Loading...
HomeMy WebLinkAboutICMA-RC ADMINISTRATIVE SERVICES AGREEMENT (CITY MANAGER) - 2015R�ISURANCE ON FILL WORK MAY PROCEED ik INTANCE EXPIRES CLERK OF COUNCIL DATE, --,7 -q — 15 ADMINISTRATIVE SERVICES AGREEMENT Between lCMA Retirement Corporation and City of Santa Ana Type: VantageCare RHS Account Number: 803550 Plan # 803550 ADMINISTRATIVE SERVICES AGREEMENT This Agreement, made as of the jday of 20L�)_ (herein referred to as the "Inception Date"), between The International City Management Association Retirement Corporation ("ICMA-RC" ), a nonprofit corporation organized and existing under the laws of the State of Delaware; and the City of Santa Ana ('Employer") a local governmental instrumentality organized and existing under the laws of the State of California with an office at 20 Civic Center Plaza, Santa Ana, California 92702. RECITALS Employer acts as a public plan sponsor for a retiree health plan with responsibility to obtain investment alternatives and services for employees participating in that plan; Employer desires to make the VantageCare Retirement Health Savings Plan ("RHS Plan" or "Plan") provided by ICMA-RC available to its employees; ICMA-RC makes available The Vantagepoint Funds, a no-load, diversified mutual fund, for investment of public employer plan assets, including RHS Plan assets; ICMA-RC provides a complete offering of services to public employers for the operation of employee retirement and retiree health savings plans including, but not limited to, communications concerning investment alternatives, account maintenance, account record - keeping, investment and tax reporting, form processing, benefit disbursement and asset management. AGREEMENTS 1. Acceptance of RHS Plan Employer agrees to make the RHS Plan provided by ICMA-RC available to its employees. The details of the RHS Plan shall be as mutually agreed between the Employer and ICMA-RC, and in general shall be as set forth in the RHS Plan materials developed by ICMA-RC and provided to Employer. The RHS Plan materials are hereby incorporated by reference and made a part of this Agreement, except that Employer and ICMA-RC may from time to time mutually agree in writing to terms that vary from the RHS Plan materials. RHS plan materials shall include the VantageCare RHS Employer Manual, available electronically through the EZ Link System upon plan adoption. The functions to be performed by ICMA-RC and its agents include: (a) allocation in accordance with participant direction of individual accounts to investment funds ("Funds") made available to Plan participants; (b) maintenance of individual accounts for participants reflecting amounts contributed, Irm Plan # 803550 income, gain, or loss credited, and amounts disbursed as benefits; (c) provision of periodic reports to the Employer and participants of the status of Plan investments and individual accounts; (d) communication to participants of information regarding their rights and elections under the Plan; (e) disbursement of benefits as agent for the Employer in accordance with terms of the Plan; and (f) performance of tax withholding and reporting in conjunction with the Employer for each RHS account. 2. Employery to Furnish Information Employer agrees to furnish to ICMA-RC on a timely basis such information as is necessary for ICMA-RC to carry out its responsibilities with respect to the Plan, including information needed to allocate individual participant accounts to Funds, and information as to the benefit eligibility and employment status of participants, and participants' ages, addresses, dependents, spouses and other identifying information (including tax identification numbers). Employer also agrees that it will notify ICMA-RC in a timely manner regarding changes in staff as it relates to various roles. This is to be completed through the online EZLink employer contact options. ICMA-RC shall be entitled to rely upon the accuracy of any information that is furnished to it by a responsible official of the Employer or any information relating to an individual participant, spouse or dependent that is furnished by such participant, spouse or dependent, and ICMA-RC shall not be responsible for any error arising from its reliance on such information. ICMA-RC will provide reports, statements and account information to the Employer through EZLink, the online plan administrative tool. ICMA-RC Representations and Warranties ICMA-RC represents and warrants to Employer that: (a) ICMA-RC is a non-profit corporation with full power and authority to enter into this Agreement and to perform its obligations under this Agreement. (b) ICMA-RC is an investment adviser registered as such with the Securities and Exchange Commission under the Investment Advisers Act of 1940, as amended. ICMA-RC Services, LLC (a wholly owned subsidiary of ICMA-RC) is registered as a broker -dealer with the Securities and Exchange Commission (SEC) and is a member in good standing of the Financial Industry Regulatory Authority (FINRA). -3- Plan # 803550 4. Employer Representations and Warranties Employer represents and warrants to ICMA-RC that: (a) Employer is organized in the form and manner recited in the opening paragraph of this Agreement with full power and authority to enter into and perform its obligations under this Agreement and to act for the Plan and participants in the manner contemplated in this Agreement. Execution, delivery, and performance of this Agreement will not conflict with any law, rule, regulation or contract by which the Employer is bound or to which it is a party. (b) Information required to be retained by the Employer shall be set forth in the RHS plan materials developed by ICMA-RC and provided to the Employer. (c) Employer is responsible for determining that there are no state or local laws that would prohibit it from establishing ICMA-RC's VantageCare RHS program. Employer is also responsible for determining that the investments selected for the RHS plan fall within state or local requirements. ICMA-RC shall not be responsible for monitoring state or local law or for administering the Plan in compliance with local or state requirements unless Employer notifies ICMA-RC of any such local or state requirements. (d) Employer acknowledges that the RHS plan may be treated as a "health plan" for Health Insurance Portability and Accountability Act ("HIPAA") purposes and therefore may be subject to HIPAA privacy rules. If it is determined that the RHS plan is considered a "health plan", an employer sponsoring RHS would be responsible for complying with the HIPAA privacy and security rules regarding protected health information of RHS plan participants. (e) Employer acknowledges that certain such services to be performed by ICMA-RC under this Agreement may be performed by an affiliate or agent of ICMA-RC pursuant to one or more other contractual arrangements or relationships, and that ICMA-RC reserves the right to change vendors with which it has contracted to provide services in connection with this Agreement without prior notice to Employer. (f) Employer acknowledges and agrees that ICMA-RC does not assume any responsibility with respect to the selection or retention of the Plan's investment options. Employer shall have exclusive responsibility for the selection and retention of the Plan's investment options, including the selection of the applicable mutual fund share class. 5. Participation in Certain Proceedings The Employer hereby authorizes ICMA-RC to act as agent, to appear on its behalf, and to join the Employer as a necessary party in all legal proceedings involving the garnishment of benefits or the transfer of benefits pursuant to a medical child support order. Unless Employer notifies ICMA-RC otherwise, Employer authorizes ICMA-RC to determine whether disbursement of Plan # 803550 benefits to a spouse or child pursuant to a medical child support order is appropriate. 6. Compensation and Payment (a) Absent an explicit agreement to the contrary between ICMA-RC and Employer, participant fees and expenses shall be payable from RHS assets, in accordance with the requirements of the RHS Plan as set forth below. (i) An annual asset fee of 0.40% (40 basis points) will be charged on a quarterly basis, based on the balance in the account on the last day of the previous quarter. In addition to the annual asset fee, a $25 annual account administration fee will be charged quarterly to each Accountholder's account. (ii) Account administration fees are subject to change with appropriate prior notification. (b) Annual account administration fees are subject to change with appropriate prior notification. (c) Compensation for Advisory and other Services to The Vantagepoint Funds. Employer acknowledges that certain wholly -owned subsidiaries of ICMA-RC receive compensation from The Vantagepoint Funds for advisory and other services furnished to The Vantagepoint Funds. The fees referred to in this subsection are disclosed in The Vantagepoint Funds Prospectus and Statement of Additional Information. Contribution Remittance Employer understands that amounts contributed to the RHS plan are to be remitted directly to Vantagepoint Transfer Agents in accordance with instructions provided to Employer in the RHS plan materials and are not to be remitted to the ICMA Retirement Trust or ICMA-RC. In the event that any check or wire transfer is incorrectly labeled or transferred, ICMA-RC will return it to Employer with proper instructions. 8. Responsibility (a) ICMA-RC shall not be responsible for any acts or omissions of any person with respect to the Plan, or related Trust, other than ICMA-RC in connection with the administration or operation of the Plan. (b) The Employer understands that, as a general matter, the Internal Revenue Service ("IRS") may decline to rule on certain design features or provisions that the Employer may request to have added to the RHS plan materials. The Employer agrees to hold ICMA- RC harmless in connection with the addition and administration of any RHS plan feature or provision requested by the Employer for which the IRS will not provide express I'M Plan # 803550 interpretive guidance. 9. Indemnification Employer shall indemnify ICMA-RC against, and hold ICMA-RC harmless from, any and all loss, damage, penalty, liability, cost, and expense, including without limitation, reasonable attorney's fees, that may be incurred by, imposed upon, or asserted against ICMA-RC by reason of any claim, regulatory proceeding, or litigation arising from any act done or omitted to be done by any individual or person with respect to the Plan or related Trust, excepting only any and all loss, damage, penalty, liability, cost or expense resulting from ICMA-RC's negligence, bad faith, or willful misconduct. 