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Home My WebLink AboutWA Resolution 23-45 BOX Insurance Agency Property and Casualty Insurance TOWN OF WESTLAKE RESOLUTION NO. 23-45 A RESOLUTION OF THE WESTLAKE ACADEMY BOARD OF TRUSTEES AWARDING THE BID FOR PROPERTY/CASUALTY INSURANCE PRODUCTS AND SERVICES TO BOXINSURANCE AGENCY FORFY 23-24. 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,theBoard of Trustees finds that the passage of this resolution is in the best interest ofthe 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 BoxInsurance Agency for FY 23-24,attached hereto as ; 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. ResolutionWA23-45 Page 1 of3 TH PASSED AND APPROVED ON THIS 7DAY OF AUGUST2023. ___________________________________ Sean Kilbride, President ATTEST: ___________________________________________________________________ Amy Piukana , Board SecretarySean Wilson,Head of School APPROVED AS TO FORM: ________________________________ Janet S. Bubert or L. Stanton Lowry, School Attorney ResolutionWA23-45 Page 2 of3 Recommended Bid ResolutionWA23-45 Page 3 of3 PROPOSAL WESTLAKE ACADEMY 202Westlake 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&O 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 REQUEST FOR PROPOSAL PROPOSAL FOR:Property, Liability, Workers Compensation, Auto, and Student Accident Insurance POSTED DATE:July 16,2023 EFFECTIVE DATES: September 1, 2023 to August 31, 2024 PROPOSAL DUE DATE:August 1, 2023 PROPOSAL DUE TIME:2:00 PM CST CONTACT:Oliver Duff, Purchasing Agent E-mail: oduff@westlaketx.gov Electronic proposals subject to the Terms and Conditions of this REQUEST FOR PROPOSAL and other provisions, must be received by the Purchasing Agent atoduff@westlaketx.govbefore 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. Company Name and Address:Company’s Authorized Agent Name and Title (Typed or Printed): Signature Federal ID Number (TIN) or SSN and Name Date: Telephone No. Fax No.: Email address: Westlake Academy – FY 23/24 Comprehensive Insurance RFP Page 1 of 38 Request for Proposal – Westlake Academy Property, Liability, Workers Compensation, and Student Accident Insurance Table of Contents .……………………………………………………..2 Acknowledgementof Receipt......…………..……………………….....3 Questionnaire .………………………………………………………….4 General Requirements and Instructions .…………………………….....5 Policy Requirements and Limits ...……………………………………..8 Property Insurance, Fire and Extended Equipment Coverage..…….8 GeneralLiability, EPLI, EBLI, ELLI, D&OInsurance .…….…….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 InterestQuestionnaire ….…………………………………30 W-9 Form ..……………………………………………………………32 Form 2270 ..……………………………………………………………38 Westlake Academy – FY 23/24 Comprehensive Insurance RFP Page 2 of 38 ACKNOWLEDGEMENT OF RECEIPT THIS FORM MUST BE COMPLETED AND RETURNEDPRIOR 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 pages three and four (3 and 4)and return by email by July 29,2023, to: Oliver Duff Town of Westlake oduff@westlaketx.gov Name of Firm: _________________________________________________ Address: ______________________________________________________ City/State/Zip: _________________________________________________ Phone: (_____) _______________________Fax: (_____)_______________ E-Mail: _______________________________________________________ Name: (Print) __________________________________________________ Title: _________________________________________________________ Signature: _________________________________________ Date: ________ _______Yes, our company does have an interest in responding. _______No, our company does not have an interest in responding. Westlake Academy – FY 23/24 Comprehensive Insurance RFP Page 3 of 38 QUESTIONNAIRE 1.Who will have primary responsibility for Westlake Academy’s account? ____________________________________________________________________________________ a.Number of years in the insurance business: _____________________________________________ b.Insurance background: _____________________________________________________________ _________________________________________________________________________________ c.Number of schools or public entities serviced: __________________________________________ 2.Who will be the back-up person for Westlake Academy’s account? _____________________________ a.Number of years in the insurance business: _____________________________________________ b.Insurance background: _____________________________________________________________ _________________________________________________________________________________ c.Number of schools or public entities serviced: __________________________________________ 4.Westlake Academywill expect the following annual reports from its agents: a)Summary of premiums and losses by coverage. b)Forecast of insurance marketstatus 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 managementservices. 5.Please attach a copy of the following documents: a)A copy of the current license. b)A certificate for agent’s error and omission coverage insured for at least $1 million limit. Westlake Academy – FY 23/24 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 will be fromSeptember 1,2023 through August 31, 2024. 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 theformalities 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 mustbe 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: oduff@westlaketx.gov. 5.The information contained herein is believed to be accurate and up-to-date butis not intended to be an express or implied warranty. 6.No telephone, or fax, or e-mailedproposals will be accepted. Proposals may only be accepted if delivered by mailor dropped off to Oliver Duff, Procurement Manager, Town of Westlake, 1500Solana Boulevard, Bldg. 7, Ste. 7200, Westlake, TX 76262 7.Vendors are cordially invited view the opening of received proposals butare not required to attend. A link will be posted on the Town of Westlake Bidding page no later than July 20,2023.Advertisements will be posted for two (2) weeks in the Town’s newspaper of record (The Commercial Recorder)on July 16,2023 and July 23,2023. B.L EGAL 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.C OMMUNICATION 1.Proposersshouldprovide a paper (printed) copyof proposals by the deadline to: Oliver Duff Town of Westlake 1500 Solana Boulevard, Bldg. 7, Ste. 7200, Westlake, Texas 76262 D.COMMUNICATION WITH TOWN OF WESTLAKE/WESTLAKE ACADEMY MEMBERS Companiessubmitting 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 Westlake Academy – FY 23/24 Comprehensive Insurance RFP Page 5 of 38 company will be notified in writing. Failure to abide by this requirement may result in automatic disqualification. E.TIME FRAME 1.The RFPpackage will be available for download from our website at https://westlaketx.gov. Vendors WILL NOT benotified 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 ormailed to Oliver Duff, 1500 Solana Boulevard, Bldg. 7, Ste. 7200, Westlake, TX 76262by the deadline no later than 2:00 p.m.,Tuesday,August 1,2023. 3.The parties submitting the selected proposals will be notified by August 9, 2023 of the Academy’s decision. 4.The effective datefor proposalsis September 1,2023. 5.Policies or coverage documents are to be provided to the Academy by October 1, 2023.The Academy reserves the right to not pay any premium until valid policies or coverage documents are received. F.P ROPOSALS 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.D ISQUALIFICATION AND R EJECTION OF P ROPOSALS 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 these exceptions to the specifications will, in and of themselves, result in disqualification. H.S ELECTION OF V ENDOR 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 44.031and 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 CriteriaMaximum Points Coverage 35 Cost 35 Professional Qualifications 15 Service 15 Total 100 Westlake Academy – FY 23/24 Comprehensive Insurance RFP Page 6 of 38 I.T ERMS OF A GREEMENTS 1.Westlake Academy desires to receive proposals for a one (1) year period, beginning on September 1, 2023,through August 31, 2024. 