislative Senate Bill No. 1, Section 44.034, Notification of Criminal History, Subsection (a), states "a person or business entity that enters into a contract with a school district must give advance notice to the district if the person or an owner or operator of the business entity has been convicted of a felony. The notice must include a general description of the conduct resulting in the conviction of a felony. Subsection (b) states "a school district may terminate a contract with a person or business entity if the district determines that the person or business entity failed to give notice as required by Subsection (a) or misrepresented the conduct resulting in the conviction. The district must compensate the person or business entity for the services performed before the termination of contract." THIS NOTICE IS NOT REQUIRED OF A PUBLICLY-HELD CORPORATION I, the undersigned agent for the firm named below, certify that the information concerning notification of felony has been reviewed by me and the following information furnished is true to the best of my knowledge. VENDOR'S NAME: Box Bonding Agency, LLC, DBA Box Insurance Agency AUTHORIZED COMPANY OFFICIAL'S NAME (PRINTED) Adam Syswerda Please check all that apply: ❑ My firm is publicly-held corporation, therefore, this reporting requirement is not applicable. 0 My firm is neither owned nor operated by anyone who has been convicted of a felony: � My firm is owned or operated by the following individual(s)who has/have been convicted of a felony: Name: Details of Conviction(s): /�' 8/7/2020 Contractor/Company Official Signature Date 1500 Solana Blvd, Bldg. 7, Suite#7200 �Westlake,Texas 76262 Metro: 817-490-5711 ♦ Fax: 817-430-1812 ♦w�vw.westlakeacademy.org .��5 � � � � � � � � '��w��" Town of Westlake Westlake Academy Human Resources Department NON-COLLUSION STATEMENT The undersigned Proposer, by signing and executing this proposal, certifies and represents to the Town of Westlake and Westlake Academy that Proposer has not offered, conferred or agreed to confer any pecuniary benefit, as defined by Section 1.07 (a)(6) of the Texas Penal Code, or any other thing of value, as consideration for the receipt of information or any special treatment or advantage relating to this proposal; the Proposer also certifies and represents that Proposer has not offered, conferred or agreed to confer any pecuniary benefit or other things of value as consideration for the recipient's decision, opinion, recommendation, vote or other exercise of discretion concerning this proposal; the Proposer certifies and represents that Proposer has neither coerced nor attempted to influence the exercise of discretion by any officer, trustee, agent or employee of the Town of Westlake and Westlake Academy concerning this proposal on the basis of any consideration not authorized by law; the Proposer also certifies and represents that Proposer has not received any information not available to other proposers so as to give the undersigned a preferential advantage with respect to this proposal; the Proposer further certifies and represents that Proposer has not violated any state, federal or local law, regulation or ordinance relating to bribery, improper influence, collusion or the like and that Proposer will not in the future, offer, confer, or agree to confer any pecuniary benefit or other thing of value of any officer, trustee, agent or employee of the Town of Westlake and Westlake Academy in return for the person having exercised the person's official discretion, power or duty with respect to this proposal; the Proposer certifies and represents that it has not now and will not in the future offer, confer, or agree to confer a pecuniary benefit or other thing of value to any office, trustee, agent or employee of the Town of Westlake and Westlake Academy in connection with information regarding this proposal, the submission of this proposal, the award of this proposal or the performance, delivery or sale pursuant to this proposal. Firm Name: Box Bonding Agency, LLC, DBA Box Insurance Agency Address: 1200 S. Main St. Suite 1600 City/State/Zip: Grapevine, TX 76051 817-865-1806 817-424-1404 Phone: Fax: Name of Representative(s): Adam Syswerda Signature of Representative(s): Date: $�7�2020 1500 Solana Blvd., Bldg 7, Suite#7200 •Westlake,Texas 76262 Metro: 817-490-5711 • Fax: 817-430-1812 ��wvw.westlakeacademy.org CONFLICT OF INTEREST QUESTIONNAIRE FORM CIQ For vendor doing business with local governmental entity This questionnaire reflects changes made to the law by H.B. 23, 84th Leg., Regular Session. OFFICEUSEONLY This questionnaire is being filed in accordance with Chapter 176, Local Government Code, by a vendor who Date Received has a business relationship as defined by Section 176.001(1-a) with a local governmental entity and the vendor meets requirements under Section 176.006(a). By law this questionnaire must be filed with the records administrator of the local governmental entity not later than the 7th business day after the date the vendor becomes aware of facts that require the statement to be filed. See Section 176.006(a-1), Local Government Code. A vendor commits an offense if the vendor knowingly violates Section 176.006, Local Government Code.An offense under this section is a misdemeanor. 1 Name of vendor who has a business relationship with local governmental entity. Box Bonding LLC, DBA Box Insurance Agency 2 � Check this box if you are filing an update to a previously filed questionnaire.(The law requires that you file an updated completed questionnaire with the appropriate filing authority not later than the 7th business day after the date on which you became aware that the originally filed questionnaire was incomplete or inaccurate.) 3 Name of local government officer about whom the information is being disclosed. Name of Officer 4 Describe each employment or other business relationship with the local government officer, or a family member of the officer,as described by Section 176.003(a)(2)(A). Also describe any family relationship with the local government officer. Complete subparts A and B for each employment or business relationship described. Attach additional pages to this Form CIQ as necessary. A. Is the local government officer or a family member of the officer receiving or likely to receive taxable income, other than investment income, from the vendor? � Yes � No B. Is the vendor receiving or likely to receive taxable income,other than investment income,from or at the direction of the local government officer or a family member of the officer AND the taxable income is not received from the local governmental entity? � Yes X� No 5 Describe each employment or business relationship that the vendor named in Section 1 maintains with a corporation or other business entity with respect to which the local government officer serves as an officer or director, or holds an ownership interest of one percent or more. 6 ❑ Check this box if the vendor has given the local government officer or a family member of the officer one or more gifts as described in Section 176.003(a)(2)(B), excluding gifts described in Section 176.003(a-1). 7 8/7/2020 Signature of vendor doin business with the governmental entity Date Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015 CONFLICT OF INTEREST QUESTIONNAIRE For vendor doing business with local governmental entity Acomplete copy of Chapter 176 of the Local Government Code may be found at http://www.statutes.legis.state.tx.us/ Docs/LG/htm/LG.176.htm. For easy reference, below are some of the sections cited on this form. Local Government Code§176.001(1-a):"Business relationship"means a connection between two or more parties based on commercial activity of one of the parties. The term does not include a connection based on: (A) a transaction that is subject to rate or fee regulation by a federal,state,or local governmental entity or an agency of a federal,state,or local governmental entity; (B) a transaction conducted at a price and subject to terms available to the public; or (C) a purchase or lease of goods or services from a person that is chartered by a state or federal agency and that is subject to regular examination by, and reporting to,that agency. Local Government Code§176.003(a)(2)(A)and(B): (a) A local government officer shall file a conflicts disclosure statement with respect to a vendor if: *�* (2) the vendor: (A) has an employment or other business relationship with the local government officer or a family member of the officer that results in the officer or family member receiving taxable income, other than investment income, that exceeds $2,500 during the 12-month period preceding the date that the officer becomes aware that (i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor; (B) has given to the local government officer or a family member of the officer one or more gifts that have an aggregate value of more than$100 in the 12-month period preceding the date the officer becomes aware that: (i) a contract between the local governmental entity and vendor has been executed; or (ii) the local governmental entity is considering entering into a contract with the vendor. Local Government Code§ 176.006(a)and (a-1) (a) Avendor shall file a completed conflict of interest questionnaire if the vendor has a business