RENEWAL CERTIFICATE Policy #ALOl 9-14 PUBLIC ENTITY LIABILITY INSURANCE POLICY INSURER: St. Louis Area Insurance Trust c/o The Daniel and Henry Company 1001 Highlands Plaza Drive West, Suite 500 St. Louis, Missouri 63110 (J 14) 421-1525 DECLARATIONS: Item One 1. Named Insured Mailing Address The Named Insured is: City of Des Peres 123 25 Manchester Road Des Peres, MO 63131 _x City _ County Other 2. Policy Period July L 2014 Inception Date July l, 2015 Expiration Date 12:01 a.m., standard time at the address of the Named Insured as stated herein. Item Two 1. Deposit Premium Minimum Earned $82,178, initial assessment. Includes assessment for general liability and police liability coverages also. Any additional assessments would be made in accordance with Article Seven of the Article of Association. Adjustment in the event of cancellation would be made in accordance with Article II, Section 11 of the By-Laws. 1001 HIGHLANDS PLAZA DRIVE WEST SUITE 500 SAINT LOUIS, MISSOURI 63110 314-421-1525
RENEWAL CERTIFICATE - City of Des Peres PUBLIC ENTITY LIABILITY INSURANCE POLICY Page2 Insurance is afforded for the following coverages and limits of Liability, subject to all terms of the policy relating thereto. 2. Coverage Liability including hired and nonowned Med Pay Uninsured Motorist Per Person Per Accident CSL $250 $25,000 $50,000 3. 4. Deductible: Covered Autos: $500 per occurrence Any Auto - Symbol 1 (Medical payments - owned autos only - Symbol 2) 5. Form Numbers of Endorsements that are part of this policy: CAOOOl, CA9903, CA9915, CA9933, Governmental Immunity Item Three 1. Schedule of covered autos on file with company. This Policy will not be valid unless countersigned by duly authorized representative.. Jj) 1<1~!~ Authorized Agent 1001 HIGHLANDS PLAZA DRIVE WEST SUITESOO SAINTLOUIS,MlSSOURI63110 314-421-1525
A Self-lnsura12ce Pool RENEWAL CEH.TIFICATE Policy #GLO 19-14 PUBLIC ENTITY LIABILITY INSURANCE POLICY - CLAIMS MADE INSURER: St. Louis Area Insurance Trust c/o The Daniel and Henry Company 1001 Highlands Plaza Drive West, Suite 500 St. Louis, Missouri 63110 (314) 421-1525 DECLARATIONS: Items 1. Named Insured Mailing Address The Named Insured is: City of Des Peres 12325 Manchester Road Des Peres, MO 63131 _x City _ County Other - --- 2. Policy Period July l, 2014 Inception Date July l, 2015 Expiration Date 3. 4. Retroactive Date Deposit Premium Minimum Earned 12:01 a.m., standard time at the address of the Named Insured as stated herein. 7/1/85 (GIL), 7/1/85 (Police), 7/1/88 (EBP), 7/1/85 (EMT), if no date is entered herein coverage does not apply prior to the inception date stated in Item 2. $82, 178, initial assessment. Includes assessment for auto liability coverages also. Any additional assessments would be made in accordance with Article Seven of the Articles of Association. Adjustment in the event of cancellation, would be made in accordance with Article II, Section 11 of the By-Laws. 1001 HIGHLANDS PLAZA DRIVE WEST SUITE 500 SAINT LOUIS, MISSOURI 63110 314-421-1525
RENEW AL CERTIFICATE - City of Des Peres PUBLIC ENTITY LIABILITY INSURANCE POLICY - CLAIMS MADE Page2 Insurance is afforded for the following coverages and limits of Liability, subject to all terms of the policy relating thereto. 5. Coverage Products-Completed Operations Per Occurrence Limit Aggregate Limit Bodily Injury and Property Damage (other than Products-Completed Operations) Per Occurrence Limit Personal Injury and Advertising Injury Per Person or Organization Limit Med Pay General Aggregate Limit $ 250 $7,500,000 Deductibles: Law Enforcement $2,500 General Liability (other than Law Enforcement) $500 6. 7. Classifications: Employee Benefits Liability Per Occurrence Limit Aggregate Limit Description of Operations: Refer to policy extension schedule See Schedule of Included/ Excluded Operations in policy. 8. Form Numbers of Endorsements that are part of this policy. Endorsements A through S and including 001 This Policy will not be valid unless countersigned by duly authorized representative. DATE: Authorized Agent '/; 3 /;q ---"~, --'---"""-17'-'-+-- 1001 HIGHLANDS PLAZA DRIVE WEST SUITE 500 SAfNT LOUIS, MISSOURI 63ll0 314-421-1525
MEMBER NAME: Citv of Des Peres POLICY NUMBER: 2014-007 TERM: 07/01/14 to 07/01/15 WORKERS' COMPENSATION COVERAGE NOTE: SLAIT IS QUALIFIED AS A SELF-INSURED TRUST IN THE STATE OF MISSOURI ONLY, AND IS LEGALLY RESPONSIBLE TO PROVIDE ONLY BENEFITS AS DEFINED UNDER THE WORKERS' COMPENSATION LAWS OF THE STATE OF MISSOURI TO INJURED EMPLOYEES. COVERAGE A: Workers' Compensation Laws of the State of Missouri COVERAGEB: Bodily Injury by Accident - Bodily Injury by Disease Bodily Injury by Disease $1,000,000 Each Accident $1,000,000 Policy Limit $1,000,000 Each Employee Coverage is provided for an incidental exposure in states other than North Dakota, Ohio, Washington, West Virginia, Wyoming. The following coverages are NOT available under the SLAIT Program: Voluntary Compensation - Extends benefits to exempt employees to whom Workers' Compensation benefits may not apply, subject to the provisions of the states Workers' Compensation laws. Stop Gap - Provides Employers Liability coverage for injuries arising out of incidental operations or exposures in the monopolistic states. Longshoreman's & Harbor Workers Act - Provides Workers' Compensation and Employers Liability coverage for employees engaged in maritime employment or employed, in whole or in part, on navigable waterways in the United States, including piers, terminals, docks and other areas used for loading or unloading or repairing of vessels. Jones Act - Extends Employers Liability coverage to apply to bodily injury or disease of a master or the crew members of a vessel. The bodily injury must occur in the territorial limits of, or in the operation of a vessel sailing directly between the ports of, the continental United States, Alaska, Hawaii or Canada. Waiver of Our Right to Recover from Others - Waives insurer's rights of subrogation against third parties named in the endorsement when the insured has contractually agreed to waive subrogation rights against another party. 1001 HIGHLANDS PLAZA DRIVE WEST SUITE 500 SAINT LOUIS, MISSOURI 63110 314-421-1525 FAX 314-444-1774 www.danielandhenry.com
ST. Lours AREA INSURANCE TRUST IMPORTANT This information has been prepared expressly for your use and is intended to provide a simplified explanation of the St. Louis Area Insurance Trust insurance program. This information is based on the exposures to loss disclosed by your company. This information does not preempt or take the place of the "By-Law's" and/or "Trust Agreement". In the event you should have a specific question concerning the program or its coverage, please contact our office for assistance. 1001 HIGHLANDS PLAZA DRIVE WEST SUITE 500 SAINT LOUIS, MISSOURI 63110 314-421-1525 FAX 314-444-1774 www.danielandhenry.com