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 asixty(60) day 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 a sixty (60) day noticeof cancellation (except for non-payment) and sixty (60) days e for non-renewal or material change. J.Q UALIFICATION OF I NSURERS 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.A GENT M INIMUM Q UALIFICATIONS 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 agent’s 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) yearsof experience in commercial property and liability insurance lines orhold the C.P.C.U. or A.R.M. designation. L.A UTHORIZED S IGNATURE 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 belisted separately as an alternate quote. Westlake Academy – FY 23/24 Comprehensive Insurance RFP Page 7 of 38 QSPQFSUZ-!GJSF-!BOE!FYUFOEFE!FRVJQNFOU!JOTVSBODF! B/C BDLHSPVOE!J OGPSNBUJPO 1.Please contact Purchasing Agent at oduff@westlaketx.govfor loss runs. 2.Scheduleof 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 coinsuranceasof September 1, 2023 is as follows: EftdsjqujpoMjnjuEfevdujcmfDpjotvsbodf Building Physical Property $ 4,750$ 5,000 100% Building Personal Property$4,,550$ 5,000 100% Business Income and Extra Expense: $ 484,000 Upubm!Qspqfsuz!Mjnjut %-411 Opuf;!!Cmbolfu!Dpwfsbhf!bu!gvmm!sfqmbdfnfou!dptu!jt!sfrvjsfe!gps!bmm!qspqfsuz!rvpuft/ C/Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 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%coinsurance,if available.In the event a $50,000 wind/hail deductible (or lower) is not available, the lowest deductible available should be quotedas a percentage. 7.Wind and hail deductibles may be accompanied by a “buy-down” reinsurance policy. This policy should be shown separately from the primary policy, including premiums. 8.Include a listing of endorsements, extensions, and exclusions. D/Rvpufe!Dpwfsbhf!Qspwjtjpot 1.EftdsjqujpoMjnju Building PhysicalProperty$,750 Building Personal Property$ Business Income andExtra Expense:$484,000 2.Is automatic coverage for newly acquired property provided: Yes No If yes, please attach description. 3.Does coverage include equipment breakdown? Yes No If yes, please attach description. 4.Is there additional deductible or exclusion forwind, hail or earthquake?Yes No If yes, please attach descriptionand/or provide additional proposal to cover this risk. Rvpubujpo Property, Fire, andExtendedEquipmentQuote (Attach complete coverageinformation) AnnualPremium (Period 09/01/2023 to08/31/2024):$__________________ AlternateProperty,Fire,and ExtendedEquipment Quote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024):$________________________________ Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!9!pg!49 F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!:!pg!49 HFOFSBM!MJBCJMJUZ!JOTVSBODF! B/C BDLHSPVOE!J OGPSNBUJPO 1.All coverage in Section “B” must be included. Please contact Purchasing Agent at oduff@westlaketx.govfor loss runs. 2.Estimated student count is 880.Grades K-8: 555 Grades 9-12: 325 3.Estimated number of full-time equivalent employees is 108. 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. C/Jotvsbodf!dpwfsbhf!tipvme!jodmvef!uif!gpmmpxjoh; 1.Incidental medical malpractice coverage for registered nurses administeringfirst aid, dispensing prescribed medications,and maintainingstudents’ 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 andexclusions. 7.If EPLI, EBLI, ELLI, and D&O coverage is not automatically included, please provide separate quote(s).These are required components of the liability coverage policy. Qfs!PddvssfodfBhhsfhbuf!Efevdujcmf 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 D/Rvpufe!Dpwfsbhf!Qspwjtjpot 1.Coverage Detail Qfs!PddvssfodfBhhsfhbufEfevdujcmf General Liability______________ __________ __________ Products/Completed Operations______________ __________ __________ Personal & Advertising Injury______________ __________ __________ Damage to Rented Premises______________ __________ __________ Medical Expenses______________ __________ __________ Employee Benefits Liability______________ __________ __________ Abuse & Misconduct Liability______________ __________ __________ Professional Liability – D&O______________ __________ __________ Educators Legal Liability______________ __________ __________ Employment Practices Liability______________ __________ __________ Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!21pg!49 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.Iscorporal 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." E/Rvpubujpo)Nvtu!jodmvef!bmm!dpwfsbhft!boe!mjnjut!gspn!Tfdujpo!B* 1.General Liability, EPLI, EBLI, ELLIand D&OQuote – (Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ 2.Alternate General Liability, EPLI, EBLI, EELI, and D&OQuote (Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!22pg!49 Bvupnpcjmf!'!Qiztjdbm!Ebnbhf!Jotvsbodf B/C BDLHSPVOE!J OGPSNBUJPO 1.Please contact Purchasing Agent at oduff@westlaketx.govfor loss runs. 2.Current list of vehicles:2006 Chevrolet Girardin Bus – 18 passengers 2010 Chevrolet SpartansBus – 20 passengers 2018 Blue Bird Bus –77 passengers 2020Blue Bird Bus –77 passengers 4.All drivers have properclass endorsements and driving histories are reviewed annually. C/Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 1.Liability Limits & Coverage Desired: Auto Liability must be as follows: Mjnju QfsEfevdujcmf Bodily Injury & Property Damage$ 1,000,000Accident $ 1,000 Personal Injury Protection $ 2,500Person $ 0 Uninsured Motorist$ 1,000,000Accident $ 0 Underinsured Motorist$ 1,000,000Accident $ 0 Physical Damage Coverage Comprehensive ACV/RepairLoss$ 1,000 VandalismACV/RepairLoss$ 0 Collision $ 1,000,000Accident$ 1,000 2.Basis of Recovery is to be full repaircostor 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. D/Rvpufe!Dpwfsbhf!Qspwjtjpot 1.Coverage Detail Qfs!PddvssfodfBhhsfhbufEfevdujcmf Bodily Injury & Property Damage______________ __________ __________ Personal Injury Protection______________ __________ __________ Uninsured Motorist______________ __________ __________ Underinsured Motorist______________ __________ __________ Medical Expenses______________ __________ __________ Physical Damage Coverage ComprehensivePhysical Damage______________ __________ __________ Vandalism______________ __________ __________ Collision______________ __________ __________ 2.Does coverage include automatic coverage for substitute or newly acquired vehicles? Yes No If yes, please describe: E/Rvpubujpo 1.AutomobileInsuranceQuote(Attach complete coverage information) Annual Premium (Period 09/01/2023to 08/31/2024): $________________________________ 2.Alternate Automobile Insurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2023to 08/31/2024): $________________________________ Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!23pg!49 F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!24pg!49 Vncsfmmb0Fydftt!Mjbcjmjuz!Jotvsbodf! B/C BDLHSPVOE!J OGPSNBUJPO 1.Noclaims since inception of coverage in 2003. 2.Coverage is to be in excess of bmm!Mjbcjmjuz!mjnjut. C/Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 1.Liability Limits & Coverage: Mjnju QfsBhhsfhbuf GeneralLiability $5,000,000Occurrence$5,000,000 Personal & Advertising Injury$5,000,000Person/Org.$ 5,000,000 Wrongful Acts – Claims Made Basis$1,000,000Occurrence$ 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. D/Rvpufe!Dpwfsbhf!Qspwjtjpot 1.Coverage Detail Mjnju QfsBhhsfhbuf General Liability_________ _____________ __________ Personal & Advertising Injury_________ _____________ __________ Wrongful Acts – Claims Made Basis_________ _____________ __________ Aggregate Limit__________ Self-Insured Retention_________ 2.Is prior actscoverage provided?Yes No If yes, please give effective date(s) and explanation. E/Rvpubujpo 1.UmbrellaInsuranceQuote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ 2.Alternate Umbrella Insurance Quote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!25pg!49 Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!26pg!49 Dsjnf!Jotvsbodf! B/C BDLHSPVOE!J OGPSNBUJPO 1.No claims since inception of coverage in 2003. 