relationship with a local governmental entity and: (1) has an employment or other business relationship with a local government officer of that local governmental entity,or a family member of the officer,described by Section 176.003(a)(2)(A); (2) has given a local government officer of that local governmental entity, or a family member of the officer,one or more gifts with the aggregate value specified by Section 176.003(a)(2)(B),excluding any gift described by Section 176.003(a-1);or (3) has a family relationship with a local government officer of that local governmental entity. (a-1) The completed conflict of interest questionnaire must be filed with the appropriate records administrator not later than the seventh business day after the later of: (1) the date that the vendor: (A) begins discussions or negotiations to enter into a contract with the local governmental entity; or (B) submits to the local governmental entity an application,response to a request for proposals or bids, correspondence, or another writing related to a potential contract with the local governmental entity;or (2) the date the vendor becomes aware: (A) of an employment or other business relationship with a local government officer, or a family member of the officer,described by Subsection (a); (B) that the vendor has given one or more gifts described by Subsection (a);or (C) of a family relationship with a local government officer. Form provided by Texas Ethics Commission www.ethics.state.tx.us Revised 11/30/2015 Form �'9 Request for Taxpayer G+��o�m�o�r�e (Rev.December2071) Identifica#ion Number and Certification requester.Do nat bepartment of the Treasury Send tv#he IRS. Internal Aevenue Service Name(as shown on your income tax return) � Business name/disregarded entity name,ii different frotn abava � Box Insurance Agency,Inc. � Check appropriate box for federal tax classification: � � ❑ IndividuaVsole proprietor n✓, C Corporation ❑ S Corporation ❑ Partnarship ❑TrusUesfate K ao '�� Limited liability company.Enter the tax elassification(C=C corporation,S=5 corpora#ivn,P=partnership)► ❑Exempt payee o --------�----------------------- � � �'�' [] Other(see Instructions}► U !_ Address(number,street,and apt,or suite no.} Requester's�ame and address(optionat) v Q 12D0 S.Main 5t„ 5te. 7600 � City,state,and ZIP code � Gra}�e�iroe,TX 76051 List account numi�er{s)here(vptional) � Taxpayer ldenti#ication Number(TINy Enter your TIiV in the appropriate box.The T1N provided rr�ust match the name given nn the"Name"line Social security number to avoid backup withholding.For individuals,this is your social security nurnber(SSN}.However,for a � T m _� resident alien,sofe�roprietor,or disregarded entity,see the Part 1 instructions on pag�3.For oth�;r entities,it is your emgloyer identification number(EIN).ff you do not have a number,see Now tn gef a T1N on page 3. Note.If the aocount is in more than one name,sse the chas't on page 4 for gu3delines on whvse Employer identification numher number to snter. 7 5 — 2 8 3 5 4 2 3 Certification Under penalties of perjury,I cestify that: 1. 7'he number shown on this form is my correct taxpayer identification number(or I am waiting far a number to be issued to meJ,and 2. f am not subject to backup withholding because:{a)I am exempt frvm hackup withholding,or(b)(have not been notified by the Internal Revenue Service(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,ar(c}the IR5 has notified me that E am no fonger subject to backup wiEhholding,and 3. I am a U.S.citizen ar otl�er U.S,person(defined below). Certifioation instruotions.You must crass aut item 2 above if you have been notified by the IRS that you are currently subject tv backup withholding because you have failed to report all interest and dividends on your tax return.for real estate transactions,item 2 does not epply.For mortgage interest paid,acquisition or abandonment of s cured Aroperty,cancellation of debt,contributions to an individual retirement arrangemenf(fRA},and gsneraily,payments other in ere nd di idends,you are nof required to sign the certification, but you must provide your correct TIN.5ee the instrt�ctions on page 4. 5i�� 5ignature of �� H�r�' U.S.person► Date► Ci@1i01'a� �IlStl'UC#iO11S Note.If a requester gives you a fiorm other#han Form W-9 to request your TIN,you must use the requestePs form if it is substantialEy simifar Section references are to#he Internal Revenue Code ur�less otherwise to this Form W-9. noted. pefinition of a U.S.person.For federal tax purposes,yau are PUP�.?OS@ O'� �Oi'I'Yl considered a 11.5,person if you are: A person who is required Eo fife an inform�tion return with the IRS must •An individual w�a is a U.S.cit3zen or U.S.resident alien, obtain your correct taxpayer identification number(TIN)ta report,for •A partnership,corporation,company,nr associatinn created nr example,incvme paid#o you,real astata transaciions,martgage interest organized in the United 5tates or under the laws af#he United 9tates, you paid,acquisi#ion or abandonmen#af secured property,canceilation .An estate{other than a foreign estate),ar of debt,or contributions you made to an IRA. •A domestic trust{as defined in Regulations section 301.7761-7). f3se Form W-9 only if you are a U.S.person(inciuding a resident alien},to provide your correct T!N to the person requesting it{the 5pecial rufes for partnerships.Partnsrships that conduct a trade or requester}and,w�en applicable,#o: business in the�nited States are generaliy required to pay a withholding tax an any foreign partners'share of income from such business. 1.CertEfy that the T1N you are giv'sng is carrect(or you ar�waiting for a Further,in cer#ain cases where a Form W-9 has not been reoeived,a number ta be issued), pa�tnership is required to presume that a partner is a foreign person, 2.Certify that you are nat sub}ect to backup wi#hholding,or and pay the withfiolding tax.Therefore,if you are a U.S.person that is a 3.Claim exemptEon from backup withholding if you are a U.S.exempt partner in a partnership conducting a trade or b�siness in the United payee.If applicable,you are afsa cer�ifiying that as a U.S.person,yvur S#ates,provide Form W-9 to the partnership to es#ablish your U.S. allocabfe share of any partnership income fram a U.S.trade or bt�siness status and avoid withholding ort your share of partnership incnme. is not subject to the withholding tax on foreign partners'share oP effectively connecEed income: Cat.No.t0237X Form{N-�(Ftev.12-2U11) VERIFICATION REOUIRED BY TEXAS GOVERNMENT CODE CHAPTER 2270 By signing below, the signatory hereby verifies that the firm it represents: 1. Does not boycott Israel; and, 2. Will not boycott Israel during the term of the contract. SIGNED BY: —� Print Name& Title: Adam Syswerda, Vice President Box Insurance Agency Firm Name: Date Signed: ��J I �� O NOTARIZATION THE STATE OF� t� ) ) COUNTY OF ) BEFORE ME, the undersigned notary public on this day personally appeared nC�y��5 v s�e 20l�a ,on behalf of �pX��„s ��a,,,.�,�, d�q .�., .�.� (Company),who,being duly sworn, stated under oath that he/she has read the foregoing verification requir d by Texas Government Code Section 2270.002 and said statements contained therein are true and correct. SWORN TO AND SUBSCRIBED before me on the�day of�,20�� . �,�,�Y w,�, SHAAON KAY MINITRE -��1� � � * * NOTAAY PUBIJC STATE OF TEXAS NOTARY PUBLIC IN ND �,'�Of��,y MYCOMM.IXP.02I14�2021 FOR THE STATE OF��S . �� NOTARY ID 17A6953 The following definitions apply to Texas Government Code Section 2270.001: (1) "Boycott Israel" means refusing to deal with, terminating business activities with, or otherwise taking any action that is intended to penalize, inflict economic harm on, or limit commercial relations specifically with Israel, or with a person or entity doing business in Israel or in an Israeli-controlled territory, but does not include an action made for ordinary business purposes; and (2) "Company"means a for-profit sole proprietarship,organization,association,corporation, partnership,joint venture, limited partnership, limited liability partnership, or limited liability company, including a wholly owned subsidiary, majority-owned subsidiary, parent company, or affiliate of those entities or business associations that exists to make a profit. State law requires any�irm entering into an agreement or contract with the Authority to complete the foregoing veri�cation. TEx. GOV'T CODE §2270.002. I 1 ' I I • ' Westlake Academy Presented by: Underwriter Andy Clark �RU M 8� F�RSTER� N -a.�-Ati . .;r.