10. Term This Agreement shall be in effect for an initial term beginning on the Inception Date and ending 5 years after the Inception Date. This Agreement will be renewed automatically for each succeeding year unless written notice of termination is provided by either party to the other no less than 60 days before the end of such Agreement year. 11. Amendments and Adiustments (a) This Agreement may be amended by written instrument signed by the parties. (b) The parties agree that only an adjustment to compensation or administrative and operational services under this Agreement may be implemented by ICMA-RC through a proposal to the Employer via correspondence or the Employer Bulletin. The Employer will be given at least 60 days to review the proposal before the effective date of the adjustment. Such adjustment shall become effective unless, within the 60 day period before the effective date, the Employer notifies ICMA-RC in writing that it does not accept such adjustment, in which event the parties will negotiate with respect to the adjustment. (c) No failure to exercise and no delay in exercising any right, remedy, power or privilege hereunder shall operate as a waiver of such right, remedy, power or privilege. 11. Notices All notices required to be delivered under this Agreement shall be delivered personally or by registered or certified mail, postage prepaid, return receipt requested, to (i) Legal Department, ICMA Retirement Corporation, 777 North Capitol Street, N.E., Suite 600, Washington, D.C, 20002-4240; (ii) Employer at the office set forth in the first paragraph hereof, or to any other address designated by the party to receive the same by written notice similarly given. Plan # 803550 12. Complete Agreement This Agreement shall constitute the sole agreement between ICMA-RC and Employer relating to the object of this Agreement and correctly sets forth the complete rights, duties and obligations of each party to the other as of its date. Any prior agreements, promises, negotiations or representations, verbal or otherwise, not expressly set forth in this Agreement are of no force and effect. 13. Governing Law This agreement shall be governed by and construed in accordance with the laws of the State of California applicable to contracts made in that jurisdiction without reference to its conflicts of laws provisions. In Witness Whereof, the parties hereto have executed this Agreement as of the Inception Date first above written. -')PP,OVEsD AS TO FORM USA E. STORCK "--1,Jant City Attornev ATTES'P vno""Z ,::) //JFit- V MAR1Ai3 HUIZAR CLERK OF THE COUN CITY OF SANTA ANA By: — 6�� 1 Print Name: Edward S. Rbya Title: Executive Director, Personnel Services INTERNATIONAL CITY MANAGEMENT ASSOCIATION RETIREMENT CORPORATION Angela C. Montez Assistant Corporate Secretary -7- SUGGESTED AFFIRMATIVE STATEMENT FOR ADOPTION OF THE VANTAGECARE RETIREMENT HEALTH SAVINGS (RHS) PLAN Plan Number: 8 03550 Name of Employer: City of Santa Ana State: California Affirmative Statement of the above -named Employer (the "Employer"): WHEREAS, the Employer has employees rendering valuable services; and WHEREAS, the establishment of a retiree health savings plan serves the interests of the Employer by enabling it to provide reasonable security regarding such employees' health needs during retirement, by providing increased flexibility in its personnel management system, and by assisting in the attraction and retention of competent personnel; and WHEREAS, the Employer has determined that the establishment of the retiree health savings plan (the "Plan") serves the above objectives; NOW THEREFORE, as a duly authorized agent of the Employer, I hereby: ESTABLISH. the Employer's Plan in the form of the ICMA Retirement Corporation's VantageCare Retirement Health Savings program; and SPECIFY that the assets of the Plan shall be held in trust, with the following entity or individual serving as trustee (Select one): 91 the Employer ❑ the following position within the Employee ❑ the following group or committee within the Employer: ❑ the following third -party trustee: ( Inscn ddcdim hvid-1 naing. ", '.) aw.... ... , u, min,ntrmc "t.." ae aumc) (Insert n,m of 66d-pn., au ... c) for the exclusive benefit of the Plan participants and their survivors, and the assets of the plan shall not be diverted to any other purpose prior to the satisfaction of all liabilities of the Plan. The Employer has executed the Declaration of trust of the City of Santa Ana _ Integral Part Trust in the form of: (Select one) la The model trust made available by the ICMA Retirement Corporation ❑ The trust provided by the Employer (executed copy attached hereto). SPECIFYthatthe Personnel Services/Employee Benefits Department and contact for the Plan and shall receive necessary reports, notices, etc. DATE: shall be the coordinator Executive Director, Personnel Services Title of Designated Agent Signature EMPLOYER VANTAGECARE RETIREMENT HEALTH SAVINGS (RHS) PLAN ADOPTION AGREEMENT Plan Number: 8 03550 Select as applicable: ❑ Standalone RHS ❑ Integrated RHS ❑ Amendment to Existing Plan m New Plan (see NOTE below) NOTE: (For existing employers only): Check here © if you want ICMA-RC to use existing plan contact information for this new plan setup. Otherwise, if contact information has changed, please complete and return the Implementation Data Form found on pg. I1:31 along with the adoption materials. Employer Retirement Health Savings Plan Name: I. Employer Name: City of Santa Ana State: California II. The Employer hereby attests that it is a unit of a state or local government or an agency or instrumentality of one or more units of a state or local government. III. Effective Date of the Plan: 01/20/2015 N The Employer intends to utilize the Trust to fund only welfare benefits pursuant to the following welfare benefit plans) establishedby the Employer: City of Santa Ana Retiree Welfare Benefits Plan V. Eligible Groups, Participation and Participant Eligibility Requirements A. Eligible Groups The following group or groups of Employees are eligible to participate in the VantageCare Retirement Health Savings Plan (check all applicable boxes): _ ❑ All Employees ❑ All Full -Time Employees ❑ Non -Union Employees ❑ Public Safety Employees —Police ❑ Public Safety Employees — Firefighters ❑ General Employees ❑ Collectively -Bargained Employees (Specify unit(s)) ❑ Other (specify group(,)) City Manager The Employee group(s) specified must correspond to a group(s) of the same designation that is defined in the statutes, ordinances, rules, regulations, personnel manuals or other documents or provisions in effect in the state or locality of the Employer. B. Participation Mandatory Participation: All Employees in the covered group(s) ate required to participate in the Plan and shall receive contributions pursuant to Section VI. If the Employer's underlying welfare benefit plan of funding under this VantageCare Retirement Health Savings Plan is to whole or part a non -collectively bargained, self -insured plan, the nondiscrimination requirements. of Internal Revenue Code (IRC) Section'105(h) will apply. "These rules may impose taxation on the benefits received by highly compensated individuals if the Plandiscriminates in favor of highly compensated individuals in terms of eligibility or'bcnefirs. The Employer should discuss these rules with appropriate counsel. C. Participant Eligibility Requirements I. Minimum service: The minimum period of service required for participation is N/A (write N/A if no minimum service is required). 2. Minimum age: The minimum age required for eligibility to participate is N/A (write N/A if no minimum age is required). VI. Contribution Sources and Amounts A. Definition of Earnings The definition of Earnings will apply to all RHS Contribution Features that reference "Earnings', including Direct Employer Contributions (Section VI.B.1.) and Mandatory Employee Compensation Contributions (Section VI.13.2.). Definition of earniaes: As defined by Resolution 2015-01, B. Direct Employer Contributions and Mandatory Contributions 1. Direct Employer Contributions The Employer shall contribute on behalf of each Participant ❑ % of Earnings ❑ $ _ each Plan Year ❑ A discretionary amount to be determined each Plan Year [71 Other (describe): A one-time contribution as a conversion from the existing Medical Retirement Subsidy Plan. 2. Mandatory Employee Compensation Contributions The Employer will make mandatory contributions of Employee compensation as follows: 0 Reduction in Salary - 1.25 _ % of Earnings or $ will be contributed for the Plan Year. ❑ Decreased Merit or Pay Plan Adjustment - Alt or a portion of the Employees' amoral merit or pay plan adjustment will be contributed as follows: An Employee shall not have the right to discontinue or vary the rate of Mandatory Contributions of Employee Compensation. 3. Mandatory Employee Leave Contributions The Employer will make mandatory contributions of accrued leave as follows (provide formula for determining Mandatory Employee Leave contributions): 0 Accrued Sick Leave 100% of sick leave cash out ❑ Accrued Vacation Leave ❑ Other (specify type of leave) Accrued _ _ Leave An Employee shall not have the right to discontinue or vary the rate of mandatory leave contributions. C. Limits on Total Contributions (check one box) The total contribution by the Employer on behalf of each Participant (including Direct Employer and Mandatory Employee Contributions) for each Plan Year shall not exceed the following limit(s) below. Limits on individual contribution types are defined within the appropriate section above. There is no Plan -defined limit on the percentage or dollar amount of earnings that may be contributed. ❑ % of earnings* *Definition of earnings: ❑ Same as Section VIA.. ❑ Other ❑ $ for the Plan year. See Section V.B. for a discussion of nondiscrimination rules that may apply to non -collectively bargained self -insured Plans. VII. Vesting for Direct Employer Contributions A. Vesting Schedule (check one box) ® The account is 100% vested at all times. ❑ The following vesting schedule shall apply to Direct Employer Contributions as outlined in Section VI.B.l.: Years of Service Vesting Completed Percentage % % B. The account will become 100% vested upon the death, disability, retirement*, or attainment of benefit eligibility (as outlined in Section IX) by a Participant. *Definition of retirement includes a separation from service component and is further defined by (check one): 7A ■ ■ The primary retirement plan of the Employer Separation from service Other C. Any period of service by a Participant: prior