2.Copy of current policy declaration schedule is attached. C/Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 1.Crime Limits & Coverage Desired: Tjohmf!Mptt!MjnjuSfufoujpo 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. D/Rvpufe!Dpwfsbhf!Qspwjtjpot 1.Coverage Detail Tjohmf!Mptt!MjnjuSfufoujpo Employee Theft_____________________________ ERISA Fidelity_____________________________ Forgery or Alteration_____________________________ On Premises_____________________________ In Transit_____________ ________________ Money Orders/Counterfeit_____________________________ Computer Fraud_____________________________ Program/Restoration Expense_____________________________ Funds Transfer Fraud_____________________________ Claim Expense_____________________________ E/Rvpubujpo 1.CrimeInsuranceQuote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ 2.Alternate Crime Insurance Quote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!27pg!49 Gps!Bmufsobuf!Rvpuf)t*; Name ofCompany: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!28pg!49 Xpslfst!Dpnqfotbujpo!Jotvsbodf! B/C BDLHSPVOE!J OGPSNBUJPO 1.Please contact Purchasing Agent at oduff@westlaketx.govfor loss runs. 2.Experience Modifier is currently 0.67. 3.Estimated FY 23-24 payroll schedule is below. 4.Estimated number of regular employees is 108 (excluding substitute teachers & part-time coaches.) C/Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 1.Workers Compensation Limits & Coverage Desired: Mjnju Qfs Bodily Injury by Accident$1,000,000Accident Bodily Injury by Disease$1,000,000Policy Limit Bodily Injury by Disease$1,000,000Employee 2.Estimated FY 22-23 payroll is as follows: Qbzspmm!DpefBoovbm!BnpvouFnqmpzfft 8868$ 6,148,00097 (does not include substitute teachers) 8810$348,0006 9101$ 282,0005 Upubm!Ftujnbufe!Qbzspmm;!!%7-889-111219 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. D/Rvpufe!Dpwfsbhf!Qspwjtjpot 1.Does coverage utilize a specific provider network? Yes No If yes,please provide details. E/Rvpubujpo 1.Workers Compensation InsuranceQuote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ 2.Alternate Workers Compensation Insurance Quote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!29pg!49 Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!2:pg!49 Joufsobujpobm!Usbwfm!Mjbcjmjuz!Jotvsbodf! B/C BDLHSPVOE!J OGPSNBUJPO 1.No claims since inception of coverage in 2015. 2.Coverage is for employees engaged in overseas travel,and no countries excluded. 3.Coverage should include Medical Assistance, Personal Assistance, and Travel Assistancefor employeesand students, based on 50participantsper year. C/Eftjsfe!Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 1.Benefits MjnjuQfsBhhsfhbuf Medical ExpenseLimit$ 50,000Person$50,000 Dental Treatment$ 250Tooth $ 500 Room and BoardAverage semi-private room rate ICU Room and Board ChargesTwice the semi-private room rate Treatment of PregnancyTreated as any other medical condition Preexisting ConditionsTreated as any other medical condition Chiropractic Care$ 35Visit $ 350 Emergency Medical Evacuation100%Expenses Repatriation of Remains100%Expenses Chaperone Replacement$ 2,000 Accidental Death & Dismemberment$ 10,000Student Accidental Death & Dismemberment$ 50,000Faculty Kidnap/Ransom$100,000Event$100,000 Aggregate Limit$ 250,000Benefit Max 2.All coverage is $0 deductible with 100% coinsurance. 3.Include a listing of additional coverages, coverage extensions, and AD&D schedule. 4.Include a listing of exclusions. D/Rvpufe!Dpwfsbhf!Qspwjtjpot 1.Coverage Detail Mjnju QfsBhhsfhbuf Medical Expense Limit_________ _________ ___________ Dental Treatment_________ _________ ___________ Room and Board_________ _________ ___________ ICU Room and Board Charges_________ _________ ___________ Treatment of Pregnancy_________ _________ ___________ Preexisting Conditions_________ _________ ___________ Chiropractic Care_________ _________ ___________ Emergency Medical Evacuation_________ _________ ___________ Repatriation of Remains_________ _________ ___________ Chaperone Replacement_________ _________ ___________ Accidental Death & Dismemberment_________ _________ ___________ Accidental Death & Dismemberment_________ _________ ___________ Kidnap/Ransom_________ _________ ___________ Aggregate Limit_________ _________ ___________ 2.Does coverageinclude evacuation/repatriation? Yes No Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!31pg!49 E/Rvpubujpo 1.International TravelInsuranceQuote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024) 2.Alternate International Travel Insurance Quote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!32pg!49 Tuvefou!Bddjefou!Jotvsbodf! B/C BDLHSPVOE!J OGPSNBUJPO 1.Coverage is for all K-12 students participating in school sponsored activities,including sports. Liability waivers are obtained on all participants in sports programs. 2.Estimated Student Enrollment Count:880 Grades K-8: 555Grades 9-12: 325 3.Estimated Sports Participation is as follows: Football (grades 9-10): 35Football (grades 11-12): 26 All other sports (grades 9-10): 170All other sports (grades 11-12): 180 4.Batting cages or trampolines are not within the scope of the program. C/Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 1.Liability Limits & Coverage: Mjnju Efevdujcmf Accident Medical Expense$ 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. D/RvpufeDpwfsbhf!Qspwjtjpot 1.Coverage Detail: Mjnju Efevdujcmf Accident Medical Expense_________ _________ Accidental Death Benefit_________ _________ Accidental Dismemberment_________ _________ AD&D Aggregate Limit_________ 2.Is arranged transportation included, prior, during, and after sponsored events?: Yes No If yes, please give effective date(s) and explanation. E/Rvpubujpo 1.Student AccidentInsurance Quote (Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ 2.Alternate Student Accident Insurance Quote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!33pg!49 F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!34pg!49 Dzcfs!Sjtl!Mjbcjmjuz!)pqujpobm* B/C BDLHSPVOE!J OGPSNBUJPO 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: C/Jotvsbodf!dpwfsbhf!jt!up!jodmvef!uif!gpmmpxjoh; 1.Liability Limits & Coverage: Mjnju Efevdujcmf Liability Coverages Networks and information security $ 1,000,000$10,000 Communications and media$ 1,000,000$10,000 Regulatory defense expenses$500,000$10,000 st 1Party coverage Crisis Management event expenses$ 500,000 $10,000 Security Breach remediation and $ 500,000$10,000 notification expenses E-commerce extortion$ 500,000$10,000 Business interruption and additional$ 500,00024 Hours Expenses 2.Include coverage descriptions of each insuring agreement 3.Include a listing of additional coverages, coverage extensions, and exclusions. D/RvpufeDpwfsbhf!Qspwjtjpot 1.Coverage Detail: Mjnju Efevdujcmf Liability Coverages Networks and information security____________________ Communications and media____________________ Regulatory defense expenses____________________ st 1Party coverage____________________ Crisis Management event expenses____________________ Security Breach remediation and____________________ notification expenses E-commerce extortion____________________ Business interruption and additional____________________ expenses E/Rvpubujpo 1.Cyber liability InsuranceQuote (Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ 2.Alternate Cyber liability InsuranceQuote(Attach complete coverage information) Annual Premium (Period 09/01/2023 to 08/31/2024): $________________________________ Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!35pg!49 F/J OTVSBODF!D PNQBOZ 0S JTL!Q PPM!J OGPSNBUJPO Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No Gps!Bmufsobuf!Rvpuf)t*; Name of Company: _________________________________________________________ A.M. Best Rating/Size: _________________________________ Insurance Company: Yes No Risk Pool: Yes No G/M JTU!BOZ!EFWJBUJPOT!PS!BEEJUJPOBM!JOGPSNBUJPO; Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!36pg!49 QSPQPTBM!TVCNJUUBM!GPSNBU! Quotations should beclearlylabeled, using theformat 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, EBLIand 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- Agent’s 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 Form2270 Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!37pg!49 Fyijcju!B!.!QspqfsuzTdifevmf 1.All buildings are located on 2600 JT Ottinger Road, Westlake TX, 76262.Blanket coverage is required for buildings and contents. CvjmejohTr/!GppubhfWbmvbujpoSppg!Uzqf #1 15,600 12,899,250 100% concrete tile #2:20,000 9,208,500100% concrete tile #311,200 4,715,550100% concrete tile #4: 8,400 5,965,05080% concrete tile, 20% flat membrane #5: #6: #7:1 #8:1,000 #9:0 Qspqfsuz!)Cmbolfu*!Mjnjut;!