�� . . . �� MBEST � A 6iaeNert � A. M. Best Rated A(Excellent) Confidentiality notice: The information contained in this Quote Proposal is confidential and may be privileged and protected from disclosure. If the reader of this Quote Proposal is not the intended recipient,or an employee or agent responsible for delivering this message to the intended recipient,you are hereby notified that it is strictly prohibited(a)to disseminate,distribute or copy this communication or any of the information contained in it,or(b)to take any action based on the information in it. If you have received this communication in error, please notify us immediately by replying to this message and deleting it from your computer. Electronic policy delivery notice: This quote is conditioned upon the Insured's consent to receive electronic copies of policies,change endorsements, notices,and related materials(other than those that are subject to statuses or regulations specifically prescribing methods of delivery other than electronic delivery). By accepting this quote on behalf of the applicant/insured you acknowledge that you have received authority from the applicant/insured to accept this condition. �RUM & F�RSTER` Commercial Output Program Property Summary Coverege Deductible Valuation Limit Building 10,000 Replacement Cost See Statement of Values Business Personal Property-Incl Stock 10,000 Replacement Cost See Statement of Values Income-Earnings,Rents,Extra Expenses 72 Hours See 5[atement of Values Flood 50,000 5,000,000 Ea rthq u a ke 50,000 5,000,000 Blanket Spoilage 10,000 250,000 Ordinary Payroll Limitation 90 Days Windstorm/Hail 2%subject to 100,000 min. Terrorism Equipment Breakdown Coverage Type Deductible Limit Property 10,000 48,516,000 Income-Earnings and Extra Expense 484,000 Spoilage 10,000 250,000 Breakdown,Malfunction or Failure(Equipment Breakdown) Incl. Incl. Refrigerant Contamination(Equipment Breakdownf Incl. Incl. Refrigerant Contamination(Other Causes of LossJ Incl. Incl. Power Disruption(Equipment BreakdownJ Incl. Incl. Power Disruption(Other Causes of Loss) Incl. Incl. Expediting Expenses 250,000 Hazardous5ubstances 250,000 Data Restoration 250,000 CRU M &FaRSTER' Statement of Values Location Building Address Building Business Personal Property Income 1 1 2600 Ottinger Road,Westlake,TX 76262 12,285,000 1,600,000 334,000 1 2 2600 Ottinger Road,Westlake,TX 76262 8,770,000 791,000 15,000 1 3 2600 Ottinger Road,Westlake,TX 76262 4,491,000 500,000 15,000 1 4 2600 Ottinger Road,Westlake,TX 76262 5,681,000 380,000 15,000 1 5 2600 Ottinger Road,Westlake,TX 76262 45,000 10,000 10,000 1 6 2600 Ottinger Road,Westlake,TX 76262 45,000 10,000 10,000 1 7 2600 Ottinger Road,Westlake,TX 76262 45,000 10,000 10,000 1 8 2600 Ottinger Road,Westlake,TX 76262 2,920,000 350,000 15,000 1 9 2600 Ottinger Road,Westlake,TX 76262 3,533,000 440,000 15,000 1 30 2600 Ottinger Road,Westlake,TX 76262 5,895,000 550,000 15,000 1 11 2600 Ottinger Road,Westlake,TX 76262 45,000 10,000 10,000 1 12 2600 Ottinger Road,Westlake,TX 76262 45,000 10,000 10,000 1 13 2600 Ottinger Road,Westlake,TX 76262 45,000 10,000 10,000 Note:Blanket Building and Business Personal Property Limits Applicable �RLJM & F�R�TER�� , -.. .-. . " - .' ..f- Coverage Extensions Description Limit Consequential Loss Subject to Applicable Covered Property Limit Damage From Theft Subject to Applicable Covered Property Limit Debris Removal (Additional Expense) 50,000 Emergency Removal 365 Days Emergency Removal Expense 5,000 Fraud and Deceit 5,000 Off Premises Utility Service Interruption 50,000 Overhead Transmission Lines Included Supplemental Coverages Description Limit Brands or Labels Expense 50,000 Expediting Expenses 50,000 Fire Department Service Charges 25,000 Inventory and Appraisal Expense 50,000 Ordinance or Law(Undamaged Parts of a Bldg) Subject to Applicable Covered Property Limit Ordinance or Law (Increased Cost to Repair/Cost to Demolish and Clear Site) 100,000 Personal Effects 15,000 Pollutant Cleanup and Removal 50,000 Recharge of Fire Extinguishing Equipment 50,000 Rewa rds 10,000 Sewer Backup and Water Below the Surface 25,000 Trees, Shrubs and Plants 50,000 Underground Pipes, Pilings, Bridges and Roadways 250,000 Supplemental Marine Coverages Description Limit Accounts Receivable 50,000 Virus and Hacking Excluded Fine Arts 100,000 Off Premises Computers 25,000 Property on Exhibition 50,000 Property in Transit 50,000 Sales Representatives Samples 50,000 Software Storage 50,000 Electrical or Magnetic Disturbance of Computers Subject to Applicable Covered Property Limit Power Supply Disturbance of Computers Subject to Applicable Covered Property Limit Valuable Papers 100,000 CRU M & F�RSTER� Coverage Options Description Limit Newly Built or Acquired Buildings 1,000,000 Personal Property-Acquired Locations 250,000 Locations 'You' Elect Not to Describe 50,000 Erroneous Delivery Excluded Surface Water Contamination Excluded Tanks Leakage Excluded Income Coverage Extensions Description Period Interruption by Civil Authority 30 Days Period of Loss Extension 90 Days Income Supplemental Coverages Description Limit Dependent Locations 100,000 Pollutants Cleanup and Removal 10,000 Property in Transit, On Exhibition, or Custody of Sales Representatives 50,000 Off Premises Utility Service Interruption 10,000 Off Premises Utility Service Interruption -Waiting Period 72 Hours Overhead Transmission Lines Included Computer Virus & Hacking Excluded Contract Penalty Limit Any One Occurrence 25,000 LimitAny 12 Month Period 25,000 Income Coverage Options Description Limit Newly Built or Acquired Locations 100,000 �RU M � F�RSTER� ., �.a�w�ax :..:�r:s - :� SCHEDULE OF FORMS Title Form Number Edition Policyholder Disclosure Notice of Terrorism Insurance Coverage CL 10 45 0115 Commercial Output Program Policy Declarations CO 05 001 0918 Schedule of Forms and Endorsements CO 06 001 0918 Certified Terrorism Loss CL 06 00 0115 Certified Terrorism Loss Disclosure of Premium and Federal Share of Insured Losses CL 06 05 0115 Virus or Bacteria Exclusion CL 07 00 1006 Schedule of Locations CO 06 002 0918 Common Policy Conditions CL 01 00 0399 Amendatory Endorsement Texas CL 02 73 0719 Equipment Breakdown Coverage Part CO 00 001 0119 Amendatory Endorsement-Texas CO 01010 0119 Equipment Breakdown Schedule CO 06 010 0119 Commercial Output Program - Property Coverage Part CO 10 00 1002 Commercial Output Program - Income Coverage Part CO 10 01 0402 Spoilage Coverage Part-Scheduled Coverage CO 10 04 0402 Schedule of Coverages-Commercial Output Program CO 10 SO 0305 Location Schedule CO 10 52 0402 Earthquake Schedule CO 10 62 0402 Flood Schedule CO 10 63 0402 Ordinary Payroll Limitation Schedule CO 10 67 0402 Spoilage Schedule CO 10 74 0402 Scheduled Locations Endorsement CO 12 27 0502 Ordinary Payroll Limitation CO 12 42 0402 Waiting Period - Income Coverage CO 12 81 0402 Windstorm or Hail Deductibles (Percentage Deductible Subject to a Minimum Dollar Deductible) CO 03 001 0819 Earthquake Endorsement CO 04 002 0918 Flood Endorsement CO 04 004 0918 Windstorm or Hail Schedule CO 06 012 0819 Windstorm Meaning and Clarification Endorsement CO 24 029 1119 Account Name: WESTLAKE ACADEMY Policy Period: 08/31/2020 to 08/31/2021 Quote Number: 5376290 I I � • I I • Commercial General Liability Limits General Aggregate $2,000,000 ProducUCompleted Operations Aggregate $2,000,000 Per Occurrence $1,000,000 Personal &Advertising Injury $1,000,000 Damage to Premises Rented to You $1,000,000 Medical Expenses (Excludes Student Medical Expenses) $10,000 Deductible or Self Insured Retention None Defense including court costs Outside the limits Athletic Participants Coverage Included Incidental Malpractice Liability Included Prejudgment and postjudgment interest Outside the limits Rating Classification(s): Description Rating Basis Exposure Schools - Private- Elementary, Kinder- Garten Or Junior Per Pupil 567 Schools - Private- High - Not-For-Profit Only Per Pupil 339 Museums - Not-For- Profit Only- Products - Completed Per Thousand Sq. Ft. 8400 Endorsements *Any Exclusions/Limitations listed are in addition to those in the coverage forms. 8C2636 Employment Related Practices- Liability Coverage Form 8D2636 Employment Related Practices- Liability Insurance Declaration 8E2813 Texas Employment Related Practices 8C1014 Employee Benefit Programs Liability Coverage Form 8E3529 Texas Amendatory Endorsement 8D1014 Employee Benefit Programs Liability Coverage Part Dec 8C1213 Sdell Coverage Form 8D1213 School District And Educators Legal Liability Insurance Declarations 8C3326TX Abuse or Molestation Liability Coverage Form 8D3326 Abuse or Molesation Liability Coverage Part(Claims-Made Basis) 8E3548TX General Liability Extension Endorsement 8D4117 Cyber Suite Declarations 8C4117 Cyber Suite Coverage Form 8E3350TX Exclusion - Fungi or Bacteria IL0985 Disclosure Pursuant to Terrorism Risk Insurance 8L938 Utica Lloyds of Texas CG2646 Texas Abuse or Molestation Exclusion 8E3345TX Fungi or Bacteria Exclusion 8E3149 Extended Reporting Period for Limted Erp Coverage 8L1788 Important Notice-TX Disclosure Form CG2167 Fungi or Bacteria Exclusion 8E1782 Exclusion - Lead Liability Exclusions 8E4174 Educational Institutions Limited Unmanned Aircraft Coverage 8E3042TX Educational Institution Coverage Endorsement 8E3204 Employment- Related Practices Exclusion 8E1611 TX Changes-Amendatory Endorsement 8E3674 Exclusion - Recording And Distribution of Material or Info In Violation of Law 131038 Account Name:WESTLAKE ACADEMY Policy Period: 08/31/2020 to 08/31/2021 Quote Number:5376290 Endorsements *Any Exclusions/Limitations listed are in addition to those in the coverage forms. (continued) 8E3857 Knowledge of Wrongful Acts 8E3350TX Exclusion - Fungi or Bacteria CG2639 Texas Changes- Employment Related Pracitces Exclusion 8E4182 Your Investigation And Public Relations Expenses Educational Institutions Limited Unmanned Aircraft Coverage 8E4174 Adds Bodily Injury and Property Damage liability coverage for drones used in connection with the named insured's operations. Unscheduled Unmanned Aircraft $250,000 131038 Account Name:WESTLAKE