to a rehire of the Participant by the Employer shall not count toward the vesting schedule outlined in A above. VIII. Forfeiture Provisions Upon separation from the service of the Employer prior to attainment of benefit eligibility (as outlined in Section IX), or upon reversion to the Trust of a Participant's account assets remaining upon the participant's death (as outlined in Section XI), a Participant's non -vested funds shall (check one box): ❑ Remain in the Trust to be reallocated among all remaining Employees participating in the Plan as Direct Employer Contributions for the next and succeeding contribution cycle(s). In Remain in the Trust to be reallocated on an equal dollar basis among all Plan Participants. ❑ Remain in the Trust to be reallocated among all Plan Participants based upon Participant account balances. ❑ Revert to the Employer. IX. Eligibility Requirements to Receive Medical Benefit Payments from the VantageCare Retirement Health Savings Plan A. A Participant is eligible to receive benefits: ❑ At retirement only (also complete Section B.) Definition of retirement: ❑ Same as Section VII.B. ❑ Other ® At separation from service with the following restrictions ® No restrictions ❑ Other B. Termination prior to general benefit eligibility: In case where the general benefit eligibility as outlined in Section IKA includes a retirement component, a Participant who separates from service of the Employer prior to retirement will be eligible to receive benefits: 0 Immediately upon separation from service ❑ Other C. A Participant that becomes totally and permanently disabled ❑ as defined by the Social Security Administration 91 as defined by the Employer's primary retirement plan ❑ other will become immediately eligible to receive medical benefit payments from his/her VantageCare Retirement Health Savings Plan account. D. Upon the death of the Participant, benefits shall become payable as outlined in Section XI. X. Permissible Medical Benefit Payments Benefits eligible for reimbursement consist of: ® All Medical Expenses eligible under IRC Section 213* other than (i) direct long-term care expenses, and (ii) expenses for medicines or drugs which are not prescribed drugs (other than insulin). ❑ 1he following Medical Expenses eligible under IRC Section 213* other than (i) direct long-term care expenses, and (ii) expenses for medicines or drugs which are not prescribed drugs (other than insulin). Select only the expenses you wish to cover tinder the VantageCare Retirement Health Savings Plan: ❑ Medical Insurance Premiums ❑ Medical Out -of -Pocket Expenses* ❑ Medicare Part B Insurance Premiums ❑ Medicare Part D Insurance Premiums ❑ Medicare Supplemental Insurance Premiums ❑ Prescription Drug Insurance Premiums ❑ COBRA Insurance Premiums ❑ Dental Insurance Premiums ❑ Dental Out -of -Pocket Expenses* ❑ Vision Insurance Premiums ❑ Vision Out -of -Pocket Expenses* ❑ Qualified Long -Term Care Insurance Premiums ❑ Non -Prescription medications allowed under IRS guidance* ❑ Other qualifying medical expenses (describe)* *See Section V.A. for a discussion ofnondiscrimination rules which may apply to non -collectively bargained, self -insured Plans. XI. Benefits After the Death of the Participant In the event of a Participant's death, the following shall apply: A. Surviving Spouse and/or Surviving Dependents The surviving spouse and/or surviving eligible dependents (as, defined in Section XII.D.) of the deceased Participant are immediately eligible to maintain the account and utilize it to fund eligible medical benefits specified in Section X above. Upon notification of a Participant's death, the Participants account balance will be transferred into Dreyfus Cash Management fund* (or another fiord selected by the Employer). The account balance may be reallocated by the surviving spouse or dependents. *An investment in the Dreyfus Cash Management money market fiend is not insured or guaranteed by the Federal Deposit Insurance Corporation ar any other government agency. Although the fund seeks to preserve the value ofyour investment at $1.00 per share, it is possible to lose money by investing in the fund. Investors should consider the investment objectives, risks, charges, and expenses ofthe ford carefully before investing You may visit us at want, icmare.org or call800-669-7400 to obtain a prospectus that contains this and other information about the fund. Read theprospectus carefully before investing. If a Participants account balance has not been fully utilized upon the death of the eligible spouse, the account balance may continue to be utilized to pay benefits of eligible dependents. Upon the death of all eligible dependents, the account will revert to the Plan to be applied as specified in Section VIII. B. No Surviving Spouse or Surviving Dependents If there are no living spouse or dependents at the time of death of the Participant, the account will revert to the Plan to be applied as specified in Section VIII. XII. The Plan will operate according to the following provisions: A. Employer Responsibilities 1. The Employer will submit all VantageCare Retirement Health Savings Plan contribution data via electronic submission. 2. The Employer will submit all VantageCare Retirement Health Savings Plan Participant status updates or personal information updates via electronic submission. 'Ibis includes but is not limited to termination notification and benefit eligibility notification. B. Participant account administration and asset -based fees will be paid through the redemption of Participant account shares, unless agreed upon otherwise in the Administrative Services Agreement. C. Assignment of benefits is not permitted. Benefits will be paid only to the Participant, his/her Survivors, the Employer, or au insurance provider (as allowed by the claims administrator). Payments to an third -party payee (e.g., medical service provider) are not permitted with the exception of reimbursement to the Employer or insurance provider (as allowed by the claims administrator). D. An eligible dependent is (a) the Participant's lawful spouse, (b) the Participant's child under the age of 27, as defined by IRC Section 152(f)(1) and Internal Revenue Service Notice 2010-38, or (c) any other individual who is a person described in IRC Section 152(a), as clarified by Internal Revenue Service Notice 2004-79. E. The Employer will be responsible for withholding, reporting and remitting any applicable taxes for payments which are deemed to be discriminatory under IRC Section 105(h), as outlined in the VantageCare Retirement Health Savings Plan Employer Manual. XIII. Employer Acknowledgements A. The Employer hereby acknowledges it understands that failure to properly fill out this Employer VantageCare Retirement Health Savings Plan Adoption Agreement may result in the loss of tax exemption of the Trust and/or loss of tax -deferred status for Employer contributions. B. ❑ Check this box if you are including supporting documents that include plan provisions. EMPLOYER SIGNATURE By: 0e I Date: E cutive Director. Pe services Date: Clerk of the Council Accepted: VANTAGEPOINTTRANSFER AGENTS, LLC APPROVED AS TO FORM }J" ISA .STORC� r"'z Assistant City Attorney Assistant A ecretary ICMA-RC IaTTESr M4RAD A CLERK OF THE COU .IL Vantage(are Retirement Health Savings Plan r Implementation Data Form — Page 1 ,< ICMA 1-Z" Instructions to Employer: Provide necessary information to establish your plan propedy. Building Ratim,ne», s,,,,,iry Please contact your New Business Analyst at 1-800-326-7272, If you have any questions. ICMA-RC Use Only: Employer # General Information 1. (902) Employer's Full Name: City of Santa Ana (Executive Management RHS Plan) 2. (924) Street Address: 20 Civic Center Plaza, M-34 (9P5) P.O. Box 1988, M-34 3. (918) Gty: Santa Ana (919) State: CA _ (920) Zip Code: 92702 4. (633)Primay(ontact: Kathleen Crook S. (634)Primmy(omactTitle: Benefits & Compensation Supervisor 6. (631) Primary Contact Telephone #: (714) 647-6967 7. (632) Fax#: (714 ) 647-5321 B. (PT00)E-mail address: kcrook@santa-ana.org This email will be used to provide an electronic copy of your plan summary. 9. (882) Employer's Federal Tax Identification Number: 95-6000785 10. #of Employees: 1400 Tl. #of Employees Eligible for Plan Participation: $ 12. #of Employees Eligible to Receive Medical Benefits upon plan implementation: 12 Plan Implementation 13. (611) Contribution Information: (Note:* = default) Information a, Frequency: (check one): ❑ (0) Biweekly* ❑ (4) Monthly ❑ (8) Semi -quarterly ❑ (1) Weekly 0 (5) Semi -Monthly ❑ (9) Bi-annually ❑ (2) Semi -weekly ❑ (6) Bi-quarterly ❑ (10) Annually ❑ (3) Bi-monthly ❑ (7) Quarterly ❑ (11) Semi-annually ❑ ( ) Other: b. Deposit Medium: (624) ❑ Chock * ® Wire 0 EFT c. Data Medium: EZLmk Required to participate in RHS Plan d. First Contribution Date Fallowing Implementation: 02/20/2015 ICM/�C Building Reriremen[ Seazairy Vantage(are Retirement Health Savings Plan Implementation Data Form — Page 2 Default Investment The default fund will be used if a participant does not provide valid allocation instmctions. Option f you do not make an election in this section, the Milestone Fund with the target date closest to a purticipant's 60th birthday will be used us your plan's default option. You may select the "Altemative Default" option if you would like to use a fund (or funds) other than the Milestone Funds as your plan's default option. Please see ICMA-RC's Standard Plan Fund lineup at www.icmoo.mg to complete this section. Nate: Prior to selecting the "Alternative Default" option, employers should carefully review the Department of tabor's final regulations an qualified default investment alternatives (ODIAs). More information is available online at www.dol.gov or www.icmarc.org/ppa. Default Fund for Investment Allocations (Select one option): El The Milestone Funds (Default) with a target retirement age of: . ❑ Age 60 (Default) VJ Age 55 (Input the Target Retirement Age to he used for your plan) ❑ Alternative Default (Input the fund name that will be used as the plan's default investment option) Claims Contact Plan Contacts Information (Complete item #18. If item #14-17 and 19 are left blank, the Primary Contact in #4 will receive mailings.) Please indicate 14. PTOI Contact Signature: alternate addresses (200) Contact Name: Kathleen Crook in Comments (210) Benefits & Compensation Su ervisor Contact Title: P P Section (420) Telephone: ( 714) 647-6967 (421) Fax: (714 ) 647-5321 15. PT08 Contact Signature: (200) Contact Name: (210) Contact Title: (420) Telephone: ( 1 _ (421) Fax: I—) 16. PT09 Contact Signature: (200) Contact Name: (210) Contact Title: (420) Telephone: ( 1 __ (421) Fax: ( I Contribution Contact I 17. PT02 (200) Contact Nome: Kathleen Crook — Information Benefits & Com ensation e Su rvisor (210) Contact Title: p p (4201 Telephone: ( 714 ) 647-6967 (421) Fax: ( 714 ) 647-5321 ICMA Retirement Corporation • P.O. Box 96220 • Washington, DC 20090-6220 • Tall Free 1-BOO 669-7400 VantageCare Retirement Health Savings Plan Implementation Data Form — Page 3 ICMAC Plan Contacts (Continued) aarnwgRai .errzeaS,,.,hy (Complete item #18. If item #14-17 and 19 are left blank, the Primary Contact in #4 will receive mailings.) Trustee Contact Information 18. PT10 (200) (210) (215) (310) (305) (320) (401) (420) Trustee Name: Francisco Gutierrez Trustee Title: Finance Director Trustee: City of Santa Ana Trustee Address: 20 Civic Center Plaza, M-17 Street City Santa Ana (325)State CA Y/N (402) Telephone: ( 714) 647-5420 (421) Fax: (330)Zip 92702 Y/N ( 714) 647-5414 Billing (Fees) Contact Information 19. PT06 (200) (210) (420) Contact Name: n/a Contact Title: Telephone; ( ) _. (421) Fax: ( ) Comments: (Alternate Addresses for #14-19) Internal Use Only 641 912 608 074 ICMA Retirement Corporation • P.O. Box 96220 • Washingtan, DC 20090-6220 • Toll Free 1-800 669-7400 ® DAM (MMIDD/YYYYI CE TI ICATE ®F LIA ILITY INSU NCE OB D420,4 IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFICATE 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 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 endomement(s). .ODUCER - CONTACT NAME: PHONE FAX aIc No: MARSH USA INC. SUITE400 E-MARESS: 1255 23RD STREET, N.W. INSURERS AFFORDING COVERAGE NAIC # WASHINGTON, DC 20037 INsuRER A : Phoenix Insurance Company 25623 10356—EO+FI-1415 SURED INSURERS: NIA NIA INSURER O: Travelers Casualty Insurance Co. Of America 19046 ICMA RETIREMENT CORP. ATTN: DJUANATHOMIAS 777 NORTH CAPITOL ST., NE INSURER 0 Federal Insurance Company 20281 INSURER E: St. POUI Fire & Marine Insurance Co. 24767 WASHINGTON, DC 20002 gilm F: nicr�reicery A-ra all lannco. CIP-M771g194-1F REVISION NUMBER:5 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. EOFINSURANCE LIABILITY ADOL SUER wyn POLICY NUMBER 6306E588375 M-0IDDYEFF OBI011Z014 MWDDIYYYY 0810112015 LIMITS EACH OCCURRENCE $ 1,000,000 -RENTED ITAMAGE TO PREMISES Eacccuence $ 1,000,000 IAL GENERAL LWBILTIY S-MADE � OCCUR UAL COV. INCL. WEILOC MED EXP(Any one person) $ 10,000 PERSONAL &ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 ATE LIMIT APPLIES PER: PROOUCTS- COMPIOP AGG $ 2,000,000 $ PRO- JECTLOC MOBILE "ABILITY COMBINED SINGLE LIMIT 'Ea accident BODILY INJURY (Per person) $ NYAUTO BODILY INJURY (Per accident) $ FALLOWNED SCHEDULED AUTOS AUTOS NON OWNED HIRED AUTOS AUTOS PROPERTY DAMAGE Per accident $ UMBRELLA "AB OCCUR EACH OCCURRENCE S AGGREGATE s EXCESS UAB CLAIMS-MADEI DED RETENTION$ a C WORKERS COMPENSATION U86508M894 08/0112014 0810112015 X I WC STATU- I OTH- E.L. EACH ACCIDENT $ 1,000,000 AND EMPLOYERS' LIABILITY YIN ANY PROPRIETORIPARTNERIEXECUTIVE N OFFICERIMEMBER EXCLUDED? (Mandatory in NH) If yes, desaibe under DESCRIPTION OF OPERATIONS bola. NIA E.L. DISEASE -EA EMPLOYE $ 1,000,000 E.L. DISEASE -POLICY LIMIT $ 1,000,000 D BANKERS PROF. LIAR. 8211-6261 06/3012014 0613012015 $7,500,000 plo$12,500,000 E SIR: $1,000,000 7107549 0013012014 0613012015 $5,000,000 pro $12,500,000 IESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101, Addhional Remarks Schedule, If more space is required) CITY OF SANTA ANA ATTN: EXECUTIVE DIRECTOR OF PERSONNEL SVS 20 CIVIC CENTER PLAZA M-34 SANTA ANA, CA 92702 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 of Marsh USA Inc. ACORD 25 (2010105) Manashi Mukhedeea-^ate- ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD 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 be endorsed. If SUBROGATION IS WANED, subject to the terms and conditions of the policy, certtin policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsernent{s)• I PRODUCER CONrACT f,"SH USA INC NAPyE......_ SUITE AGO PHONE FAX 725523R0 STREET N!fJ. NASHINf JN.. CC 2CO37 ADDRESS: INSURER(S) AFFORMING COV=FAGE IIAICm CA035`EOr'+415 INSURER A: PhLervxinsuru;:ce Comparry INSURED UdSURER a; NIA FUA ICMA REITREMENT CORP. - - ATTN:UJUA.NATHOMAS INSURER c: Ttveins Casualty lralra:a Co. Of Arreri 1" III seas A7 NORTH N DO 002IJE ! INsuRERD: - 1 1lrsur..-Cargany .—._ _—_-.__....__12028I_..__.- 'aVASH14iGTCiV. DC 26tX72 I --- - - - COVERAGES CERTIFICATE NUMBER: CLE-M3743124-15 REVISION NURMBER:5 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 CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE ^JAY 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 SHONM MAY HAVE BEEN REDUCED BY PAID CLAIMS. ) INSR I LTR PfPE CFktdaURANCE !�qp �; UBR — MoI POLICYNUMeER I r POL'C`f EPP POLICY EXP i imyN JD" ._(MPAIDDNYYYt.�LIMS A I I�COiv10.tERCW. GENERAL _ LIABIurr GENERAL LWBILIT'f CLAIMS -MADE a OCCUR i6306E585375 iO81OV2014 10810V2015 1 EACH OCC�0URRREEMNCFDE LI l vRlEa Paurterxe i htED EXP (AM ' Fer+PP) 1.OW,TAO �s S i,C�'CFfd S t0.� �xCONiRACTUAL COV. {NCI. ! ON Y� gy i >'CnF /a F'eRSONALBADV INJURY �yy �� i 10E0ERAL AGCROGA E i _� ( l PRODUCTS COMP/DP AGG_J5_ S 1.L'".,C•006 S 2•�•� GENOL AGGRECATE LIMIT APPLIES PER �^ p X EOLICY C ("' 7 11 LOC 2,000,GCG 5 AULMOBILE LIAa'LRY I ANY AUTO ALL OANEC SCHEDULED _- hlON-OYMIEU HIRED AU'OB 705S9"1S I � N .?�P, 1 l$i�• L� q ILCM I a' SINGLE LIMIT Boot Y INJURY(P., s'sar) BODILY IN URY (Pxr ate ari):5 *J IPfi(, c '.)AMAGE .Pr au -! ----� IS ...1 S f E ! iUNGRELLALIAR _1 OCCUR L EXCESS UAB ! CLAIMS'MAOE -I I� 1 ! I hCH CCCJPJ2J_NCE AGCR ATE 5 _ _ 5 = C r RETENTIONS DED WORKERS COMPENSATION AN" EMKOYERVLIASIUrY YIN ANY PRCFRIETCRPARTNERfEXECIIriVE 0 FICERIMEMSER EXCLL-DE07 N (Mandatory in NH} If ye d1 ti1V I'de' DESCRIPTION OF OP -on IONS teicw 9lAl w 08f01261d GEfC n0.5 X 1 %IJC 5TAtU- OTH. TD"'1�AiC(S i E.L EACHACCIDENT r"' "" ' LEL D SrAS__ EA EMPLOYE E.L D GEASE -POLICY LIMB S 1 CC4.007 D EANK Rs PROF. LIA6 82'11326i 0302014 0613M015 $7,S00000 pfo S12,500,CC0 ! I E ,SIR: $1 ;C-0.X0 1711VD751S 0161?012014 05DQ12015 S5,Cr0090:10 S12,500,!,00 I I DESCRIPTION 09 OPEP.AT ONE 1 LOCATIONS! VEHICLES (Attaor ACOFV 101, Additoral Ranarks Z.h.duhr, i4 more sy, ea !s regnired) i �) I I. A?/•GF a ATtr.nl i CITY CF SAN N ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE AifN eX r'J'I ✓'DIREUI P FPERBCNNEI S'/S THE EXPIRATION DATE TEER'_-OF NOTICE. VA L BE C=AVERED IN 20 CIVIC CS"TER P,AD, i,-3A A.•OORDANCE k =' THE POLICY PRO $10NS. 1 AU'N PlI D R - SEYlTS.TNE� ' 1 I 1 '. y, ashiKhe 1 M I L-----.�,�__.�...___ 7 �._._..._. J'i nflg.;?3'diaAC'?R?D C:OP.PORATSOH1. A3f rlrn".5` r25e0✓etl. ACOR^ 26 (201,NO~ The .ACORD name and tog.^ a;G registerad marks; Gf ACOPO AGENCY CUSTOMER ID: 040356 LOC F: 'aVashington AGENCY MARSH USA INC. PcucY NUMSER CARRIER Ui 431P THIS ADDITIONAL RE?AARKS FORRM 1S A SCHEDULE TO ACORD FORIA, FORtaI INU&IBER: 25 FORM TITLE: Certificate of Liability lnsul FlOELPf �AIDICRIhL CARRIER: Grzat Amed[an leniaua G*mnany POLICY NO.: FS ZJd 63-54 EFF.:ExP 05f�01 1<.0;130ritl15 JM:T-. $3 XP.. O0 DED 5250, t' NAMED INSURED ICMAI2ETIREMENT CORP. AMN: UJUANA THOMAS 7T7 NORTH CARITOL ST., HE WASHINGTON, DC 2M EFrcCTIVE DATE: Page 2 of 2 The ACORD na;n2 and IegD ar registered narks of ACORD rese.'ved_ RESOLUTION NO. 2015-001 A RESOLUTION OF THE CITY COUNCIL OF THE CITY OF SANTA ANA MODIFYING, REESTABLISHING AND DELINEATING THE BASIC COMPENSATION AND BENEFIT PLAN FOR CLASSES OF EMPLOYMENT DESIGNATED AS UNREPRESENTED EXECUTIVE MANAGEMENT (EM) AND RESCINDING RESOLUTION NO. 91-066, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF SANTA ANA AS FOLLOWS: Section 1: The City Council hereby finds, determines and declares as follows: A. Section 1004, Article X of the City Charter of the City of Santa Ana requires the City Manager to prepare, install and maintain a position classification and pay plan subject to civil service rules and regulations and the approval of the City Council. B. On July 1, 1991, the City Council passed and adopted Resolution No. 91-066, re-establishing the Basic Classification and Compensation Plan for classifications of employment designated as unrepresented Executive Management (EM) and Middle Management (MM). C. The City Council has amended Resolution No. 91-066 on numerous occasions since its adoption. D. Pursuant to Resolution No. 81-075, the Employee Relations Resolution of the City of Santa Ana, and applicable State law, the City of Santa Ana certified the Santa Ana Management Association (SAMA) on September 25, 2002, as the majority representative of the Middle Management and Administrative Management Representation Unit. Hence, the City has recognized SAMA as the certified majority representative of the full time employees in said Unit. E. In an effort to clarify the compensation of unrepresentative Executive Management (EM) employees, and delete obsolete language related to unrepresented Middle Management (MM) employees, the City Attorney recommends reestablishing and delineating the Basic Classification and Compensation Plan for classifications of employment designated as unrepresented Executive Management (EM) through this resolution, by separate resolution reestablishing and delineating the Basic Classification and Compensation Plan for all represented full-time employees in the City, including represented Middle Management (MM) employees, and all represented and non -represented part-time employees, and rescinding Resolution No. 91-066. Resolution No. 2015-001 Page 1 of 15 F. The City Manager recommends an increase to the Tuition Reimbursement Program to provide the highest amount that is available to other represented employees. G. The City Manager recommends establishing and delineating a Retirement Health Savings Account for unrepresented Executive Management (EM) employees and contributing to said account the highest amount that is available to other represented management employees. H. The City Manager recommends establishing and delineating a 401(a) Retirement Savings Account for unrepresented Executive Management (EM) employees to participate in, at his or her sole discretion. It is now desired to rescind Council Resolution No. 91-066 and reestablish and affect the aforementioned changes. Section 2: Unrepresented Executive Management (EM) Basic Compensation and Benefit Plan. The City Council hereby reestablishes the unrepresented Executive Management (EM) Basic Compensation and Benefit Plan effective January 1, 2015, to read as follows: Unrepresented Executive Management (EM) Basic Compensation and Benefit Plan Effective January 1, 2015. Section 1. Executive Management (EM) Classifications and Compensation Plan. A. Unrepresented Executive Management (EM) Emplovee Classifications Assistant City Manager (EM) Deputy City