%5-861 2.Contents:%5-661 3.Business Income and Extra Expense:%595-111 4/UpubmQspqfsuz!Mjnjut%-411 Xftumblf!Bdbefnz!!GZ!34035!Dpnqsfifotjwf!Jotvsbodf!SGQ!!!!!!Qbhf!38pg!49 PROPERTY CHOICE - 46UUNAZ0D9M POLICY PREMIUM ThetotalinsuredvaluesshowninthePremiumsectionofthisproposalbelowarenotlimitsofinsurance.Theyrepresent thesumofallvaluesforCoveredPropertyandBusinessInterruptionaccordingtotheapplicationorareportofvalues, subject to our agreed upon adjustment, and are the basis of premium determination. PleaserefertotheSchedulesofCoveredProperty,CausesofLoss,CoverageExtensions,AdditionalCoveragesand Insured Premises for applicable Limits of Insurance which follow this Premium section. DESCRIPTIONTOTAL INSURED VALUES Real Property Business Personal Property (Including or Excluding Stock) Business Income$44,000 CrimeSee Quote Details Equipment BreakdownIncluded in the Limits of Insurance applicable to Covered Property and Business Interruption DESCRIPTIONPREMIUM Property Choice Subtotal Terrorism Total Property Premium Quote ProposalPage5 of56 LIMITS OF INSURANCE POLICY DEDUCTIBLE AND WAITING PERIOD ThePolicyDeductibleappliestoCoveredProperty,CoveredCausesofLoss,AdditionalCoverages,Coverage ExtensionsorStatedCausesofLossunlessamorespecificdeductibleisshownintheDeclarations.ThePolicy Deductible does not apply to anyBusiness Interruption coverage. ThePolicyWaitingPeriodappliestoalllossofBusinessIncome,CoveredCausesofLoss,BusinessInterruption AdditionalCoverages,BusinessInterruptionCoverageExtensionsorStatedCausesofLossunlessamorespecific Waiting Period is shown in the Declarations. NoWaiting Period applies toExtra Expense. POLICY DEDUCTIBLE AND WAITING PERIODANY ONE OCCURRENCE Policy Deductible$10,000 Policy Waiting Period72 Hours Quote ProposalPage6 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo STATED CAUSES OF LOSS Limits of Insurance shown below apply in any one occurrence, unless otherwise stated. ThefollowingisapplicablewhenanAnnualAggregateisshown:AnnualAggregaterepresentsthemostwewillpayin totalforalllossordamageinanyonePolicyYear,regardlessofthenumberofoccurrences,orInsuredPremises involved in an occurrence. LIMITS OF INSURANCE IN ANY ONE STATED CAUSES OF LOSS EQUIPMENT BREAKDOWN ACCIDENT Included in the Limits of Insurance applicable to Equipment Breakdown Covered Property and Business Interruption Waiting Period72 Hours Valuation - Equipment Breakdown PropertyReplacement Cost Equipment Breakdown Coverage Extensions Included in the Equipment Breakdown Limit of CFC Refrigerants Insurance Expediting Expenses$100,000 Hazardous Substances$100,000 Spoilage$100,000 Quote ProposalPage7 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS TheLimitsofInsuranceapplicabletotheCoverageExtensionsshownbelowareadditionalamountsofinsuranceunless otherwisestated.AllLimitsofInsuranceapplyinanyoneoccurrence,regardlessofthenumberofInsuredPremises involved in that occurrence, unless otherwise stated. TheseCoverageExtensions,LimitsofInsurance,DeductiblesandWaitingPeriodsapplytoeachInsuredPremises, unlessmorespecificLimits,DeductiblesandWaitingPeriodsareshownatanInsuredPremisesintheScheduleof Premises and Coverage Section below. ApplicabletoCoverageExtensionswithanAnnualAggregate:AnnualAggregaterepresentsthemostwewillpayin totalforalllossordamageinanyonePolicyYear,regardlessofthenumberofoccurrences,orInsuredPremises involved in an occurrence. DeductiblesshownbelowarespecifictothatCoverageExtension.Deductiblesapplyseparatelytothatcoverageandare in addition to any other deductible that may apply to other loss or damage in the same occurrence. COVERAGE EXTENSIONSLIMIT OF INSURANCE Included in the Business Personal Property Limit of Brands and Labels Insurance Building Glass RepairIncluded Business Travel$50,000 Claim Expenses$50,000 Combined Additional Protection$250,000 Any One Plant, Shrub or Tree$10,000 Lawns or Sod$10,000 Stock$25,000 Contract Penalties$50,000 25% of the amount we pay for covered loss or Debris Removal damage Debris Removal - Additional Amount$250,000 $2,500 Wind-Blown Debris Annual Aggregate Other Property Debris Removal$10,000 Deferred Sales$50,000 Employee's Personal Property$50,000 Per Employee$2,500 Exhibitions$50,000 Expediting Expenses$50,000 Fine Arts$50,000 Per Item$10,000 Fire Department Service Charge$50,000 Quote ProposalPage8 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONSLIMIT OF INSURANCE Fire Device Recharge$50,000 $50,000 Fungus, Wet Rot, Dry Rot Physical Damage Policy Annual Aggregate Limited Coverage Form Applies Installation$25,000 Deductible$2,500 $50,000 Land and Water Decontamination Expense Annual Aggregate Locks and Keys$25,000 Miscellaneous Unnamed Premises Building$100,000 Business Personal Property$50,000 Newly Acquired Property Number of Days180 Days Building$2,000,000 Business Personal Property$1,000,000 Stock$25,000 Non-Owned Detached Trailers$50,000 Deductible$2,500 Outdoor Trees, Shrubs, Sod, Plants and Lawns$50,000 Any One Tree, Shrub, Plant, Lawn or Sod$10,000 Included in the Business Personal Property Limit of Pairs and Sets Insurance Included in the Limit of Insurance applicable to Preservation and Protection of Property Covered Property that sustains loss or damage Number of DaysExpenses incurred for 180 Days Reward Coverage$50,000 Tenant's Leaseholder's Interest Coverage$25,000 Lease Assessment$5,000 Deductible$2,500 Miscellaneous Interior Real Property$25,000 Included in the Tenant's Leaseholder's Interest Leaseholder's Interest Coverage Coverage Limit of Insurance Included in the Tenant's Leaseholder's Interest Bonus Payments Coverage Limit of Insurance Quote ProposalPage9 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONSLIMIT OF INSURANCE Included in the Tenant's Leaseholder's Interest Prepaid Rent Coverage Limit of Insurance Included in the Tenant's Leaseholder's Interest Undamaged Tenant's Improvements or Betterments Coverage Limit of Insurance Transit Shipper's Interest$50,000 Maximum Limit Per Vehicle$10,000 Deductible$2,500 Utility Service Interruption - Physical Damage Any One Occurrence$25,000 Deductible$5,000 Interruption caused by loss or damage to Transmission or Included Distribution Lines Valuable PapersIncluded as Business Personal Property Included in the Limit of Insurance applicable to Water Damage - Building Tear Out and Repair Covered Property BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Refer to Location Level Details for applicable Limits of Business Income Insurance Waiting Period72 Hours PayrollIncluded BUSINESS INTERRUPTION COVERAGE EXTENSIONS TheLimitsofInsuranceapplicabletotheCoverageExtensionsshownbelowareadditionalamountsofinsurance,and includeBusinessIncomeandExtraExpenseunlessotherwisestated.AllLimitsofInsuranceapplyinanyone occurrence, unless otherwise stated. ApplicabletoCoverageExtensionswithanAnnualAggregate:AnnualAggregaterepresentsthemostwewillpayintotal foralllossordamageinanyonePolicyYear,regardlessofthenumberofoccurrences,orInsuredPremisesinvolvedin an occurrence. WaitingPeriodsapplicabletoanyCoverageExtensionshownbelowapplyseparatelyandarespecifictothatCoverage Extension.IftwoormoreWaitingPeriodsapplyinanyoneoccurrence,wewillonlyapplythelongestWaitingPeriod. No deductible orWaiting Period applies toExtra Expense. COVERAGELIMIT OF INSURANCE Attraction PropertiesPolicy Occurrence Limit Limit$25,000 Waiting Period72 Hours Distance from Insured PremisesContiguous with the Insured Premises Quote ProposalPage10 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGELIMIT OF INSURANCE Included in the Limits of Insurance applicable to Business Travel Business Income and/or Extra Expense Included in the Limits of Insurance applicable to Civil or Military Authority Business Income and/or Extra Expense Number of Days30 Days Distance from Insured PremisesWithin 1,000 feet of the Insured Premises Waiting Period72 Hours Contingent Business InterruptionPolicy Occurrence Limit Waiting Period72 Hours Direct Contingent Properties$100,000 Indirect Contingent Properties$25,000 Utility Services Interruption - Direct Contingent PropertiesNot Covered Included in the Limits of Insurance applicable to Exhibitions