ACADEMY Policy Period: 08/31/2020 to 08/31/2021 Quote Number:5376290 Claims-Made Liability Coverages: School District and Educators Legal Liability Coverage: Limits $1,000,000 Each "Loss" $2,000,000 Annual Aggregate Retention $10,000 Each Loss Retained Amount Retroactive Date 08/31/11 Coinsurance None Defense Outside the limits Optional Extended Reporting Period Premium of inception premium Who is insured? • Educational Institution • School Board, School Committee, Board of Trustees, or similar governing body • Elected or appointed members of the School Board, School Committee, Board of Trustees, School Directors, Board of Governors, etc. • Employees • Student Teachers • School Volunteers • Student serving school sponsored internship Payment of Damages Pay on behalf of Typical allegations brought under this coverage • Failure to educate • Budget dispute claims Definition of suit includes • Arbitration • Other alternative dispute resolution proceedings Limited Coverage for Salary or Benefits Claims $2,500 Each Loss Limit $100,000 Annual Policy Year Limit Cost of appeal bonds or bonds to release attachments Included Loss of Earnings due to assisting with investigation/defense $250 per day of claim All costs taxed against insured in suit Included Prejudgment and Postjudgment interest Included Cyber Suite Coverage: Aggregate Limit $1,000,000 Deductible $10,000 Retroactive Date Exclusion(s) and Endorsement(s) in addition to those in the School District and Educators Legal Liability Coverage Form: 8E3204 Employment Related Practices Exclusion Included Abuse or Molestation Liability (including Sexual Misconduct or Sexual Molestation): Limits $1,000,000 Each "Loss" Limit $1,000,000 Annual Aggregate Limit Retroactive Date 08/31/11 Defense Applies outside the limits Optional Extended Reporting Period Premium 131038 Account Name:WESTLAKE ACADEMY Policy Period: 08/31/2020 to 08/31/2021 Quote Number:5376290 Abuse or Molestation Liability (including Sexual Misconduct or Sexual Molestation) (continued): Who is insured includes • Named Insured • Directors, Officers or Trustees • Teachers • Board of trustees, governors or education • Same positions as above on Affiliates • Volunteer Worker Payment of Damages Pay on behalf of Definition of suit includes • Arbitration • Other alternative dispute resolution proceedings Cost of appeal bonds Included Loss of Earnings due to assisting with investigation/defense $250 per day of claim All costs taxed against insured in suit Included Prejudgment and Postjudgment interest Included Employee Benefit Programs Liability Coverage: Limits $1,000,000 Each Loss Limit $3,000,000 Annual Aggregate Limit Retention $1,000 Per Loss Retroactive Date 08/31/11 Defense Applies outside the limits Optional Extended Reporting Period Premium of premium Employment-Related Practices Liability: Limits $1,000,000 Each Claim Limit $1,000,000 Policy Aggregate Limit Retention Amount Each Claim Select Retroactive Date 08/31/11 Coinsurance 0% Subject to a Maximum of Each Claim Defense Inside the limits Optional Extended Reporting Period Premium if 12 months extended reporting is chosen if 24 months extended reporting is chosen if 36 months extended reporting is chosen Cost of appeal bonds or bonds to release attachments Included Payment of Damages Pay on behalf of Loss of Earnings due to assisting with investigation/defense $250 per day of claim All costs taxed against insured in suit Included Salary Remuneration Sublimit does not apply Definition of claim includes • Arbitration • Other alternative dispute resolution proceedings Who is insured • Named Insured • Current or Former Directors • Current or Former Employees • Current or Former Leased Employees Access to Risk Management Library via web Included 131 U:i�3 Account Name: Policy Period: 08/31/2020 to 08/31/2021 Quote Number: • I � I Policy Coverage Symbol Limit Liability Combined Single Limit 1 $1,000,000 Personal Injury Protecton (PIP) 5 $2,500 Medical Payments Coverage Not Selected Uninsured/Underinsured Motorists 7 $1,000,000 Comprehensive Deductible - See Vehicles 7 Collision Deductible - See Vehicles 7 Hired Auto Liability Combined Single Limit Combined Single Limit Comprehensive Coverage Not Selected Specified Causes of Loss Coverage Not Selected COIIISIOn Coverage Not Selected Non-Owned Auto Liability Combined Single Limit $1,000,000 Drive Other Car Liability Combined Single Limit Coverage Not Selected Medical Payments Coverage Not Selected Uninsured/Underinsured Motorists Coverage Not Selected Comprehensive Coverage Not Selected COIIISIOn Coverage Not Selected 1:31 U:�t3 Account Name: Policy Period: 08/31/2020 to 08/31/2021 Quote Number: Commercial Automobile Auto Endorsements / Enhancements Premium 8E2419 04/17 Commercial Automobile Extension Endorsement $50.00 CA2264 07/08 Texas Personal Injury Protection Endorsement Included 8L1303 06/15 Texas Policyholder Complaint Procedures Included IL0021 04/98 Nuclear Energy Liability Exclusion Endorsement Included CA0001 03/10 Business Auto Coverage Form Included CA0196 03/12 Texas Changes Included IL0017 11/98 Common Policy Conditions Included CA2394 03/06 Silica or Silica-Related Dust Exclusion for Covered Autos Exposure Included CA0243 03/01 Texas Changes-Cancellation And Nonrenewal Included 8L2182 05/16 Texas Uninsured/Underinsured Motorist Coverage Selection/Rejection Included CA2109 05/13 Texas Uninsured/Underinsured Motorist Included 8L938 04/05 Utica Lloyds of Texas Included 131038 Account Name: Policy Period: 08/31/2020 to 08/31/2021 Quote Number: State: TX Vehicle Schedule A list of vehicles and the coverages that apply to each: Make,Model, Other Than Vehicle Vehicle ID Number Personal Injury Medical Collision Collision # Year VIN Liabilit Protection PIP Pa ments Deductible Deductible Towin Premium 1 2006 CHEVROLET GIRARDIN X X Comprehensive $1,000 $1,050.0 1 GBJG31 U661239584 $1,000 2 2010 CHEVROLETSTARTRANS X X Comprehensive $1,000 $1,072.0 1 GB6G3AG5A1111517 $1,000 3 2018 BLUEBIRD BUS X X Comprehensive $1,000 $1,241.0 1 BAKGCEA4J F346083 $1,000 4 2020 BLUEBIRD 77P BUS X X Comprehensive $1,000 $1,477.0 1 BAKGCEA8LF366551 $1,000 If physical damage coverage is selected, valuation applies on an actual cash value basis unless otherwise indicated. 131038 Account Name:WESTLAKE ACADEMY Policy Period: 08/31/2020 to 08/31/2021 Quote Number:5376732 Limits of Insurance: Each Occurrence: $5,000,000 Aggregate Limit: $5,000,000 Self-Insured Retention: $10,000 Schedule of Applicable Underlying Insurance: Commercial General Liability Automobile Liability Employers Liability Abuse or Molestation Liability School District/Educators Legal Liability Employee Benefits Liability Employment Related Practices Liability Additional Considerations: 131038 v EDUCATIONAL INSTITUTIONS � ' Utica National ,� � � Insurance Group" • � � • ' ' ' H D cLnss Educational Institution Coverage Endorsement (Excluding Student Medical Expense) General Liability Coverages Additional Insureds * By Contract, Agreement or Permit— Primary if required * Engineers, Architects or Surveyors * Lessor of Leased Equipment * Managers/Lessors of Premises * Owner of Leased Land * Vendors of your products Aircraft • Hired, Chartered, or loaned to an insured with a paid crew Included if no other insurance that is not owned by the insured if no other insurance • "Insured Contract"coverage for use of aircraft that are not Included used for rides to and from school Bail Bonds Up to $2,500 "Bodily Injury" • Arising from providing or failing to provide professional health Included care services—includes employees, volunteers and auxiliary instructors • Includes shock, mental anguish or mental injury Included • To co-employees, co-volunteers &co-instructors $25,000 Per Occurrence $25,000 General Aggregate Damage to Premises Rented to You — Includes Fire, Lightning, Greater of $500,000 or Amount Listed Explosion in Declarations Extended Bodily Injury includes use of reasonable force to: • Protect persons or property Included • Restrain or remove a pupil whose behavior is disruptive Included despite request to refrain from such behavior Knowledge of occurrence— limits notification requirements to certain Included specified individuals Loss of Earnings due to assisting with investigation/defense of claim Up to $500 a day Medical Payments extended to cover volunteers Included 7-A-469 Ed. 02-2018 Page 1 of 2 Coverages (continued) New broadenings to General Liability, if no additional premium, Included immediately apply Parking non-owned autos on or on ways next to owned or rented Included premises Personal and Advertising Injury assumed in an "insured contract" Included Personal and Advertising Injury definition includes mental anguish, Included shock, and humiliation "Personal injury"covers non-employment discrimination—other carriers Included may call this Third-Party Employment Practices Liability Pollution incidents occurring inside buildings due to sanctioned Included classroom activities Property Damage to personal property in your care, custody or control Applies on excess basis Unintentional failure to disclose hazards will not prejudice your rights to Included coverage Watercraft • While ashore on premises owned or rented Included • Non-owned boats not for hire, profit or rides to/from school Included if no other insurance • Nonowned watercraft No length limitation Who Is Insured broadened to include: • Appointed or elected administrative officials Included • Auxiliary instructors; not employee or volunteer teacher Included • Board Members or commissioner if a public board or Included commission • Employees Included • Limited Liability Company including managers and members Included • Student and volunteer workers participating in: Included • Internships, • School to work or similar programs • Trustees or Board of Governors Included • Student teachers Included • Subsidiaries if no other insurance Included This summary represents an outline of coverage available from the companies of the Utica National Insurance Group. No coverage is provided by this summary. Coverage availability, terms and conditions are dictated by the policy and may vary by state. For questions on coverages, contact your independent agent. v� Utica National Insurance Group Insurance that starts with you° Utica Mutual Insurance Company and its affiliated companies, New Hartford, NY 13413 www.uticanational.com � � 7-A-469 Ed. 02-2018 Page 2 of 2 1�� v EDUCATIONA� INSTITUTIONS . ��'� - � Utica National .