Manager (EM) Police Chief (EM) Executive Director of Community Development (EM) Executive Director of Finance and Management Services (EM) Executive Director of Parks, Recreation and Community Services (EM) Executive Director of Personnel Services (EM) Executive Director of Planning and Building Safety (EM) Executive Director of Public Works (EM) Special Assistant to the City Manager (EM) B. Schedule of Salaries. A schedule of salaries showing salary rate ranges for classifications of employment designated as unrepresented Executive Management (EM), is attached hereto and made a part hereof as though set forth in full herein. The schedule for unrepresented Executive Management (EM) classifications and effective dates is listed as follows: Salary Schedule Resolution Nc. 2015-001 Page 2 of 15 Unrepresented EM Classifications No. Effective Date Assistant City Manager (EM) EM-39 01/01/2015 Deputy City Manager (EM) EM-41 01/01/2015 Police Chief (EM) EM-47 01/01/2015 Executive Director of Community Development (EM) EM-33 01/01/2015 Executive Director of Finance and Management Services (EM) EM-37 01/01/2015 Executive Director of Parks, Recreation and ' Community Services (EM) EM-37 01/01/2015 Executive Director of Personnel Services (EM) EM-33 01/01/2016 Executive Director of Planning and Building Safety (EM) EM-42 01/01/2015 Executive Director of Public Works (EM) EM-38 01/01/2015 Special Assistant to the City Manager (EM) EM-37 01/01/2015 The unrepresented Executive Management (EM) salary schedule contains numerous salary rate ranges, each range comprised of fifteen (15) separate rates of pay shown in monthly amounts. The rate ranges are identified by a two -digit number preceded by the capital letters "EM" for Executive Management. The -separate rates of pay or steps within each salary rate range are identified by the numbers "1" through "15" inclusive, with Step 1" being the lowest or minimum rate of the range, Step "8" the middle or midpoint rate of the range, and Step "15" being the highest or maximum rate. Terminal Classifications, The capitalized letter "T" shown within parenthesis [i.e., (T)] next to a classification title signifies a position classification that has been designated as "terminal" by formal City Council action and, as such, will be deleted from this classification and compensation plan for unrepresented Executive Management (EM) classifications of employment when vacated by its last remaining incumbent. No new appointment may be made to a classification that has been designated as terminal. Section 2. Special Pay Additives and Additional Compensation Provisions, Bilingual Skill Pay. Qualified employees who are assigned to positions involving the regular and frequent use of bilingual skill in both English and either Spanish, Vietnamese or any other language designated by the City Manager will be paid in the highest amount as available to represented management employees. Incumbents of positions where bilingual proficiency is essential to the performance of duties and responsibilities of a critical and/or emergency nature, or of positions where bilingual public contact is a major, essential or integral element of the work being performed, will be paid in the highest amount as available to represented management employees. Section 3. Administration and Applicability of the Compensation Plan A. Unless specified otherwise herein, unrepresented Executive Management (EM) employees will be subject to the same changes in compensation plan provisions, including but not limited to, sick leave maximum accrual; bereavement leave; holidays; longevity vacation cash out; health and dental insurance; access to participation in the City's Vision Plan; retirement; Retirement Health Savings Plan; and work week Resolution No. 2015-001 Page 3 of 15 schedule, as provided in the highest amount as available to represented management employees on or after January 1, 2015. B. Compensation Plan Implementation. Upon implementation of the basic salary schedule set forth in Sub -section 1.13. of this Resolution, a current incumbent of an Executive Management (EM) classification listed herein above will be placed at the monthly rate in the assigned salary rate range which matches the incumbent's assigned base monthly salary rate on the day preceding the effective date of this Resolution. C. Hiring Pay Policy. A newly hired Executive Management (EM) employee will be compensated at a monthly rate within the lower third of the salary range (Steps 1 through 5) for his/her job classification as authorized by the appointing authority. When economic conditions, unusual employment conditions, or exceptional qualifications of a candidate for employment indicates a higher rate would be in the City's best interest, the City Manager may authorize compensating the new employee within the middle third of the salary range (Steps 6 through 10) but the higher starting salary will generally not be above Step 8. D. Rates of Pay for Temporary and Part -Time Work. When an employee is hired in an Executive Management (EM) classification on a temporary basis, which is defined as employment with an anticipated duration of less than six (6) months, or an employee is hired in an Executive Management (EM) classification on a part-time basis, which is defined as employment of forty (40) hours or less per semi-monthly pay period, the employee will be paid at a rate per hour for actual time spent in the duties of his or her employment. Rate per hour will be computed to the nearest whole cent by dividing the classification's standard monthly rate of compensation by 173.33. A computation resulting in exactly one-half (1/2) cent will fix the rate at the next higher whole cent. E, Service. The word "service" as used in this Resolution will be deemed to mean continuous, full-time service in the classification in which the employee is being considered for salary advancement, service in the higher classification or service in a classification allocated to the same salary rate range and having generally similar duties and requirements. Employees hired after the first (1s) working day of the month will not be credited with "time in service" for that month when determining the length of service required for salary step advancement. A lapse of service by an Executive Management (EM) employee for a period of time longer than ten (10) calendar days by reason of resignation, quit, or discharge, will serve to eliminate the accumulated length of service time of such employee for the purpose of this Resolution. F. Appointment or Promotion of Current Employee. An employee who is appointed or promoted to an Executive Management (EM) classification from a represented management or non -management classification of the City service will be placed at a salary rate in the Executive Management (EM) salary rate range which provides a minimum of a five percent (5%) pay increase. Resolution No. 2015-001 Page 4 of 15 G. Reduction in Pay. An Executive Management (EM) employee may receive a reduction in salary on the basis of unsatisfactory work performance, conduct or other reasons at the discretion of the City Manager. H. Temporary Upgrade to an Executive Management (EM) Classification. Regular employees of the City who are incumbents of classes of employment not included in this Resolution and who are temporarily upgraded to an Executive Management (EM) classification will receive a five percent (5%) increase or the minimum rate of the Executive Management (EM) salary range, whichever is higher, in accordance with current upgrade provisions, I. Reallocation of Salary Rate Ranges. When an employee is in an Executive Management (EM) classification which is reallocated from the current salary rate range to a different salary rate range, the employee will retain the same salary step he or she held prior to the reallocation. The employee will retain credit for length of service in such salary step towards advancement to the next higher salary step. J. Y-Rating. In special circumstances the City Manager may approve compensating an employee in excess of the salary range of the classification to which he or she is assigned by "freezing" the employee's salary at the current rate. In such cases, incumbents will not receive step increases or current and future general "across- the-board" salary adjustments scheduled for other classes until the salary level is equal to or greater than the "frozen" salary for the assigned classification. K. Z Rating. A Z-Rate is a special salary rate established by the City Manager which allows an employee who has been reclassified to a classification at a lower salary rate range to be paid at a rate of pay higher than that assigned to his or her reclassified position title for a specified transition time period. Section 4. Health and Welfare Benefits. The following optional insurance benefits available to Executive Management (EM) employees are provided through a cafeteria plan adopted in accordance with the provisions of Internal Revenue Code § 125. The City will contribute to the cafeteria plan in the highest amount as available to represented management employees. Since the City contracts with CalPERS for medical insurance, the amount described above will include the CalPERS statutory minimum paid by the City. A. Medical insurance. Eligible Executive Management (EM) employees may select any of the medical insurance plan options offered by CalPERS. B. Dental insurance. Eligible Executive Management (EM) employees will have the ability to select either an HMO or PPO dental insurance plan. Resolution No. 2015-001 Page 5 of 15 C. Vision insurance. Eligible Executive Management (EM) employees will have the ability to select vision insurance coverage through the City's insurance provider. D. Cash -in -Lieu of Benefits. Executive Management (EM) employees will be eligible to receive cash (subject to taxation as wages) through the cafeteria plan if they either opt -out of receiving one of the optional benefits provided through the plan or if they choose optional benefits that do not cost as much as the maximum dollar amount they receive through the plan. E. Employee Contributions for Benefits. If an Executive Management (EM) employee chooses optional benefits whose aggregate premium cost exceeds the maximum City Contributions to the Cafeteria Plan, the City will automatically deduct the excess premium amount on a pre-tax basis from the employee's regular paycheck. F. Disability Insurance. The City .will pay one hundred percent (100%) of the premium cost for a long-term disability insurance plan under the policy it maintains on behalf of its employees in order to provide Executive Management (EM) employees