Business Income and/or Extra Expense Extended Income Number of DaysIncluded for 180 Days Included in the Limits of Insurance applicable to Fungus, Wet Rot, Dry Rot – Business Interruption Business Income and/or Extra Expense Number of Days30 Days Limited Coverage Form Applies Included in the Limits of Insurance applicable to Ingress or Egress Business Income and/or Extra Expense Number of Days30 Days Distance from Insured PremisesContiguous with Insured Premises Waiting Period72 Hours Included in the Limits of Insurance applicable to Installation Installation $25,000 Land and Water Decontamination - Increased Period of Restoration Policy Annual Aggregate Waiting Period72 Hours Included in the Limits of Insurance applicable to Machinery and Testing and Training Business Income and/or Extra Expense Miscellaneous Unnamed Premises - Business Interruption$100,000 Waiting Period72 Hours Included in the Limits of Insurance applicable to Newly Acquired Premises Business Income and/or Extra Expense Quote ProposalPage11 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGELIMIT OF INSURANCE Included in the Limits of Insurance applicable to Ordinance or Law - Increased Period of Restoration Business Income and/or Extra Expense Included in the Limits of Insurance applicable to Research and Development Expenses Business Income and/or Extra Expense Included in the Limits of Insurance applicable to the Transit Shipper's Interest Transit - Shipper’s Interest Utility Service Interruption - Business Interruption Business Income and Extra Expense Combined$25,000 Waiting Period72 Hours Interruption caused by loss or damage to Transmission or Included Distribution Lines Quote ProposalPage12 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo EDUCATIONADDITIONAL COVERAGES TheHartfordhasincludedthefollowingSpecializedCoveragesspecifictotheEducationIndustry.AllLimitsofInsurance are additional amounts of insurance and apply in any one occurrence, unless otherwise stated. ApplicablewhenanAnnualAggregateisshown:AnnualAggregaterepresentsthemostwewillpayintotalforallloss ordamageinanyonePolicyYear,regardlessofthenumberofoccurrences,orInsuredPremisesinvolvedinan occurrence. DeductiblesshownbelowarespecifictothatCoverageExtension.Deductiblesapplyseparatelytothatcoverageandare in addition to any other deductible that may apply to other loss or damage in the same occurrence. WaitingPeriodsshownbelowapplyseparatelyandarespecifictothatAdditionalCoverage.IftwoormoreWaiting Periodsapplyinanyoneoccurrence,wewillonlyapplythelongestWaitingPeriod.NodeductibleorWaitingPeriod applies toExtra Expense. COVERAGELIMIT OF INSURANCE Additional Outdoor Property$100,000 Per Item$2,500 Deductible$5,000 Included in Business Personal Property Limit of Agricultural Products Storage Insurance Animals$10,000 Per Animal$1,000 Deductible$2,500 Archaeological Expenses$10,000 Deductible$5,000 Athletic Equipment - Away From an Insured Premises$50,000 Deductible$2,500 Athletic Uniforms, Band Uniforms or Theatrical Wardrobe - Away $50,000 from an Insured Premises Deductible$2,500 Audio and Visual Equipment - Away From an Insured Premises$10,000 Per Item$2,500 Deductible$2,500 $10,000 Biomedical Hazardous Waste Decontamination and Clean-Up Expense Annual Aggregate Deductible$5,000 Contractor's Tools and Equipment Leased or Rented from OthersIncluded Valuation TypeActual Cash Value Applies Quote ProposalPage13 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGELIMIT OF INSURANCE Per Occurrence$50,000 Per Item$5,000 Deductible$2,500 Contractor's Tools and Equipment Coverage Extensions Employee’s Tools and Work ClothingIncluded Per Employee$2,500 Newly Acquired Contractor's Equipment$10,000 Rental Expense$10,000 $50,000 Crisis Event Annual Aggregate Number of Days30 Days Distance from Insured PremisesAt the Insured Premises $10,000 Good Faith Advertising Expense Annual Aggregate Deductible$5,000 $10,000 Business Interruption Annual Aggregate Waiting Period24 Hours Embryo, Eggs, Cells and Tissue$10,000 Deductible$5,000 $250,000 Emergency Evacuation Expenses Annual Aggregate In Any One Occurrence$10,000 Fundraising Expense Reimbursement$10,000 Harvested Crops$25,000 Deductible$5,000 Musical Instruments and Theatrical Sets or Scenery - Away $100,000 From Premises Deductible$2,500 Patient’s and Patient Visitor’s Personal Property$25,000 Per Patient or Visitor$1,000 Precious and Semi-Precious Metals and Stones$25,000 Deductible - Covered Causes of Loss other than Theft$2,500 Theft Limit of Insurance$25,000 Quote ProposalPage14 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGELIMIT OF INSURANCE Deductible - Theft$2,500 Professional Employee Replacement Expense$25,000 Included in the Limits of Insurance Applicable to Release of Impounded Water Business Interruption Number of Days180 Days Research Animals$10,000 Per Research Animal$10,000 Deductible$2,500 Research Materials - Restoration Costs$50,000 Deductible$2,500 Student, Patient and Resident Relocation and Move-Back $50,000 Expenses Students' Personal Property$50,000 Per Student$2,500 Telecommunication Equipment Recalibration Expense$10,000 Deductible$2,500 Industry Combined Additional Protection$25,000 Quote ProposalPage15 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo CRIME COVERAGE PART COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the Premises$100,000 Deductible$2,500 Theft of Money and Securities Outside the Premises$100,000 Deductible$2,500 Deception Fraud$10,000 Forgery or Alteration$25,000 Deductible$2,500 Money Orders and Counterfeit Currency$25,000 Deductible$2,500 Employee Theft$50,000 Deductible$2,500 Acts Against ClientsNot Covered Agents as EmployeesNot Covered Computer Fraud$25,000 Deductible$2,500 Volunteer Solicitors as EmployeesNot Covered Claim Expenses$10,000 Quote ProposalPage16 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo POLICY CONDITIONS AND EXCLUSIONS FORM NUMBERFORM NAMEDETAILS Application Of Windstorm Or Hail Dollar Deductibles – PC45090121 Revised LOCATION CONDITIONS AND EXCLUSIONS LOCATION NUMBER(S)FORM NUMBERFORM NAME Loc 9 - 1: Building 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 , Loc PC40140121Protective Safeguards 10 - 1: Building 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Quote ProposalPage17 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo SCHEDULE OF INSURED PREMISES AND COVERAGE Limits of Insurance shown below apply in any one occurrence, unless otherwise stated. LOC 1 - 1: BUILDING2600 J T OTTINGER RD WESTLAKE, TX 76262-8012 LOCATION NAME: ACADEMY/FRONT OFFICE LOCATION PREMIUM$30,158.00 DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property$51,207,800 ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property$12,899,250 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property$1,680,000 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible3% Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Quote ProposalPage18 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$10,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$334,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage19 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 2 - 1: BUILDING2600 J T OTTINGER RD WESTLAKE, TX 76262-8012 LOCATION NAME: REC CENTER/CAFETERIA LOCATION PREMIUM$19,605.00 DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property$51,207,800 ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property$9,208,500 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property$830,550 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible3% Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage20 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$10,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$15,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage21 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 3 - 1: BUILDING2600 J T OTTINGER RD WESTLAKE, TX 76262-8012 LOCATION NAME: REAR BLDG LOCATION PREMIUM$11,727.00 DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property$51,207,800 ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property$4,715,550 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property$525,000 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible3% Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage22 