` 1 � � � Insurance Group� � � � • � � • • ?H � " �V ciAss Minimize the Chance of Employment Issues! Toll-Free Advice Line Available for Employment Practice Questions Utica National has partnered with Jackson Lewis P.C., a law firm specializing in employment law, to provide risk management services that can help you prevent employment issues, out-of-pocket expenses, and damage to your reputation. Take advantage of employment practices advice to get the help you need when you need it— provided at no additional cost to our school policyholders! Legal context and advice on workplace law issues including: • What you should generally do when faced with a sexual harassment, discrimination, or retaliation issue • Points to consider when adding a section to the employee handbook about references • What employment training you are required by law to offer? Which topics will best help you prevent adverse employment situations Advice Line • Service is always confidential. • Available from 9:00 a.m. to 5:00 p.m. If there is an unusually high volume of inquiries, calls are returned the same day or within 24 hours. How It Works School administrators and human resource staff can call 1-844-635-8696 and seek the employment practices advice they need. You will be asked for your Utica National CPP policy number. Take advantage of this new risk management resource to reduce the risk of accusations! For more information on the hotline, contact Jackson Lewis P.C. at 1-844-635-8696 or your agent. If you have a claim to report, email us at claimsnewreport@uticanational.com or call us at 1-800-216-1420. In responding to helpline calls, Jackson Lewis P.C. cannot provide legal advice on specific employment matters, such as the firing or other treatment of specific employees, or on complex matters such as employee benefits, executive compensation, non-competition or other employment agreements, reductions-in-force, or transactional matters. In situations where Jackson Lewis P.C. is asked to give advice on complex matters or the legal risks of, or strategies for, a particular course of action, you will be advised to retain an attorney to conduct a proper review of surrounding facts and applicable laws. VUtica National Insurance Group Insurance that starts with you� Utica MUNaI Insurance Company and its affiliated companies,New Hartford,NY 13413 www.uticanational.com•1.800.598.5422 1 TRAVELERS� wrap+° Sharon Minitre BOX INSURANCE AGENCY 1200 S MAIN ST STE 1600 GRAPEVINE, TX 76051 RE: Insured Name: WESTLAKE ACADEMY 1500 Solana Boulevard Building 7, Suite 7200 WESTLAKE,TX 76262 Expiring Policy Number: 106364590 Policy Period: August 31, 2019 to August 31, 2020 Dear Sharon Minitre: On behalf of Travelers Casualty and Surety Company of America we are pleased to provide the attached proposal of insurance for your review. The quotes contained in this document are valid until the expiration of your current policy, and are subject to the provision of, and Travelers' review and acceptance of, the required underwriting information noted in the Contingencies section. Travelers reserves the right to change the quotes in this document, or to refuse to bind coverage entirely, based on review of the required underwriting information or based on adverse change in the risk(s)to be insured prior to the quote expiration date noted in this document. Please note that we require a response to this document prior to expiration of the Insured's current policy in order to facilitate policy renewal. The insured's current policy will expire and not be renewed in the absence of a request, and Travelers'agreement,to bind coverage. Travelers is pleased to offer Risk Management PLUS+ Online�, the industry's most comprehensive program for mitigating your management liability exposures, which is available to you at no additional cost. Please visit www.rmplusonline.com to view the services that are available. If you have additional questions about the site please contact your Underwriter. Travelers Casualty and Surety Company of America, a subsidiary of The Travelers Companies, Inc., has consistently earned high ratings for financial strength and claims-paying ability from independent rating services, including a current A.M. Best rating of A++*. Founded in 1853, The Travelers Companies, Inc. is a Fortune 500 company, a component of the Dow Jones Industrial Average, and a leading provider of property casualty insurance for businesses. Thank you for considering Travelers for your clienYs insurance coverages. We look forward to discussing this opportunity with you. Sincerely, Savannah M Peterson Travelers Bond &Specialty Insurance 'A.M. BesYs rating of A++applies to Travelers Casualty and Surety Company of America as well as to certain insurance subsidiaries of Travelers that are members of the Travelers Insurance Companies pool;other subsidiaries are included in another rating pool or are separately rated. For a listing of companies rated by A.M. Best and other rating services visit www.travelers.com. Ratings listed herein are as of October 2018, are used with permission,and are subject to changes by the rating services. For the latest rating,access www.ambest.com. LTR-4000 Rev. 07-16 Page 1 of 3 O 2016 The Travelers Indemnity Company. All rights reserved. Travelers Casualty and Surety Company of America QUOTE OPTION#1 CRIME COVERAGES: Crime Single Loss Single Crime Single Loss Single Insuring Limit of Loss Insuring Limit of Loss Agreements Insurance Retention Agreements Insurance Retention A- Fidelity F- Computer Crime 1. Employee Theft $250,000 $2,500 1. Computer Fraud $250,000 $2,500 2. ERISA Fidelity $250,000 $0 2. Computer Program and Electronic $100,000 $2,500 3. Employee Theft of Client Not Covered Data Restoration Expense Property B- Forgery or Alteration $250,000 $2,500 G- Funds TransferFraud $250,000 $2,500 C- On Premises $250,000 $2,500 H- Personal Accounts Protection 1. Personal Accounts Forgery or Alteration Not Covered 2. Identity Fraud Expense Reimbursement Not Covered D- In Transit $250,000 $2,500 I- Claim Expense $5,000 $0 E- Money Orders and $250,000 $2,500 Counterfeit Money Insured's Premises Covered: Worldwide, except Not Applicable TOTAL ANNUAL PREMIUM -$2,850.00 (Other term options listed below, if available) ��""�T°ETA��: Policy Term is 8/31/2019-8/31/2022 Shared Additional Defense Limit of Liability: N/A Crime Policy Aggregate Limit of Insurance: N/A PREMIUM DETAIL: Term Payment Premium Taxes Surcharges Total Total Term Type Premium Premium 2 Year Prepaid $5,416.00 $0.00 $0.00 $5,416.00 $5,416.00 3 Year Prepaid $8,124.00 $0.00 $0.00 $8,124.00 $8,124.00 2 Year Installment $2,850.00 $0.00 $0.00 $2,850.00 $5,700.00 3 Year Installment $2,850.00 $0.00 $0.00 $2,850.00 $8,550.00 POLICY FORMS APPLICABLE TO QUOTE OPTION#1: CRI-2001-0109 Crime Declarations Page CRI-3001-0109 Crime Policy Form ENDORSEMENTS APPLICABLE TO QUOTE OPTION#1: ACF-7006-0511 Removal of Short-Rate Cancellation Endorsement CRI-19060-0713 Replace General Agreement E-Change of Control -Notice Requirements Endorsement CRI-19072-0315 Global Coverage Compliance Endorsement—Adding Financial Interest Coverage and Sanctions Condition and Amending Territory Condition CRI-19085-0516 Social Engineering Fraud Insuring Agreement Endorsement CRI-19097-0517 Replace Exclusion BB. Endorsement CRI-19101-1117 Amendatory Endorsement for Certain ERISA Considerations CRI-4019-0911 Texas Changes Endorsement CRI-5044-0613 Texas Cancellation or Termination Endorsement LTR-4000 Rev. 07-16 Page 2 of 3 O 2016 The Travelers Indemnity Company. All rights reserved. ��AC�f[ferl#F�r1d" � • � - i • To: WESTLAKE ACADEMY From: Accident Fund General Ins Co agency: Box Bonding Agency, LLC dba Box Insurance Agency AgencyCode: 9044630 Agency Contact: SHARON MINITRE Date: Friday, July 17, 2020 Insured: WESTLAKE ACADEMY C2uote Id: 2691842-00 City/State: WESTLAKE, TX FeiNlssN: 752449357 Effective Date: 08/31/2020 Expiration Date: 08/31/2021 Premium: $25,924.00 Minimum �250.00 Premium: Dividend Plan: VAR NATIONAL DIVIDEND PL NDP1 Payment Plan: Direct Bill - 10 Pay (Deposit 10%) Each Accident Disease-Policy Limit Disease-Each Employee $1,000,000.00 $1,000,000.00 $1,000,000.00 Jate Due Installments Amount($) 1 8/31/2020 WC Policy - Initial Installment - 10% 2,592.40 2 9/30/2020 WC Policy - Installment 2,592.40 3 10/31/2020 WC Policy - Installment 2,592.40 4 11/30/2020 WC Policy - Installment 2,592.40 5 12/31/2020 WC Policy - Installment 2,592.40 6 1/31/2021 WC Policy - Installment 2,592.40 7 2/28/2021 WC Policy - Installment 2,592.40 8 3/31/2021 WC Policy - Installment 2,592.40 9 4/30/2021 WC Policy - Installment 2,592.40 10 5/31/2021 WC Policy - Installment 2,592.40 Total Installments $25,924.00 A per bill fee may apply. 