a monthly benefit of sixty-six and two-thirds percent (66 213) of base monthly salary (insured payroll), less offsets contained in the existing plan, to a maximum monthly benefit of $5,000. G. Life Insurance and Accidental Death & Personal Loss ADD&PL). The City will pay one hundred percent (100%) of the premium cost for term life and AD&PL insurance coverage under the policy it maintains on behalf of its employees in order to provide Executive Management (EM) employees with life and AD&PL insurance coverage in an amount equal to three times the employee's annual rate of salary to a maximum of $.300,000 provided Executive Management (EM) employees can provide evidence of insurability for coverage above $150,000 if so required by the terms and conditions of said term life and AD&PL. insurance policy. In the event an Executive Management (EM) employee is determined to be ineligible for said insurance coverage, the City will attempt to provide as much coverage as may be obtained at a reasonable cost without having to provide evidence of insurability Section 5. Leave Accruals and Cash -Out Provisions. A. Paid Holiday Time Off. Executive Management (EM) employees are not required to appear for work, except in emergencies, and will receive payment at his or her current base salary rate for the following twelve (12) holidays during each year: January 1st; third Monday in January; third Monday in February; last Monday in May; July 4t"; first Monday in September; November 11t"; Thanksgiving Day and the day immediately following (Friday); Christmas Day; the last working day before Christmas Day (unless Christmas Day falls on Thursday, in which instance the day following Christmas Day will be observed) and one (1) floating holiday. Any holiday which falls on Sunday will be observed on the following Monday and any holiday which falls on a Saturday will be observed on the Friday preceding the holiday. Resolution No. 2015-001 Page 6 of 15 B. Vacation Time Off, Executive Management (EM) employees will be granted regular and longevity paid vacation leave on the same basis as provided to represented employees of the City, with the exception that such affected employees will be granted: 1. Regular vacation with pay at the annual rate of fifteen (15) working days for each of his or her first and second completed year of service.. 2. An additional five (5) working days per year over the regular and longevity vacation accruals applicable to represented employees of the City. Affected Executive Management (EM) employees must take at least five (5) consecutive days of vacation leave each year. C. Longevity Vacation Credits for Newly. Hired Executive Management (EM) Employees. The City Manager is authorized to grant to a person newly hired by the City to a position designated as Executive Management (EM), longevity vacation credits in the form of years of service to the City up to a maximum of 20 years. The credits will be counted as completed years of service with the City for the purpose of calculating longevity vacation accrual only. The longevity vacation credits will be added to the years of service actually completed with the City of Santa Ana by the employee to establish total years of service for the purpose of calculating longevity vacation. D. Longevity and Vacation Pay Option. Once per fiscal year, Executive Management (EM) employees will be given the option to receive cash compensation, computed on a straight time basis, in lieu of up to five (5) working days of earned, unused vacation benefits set forth in Section B. E. Sick Leave Credits for New Hires. The City Manager is authorized to grant a newly appointed Executive Management (EM) employee sick leave credits up to an amount equal to any earned but unused sick leave credits available to such appointee at the time of his or her separation from his or her most recent previous employer. F. Payment for Unused Sick Leave. Executive Management (EM) employees will be granted payment for unused sick leave on the same basis as provided to Santa Ana Management Association (SAMA) represented employees of the City. G. Paid or unpaid Administrative Leave Polioy. The City Manager is authorized to grant, at his or her discretion, paid or unpaid leave for Executive Management (EM) employees. Section 6. Retirement Plan Contributions. A. The terms of the existing contract between the City and California Public Employees' Retirement System (CaIPERS) governing the City retirement benefits of Executive Management (EM) employees covered by this Resolution are incorporated by reference herein. The City will make contributions to CaIPERS in accordance with its contract with CaIPERS for employees covered by said contract as amended. Resolution No. 2015-001 Page 7 of 15 B. 2.7% at 55 Service Retirement Benefit for Classic Miscellaneous Members. The City agrees to provide Executive Management (EM) employees covered by this Resolution, and who are defined as Classic Miscellaneous Members under the California Public Employees' Pension Reform Act (PEPRA) of 2013 (AB340), with the 2.7% at 55 Service Retirement benefit. C. Payment of 2.7% at 55 Service Retirement Benefit. Classic Miscellaneous Executive Management (EM) employees covered by this Resolution will contribute eight percent (8%) of CalPERS reportable compensation toward the employer cost of the 2.7% at 55 enhanced retirement formula. This payment will be implemented as cost - sharing pursuant to Government Code Section 20516(f). Pre -Taxable Benefit. To the extent permitted by CaIPERS and Internal Revenue Service regulations, this eight percent (8%) employee contribution will be implemented through payroll deductions on a pre-tax basis. D. 2.0% at 62 Service Retirement Benefit for New Miscellaneous Members. The City agrees to provide Executive Management (EM) employees covered by this Resolution who were appointed to their classification on or after January 1, 2013, and who are defined as new members under the California Public Employees' Pension Reform Act (PEPRA) of 2013 (AB340), with the 2.0% at 62 Service Retirement benefit. E. Payment of 2.0% at 62 Service Retirement Benefit. Executive Management (EM) employees defined in 6.D. (above) will contribute at least 50% of normal cost of the 2.0% at 62 retirement benefit. Pre -Taxable Benefit. To the extent permitted by CaIPERS and Internal Revenue Service regulations, the City will make the above employee deductions pre-tax contributions. F. 3% at 50 Service Retirement Benefit for Classic Safety Members. The City agrees to provide Executive Management (EM) employees covered by this Resolution, and who are defined as Classic Safety Members under the California Public Employees' Pension Reform Act (PEPRA) of 2013 (AB340), with the 3% at 50 Service Retirement benefit. G. Payment of 3.0% at 50 Service Retirement Benefit. Classic Safety Executive Management (EM) employees covered by this Resolution will contribute nine percent (9%) of CalPERS reportable compensation toward the employer cost of the 3.0% at 50 enhanced retirement formula. This payment will be implemented as cost -sharing pursuant to Government Code Section 20516(f). Pre -Taxable Benefit. To the extent permitted by CalPERS and Internal Revenue Service regulations, this nine percent (9%) employee contribution will be implemented through payroll deduction on a pre-tax basis. H. 2.7% 2 57 Retirement Benefit for New Safety Members. The City agrees to provide Executive Management (EM) employees covered by this Resolution who were Resolution No. 2015-001 Page 8 of 15 appointed to their classification on or after January 1, 2013, and who are defined as new members under the California Public Employees' Pension Reform Act (PEPRA) of 2013 (AB340), with the 2.7% @ 57 Service Retirement benefit. I. Payment of 2.7% at 57 Service Retirement Benefit, Executive Management (EM) employees defined in 6.H. (above) will contribute at least 50% of normal cost of the 2.7% at 57 retirement benefit. Pre -Taxable Benefit. To the extent permitted by CalPERS and Internal Revenue Service regulations, the City will make the above employee deductions pre-tax contributions. J. Final Compensation for Pension Calculation. Final compensation for Classic Safety and Classic Miscellaneous Members will be based on the highest annual average compensation earnable during the 12 consecutive months immediately preceding the effective date of his or her retirement, or some other 12 consecutive month period designated by the member. Final compensation for Safety and Miscellaneous Members who are defined as New Members under PEPRA will be based on the highest annual average compensation earnable during the 36 consecutive months immediately preceding the effective date of his or her retirement, or some other 36 consecutive month period designated by the member. K. MilitarV Service Credit as Public Service. An Executive Management (EM) employee covered by this Resolution will be permitted to purchase up to four (4) years of service credit for any continuous active military or merchant marine service prior to employment. The cost to purchase this service credit is subject to CalPERS Regulations and calculated using a present value method. L Deferred Retirement for Classic Safety and Classic Miscellaneous Members as defined in Section B and F (above). The City will continue to make payments to CalPERS on behalf of each eligible affected employee in an amount necessary to pay one hundred percent (100%) of his or her individual retirement contribution which is equal to eight percent (8%) of reportable compensation for Classic Miscellaneous Members and nine percent (9%) for Classic Safety Members. Such payments will be credited to the individual employee's CaIPERS account. Such payments are not an increase in base salary and no salary rate range applicable to any of the employees covered by this Resolution will be changed or deemed to have been changed by reason thereof. As a result, the City will not treat these payments as ordinary income and thus will not withhold federal or state income tax from said payments. The City previously received a ruling from the Internal Revenue Service confirming that such payments are deferred compensation and not ordinary income. In the event that the City receives a new ruling from the Internal Revenue Service that such payments are ordinary income of the employees instead of deferred compensation, the City's obligation to make such payments will discontinue and in place thereof the reportable compensation of each Classic Miscellaneous Member eligible for Resolution No. 2015-001 Page 9 of 15 the 2.7% at 55 Benefits Formula will be increased by eight percent (8%) and each Classic