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$10,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$15,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage23 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 4 - 1: BUILDING2600 J T OTTINGER RD WESTLAKE, TX 76262-8012 LOCATION NAME: ARTS & SCIENCE CENTER LOCATION PREMIUM$13,664.00 DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property$51,207,800 ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property$5,965,050 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property$399,000 ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible3% Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage24 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$10,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$15,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage25 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 5 - 1: BUILDING2600 J T OTTINGER RD LOCATION NAME: WESTLAKE, TX 76262-8012 LOCATION PREMIUM DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage26 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$100,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$1,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage27 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 6 - 1: BUILDING2600 J T OTTINGER RD LOCATION NAME: WESTLAKE, TX 76262-8012 LOCATION PREMIUM DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage28 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$100,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$1,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage29 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 7 - 1: BUILDING2600 J T OTTINGER RD LOCATION NAME: WESTLAKE, TX 76262-8012 LOCATION PREMIUM DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage30 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$100,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$1,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage31 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 8 - 1: BUILDING2600 J T OTTINGER RD LOCATION NAME: WESTLAKE, TX 76262-8012 LOCATION PREMIUM DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible% Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage32 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$10,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$1,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage33 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo LOC 9 - 1: BUILDING2600 J T OTTINGER RD LOCATION NAME:WESTLAKE, TX 76262-8012 LOCATION PREMIUM DEDUCTIBLE AND WAITING PERIOD Waiting Period72 Hours Deductible$10,000 COVERED PROPERTY The following blanket limits apply to this Insured PremisesLIMIT OF INSURANCE Real Property and Business Personal Property ForanyCoverageshownforwhichaBlanketLimitofInsuranceapplies,thecorrespondingLimitofInsurancebelowrepresentstheTotal Insured Value used for purposes of rating only. COVERAGELIMIT OF INSURANCE Real Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply Business Personal Property ValuationReplacement Cost Applies CoinsuranceDoes Not Apply StockIncluded STATED CAUSES OF LOSSLIMITS OF INSURANCE Equipment BreakdownIncluded Deductible$10,000 Waiting Period72 Hours Windstorm/HailIncluded Deductible% Waiting Period72 Hours COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE $250,000 Accounts Receivable (Most we will pay in total in any one occurrence is the highest Accounts Receivable limit shown on the policy) Fungus, Wet Rot, Dry RotIncluded in the Fungus Wet Rot Dry Rot Policy Limit of Insurance Limited Coverage Form Applies Green Coverage - Costs to Upgrade$100,000 Quote ProposalPage34 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination Expense Policy Land and Water Decontamination Expense Annual Aggregate Ordinance or Law Undamaged Portion of the BuildingIncluded in Real Property Limit of Insurance $1,000,000 (Most we will pay in total in any one occurrence is the highest Demolition and Increased Cost of Construction Demolition and Increased Cost of Construction limit shown on the policy) Mandated Decontamination ExpenseNot Covered Utility Service Interruption - Physical DamageIncluded in the Utility Service Interruption Policy Limit of Insurance Deductible$5,000 Windstorm/Hail Dollar Deductible$10,000 ADDITIONAL COVERAGES COVERAGELIMIT OF INSURANCE Theft of Money and Securities Inside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 Theft of Money and Securities Outside the PremisesIncluded in the Money and Securities Limit of Insurance Deductible$2,500 BUSINESS INTERRUPTION COVERAGELIMIT OF INSURANCE Business Income$1,000 Waiting Period72 Hours BUSINESS INTERRUPTION COVERAGE EXTENSIONS COVERAGELIMIT OF INSURANCE Included in the Land and Water Decontamination - Increased Land and Water Decontamination - Increased Period of Restoration Period of Restoration Policy Annual Aggregate Included in the Utility Service Interruption Policy Level Limit of Utility Service Interruption - Business Interruption Insurance Waiting Period72 Hours Windstorm/Hail Waiting Period72 Hours Quote ProposalPage35 of56 Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo PROPERTY EXTENDED SUMMARY DESCRIPTIONPREMIUM 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 2 - 1: Building $19,605.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 3 - 1: Building $11,727.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 4 - 1: Building $13,664.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 5 - 1: Building $11,832.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 6 - 1: Building $9,801.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 7 - 1: Building $14,305.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 8 - 1: Building $6,209.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 Loc 9 - 1: Building $6,209.00 2600 J T OTTINGER RD, WESTLAKE, TX 76262-8012 TOTAL PROPERTY PREMIUM$128,851.00 Quote ProposalPage35 of47 Rvpuf!Qspqptbm Gpsnt!Mjtujoh Property Choice Forms Coverage Forms, Schedules, Endorsements and other forms that are a part of this policy. FORM NUMBERFORM NAME G-4038(0121ED.)Texas Period To File A Claim Or Bring Legal Action Against Us Notice -Windstorm Or Hail - Catastrophe Area G-4164(0121ED.)Texas Flood Insurance Disclosure Notice PC00010121Property Choice Coverage Form PC00020121Declarations: Property Choice Coverage Part PC00030121REFERENCE GUIDE PC10700121Equipment Breakdown Coverage Form PC20000121Combined Additional Protection – Industry Additional Coverages PC20030121Additional Outdoor Property PC20040121Agricultural Products Storage Endorsement PC20060121Animals PC20070121Archaeological Expenses PC20090121Athletic Equipment – Away From Premises PC20100121Athletic Uniforms, Band Uniforms Or Theatrical Wardrobe – Away From Premises PC20110121Audio And Visual Equipment – Away From Premises PC20120121Biomedical Hazardous Waste Decontamination And Clean-Up Expense – Additional Coverage PC20180121Contractor's Tools And Equipment – Additional Coverage PC20190121Crisis Event – Additional Coverage PC20230121Emergency Evacuation Expenses PC20290121Fundraising Expense Reimbursement PC20320121Harvested Crops PC20340121Musical Instruments And Theatrical Sets Or Scenery Away From Premises PC20460121Patient's And Patient Visitor's Personal Property PC20470121Precious And Semi-Precious Metals And Stones - Limited Coverage PC20490121Professional Employee Replacement Expense Additional Coverage PC20530121Release Of Impounded Water Business Interruption PC20550121Research Animals PC20560121Research Materials Restoration Costs PC20590121Student's Personal Property PC20600121Students, Patients Or Residents - Relocation And Move-Back Expenses - Additional Coverage PC20620121Telecommunication Equipment Recalibration Expense – Additional Coverage Quote ProposalPage45 of56 Rvpuf!Qspqptbm Gpsnt!Mjtujoh FORM NUMBERFORM NAME PC20660121Animal Tissue, Bodily Fluids, Eggs, Embryos And Live Cells PC20720121Fine Arts – Breakage Additional Coverage PC31420121Texas Changes PC45200121Windstorm Or Hail Dollar Deductible And Waiting Period PC45210121Windstorm Or Hail Percentage Deductible And Waiting Period PC50010121Commercial Crime Coverage Form PC50030121Deception Fraud - Additional Coverage(Commercial Crime) PC99020121Contractor's Tools And Equipment Schedule Quote ProposalPage46 of56 Bddpvou!Obnf;XFTUMBLF!BDBEFNZ Qpmjdz!Qfsjpe;1904203134 up 1904203135 Rvpuf!Ovncfs;919:317 Dpnnfsdjbm!Hfofsbm!Mjbcjmjuz!DH!11!12Mjnjut Hfofsbm!Bhhsfhbuf%3-111-111 Qspevdu0Dpnqmfufe!Pqfsbujpot!Bhhsfhbuf%3-111-111 Qfs!Pddvssfodf%2-111-111 Qfstpobm!'