1 Pay (Deposit 100%) 2 Pay (Deposit 50%) 4 Pay (Deposit 25%) Premium Finance - Full Pay AccuPremium Premium Rate per Est.Annual State LocationClass Code Class Description Basis $100/Factor Premium Texas 1 8810 CLERICAL OFFICE EMPLOYEES NOC $328,000.00 0.1200 $394.00 Texas 1 8868 SCHOOL; CHURCH $5,672,533.00 0.4600 $26,094.00 Texas 1 9101 SCHOOL ALL OTHER EMPLOYEES $280,400.00 2.8600 $8,019.00 Subtotal $34,507.00 Texas 1 9740 TERRORISM $6,280,933.00 0.0240 $1,507.00 Texas 1 9812 INCR LIMITS OF EMPLOYERS LIAB $34,507.00 0.0140 $483.00 Texas 1 0930 WAIVER OF SUBROGATION 2% $0.00 1.0000 $690.00 Texas 1 9898 EXPERIENCE MODIFICATION $35,680.00 1.0100 $357.00 Texas 1 9887 SCHEDULE CREDIT $36,037.00 0.8400 ($5,766.00) Texas 1 9874 TX HEALTHCARE NETWORK CREDIT $30,271.00 0.8800 ($3,633.00) Texas 1 0063 PREMIUM DISCOUNT $26,638.00 0.0890 ($2,371.00) Texas 1 0900 EXPENSE CONSTANT $0.00 0.0000 $150.00 Subtotal ($8,583.00) Total for Location $25,924.00 Total State Premium $25,924.00 Total For Policy $25,924.00 The quotation requested should be considered an estimate and is subject to change based on changes in rates or any other item by jurisdictions that have control over such items. The quote is valid until the effective date of the policy. �; AccidentFund Insurance Company of America 1-866-206-5851 The Accident Fund Difference More than 100 years of experience has led to Accident Fund's success in providing superior workers'compensation solutions to policyholders.We've learned that when someone gets hurt on the job, it impacts more than just one person.Our team is committed to doing what it takes to bring injured workers back to their families, back to their jobs and back to life as usual. Our Commitment and Expertise Our goal is superior claims management, underwriting expertise and value-added services designed to reduce costs for policyholders.Our industry-leading services,such as our narcotics and pharmacy programs,and Care Analytics program --which helps us identify local physicians who understand work-related injuries and provide superior care to get injured employees back to work—have resulted in claim costs that are 19%below the industry.What does this mean to you?Better care for your employees and lower premiums for your bottom line. Creating Efficiencies We offer a unique pay-as-you-go solution that bases premium on actual payrolls(rather than estimates)and allows for convenient online payments. Our online policyholder Toolbox offers a complete library of resources—including workplace safety training and videos,safety tip sheets and guidebooks,claims information and fraud information --at no cost to you. Our Team of Experts We pride ourselves on providing exceptional service.That's why we staff our own team of experts instead of using vendors and we have a local presence (not a phone number) in most of our core states. Our goal is to provide appropriate care to injured workers while reducing claims costs for our customers. • Loss Control Consultants—With workplace safety as their number one goal,our consultants provide personal, unrivaled safety services and support to policyholders. • Internal Nurse Case Managers—Our nurse case managers work closely with injured workers,employers, physicians and claims handlers throughout the entire claim process to ensure the worker receives the best care while assisting in early return to work which helps to reduce claim costs. • Corporate Medical Director—Our in-house medical director provides guidance and strategic direction on a wide range of medical management and cost containment initiatives,with a special focus on improving the quality of care for injured workers. • Pharmacist—Our staff pharmacist works closely with our claims team to recommend changes to medications and identifies inappropriate dispensing to help avoid opioid addiction and prolonged recovery times. • Investigative Services Unit—With billions of dollars lost in the industry each year to insurance fraud,our team of former law enforcement professionals partner with our claims team to investigate and expose potential fraud. • Premium Audit—Our auditors are the best in the business,working with customers to verify payroll and class codes to ensure accurate premiums. • Claim Handlers—Seasoned claim professionals located in the field who understand their local legal and medical environment—and can guide the injured worker through the recovery process. • Medical Bill Review—This team collects all injured worker bills to review for accuracy. Protecting Your Employees—And Your Bottom Line By proactively caring for injured workers and helping business owners improve workplace safety,we have successfully lowered experience mods,and therefore reduced costs,for our customers.An average mod beginning at 1.20 when written with Accident Fund is reduced by 17%to 1.0 by its third year—and to a credit mod of.98 by the fourth year. Accident Fund Insurance Company of America is a member of AF Group.Insurance policies may be issued by any of the following companies within AF Group: Accident Fund Insurance Company of America,Accident Fund National Insurance Company,Accident Fund General Insurance Company,United W isconsin Insurance Company,Third Coast Insurance Company or CompWest Insurance Company. Accident&Health Division C H U B B� 2 Riverway,Ste 900 Houston,TX��056 USA I • I I Eligibility: Class i: All students ofthe Policyholder Class2: AllfacultyandstaffofthePolicyholder CoverageTerm: August3i,2020tOAUgUSt31,2021 PolicyNumber: GLMNi43O2943 Renewal Premium: $2,000 Covered Activities: Educational Travel Coverage Out�f-Country Medical Fxpense Benefits Benefit M�imum: $5 o,000per person Deductible: $o per CoveredAccident o r Siclmess PreexistingConditions: Treated as any othermedical condition Dental Treatment: $5 00(Injury&Alleviation of Pain) PregnancyBenefit: Treated as any othermedicalcondition Ro o m&Bo ard: Av erage semi private room rate Intensive Care: Two timesthe average semiprivate roomrate Chiropractic Care: $350�$35 pervisitup to a maximum of io visits) PrescriptionDrugs: InpatientCo-insurance: i00%ofcoveredexpenses OutpatientCo-insurance: i00%ofcoveredexpenses Coinsurance: i o o%of the Usual and Customary Charges IncurralPeriod: 3o DaysfromthedateofaCoveredAccidentorSickness Max imum Benefit Period: The earlier of the date the Covered Person returns to his or her Ho me Co untry or Co untry of Permanent Assignment,or 2 6 weeks from the date of a CoveredAccident or Sickness MaximumCoveragePeriod: 18o days anysingletrip Ac cidental Death&Dismemberment Benefit: Class i: $io,000 Class 2: $50,000 Aggregate Limit: $250,000 ChaperoneReplacementBenefit $2,000 EmergencyReunionBenefit $2,000 EmergencyMedicalBenefit: upto $io,000 EmergencyMedicalEvacuation: i00%oftheCoveredEYpenses Repatriation Benefit: i o o%of the Covered Fxpenses CHUBB � PHILADELPHIA INSURANCE COMPANIES A Member of the Tokio Marine Group Westlake Academy Student Accident Insurance Quotation For August 31, 2020 Covera�e, Benefits & Limits Accident Medical Expense: $25,000 (per Participant,per Accident) Accident Medical Expense Aggregate: No Aggregate Benefit Amount: 100% of Usual & Customary Charge Accident Dental Expense: Included in Medical Deductible: $0 Deductible Type: None Benefit Period: 1 year Plan Type: Full Excess Accidental Death: $25,000 Accidental Dismemberment: Up to $50,000 per Schedule of Covered Losses Accidental Paralysis: $50,000 AD&D and Paralysis Aggregate: $500,000 (per Accident) See Schedule of Additional Benefits & Limits below Premium Policy Premium: $5,943.00 Minimum and Earned Policy Premium: $300.00 Eli�ible Persons All enrolled students of the Policyholder, grades Pre-K to 12. Covered Activities Policyholder supervised and sponsored school-time activities, including interscholastic sports, including interscholastic tackle football. Underwritin� &Administration The plan is underwritten by Philadelphia lndemnity Insurance Company (PIIC). PIIC is rated, A++, Superior, by A.M. Best & Company. If the terms are acceptable, we will issue the policy to the agent. The invoice will be issued on a direct bill basis to the agent's customer. Claims are administered by NAHGA Claim Services, Inc. of Bridgton, Maine. This quotation is based upon the underwriting information submitted. Changes to the underwriting information must be reported and may affect quotation. PathlD 13650074 Page 1 of 2 PHILADELPHIA INSURANCE COMPANIES A Member of the Tokio Marine Group Schedule of Additional Benefits & Limits DEFERRED DENTAL EXPENSE BENEFIT ENDORSEMENT Deferred Treatment Period to age 21 Deferred Treatment Maximum Benefit $1,000 Benefit Percentage 100% PathlD 13650074 Page 2 of 2 I ' � : ' ' I ' • � COVERAGE LIMITS 3rd Party Coverages: Data Compromise Liability $1,000,000 Per