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2015-2016 PROPERTY & CASUALTY TRUST INSURANCE ►.I IG, CE I • MONTANA ASSOCIATION OF COUNTIES PROPERTY & CASUALTY TRUST CERTIFICATE OF COVERAGE This certifies that Jefferson County is a member of the Montana Association of Counties Property& Casualty Trust and as such is provided with the following coverages: • General Liability • Auto Liability • Fidelity & Crime • Property Coverage • Errors & Omissions • Boiler & Machinery • Cyber Liability These coverages are provided for the period 07/01/2015 - 0613012016. Coverage limits are attached to this certificate. Coverage exists for all entities acting within the scope of their duties. Questions about coverage should be addressed to MACo PCT, 2715 Sykway Drive, Helena, MT 59602-1213 to the attention of Greg Jackson. Signed: Greg Jackson MACo PCT Representative Greg Jackson Trust Adminstrator Agent: Anna Cossel Q I PROPERTY $c CASUALTY Montana Association of Counties Property & Casualty Trust MACo Indemnity COVERAGE PERIOD: 07/01/15- 06/30/16 Agreement# PCT2016 COVERED ENTITY Jefferson County REINSURANCE POLICIES: ADDRESS: P O Box H Boiler& Machinery Hartford Steam Boiler Boulder MT 59632 Property The Hartford Fidelity& Crime Hanover Liability Reinsurance BRIT Cyber Liability AIG In consideration of payment of the assessment set out in Declaration 8 and in reliance upon the statements in the Application and any supplementary information pertaining thereto, which shall be deemed incorporated herein, being representations which, if inaccurate, will render this coverage null and void and relieve the Trust from all liability, Trust agrees to provide coverages as follows: DECLARATIONS 1 COVERAGE Section 1 A. Real& Personal Property-Blanket Replacement-$100,000,000/Occurrence B. Boiler& Machinery Hartford Steam Boiler C. Fidelity/Crime- Hanover Section 2 MACo PCT Manuscript-Comprehensive Risk Sharing Agreement Includes: A. Comprehensive Indemnity Agreement B. Law Enforcement Indemnity C. Auto Indemnity D. Errors& Omissions (EPL) Indemnity COVERAGE UNDER ERRORS AND OMISSIONS IS AFFORDED ON A CLAIM MADE BASIS AND CONTAINS PROVISIONS, WHICH MAY BE DIFFERENT FROM THOSE OF OTHER COVERAGES OF THIS AGREEMENT. CERTAIN PROVISIONS IN THIS AGREEMENT RESTRICT COVERAGE. THE ENTIRE AGREEMENT SHOUD BE READ CAREFULLY TO DETERMINE YOUR RIGHTS AND DUTIES AND TO DETERMINE WHAT IS AND IS NOT COVERED 2 LIMITS OF PROPERTY, BOILER&MACHINERY, FIDELITY&CRIME COVERAGES Property Blanket Replacement at$100,000,000 1occurrence for buildings and A. contents The Hartford 1 Property Valuation Blanket Replacement Actual Cost Value Basis/Or Machinery Scheduled Equipment Actual Cost Value Basis Contractors Equipment Actual Cost Value Basis Vehicles Actual Cost Value Basis Watercraft Actual Cost Value Basis Earth Movements $50,000,000 Limit of Liability in a single and 2 aggregate $1,000,000 Flood limit in a Flood Limits for Flood Zone A single occurrence $10,000,000 and in the Flood Limits for Flood Zone B 3 aggregate B. Boiler and Machinery Hartford Steam Boiler F nket, all risk for all property in which a member has wnershi interest C. Fidelity/Crime Hanover Employee 1 Dishonesty $500,000/Occurrence Forgery& 2 Alternation $500,000/Occurrence Theft, Disappearance& 3 Destruction $500,000 10ccurrence 4 Computer Fraud $500,000/Occurrence Faithful 5 Performance $500,000/Occurrence 3 LIMITS OF INDEMNITY Each claim $750,000 Each Occurrence 1.5 Million Medical Pay for GL&AL-Each Person $5,000 Medical Pay for GL&AL-Each Accident $50,000 Weed/Mosquito Spray sub limit-Each Claim $500,000 ""The above Limits are subject to the following additional limits`"' Annual Aggregate respects products and completed operations per member $1,000,000 Annual Aggregate respects to all Section 2 coverages per member per year for all claims and occurrences $3,000,000 Annual Aggregate respects to Cyber Liability coverages per member per year for all claims and occurrences $10,000,000 A. Excess Reinsurance Coverage for all liability coverages for Section 2 per the MACo PC Trust Manuscript form, up to the statutory limits of$750,000/claim; $1,500,000/occurrence. Tort claims not subject to state tort limits are covered to$5,000,000 limit as provided by BRIT Liability Reinsurance for federal and out-of-state claims. B. O tional Endorsement Covera es: Zoning Liability No Ethics Endorsement No Flood Plain Endorsement No 4 MAINTENANCE DEDUCTIBLE For individual claims,the Trust's coverage limits set forth above will be reduced by the amount of the deductible set forth under the section below entitled"Annual Assessment by Line of Coverage." However,the covered party shall be responsible for only one Maintenance Deductible for any non-line or multi-loss occurrence. These losses shall be subject to the highest applicable Maintenance Deductible. 5 RETROACTIVE DATE 10113/1986 6 TERRITORIAL SCOPE Liability Coverages . Applies World Wide Applies to property covered at any location described in this policy that is within the Property/Crime/Boiler&Machinery continental United States of America (including Alaska, Canada, Hawaii and Puerto Rico. 7 POLICY PERIOD 07/01/15 -06/30/16 8 ASSESSMENT The assessment is provisional and subject to review by the Trust at each Anniversary for the forthcoming period of coverage, based on current underwriting information. ANNUAL ASSESSMENT BY LINE OF COVERAGE DEDUCTIBLES General Liability $47,380 $2,000 Auto Liability $34,083 $2,000 Law Enforcement $25,691 $5,000 Errors &Omissions $21,947 $5,000($10,000/occurrence for PROPERTY land use claims) Premium Excess $30,677 $2,000 Property Loss Fund $33,636 TOTAL ASSESSEMENT NOTE: Property Excess includes: Property Excess assessment, Fidelity&Crime assessment and Boiler and Machinery assessment.