Safety Member eligible for the 3% at 50 Benefits Formula will be increased by nine percent (9%). For the purpose of reporting an employee's compensation to CalPERS, the City will include these payments as if they were a part of the employee's reportable compensation. Section 7. Tuition Reimbursement. Executive Management (EM) employees are eligible to participate in the Training and Education Assistance Program provided for all regular, full-time employees of the City. Reimbursement will be based on the cost of tuition, required enrollment/registration fees, miscellaneous fees (health, parking, student union fees, etc.) and all required texts, eBooks and related material for each course. Maximum tuition reimbursement will be paid in the highest amount as available to other represented employees. Section 8. Medical Retirement Subsidy Plan. A. The City's current annual contribution towards the Medical Retirement Subsidy Plan for Executive Management (EM) employees covered under this Resolution is 1.75% of the base salary, which is based on the first payroll period in October and deposited no later than October 31 st of each year. B. The plan will be administered by the City, at no cost to Executive Management (EM) employees pursuant to the written directives of Executive Management (EM) employees. The funds contributed by the City will be maintained in such a manner as to ensure that the funds are invested in a reasonably secure plan that bears a reasonable rate of interest/growth given current financial markets. For purposes of this Resolution, investments made pursuant to the then current Statement of Investment Policy for the City of Santa Ana, will be deemed to meet the requirements of this section. This program is for medical insurance premium reduction only. C. Effective November 28, 2011, the City adopted a resolution authorizing implementation of the "Vantage Care" Retirement Health Savings Plan (RHS), which designated ICMA-RC as the administrator of the plan. 1. The City agrees to amend the current contract with ICMA-RC to allow unrepresented Executive Management (EM) employees to participate in the Retiree Health Savings Plan upon approval of the majority of Executive Management (EM) employees. 2. Upon establishment of the RHS and adoption of the RHS plan by Executive Management (EM) employees, and upon instructions from Executive Management (EM) employees the City's annual contribution of 1.75% deposited in the Medical Retirement Subsidy Plan will cease. Concurrently with said cessation, the City will increase the base pay of each Executive Management (EM) employee by 1.25% with said amount being deposited into employees' individual RHS accounts each pay Resolution No. 2015-001 Page 10 of 15 period. This 1.25% increase in base is in -lieu of the Annual City Contribution of 1.75% paid to the Medical Retirement Subsidy fund in October each year, 3. If said RHS Plan is established after the annual payment of 1,75% into the existing Medical Retirement Subsidy plan has been made, the salary adjustment and deposit into the RHS of the 1.25% described in paragraph 8.C.2. above will be effective July 1, 2016, 4. Upon approval to participate in the RHS, Executive Management (EM) employees will determine how the existing Medical Retirement Subsidy Plan funds will be distributed among its membership and, if applicable, its retired members. Executive Management (EM) employees will dissolve the existing Medical Retirement Subsidy plan by June 30, 2016, unless said deadline has been extended by mutual agreement of Executive Management (EM) employees and the City. Section 9, Auto Allowance. With the exception of the Police Chief who receives a City vehicle, the City will contribute five hundred dollars ($500) per month to each Executive Management (EM) employee to offset reasonable and necessary expenses for the operation, maintenance and insuring of an automobile. In lieu of receiving five hundred dollars ($500) per month, the employee may request and be provided with an optional vehicle. This provision is in accordance with and as specified in Section 2-300, Division 1, Article IV, Santa Ana Municipal Code. Section 10. Deferred Compensation. The City has established and maintains a deferred compensation plan pursuant to the provisions of Section 457(b) of the Internal Revenue Code. Executive Management (EM) employees covered under this resolution, at his or her sole discretion, may defer to have deposited into the City's 457(b) plan a portion of his or her compensation up to the maximum amount permitted by law. The City is desirous of establishing a 401(a) deferred compensation plan. As permissible by law the City will establish a 401(a) deferred compensation plan at a future date. Executive Management (EM) employees covered under this resolution, at his or her sole discretion, may defer to have deposited into said 401(a) plan upon its establishment a portion of his or her compensation up to the maximum amount permitted by law. All contributions into the 457(b) and 401(a) plan are voluntary employee contributions and will meet the requirements of the Internal Revenue Code. Section 11. Unrepresented Executive Management (EM) Performance -Based Evaluation System. The provision of the unrepresented Executive Management (EM) performance -based evaluation system are as follows: 11.1 Purpose. The basic purpose of the performance -based evaluation system is to help attract, retain and motivate highly competent Executive Managers and to provide them with a strong incentive to excel. Resolution No. 2015-001 Page 11 of 16 11.2 Specific Compensation Determination. A. The City Manager is hereby given the authority to set the individual compensation, to make adjustments thereto and to make appointments at any salary within the established range for all executive positions except the City Manager, the City Attorney, and the Clerk of the Council, which will be made by the City Council. B. The City Manager will establish performance criteria and appraisal guidelines to be utilized in setting individual compensation for Executive Management (EM) employees. C. After the salary of an employee has been first established and fixed under this plan, salary advancement through the remaining steps of the 15-step salary rate range will be based on the results of an annual performance evaluation. 11.3 Evaluation System Components. The evaluation system will be comprised of the following components: A. Annual Objectives. The system will include a list of outcome -based, measurable objectives to be achieved which have been mutually agreed upon between the appropriate appointing authority and each individual manager subject to his or her authority. A relative weight will be assigned to each objective listed with a minimum weight of 10% and all must total 100%. B. Managerial Behaviors. In addition to his or her performance in achieving agreed upon objectives, each Executive Manager will also be evaluated for his or her managerial behavior performance, including such behavior as communication (oral or written), analysis and problem solving, decision -making and judgment, planning and organization, management control, leadership, interpersonal relations, time - management, technical knowledge, handling of stress, etc. 11.4 Performance Evaluation Guidelines, A. The City Manager will annually evaluate the performance of each of his or her Executive Management (EM) employees annually to determine their individual eligibility for a performance increase and how much, if any, increase will be given. Such annual performance evaluation will occur once a year and will cover the twelve month period preceding that date. Additionally, at least one informal mid -year progress review will be held between the City Manager and each of his or her Executive Management (EM) employees. B. Performance Ratings. Each manager's performance in relation to his or her agreed upon annual objectives and managerial behaviors will be evaluated according to the following performance rating scale: Point Rafting Performance Levels 3 Significantly Exceeds Expectations: Resolution No. 2015-001 Page 12 of 15 Consistently exceeds all objectives requirements and expectations by a wide margin. 2 Exceeds Expectations: Consistently meets all objectives and requirements and exceeds several. 1 Meets Expectations: Meets objectives and requirements. 0 Below Expectations: Fails to meet some objectives and requirements. 1 Unacceptable: Performance is significantly below the minimum required. 11.5 Performance -Based Salary Ad'lustments. Each Executive Management (EM) employee may be eligible to receive an annual performance -based, in -range salary increase and/or one-time monetary payment based on a percentage of current annual rate of base salary, or be subject to a performance -based salary reduction, in accordance with the following: A. For overall performance rated as "Significantly Exceeds Expectations," either step increases or one-time monetary payment or a combination of step increases and one-time monetary payment not to exceed seven and one-half percent (7.5%) in toto. B. For overall performance, rated as "Exceeds Expectations," either step increases or one-time monetary payment or a combination of a step increase and one- time monetary payment not to exceed five percent (5%) in toto. C. For overall performance rated as "Meets Expectations," a one-time monetary payment in an amount up to but not to exceed two and one-half percent (2.5%) of current annual rate of base salary or advancement of one step (2.5%) within the salary rate range. D. For overall performance rated as 'Below Expectations," no performance salary increase or monetary incentive payment. E. For overall performance rated as "Unacceptable," no performance salary increase or monetary incentive payment. Additionally, any Executive Management (EM) employee who has received such a rating and who is being paid at a step higher than the minimum rate of the salary rate range, may be reduced by one or more steps at the discretion of the City Manager. F. Application of Guidelines. Resolution No. 2015-001 Page 13 of 15 1. If an Executive Manager who is recommended for a performance increase is at the maximum of his or her salary rate range, then the entire performance increase must be awarded the equivalent amount in a one-time monetary incentive payment. 2. Any one-time monetary incentive payment granted under this plan is not an increase in base salary and no salary rate range applicable to any management employee covered by this Resolution will be changed or deemed to have been changed by reason of such payment. 