Occurrence Network Security Liability $1,000,000 Per Occurrence Electronic Media Liability $1,000,000 Per Occurrence 1 st Party Coverages: Data Compromise Response Expense $ 500,000 Per Occurrence Computer Attack and Cyber Extortion $ 500,000 Per Occurrence Response Expense $1,000,000 Per Occurrence Identity Recovery $ 25,000 Per Occurrence r�r �O/�� A � �� IIIW(� . v CYBER SUITE �� e�-: �� r. Utica National S�RF ,— �� Insurance Group" ;� � , Cyber Suite Cyber Suite Coverages: Applicable Limit Data Compromise Response Expense covers personal data compromises Included in aggregate limit, and affords: unless otherwise noted • Notification of Affected Individuals 12 Months • Services to Affected Individuals, which can include credit monitoring 50%sublimit of aggregate limit • Legal review 50%sublimit of aggregate limit • Forensic review to determine the nature and extent of breach $5,000 • Public relations services $50,000 named malware Computer Attack and Cyber Extortion coverage includes: Included in aggregate limit, • Data restoration, data recreation and system restoration unless otherwise noted • Business income/extra expense Up to 50% of aggregate limit • Public relations services $5,000 sublimit • Cyber Extortion covers the cost of a professional firm to assist the $25,000 if aggregate limit is insured through a cyber extortion threat and the costs of approved $250,000 or more extortion payments. Data Compromise Liability covers defense and settlement costs for claims Included in aggregate limit brought by or on behalf of affected individuals due to theft or loss of personally identifying information. Network Security Liability covers defense and settlement costs due to the Included in aggregate limit unintended forwarding of malicious code, the breach of third party business information, or the unintended abetting of denial of service attack. Electronic Media Liability Coverage covers defense and settlement costs in Included in aggregate limit the event of a suit alleging that the insured infringed on a copyright or trademark, defamed a third party, or violated a person's right to privacy. Identity Recovery covers expense reimbursement and case management $25,000 services for the chief school administrator, chief financial officer, and/or treasurer. Response Expense coverage for personally identitfying information posted to Included the internet in error Coverage for personally identifying information stored with a cloud service Included provider Defense applies Inside the limits Coverage for paper breach or data proven to have been breached through an Included oral disclosure. Consent required for settlement Yes Initiating breach response services required before Data Compromise Yes Liability coverage applies This summary represents an outline of coverage available from the companies of the Utica National Insurance Group. No coverage is provided by this summary. All coverages are individually underwritten. Coverage availability, terms and conditions are dictated by the policy and may vary by state. In the event of a/oss, the terms of the policy issued will determine the coverage provided. VUtica National Insurance Group Insurance that starts with you. UIiCa Mutual Insurance Company and its afld�ated cOmpanies.New Hartlord.NY 13413 www.uucanational.com�y 7-A-499 Ed.05-2017 �� . 4� Our Four- Point Claims � �, � - Promise to You Equals �: � � ► �,� -� % �- ; Peace-of- Mind ��!� � � ;; � � � H�D oE4he CLASS' � � � Trust Utica National to Handle Claims � � for Your Educational Institution ; — - ..-T -- -'� .i�=. � Accidents happen. When they do, and you have to submit a claim, our claims staff is responsive and works through the issues thoroughly. Here's why 97%* of our customers report high claims satisfaction: We've seen it. For over 45 years„ we've worked on thousands of unique school claims. There's a great chance we've handled a situation like yours and can help you navigate it. Guidance on emerging issues. Our claims staff is available to discuss recent trends to help illuminate new challenges at your school. Educational law specialists. If a claim should turn into a lawsuit, we use law firms specializing in educational law to defend schools, administrators and employees. Our Four-Point Promise to you: Utica National OWe explain our process to the insured school strives to kee�schools and its agent to describe our position. secure and to 2vork QWe discuss all aspects of the claim before collaboratively togive denying any claim. you �.vhat matters most: QWe listen to pertinent information from the insured school specialized coverage, YZSjZ and its agent before making any settlement offers. yytaylag-eyyteylt aytd QOur legal team will inform tr,e �nsured about r,oW claims expertise! a case is progressing. `Based on 2018 Claimant Satisfaction Survey For more information, contact an independent insurance agent representing the Utica National companies. VUtica National Insurance Group Insurance that starts with you� Utica Mutual Insurance Company and its affiliated companies,New Hartford,NY 13413 www.uticanationaLmm•1.R00.598.8422 1 � � ♦ I � COVERAGE ANNUAL PREMIUM Property - Crum Forster $91,995 General Liability Education Packaqe - Utica $14,461 -Abuse or Molestation Liability -School District and Educators Legal Liability Coverage -Employee Benefits Program Liability Coverage -Employment Practices Liability Coverage Business Auto - Utica $5,029 Umbrella - Utica $7,138 Crime - Travelers $2,850 Workers Compensation -Accident Fund $25,924 Travel - International $2,000 Student Accident $5,943 Cyber Liability $400 Total $155,740 EFFECTI VE: 08/31/2020 . . � � � . �• COVERAGE EXPIRING PREMIUM RENEWAL PREMIUM Property - Crum Forster $88,080 $91,995 General Liability Education Packaqe - Utica $14,029 $14,461 -Abuse or Molestation Liability -School District and Educators Legal Liability Coverage -Employee Benefits Program Liability Coverage -Employment Practices Liability Coverage Business Auto - Utica $5,664 $5,029 Umbrella - Utica $6,996 $7,138 Crime - Travelers $2,850 $2,850 Workers Compensation -Accident Fund $2g,gg3 $25,924 Travel - International $2,000 $2,000 Student Accident $5,943 $5,943 Cyber Liability $400 $400 Total $155,845 $155,740 EFFECTIVE: 08/31/2020 ' . ' . . OPT/ON TOTAL DUE NOW TOTAL ANNUAL PREMIUM 155,740 Total Premium By Carrier Crum Forster: $91,955 Travelers: $2,850 Philadelphia: $5,943 CHUBB: $2,000 Utica: $27,028 Accident Fund: $25,924 Direct Bill Terms Available from each carrier (Interest Free) INSURED: Westlake Academy INSURED SIGNATURE: DATED: / / WESTLAKE ACADEMY RESOLUTION NO. 20-10 A RESOLUTION OF THE WESTLAKE ACADEMY BOARD OF TRUSTEES AWARDING THE BID FOR PROPERTY/CASUALTY INSURANCE PRODUCTS AND SERVICES TO BOX INSURANCE AGENCY FOR FY 2020-2021. WHEREAS, Westlake Academy desires to maintain a comprehensive risk management program for the protection of its property, students, employees, elected officials, and stakeholders; and, WHEREAS, the leaders of Westlake Academy desire to exercise exceptional levels of stewardship with all financial resources; and, WHEREAS, the Board of Trustees finds that the passage of this resolution is in the best interest of the citizens of Westlake as well as the students, their parents, and faculty of Westlake Academy. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF WESTLAKE ACADEMY: SECTION 1: that the Board of Trustees of Westlake Academy does hereby award the recommended bid for property/casualty insurance products and services to Box Insurance Agency for FY 20-21, attached hereto as Exhibit "A"; and further authorize the Superintendent or designee to execute this agreement. SECTION 2: that, all matters stated in the recitals hereinabove are found to be true and correct and are incorporated herein by reference as if copied in their entirety. SECTION 3: If any portion of this resolution shall, for any reason,be declared invalid by any court of competent jurisdiction, such invalidity shall not affect the remaining provisions hereof and the Council hereby determines that it would have adopted this resolution without the invalid provision. SECTION 4: That this resolution shall become effective from and after its date of passage. Resolurion WA 20-10 Page 1 of 3 PASSED AND APPROVED ON THIS 24TH DAY OF AUGUST 2020. Laura Wheat, President ATTEST: Todd Wood, Board Secretary Amanda DeGan, Superintendent APPROVED AS TO FORM: Janet S. Bubert or L. Stanton Lowry, School Attorney Resolurion WA 20-10 Page 2 of 3 Exhibit "A" Recommended Bid — Box Insurance Coverage Expiring Premium Renewal Premium Commercial Property- Crum Forster $ 88,080 $ 91,995 General Liability—Utica $ 14,029 $ 14,461 Business Auto—Utica $5,664 $ 5,029 (4 Autos) (4 Autos) Umbrella($5,000,000)—Utica $ 6,996 $ 7,138 Crime - Travelers $ 2,850 $ 2,850 Workers Compensation - Travelers $ 29,883 $ 25,924 International Travel—CHUBB $ 2,000 $ 2,000 Student Accident Policy—AJF/Philadelphia $ 5,943 $ 5,943 Cyber Liability $400 $400 Total $155,845.00 $155,740.00 Resolurion WA 20-10 Page 3 of 3 Board of Trustees Item # 4 — Discussion Items a. Presentation and discussion of Resolution 20-11 to: (1) ratify the attestations concerning our ability to meet TEA's threshold requirements for remote synchronous instruction to Academy Students in grades 3-12; and (2) approve a plan for remote asynchronous instruction for grades K- 2 and for any other grades/courses for which the Academy cannot meet the threshold requirements for synchronous instruction to ensure funding. {x��Y�� h�',' R '� 1:�� . � estlake Academy Board of Trustees �� { s�.