Insurance Program For the State of Georgia Presented By: RC KNOX & COMPANY ONE GOODWIN SQUARE HARTFORD, CT 06103 (860) 524-7614 APRIL 21, 2009
QUOTATION PROGRAM INSURER: INSURANCE AGENCY: POLICYHOLDER: POLICY TERM: INSURED: ADDITIONAL INSUREDS: ONE BEACON INSURANCE COMPANY (A.M. Best Rating: A XV) RC Knox & Company, Inc. Knights of Columbus State Council of Georgia TBD STATE COUNCIL AND Each qualifying local council within the State Knights of Columbus Supreme Council Lessors or Manager of Premises (Local Council Parishes/Dioceses for use of facilities) ADDITIONAL UNDERWRITING INFORMATION REQUIRED IN ORDER TO BIND COVERAGE: Please provide a list of any State or Local Council Activities not included in the Summary of Typical State and Local Council Activities. Completed application and list of participating councils
COMMERCIAL GENERAL LIABILITY INSURANCE LIMITS OF INSURANCE (COVERAGE IS BASED ON GENERAL LIABILITY FORM CG 0001, ED. 1001): $2,000,000 General Aggregate (other than Products/Completed Operations 2,000,000 Products/Completed Operations Aggregate 1,000,000 Personal and Advertising Injury (any one person or organization) 100,000 Fire Legal Liability (any one fire) 10,000 Medical Expense (any one person) 1,000,000 Aggregate (per location). COVERAGE INCLUDES: Bodily Injury Property Damage Personal Injury Advertising Injury Medical Payments Host Liquor Liability Certified Acts of Terrorism Additional Insured Club Members (Council Members) Lessors or Managers of Premises as Additional Insured s as required (excluding Home Corporations or Owners/Managers of knights of Columbus Meeting Halls) Knights of Columbus Supreme Council-Additional Insured Hired and Non-owned Auto Liability Coverage at State Minimum Statutory Limits of Liability SPECIAL COVERAGE EXCLUSIONS: Abuse/Molestation/Sexual Misconduct or Sexual Offenses Asbestos Liability Athletic Participants Other than Basketball Free Throw Contest & Soccer Challenge Bodily Injury, Property Damage, Personal or Advertising Injury resulting from any altercation with demonstrators during a Right to Life rally, parade, protest or similar event Employment-Related Practices Special Events (Events not listed on Local Council Activities Summary) Intellectual Property Fungi or Bacteria War Liability Nuclear, Biological or Chemical Terrorism Home Corporations and building Owners or Lessees Local Councils for the ownership or operation of a building or hall Exclusion Described Hazards (Carnivals, Circuses and Fairs) Nuclear Energy Liability Exclusion Activities involving firearms Activities involving amusement devices such as rides, inflatables, or similar devices Terrorism Rock Concerts
SAMPLE COVERED EVENTS/ACTIVITIES: Local Council Meetings Marching in Parades Local Council Parties for Members and Guests Communion Breakfasts Basketball Free-Throw Contest Poster Contests Prayer Services Scholarships Luncheons/Family Picnics Food & Clothing Drives Family of Month/Year Family Trips Honors for Police, Fire Fighters, Veterans and other Appreciation Events Special Breakfasts, Luncheons, Dinners Car Washes Church Work: Ushers, Lectors, Choir, Youth Ministry Bingo Supporting poor and needy Home/School Association Support Tootsie Roll & Candy Sale Tournaments: Golf, Bowling, Billiards Walks: Cancer, Rally for marriage, etc. Youth Awards Senior Citizen Support: Visits and equipment donations Local Council Promotional Activities Keep Christ in Christmas: Billboards, mangers, cards Condition: Insurance will be Excess of, and Non-Contributory to any other insurance available to the State or Local Council Number of Dues Paying Members: TBD Annual Premium: $ TBD Local Council (per capita rate $1.188) 1,000 State Council 289 Hired & Non-Owned Auto 272 Terrorism Charge (optional) $ TBD Total Annual Premium Minimum Premium to Bind Coverage: $1,289 Premium must be paid in order to bind coverage. This proposal provides a brief overview of the insurance program and is not intended to be a complete summary of the policy. It does not change or replace the actual policy. You must refer to the insurance policy for full terms, conditions, coverages and exclusions.
PROGRAM ADMINISTRATION Policy Administration: Policies will be issued by One Beacon through R.C. Knox & Company. R.C. Knox will provide policy services including policy checking, endorsement processing and issuance of certificates of insurance. Accounting and Billing: R.C. Knox will issue policy invoices to the State Council for the full annual policy premium. Premium must be paid in order to bind coverage. Premium will be based upon the total number of dues paying members as of the date of application and will not be subject to audit at the end of the policy term. Claim Reporting: Claims will be reported directly to One Beacon Insurance via telephone or fax. The contact for reporting claims will be: Chet Kirby One Beacon Insurance PO Box 934 Madison, CT 06443-0934 Telephone: (203) 421-7946 Cell: (203) 494-1251 Fax: (203) 421-7947
R.C. Knox & Company Contact Information: R.C. Knox & Company, Inc. One Goodwin Square Hartford, CT 06103-4305 (860) 524-7600 (800) 742-2765 www.rcknox.com Account Executive: Account Administration: Claim Manager: Harold A. Smullen, Jr. CPCU, ARM, RPLU Executive Vice President & Chief Operating Officer Phone (860) 524-7614 Fax (860) 722-7741 Email hsmullen@rcknox.com Donna Wilson Account Analyst Phone (860) 524-7672 Fax (860) 722-7731 Email dwilson@rcknox.com Scott A. Anderson Vice President, Manager of Claim Administration Phone (860) 524-7667 Fax (860) 722-7799 Email sanderson@rcknox.com