!Bewfsujtjoh!Jokvsz%2-111-111!boz!pof!qfstpo ps!pshboj{bujpo!!! %2-111-111!boz!pof Ebnbhf!up!Qsfnjtft!Sfoufe!up!Zpv qsfnjtft! 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*LessorofLeasedEquipment *Managers/LessorsofPremises *OwnerofLeasedLand *VendorsofYourProducts Aircraft •Hired, chartered, or loaned to an insured with a Includedifnootherinsurance paid crew that is not owned by the insured, if no otherinsurance “Insured Contract” coverage for use of aircraft Included thatare notusedforridestoandfromschool BailBondsUpto $2,500 “BodilyInjury” •Arisingfromproviding,orfailingtoprovideIncluded professionalhealthcare services – includes employees, volunteers,andauxiliaryinstructors •Shock, mentalanguishormentalinjury Included $25,000Per Occurrence Toco-employees,co-volunteers & co-instructors $25,000GeneralAggregate Damage to Premises Rented to You – Includes Fire, Lightning,Greater of $500,000 or Amount ExplosionListedinDeclarations ExtendedBodilyInjury - includesuseofreasonableforceto: Included Protectpersonsorproperty Included Restrain or remove a pupil whose behavior is disruptivedespite a requesttorefrainfromsuch behavior Ufybt!pomz;Use of firearms may 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Dpmmjtjpo!Efevdujcmf!8 Ijsfe!Bvup Mjbcjmjuz!Dpncjofe!Tjohmf!MjnjuDpncjofe!Tjohmf!Mjnju Dpwfsbhf!Opu!Tfmfdufe Dpnqsfifotjwf!!!! Dpwfsbhf!Opu!Tfmfdufe Tqfdjgjfe!Dbvtft!pg!Mptt!!!! Dpwfsbhf!Opu!Tfmfdufe Dpmmjtjpo!!!! Opo.Pxofe!Bvup Mjbcjmjuz!Dpncjofe!Tjohmf!Mjnju%2-111-111 Esjwf!Puifs!Dbs Dpwfsbhf!Opu!Tfmfdufe Mjbcjmjuz!Dpncjofe!Tjohmf!Mjnju Dpwfsbhf!Opu!Tfmfdufe Nfejdbm!Qbznfout Dpwfsbhf!Opu!Tfmfdufe Vojotvsfe0Voefsjotvsfe!Npupsjtut Dpwfsbhf!Opu!Tfmfdufe Dpnqsfifotjwf!!!! Dpwfsbhf!Opu!Tfmfdufe Dpmmjtjpo!!!! 316:33 Bddpvou!Obnf; Qpmjdz!Qfsjpe;1904203134 up 1904203135 Rvpuf!Ovncfs; Dpnnfsdjbm!Bvupnpcjmf Bvup!Foepstfnfout!0!FoibodfnfoutQsfnjvn 9F352:15028Dpnnfsdjbm!Bvupnpcjmf!Fyufotjpo!Foepstfnfou%361/11 DB337518019Ufybt!Qfstpobm!Jokvsz!Qspufdujpo!FoepstfnfouJodmvefe 9M241417026Ufybt!Qpmjdzipmefs!Dpnqmbjou!QspdfevsftJodmvefe JM1132150:9Ovdmfbs!Fofshz!Mjbcjmjuz!Fydmvtjpo!FoepstfnfouJodmvefe DB111214021Cvtjoftt!Bvup!Dpwfsbhf!GpsnJodmvefe DB12:714023Ufybt!DibohftJodmvefe JM1128220:9Dpnnpo!Qpmjdz!DpoejujpotJodmvefe DB34:514017Tjmjdb!ps!Tjmjdb.Sfmbufe!Evtu!Fydmvtjpo!gps!Dpwfsfe!Bvupt!FyqptvsfJodmvefe DB135414012Ufybt!Dibohft.Dbodfmmbujpo!Boe!OposfofxbmJodmvefe 9M329316027Ufybt!Vojotvsfe0Voefsjotvsfe!Npupsjtu!Dpwfsbhf!Tfmfdujpo0SfkfdujpoJodmvefe DB321:16024Ufybt!Vojotvsfe0Voefsjotvsfe!NpupsjtuJodmvefe 9M:4915016Vujdb!Mmpzet!pg!UfybtJodmvefe 9M244:UY1:02:Buufoujpo!Ufybt!QpmjdzipmefstJodmvefe 9F3287190:6Dpvoufstjhobuvsf!FoepstfnfouJodmvefe 9M2679120:8Bvup!Hmbtt!Dmbjnt!DpwfsbhfJodmvefe 316:33 Bddpvou!Obnf; Qpmjdz!Qfsjpe;1904203134 up 1904203135 Rvpuf!Ovncfs; Dpnnfsdjbm!Bvupnpcjmf Tubuf;!UY Wfijdmf!Tdifevmf B!mjtu!pg!wfijdmft!boe!uif!dpwfsbhft!uibu!bqqmz!up!fbdi; Nblf-!Npefm-Puifs!Uibo WfijdmfWfijdmf!JE!OvncfsQfstpobm!JokvszNfejdbmDpmmjtjpoDpmmjtjpo $Zfbs)WJO*MjbcjmjuzQspufdujpo!)QJQ*QbznfoutEfevdujcmfEfevdujcmfUpxjohQsfnjvn 2 3117DIFWSPMFU!HJSBSEJOYYDpnqsfifotjwf%2-111%2-557/11 2HCKH42V77234:965%2-111 3 3121DIFWSPMFU!TUBSUSBOTYYDpnqsfifotjwf%2-111%2-557/11 2HC7H4BH6B2222628%2-111 4 3129CMVFCJSE!CVTYYDpnqsfifotjwf%3-111%2-676/11 2CBLHDFB5KG457194%3-111 5 3131CMVFCJSE!88Q!CVTYYDpnqsfifotjwf%4-111%2-:21/11 2CBLHDFB9MG477662%4-111 Jg!qiztjdbm!ebnbhf!dpwfsbhf!jt!tfmfdufe-!wbmvbujpo!bqqmjft!po!bo!bduvbm!dbti!wbmvf!cbtjt!vomftt!puifsxjtf!joejdbufe/ 316:33 Bddpvou!Obnf;XFTUMBLF!BDBEFNZ Qpmjdz!Qfsjpe;1904203134 up 1904203135 Rvpuf!Ovncfs;6699622 Mjnjut!pg!Jotvsbodf; Fbdi!Pddvssfodf;%6-111-111 Bhhsfhbuf!Mjnju;%6-111-111 Tfmg.Jotvsfe!Sfufoujpo;%21-111 Tdifevmf!pg!Bqqmjdbcmf!Voefsmzjoh!Jotvsbodf; Dpnnfsdjbm!Hfofsbm!Mjbcjmjuz Bvupnpcjmf!Mjbcjmjuz Fnqmpzfst!Mjbcjmjuz Bcvtf!ps!Npmftubujpo!Mjbcjmjuz Tdippm!Ejtusjdu0Fevdbupst!Mfhbm!Mjbcjmjuz Fnqmpzff!Cfofgjut!Mjbcjmjuz Fnqmpznfou!Sfmbufe!Qsbdujdft!Mjbcjmjuz Beejujpobm!Dpotjefsbujpot; 316:33 Employers Liability Limit: Bodily Injury$1,000,000/$1,000,000/$1,000,000 (Each Accident/Disease Policy Limit/Disease Each Employee) States Covered by Workers Compensation InsuranceTX (Part 1 or 3A) States Covered by Other States Insurance (Part 3 or 3C)All states except: Monopolistic states (ND, OH, WA, WY), US Territories, and states listed above in Part 1 or 3A Total Payroll$6,408,400 The"StatesCoveredbyWorkersCompensationInsurance(Part1or3A)"allhavetheEmployerLiabilityLimitslistedaboveunless higher limits are required by state law for CA, MA, NJ, NY or OR." Compulsory Coverage & Employers' LiabilityPremium Total Class Premium$18,318 Total Premium Subject to Experience Modification$18,940 Total Estimated Annual Standard Premium$14,319 Expense Constant$180 Terrorism$1,538 Waiver of Subrogation$366 Premium Discount-$888 Increased Limits Part Two$256 Experience Modifier-$5,303 Schedule Rating Factor$682 TOTAL ESTIMATED ANNUAL WORKERS’ COMPENSATION PREMIUM$15,149.00 MOD Experience Mod IDWC Experience ModMod Status TX Intrastate - 4209694490.720Actual EXTENDED SUMMARY State - Writing Company Name & ClassPayrollCompanyPremium Base Rate Texas Property and Casualty Insurance Company of Hartford 8868 SCHOOL: PROFESSIONAL EMPLOYEES5,800,0000.24$13,920 Quote Proposal Rvpuf!Qspqptbm Dpwfsbhf!Tfmfdujpo Texas Property and Casualty Insurance Company of Hartford 8810 CLERICAL OFFICE EMPLOYEES NOC328,0000.05$164 9101 SCHOOL - ALL OTHER EMPLOYEES & DRIVERS280,4001.51$4,234 9898 Experience modifier0.72-$5,303 0930 Waiver charge0.02$366 9889 Schedule Rating Factor1.05$682 9812 Emp liab increased limits0.01$256 Total Payroll/ Estimated Annual Premium$6,408,400$15,149.00 (after credits/discounts/surcharges) Quote Proposal Rvpuf!Qspqptbm Gpsnt!Mjtujoh Workers’ Compensation Forms Coverage Forms, Schedules, Endorsements and other forms that are a part of this policy. FORM NUMBERFORM NAME 97485-18AN IMPORTANT MESSAGE TO WORKERS' COMPENSATION POLICYHOLDERS 98456MAINTAINING YOUR PAYROLL RECORDS FOR AUDIT PURPOSES G-3058-1POLICY ADJUSTMENT NOTICE G-3116-5IMPORTANT NOTICE - TEXAS G-3418-0PRODUCER COMPENSATION NOTICE PstgNtcLtrPOSTING NOTICE ARCHIVE COVER LETTER WC000000CWORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC000001A.1INFORMATION PAGE WC000001A.2INFORMATION PAGE WC000406PREMIUM DISCOUNT ENDORSEMENT WC000414A90-DAY REPORTING REQUIREMENT- NOTIFICATION OF CHANGE IN OWNERSHIP ENDORSEMENT WC000421FCATASTROPHE (OTHER THAN CERTIFIED ACTS OF TERRORISM) PREMIUM ENDORSEMENT WC000422CTERRORISM RISK INSURANCE PROGRAM REAUTHORIZATION ACT DISCLOSURE ENDORSEMENT WC000425EXPERIENCE RATING MODIFICATION FACTOR REVISION ENDORSEMENT WC420301JTEXAS AMENDATORY ENDORSEMENT WC420304BTEXAS WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT WC420407TEXAS - AUDIT PREMIUM AND RETROSPECTIVE PREMIUM ENDORSEMENT WC550022ANOTICE TO WORKERS' COMPENSATION POLICYHOLDERS IN TEXAS LETTER WC660080JTEXAS ACCIDENT PREVENTION SERVICES WC660125ADEDUCTIBLE NOTICE OF ELECTION TO ACCEPT TEXAS WORKERS COMPENSATION BENEFITS WC660156BWORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY QUICK REFERENCE WC660330PCUSTOMER PRIVACY NOTICE WC660384HARTFORD LOSSCONNECT STUFFER WC770665WORKERS' COMPENSATION SCHEDULE RATING WORKSHEET WC884201GNOTICE TO EMPLOYEES CONCERNING WORKERS'COMPENSATION IN TEXAS WC884219ETEXAS NOTICE TO EMPLOYEES-SPANISH WC990001KSIGNATURE/COPYRIGHT Quote Proposal Rvpuf!Qspqptbm Gpsnt!Mjtujoh FORM NUMBERFORM NAME WC990002WORKERS' COMPENSATION AND EMPLOYERS' LIABILITY BUSINESS INSURANCE POLICY WC990005SCHEDULE OF OPERATIONS WC990368EXTENSION OF THE INFORMATION PAGE - ITEM 3.D. - ENDORSEMENTS WC990694GOODS AND SERVICES ENDORSEMENT WCP00040PRODUCER FACT SHEET WCPNLTR002WORKERS COMP POSTING NOTICE CUSTOMER LTR - PHS TYPE ACCTS (EXAMPLE: NON-PHS, SIMPLE MM, SIMPLE SC) Quote Proposal Named Insured:Westlake Academy Eligibility:Class 1:All students of the Policyholder Class 2:All faculty and staff of the Policyholder Coverage Term:August 31, 2023to August 31, 2024 Policy