�� TYPE OF ACTiON Regular Meeting - Action Item Westlake Board Meeting Monday, August 24, 2020 ToP�c: Presentation and discussion to: (1) ratify the attestations concerning our ability to meet TEA's threshold requirements for remote synchronous instruction to Academy Students in grades 3-12; and(2) approve a plan for remote asynchronous instruction for grades K-2 and for any other grades/courses for which the Academy cannot meet the threshold requirements for synchronous instruction to ensure funding. S'rAFF CoN'rACT: Amanda DeGan, Town Manager& Superintendent Dr. Mechelle Bryson, EXecutive Director Strategic Alignment Vision, Value, Mission Perspective Curriculum Outcome Ob'ective Academic Excellence Academic P�,P�M�,P��P Optimize Student Operations Potential Time Line - Start Date: August 3, 2020 Completion Date: Ongoing Funding Amount: N/A Status - N/A Source -N/A EXECUTIVE SUMMARY(INCLUDING APPLICABLE ORGANIZATIONAL HISTORY) As part of our planning for the 20-21 fall semester, the Academy was required to submit to the Texas Education Agency (TEA) certain attestations that affirm our ability to provide students remote synchronous (real-time/live) instruction in grades 3-12 at a level defined by TEA as sufficient to support recognizing students as in attendance for instruction using the synchronous instruction method. We answered"YES"to the questions below relative to our attestations for the Academy's plans to provide instruction to students through the remote synchronous instruction method: 1. All students, including students with disabilities and English Learners, are able to receive instruction via synchronous methods, and LEAS are able to provide accommodations or resources to support when necessary. 2. Student IEPs are followed regardless of learning environment such that students with disabilities receive a Free Appropriate Public Education(FAPE). 3. Families and students are provided with clear communications about expectations and support for accessing and participating in synchronous instruction. 4. Families are aware of options for transferring between instructional settings and the design of the synchronous remote options allows for transitions to occur with minimal disruption to continuity of instruction. 5. Educators are trained and supported to do synchronous instruction on the LEA chosen platform, including practice with the platform prior to delivery with students. 6. Educators receive ongoing,job-embedded support to continuously improve their practice in the synchronous remote setting. 7. LEA IT staff are trained on the platform and can troubleshoot access issues for parents and students when issues arise.A helpdesk or other support line is accessible for parents and students for this purpose. 8. Consistent, daily platform is identified by the LEA for delivery of instruction to students. 9. Educators have technology equipment that allows them to deliver synchronous remote instruction including proper internet bandwidth and devices with enabled cameras and microphones. 10. Curriculum is fully aligned to the TEKS and designed to ensure all TEKS are covered by the end of the year. 11. Instructional schedule meets the minimum number of daily minutes to meet full day funding: 3rd through 5th grade- 180 instructional minutes, 6th through 12th grade- 240 instructional minutes. PK- 2nd grade are not eligible to earn funding through the synchronous model. 12. School grading policies for remote student work are consistent with those used before COVID for on campus assignments. 13. The Superintendent and the Board attest that these commitments are being met as of the date the attestation is submitted. For Kindergarten through 2"d grade, and for any other grade for which the Academy cannot meet the threshold requirements for synchronous instruction, the Academy is required to submit, for TEA's approval, the Academy's remote asynchronous instruction plan. The Academy's attestations for synchronous instruction and its plan for asynchronous instruction must be approved by the Board of Trustees. The Superintendent may be authorized by the Board to submit the attestations and instructional plans once they are finalized. At our last Board of Trustees meeting, we discussed the attestations for remote synchronous instruction and the Academy's plan for remote asynchronous instruction as a part of the Back-to- School Plan and are submitting a resolution for approval of the Academy's plans for remote instruction. RECOMMENDATION Approval of the Resolution for submission of attestations and plans for remote instruction during the 2020-2021 school year. ATTACHMENTS Resolution WESTLAKE ACADEMY RESOLUTION NO. 20-11 A RESOLUTION OF THE BOARD OF TRUSTEES TO RATIFY THE REMOTE SYNCHRONOUS INSTRUCTION ATTESTATIONS SUBMITED TO THE TEXAS EDUCATION AGENCY (TEA) ON BEHALF OF WESTLAKE ACADEMY AND AUTHORIZE THE SUPERINTENDENT TO SUBMIT THE REMOTE ASYNCHRONOUS INSTRUCTION PLAN TO TEA FOR APPROVAL. BE IT RESOLVED BY THE BOARD OF TRUSTEES OF WESTLAKE ACADEMY: WHEREAS, TEA requires a school providing remote synchronous instruction to file certain attestations prior to September 7, 2020, to confirm the school is capable of ineeting TEA's threshold requirements to authorize the school to report student attendance for remote synchronous instruction; and WHEREAS, TEA requires a school providing remote asynchronous instruction to submit the school's asynchronous instruction plan for the 2020-2021 school year no later than October 1, 2020, and to obtain TEA's approval of such plan within the first three six-week periods of the school year to authorize the school to report student attendance for remote asynchronous instruction; and WHEREAS, compliance with TEA's documentation requirements related to remote instruction for the 2020-2021 school year is necessary for Westlake Academy to report student attendance for remote instruction and obtain state funding for students receiving remote instruction; and WHEREAS, the Board of Trustees wishes to comply with the COVID-19 planning and reporting requirements issued by TEA for the 2020-2021 school year; and WHEREAS, the required attestations for remote synchronous instruction have been filed on behalf of Westlake Academy prior to the deadline; and WHEREAS, Westlake Academy intends to submit a plan for remote asynchronous instruction for TEA review and approval; and WHEREAS, the Board of Trustees finds that the passage of this Resolution is in the best interest of Westlake Academy students, their parents, and faculty, as well as the citizens of Westlake. NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF TRUSTEES OF WESTLAKE ACADEMY: SECTION L• That, all matters stated in the recitals hereinabove are found to be true and correct and are incorporated herein by reference as if copied in their entirety. WA Resolurion 20-11 Page 1 of 2 SECTION 2: That the Board of Trustees hereby ratifies the affirmative answers supplied in the attestations submitted to TEA relative to Westlake Academy's ability to provide remote synchronous (in-person/live) instruction to our students. SECTION 3: That the Board of Trustees authorizes the Westlake Academy Superintendent to file with TEA the remote asynchronous instruction plan developed for the 2020-2021 school year, and further authorizes the Westlake Academy Superintendent to file any additional attestations and/or revisions to remote instruction plans required by TEA or as may be necessary during the 2020-2021 school year to ensure Westlake Academy maintains funding for attendance by remote instruction. SECTION 4: If any portion of this resolution shall, for any reason, be declared invalid by any court of competent jurisdiction, such invalidity shall not affect the remaining provisions hereof and the Council hereby determines that it would have adopted this Resolution without the invalid provision. SECTION 5: That this resolution shall become effective from and after its date of passage. PASSED AND APPROVED ON THIS 24t" DAY OF AUGUST 2020. Laura Wheat, President ATTEST: Todd Wood, Board Secretary Amanda DeGan, Superintendent APPROVED AS TO FORM: L. Stanton Lowry or Janet S. Bubert, School Attorney WA Resolurion 20-11 Page 2 of 2 Board of Trustees Item # 5 — Future Agenda Items Any Board member may request at a workshop and / or Board meeting, under ��Future Agenda Item Requests", an agenda item for a future Board meeting. The Board Member making the request will contact the Superintendent with the requested item and the Superintendent will list it on the agenda. At the meeting, the requesting Board Member will explain the item, the need for Board discussion of the item, the item's relationship to the Board's strategic priorities, and the amount of estimated staff time necessary to prepare for Board discussion. If the requesting Board Member receives a second, the Superintendent will place the item on the Board agenda calendar allowing for adequate time for staff preparation on the agenda item. Board of Trustees Item # 6 — Board Recap/ Staff Direction Board of Trustees Item # 7 — Adjournment