Number:GLM N14302943 Renewal Premium:$2,000 Covered Activities:Educational Travel Coverage Out-of-Country Medical Expense Benefits Benefit Maximum:$50,000 per person Deductible:$0 per Covered Accident or Sickness Preexisting Conditions:Treated as any other medical condition Dental Treatment:$500(Injury & Alleviation of Pain) Pregnancy Benefit:Treated as any other medical condition Room & Board:Average semi private room rate Intensive Care:Two times the average semi private room rate Chiropractic Care: $350 ($35 per visit up to a maximum of 10 visits) Prescription Drugs:Inpatient Co-insurance: 100% of covered expenses Outpatient Co-insurance:100% of covered expenses Coinsurance:100% of the Usual and Customary Charges Incurral Period:30 Days from the date of a Covered Accident or Sickness Maximum Benefit Period:The earlier of the date the Covered Person returns to his or her Home Country or Country of Permanent Assignment, or 26 weeks from the date of a Covered Accident or Sickness Maximum Coverage Period:180 days any single trip Accidental Death & Dismemberment Benefit: Class 1:$10,000 Class 2:$50,000 1 Aggregate Limit:$250,000 Chaperone Replacement Benefit$2,000 Emergency Reunion Benefit$2,000 Emergency Medical Benefit:up to $10,000 Emergency Medical Evacuation:100% of the Covered Expenses Repatriation Benefit:100% of the Covered Expenses The premium is calculated at 15%commission. The proposal is valid until August 31, 2023.If by that date you have not accepted the terms we have offered in this proposal, it will no longer be valid. We look forward to being of service to you and our mutual client. Sincerely, Shannon Roy Associate Underwriter, Accident and Health 2 Riverway Dr, Houston, TX 77056, USA O 713-403-3010M 346-539-3651 Eshannon.roy@chubb.com 2 IABILITY P ROPOSAL DATE (MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION 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 CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE 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. If 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). CONTACT PRODUCER NAME: FAX PHONE (A/C, No): (A/C, No, Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGENAIC # INSURER A : INSURED INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : COVERAGESCERTIFICATE 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. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ADDLSUBR INSRPOLICY EFFPOLICY EXP TYPE OF INSURANCELIMITS POLICY NUMBER LTR(MM/DD/YYYY)(MM/DD/YYYY) INSDWVD COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE$ DAMAGE TO RENTED CLAIMS-MADEOCCUR$ PREMISES (Ea occurrence) MED EXP (Any one person)$ PERSONAL & ADV INJURY$ GEN'L AGGREGATE LIMIT APPLIES PER:GENERAL AGGREGATE$ PRO- POLICYLOCPRODUCTS - COMP/OP AGG$ JECT $ OTHER: COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY$ (Ea accident) ANY AUTO BODILY INJURY (Per person)$ OWNEDSCHEDULED BODILY INJURY (Per accident)$ AUTOS ONLYAUTOS NON-OWNED HIREDPROPERTY DAMAGE $ (Per accident) AUTOS ONLYAUTOS ONLY $ UMBRELLA LIAB EACH OCCURRENCE$ OCCUR EXCESS LIAB CLAIMS-MADEAGGREGATE$ $ DEDRETENTION$ PEROTH- WORKERS COMPENSATION STATUTEER AND EMPLOYERS' LIABILITY Y / N ANYP ROPRIETOR/PARTNER/EXECUTIVE E.L. EACH ACCIDENT$ N / A OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE$ If yes, describe under E.L. DISEASE - POLICY LIMIT$ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDERCANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03)The ACORD name and logo are registered marks of ACORD UTICA NATIONAL INSURANCE GROUP INSURANCE AGENTS AND BROKERS ISSUED BY ERRORS AND OMISSIONS LIABILITY POLICY Utica National Insurance Group CLAIMS-MADE BASIS Utica Mutual Insurance Company Renewal P.O. Box 530, Utica, New York 13503 DECLARATIONS Telephone: (315) 734-2000 NAMED INSURED AND MAILING ADDRESS LOCATION ADDRESS Box Bonding Agency LLC dba Box Insurance Agency 1200 S. Main Street Suite 1600 Grapevine, TX 76051 See Attached 14-E-0001 AT12:01A.M.STANDARDTIMEATTHEADDRESSOFTHEINSUREDASSTATEDHEREIN.INRETURNFOR PAYMENTOFTHEPREMIUM,ANDSUBJECTTOALLTHETERMSOFTHISPOLICYWEAGREEWITHYOUTO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. POLICY PERIOD PRIOR POLICY NO POLICY NUMBERFROMTO 5330160EO02-18-202302-18-20245330160EO BASIC POLICY COVERAGELIMITS OF LIABILITY $10,000,000EACH LOSS LEGAL LIABILITY $11,000,000AGGREGATE $25,000EACH LOSS INSURED’S DEDUCTIBLE AMOUNT $75,000AGGREGATE DEDUCTIBLE APPLIES TO: LOSS ONLY XLOSS AND LITIGATION EXPENSE PREMIUMS BASIC POLICY PREMIUM $ REAL ESTATE AGENTS AND BROKERS PREMIUM$ MUTUAL FUND AND VARIABLE ANNUITY PREMIUM$ EMPLOYMENT-RELATED PRACTICES PREMIUM$ OTHER$ $ TOTAL POLICY PREMIUM $ RETROACTIVE DATE This insurance does not apply to loss, whenever occurring, from “wrongful acts” which took place before the Retroactive Date, if any, shownNONE Enter Date or “None” if no Retroactive Date applies OPTIONAL EXTENDED REPORTING PERIOD PREMIUM In Section VII - EXTENDED REPORTING PERIODS, we agree to provide an Optional Extended Reporting Period under certain conditions. The premium for such an Optional Extended Reporting Period is determined as shown in paragraph5. of Section VII. FORMS AND ENDORSEMENTSAPPLYING TO AND MADE PART OF THIS POLICY AT TIME OF ISSUE: BY COMPANY OFFICER COUNTERSIGNED AT:UTICA, NY SHANNON PECK DATE:February 17, 2023 THESE DECLARATIONS AND THE COVERAGE FORM(S) AND ENDORSEMENTS, IF ANY, ISSUED TO FORM A PART THEREOF, COMPLETE THE ABOVE NUMBERED POLICY. 14-D-EOA Ed. 09-2012SEE OVER FOR IMPORTANT CLAIMS-MADE COVERAGE NOTICEPage 1 of 2 BILLING NO. 203578231 PREMIUM AMOUNT TO BE REFLECTED ON NEXT BILLING NOTICE Agent # E0503 Town of WestlakeWestlake 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. Box Bonding Agency, LLC Dba Box Insurance Agency VENDOR’S NAME: ______________________________________________________________ Bebn!Tztxfseb AUTHORIZED COMPANY OFFICIAL’S NAME (PRINTED) _______________________________ Please check all that apply: My firm is publicly-held corporation, therefore, this reporting requirement is not applicable. y 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): _____________________________________________________________________________ _____________________________________________________________________________ _____________________________________________ __________________________ Contractor/Company Official Signature Date _________________________________________________________________________________________ , Suite #20 Westlake, Texas 76262 Metro: 817-490-5711 Fax: 817-430-1812 www.westlakeacademy.org Town of WestlakeWestlake 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. 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)2*uif!ebuf!uibu!uif!wfoeps; )B*cfhjot!ejtdvttjpot!ps!ofhpujbujpot!up!foufs!joup!b!dpousbdu!xjui!uif!mpdbm!hpwfsonfoubm foujuz<!ps )C*tvcnjut!up!uif!mpdbm!hpwfsonfoubm!foujuz!bo!bqqmjdbujpo-!sftqpotf!up!b!sfrvftu!gps!qspqptbmt ps!cjet-!dpssftqpoefodf-!ps!bopuifs!xsjujoh!sfmbufe!up!b!qpufoujbm!dpousbdu!xjui!uif!mpdbm hpwfsonfoubm!foujuz<!ps )3*uif!ebuf!uif!wfoeps!cfdpnft!bxbsf; )B*pg!bo!fnqmpznfou!ps!puifs!cvtjoftt!sfmbujpotijq!xjui!b!mpdbm!hpwfsonfou!pggjdfs-!ps!b gbnjmz!nfncfs!pg!uif!pggjdfs-!eftdsjcfe!cz!Tvctfdujpo!)b*< )C*uibu!uif!wfoeps!ibt!hjwfo!pof!ps!npsf!hjgut!eftdsjcfe!cz!Tvctfdujpo!)b*<!ps )D*pg!b!gbnjmz!sfmbujpotijq!xjui!b!mpdbm!hpwfsonfou!pggjdfs/ Gpsn!qspwjefe!cz!Ufybt!Fuijdt!Dpnnjttjpoxxx/fuijdt/tubuf/uy/vt PREMIUM SUMMARY Premium Summary LINES OF BUSINESSPREMIUM Cyber Liability – Utica Included in GL General Liability - Utica$20,349 Business Auto - Utica$6,811 Umbrella - Utica$8,848 Crime - Travelers$4,131 – to increase limits to $1M on current policy Worker’s Compensation - Hartford$15,149 International Travel - Chubb$2,000 Student Accident Liability - Philadelphia$5,943 Property- Hartford$121,114 Total Premium$184,345 BOX INSURANCE AGENCY, LLC | WESTLAKE ACADEMY2 | 4 BINDING AUTHORIZATION Binding Authorization INSURED WESTLAKE ACADEMY As presented (all lines) With changes noted below 1. 2. 3. 4. 5. SUBJECTIVITIES Signed ACORDS Signed SOV Signed TRIAs Signed Supplementals PRINT NAMETITLE SIGNATUREDATE BOX INSURANCE AGENCY, LLC | WESTLAKE ACADEMY3 | 4 1200 S Main Street, Suite 1600 Grapevine, TX 76051 Phone: (817) 865-1801 Fax: (817) 865-1804 www.boxinsurance.com