3. The City Manager will be responsible for the development and administration of detailed administrative procedures and guidelines for the consistent and effective application of the unrepresented Executive Management (EM) performance -based evaluation system. Such procedures and guidelines will define how performance objectives, measures and standards are developed; when and how performance reviews are to be carried out; how performance component ratings and composite ratings will be scored; and how performance salary increase and monetary incentive payment options are to be exercised. Section 12. Miscellaneous Provisions A. Catastrophic Leave Donation. Executive Management (EM) employees will be eligible to donate and receive catastrophic leave donations as provided to all other represented employees. C. Electronic Device Stipend. Executive Management (EM) employees who use their own personal electronic devices for City business in lieu of receiving a City owned device will be eligible to receive a stipend at a level matching that received by SAMA employees. Privileges. Each employee in a classification of employment designated in Sub -section I.A. of this Resolution as unrepresented Executive Management (EM) will continue to enjoy the same rights and privileges to which they were entitled under Resolution 91- 066 unless otherwise amended, altered or eliminated herein. Section 3: That Resolution No. 91-066, as amended, is hereby rescinded in its entirety. Section 4: This Resolution is operative from and after January 1, 2015. ADOPTED this 201h day of January, 2015. Resolution No. 2015-001 Page 14 of 15 APPROVED AS TO FORM: Sonia R. Carvalho City Attorney By:'4Yl'o'j, Sonia Carvalho AYES: Councilmembers: Amezcua, Benavides, Pulido, Reyna, Sarmiento. Tinaiero (6) NOES: Councilmembers Martinez(1) ABSTAIN: Councilmembers: NOT PRESENT: Councilmembers: None (0) CERTIFICATE OF ATTESTATION AND ORIGINALITY I, MARIA D. HUIZAR, Clerk of the Council, do hereby attest to and certify the attached Resolution No. 2015-001 to be the original resolution adopted by the City Council of the City of Santa Ana on January 20, 2015. Date: Clerk of the Council City of Santa Ana Resolution No. 2015-001 Page 15 of 15 Attachment 2 SUGGESTED AFFIRMATIVE STATEMENT 17OMA FOR THE VANTAGECARE RETIREMENT HEALTH SAVINGS PLAN AMENDMENT FOR DEFINITION OF SPOUSE Plan Number: 80 3 2 32 r 803550, 803551. Name of Employer- City of Santa Ana State: C A WHEREAS, the Employer has established and maintains a retiree health savings plan in the form of the ICMA Retirement Corporation's VantageCare Retirement Health Savings program, as amended (the "Plan"); WHEREAS, the assets of the Plan are held in crust For the exclusive benefit of Plan participants and their spouses and dependents, and. shall not be diverted to any otter purpose prior to the satisfaction of all liabilities of the Plan; WHEREAS, the plan has operated in accordance with federal recognition of same -sex spouses; and. WHEREAS, an amendment to the Employer's Plan in accordance with the federal recognition of same -sex spouses is adopted to comply with Internal Revenue Service guidance issued in response to the Supreme Court's decision in United States V. Windsor; NOW THEREFORE BE IT RESOLVED that the Employer hereby amends the Plan to define the term "Spouse" as the Participant's lawful spouse as determined under the laws of the jurisdiction in which the Participant was married. As a duly authorized agent of the above tined Employer, I hereby AMEND the Declaration of Trust of the Integral Part Trust and Retiree Welfare Benefits documents, as applicable, to include the federal recognition of same -sex spouses. The Plan allows same -sex spouse to receive tax-free reimbursements for all same -sex marriages that are valid as of September 16, 2013, unless the employer specifies an earlier valid date hereof as (Leave blank unless using earlier dare) Name of Authorized Official (please print): Signature: Title: City Manager Dare: O 5,( ;1.0 d a� Nlonefi! Day / Year PROVE S FORM Jose Sando nior Assistant City Attorney Fax tot 1CMA-RC ATTN: Workflow Management Team 202-682-6439 ATTEST c��� �� {N1dARIA D. HUIZAR CLERK OF THE COUNCIL Mail to: ICMA-RC OR ATTN: Workflow Management Team P.O. Box 96220 Washington, D.C, 20090-6220 VANTAGECARE RETIREMENT HEALTH SAVINGS PLAN AMENDMENT DEFINITION OF SPOUSE FOR City of Santa Ana )NAME OF SMPtOYER) Attaehsnent 3 D0014 City of Santa Ana `, as Plan Sponsor, herebyamends its VantageCare Retirement NAME OF EMPLOYER) Health Savings Plan by adopting the Following revisions to the Plan documents. DECLARATION OF TRUST OF City of Santa Ana INTEGRAL PART TRUST )NAME OF EMPLOYER) ARTICLE 1.1(h) DEFINITION OF "SPOUSE" t. t(h) "Spouse" means the Participant's lawful spouse as determined under the laws of the jurisdiction in which the Participant was married. City of Santa Ana RETIREE'WELFAREBENEFITS PLAN )NAME OF EMPLOYER) ARTICLE 2.I t DEFINITION OF "SPOUSE" 2.11 "Spouse" means the Participant's lawful spouse as determined under the laws of the Jurisdiction in which the Participant was married. All other defined terms in this Plan shall have the meanings specified in the various Articles of the Plan in which they appear, Fax to: ICMA-RC ATTN: Workflow Management Team 202-682-6439 Mail to: CC1VSA-RC OR ATTN; Workflow Management Team P.O, Box 96220 Washington, D.C. 20090-6220 IDA7TE lM1411oD1YYYY) 0 0.1 CERTIFICATE OF LIABILITY INSURANCE J 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(ites) must 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 enclorsernent(s), PRODUCER CONTACT MARSH USA INC. NAME:..... FAX 1050 CONNECTICUT AVENUE, SUIT E 700, (Arc, No, Ext): FAIC, No). INASHINGTON, DC 20036-5386 AE-MDAIL DI INSURER(S) AFFORDING COVERAGE NAIC Ii 040356-FINPR-FD+FI-16-17 INSURER A ee Pho'X r'SUranCe CouTailY �25623 INSURED INSURER B NIA ICVA RETIREMENT CORP ATTN. UJUANA THOMAS INSURER C llavplers Casually IfsUfanCe CO3 01 America 19046 777 NORTH CAPITOL ST, NE INSURER D. Fedeial Insurance Company i �20281 WASHINGTON, DC 20002 INSURER E St. Paul Fire & I Insurance Co 24767 COVERAGES CERTIFICATE NUMBER: CLE-004640666 23 REVISION NLJMRFR-5 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 INSR ADDLSUBRI POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD VVVO POLICY NUMBER IM 4ID01Yyyyl tMMIDE)Iyyyyl LIMITS A X COMMERCIAL GENERAL LIABILITY j6306E588375 W01/2015 08/01/2016 FACT I OCCURRENCE is 1000 000 x DAMTO TE D i RE N CLAIM, MADE I OCCUR PREIAGE occurrence) 5 1.000000 X CONTRACTUAL COV INCL. MED EXP (Any one person) S 10,000 I PERSONAL & ADV INJURY S 1,000,000 GENT AGGREGATE jIMIT APPLIES PER GENERAL AGGREGATE 2000000 X FOC PRO POLICY JFCY I PRODUCTS - COMPIOP AGG 2,000.000 1 OTHER: AUTOMOBILE LIABILITY1 COMBINED SUIX31-F, LIMIT (Ea accidpnll I! ANY AUTO BODILY INJURY (Per person) LI, OWNED SCHEDULED A AUTOS I, AUTOS BODILY INJURY (Per accldeW) $ NON -OWNED PROPERTYDAMAGE HIRED AUTOS AUTOS (Per accident) UMBRELLA LIAS i OCCUR EACH OCCURRENCE s EXCESS i AGGREGATE $ DED RETENTION S C WORKERS COMPENSATION UB6508MB94 08/01015 00112016 PER OTH- AND EMPLOYERS' LIABILITY YIN E SIATUrER ANY PROPRIETORYPARTNER)EXECUTIVE i E1 EACH! ACCIDENT S 1,000,000 OFFICEFUMEMBER EXCLUIDEW FE N/A (Mandatory in NH) I E.L. DISEASE - EA EMPLOYEE 1,000,000 If yes d scribe urder. 0 I DESCRIPTION OF OPERATIONS below I E L DISEASE - POLICY LIMIT 1,000,000 D BANKERS PROF HAB 8211-6261 106/3012016 106130017 $7 500,000 P/0 $12500,000 F SIR $1,000,000 7PL-71M07549-16-N2 i D613012016 106130/2017 $5,000,000 p/o $12,500,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached R mare space is required) cry I H-PI/A 1 1: r1ULUII k,,AI'0,r-LI-A I IUN CIITY OF SANTA ANA ATTN: EXECU TIVE DIRECTOR OF PERSONNEL SVS 20 CIVIC CENTER PLAZA M-34 SANTA ANA, CA 92702 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 of Marsh USA Inc. Manashi MUli _r-`L.­­--.— (0 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014101) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 040356 LOC #: Washington AnnITIMIAI P1=11AAPL,(Q QrWilz1-11 11 9= AGENCY NAMED INSURED MARSH USA INC 1CMA RIETIREMIEN1 CORP A I M: U)'J JANA THOMAS POLICY NUMBER 777 NORTH CARIOLS F , NE WASHINGTON, DC 20002 CARRIER NAIC CpDE EFFECTIVE DATE. DDI I ICINAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: _., 25 FORM TITLE: Certificate of Lability II2SMance FIDELITY BONDCRIME CARRIER Great American Insurance Coii,tpaiiy POLICY NO FS234-63-54 EFPEXP: 0613012016 - 0161N2017 LIMIT: $25,000,000 DID $250,000 ,-UMLJ Ju I kzuuoiu 1) 9 2008 ACCORD CORPORATION. All rights reserved. The ACCORD name and logo are registered marks of ACORD CERTIFICATE OF LIABILITY INSURANCE DATE(MM,DDfYYYY ra6raa(2a1 "r 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(les) 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 end'orsementis). PRODUCER CONTACT MARSH U3 A INC NAME: .,PHONE FAX 10'EJ0 C;C7NNFC 1' uCV.J1 AVENUE, SUFF 700 (AIC, No, Ext) _ (ArC, rack WASHINC1ON DC 20036-5366 E-MAIL ADDRESS:':... _... _. _..... ..._. .. INSURERS) AFFORDING COVERAGE NAIC 0 040356-FINPR E041-_17 1ii INSURER A: PI?oenix 25623 INSURED INSURER 8 WA N`A ICMA, RETIREMENT CORP, A I TN' R JUANA TI-IOMAS INSURER C . Slandald Fire Insufaice CoLipany 0V) 0 777 N0RTH CAPITOL S'T._ NE 2023" �NASTIiNGTC7N, DC 20[702 INSURER D : i�@dinrai Insurance Compeldy INSURER E . Travelers Casually And Surely Company Of Aweric a 311R l INSURER F : r^nk/1=0AnrPQ t^FRTIFIt'ATF AIIBWJIRPP- C[F-On6P41484-33, REVISION WtJMRFR 5 '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- WNSR ADDL SUBR:. POLICY EFF POLICY EXP NSR :. TYPE OF INSURANCE POLICY NUMBER IMMfDOIYYYYI (MMfDDYYYYY) ... LIMITS A X GOMGIP,IM1AL 1 tY,i0 E56� it �18(01F21.�1� I UBt0112015 1,000,000 5 tu9.4UEERAXLL9ADYLiT'i DC.e.JR pftMAG3ESOF FNTF��nC p a r I�IJ X CONTRACTUAL COV INCT.. � I - MEu EXP IAny one person) � S 00 L' j p PERSONAL .L EtALA/ INJURY S� '1 6006L6 . N'L iaGf1RE .,F GATE LIMIT APPLIES PER f GF'NF.RAf. AGGREGATEr - 2.Ut1UJJO0 _ PRO- X POLICY ,PEC'T ''. LOC PRODUCTS t ... ... ..... .... 2,000,000 ... L)TJtLR i r AUTOMOBILE LIABILITY COMDINEDSINGLE LIMIT (Ea oedei)I) ANY AU10 i BODILY Nf JJR r (Pe, peisoir) 5 SCHEDULED ' _ — B(.TL71LY INJURY (Per accicerre) & — AUCOS' ONLY AUTOS HI6RFp NON -OWNED � (�I-�Gd'WsfQTr`6_dAMAGE ''. AU LOS ONLY AUTOS ONLY ' I tPp;r aw.wuidrmp.. ... `„ a ... UMBRELLA LIAR OCCUR - EACH OCCURRENCE S EXCESS LIAR -_ ' CLAIMS MADE', �, " AGGREGATE 5 DEL RETENTION$ i C WORKERS COMPENSATION iU66508M8O4 .107 08101/2018 X PER OTH- AND EMPLOYERS' LIA 8I LITY YIN STATUTE ER r�NYPRI� RIETCIRYPARI NER'IEYGECUTIUE f N1AFLAI 1 E L E+�r 'rl AL'd:lll�: �J f 5 1 000 00> OFFICERwEMBEREXCLUDED9 - ._ 1.000,000 Mandator In NH (Mandatory , E L DISEASE - t. r E=MPLOYEE ,.,,... If YOS. aescnbe uiTder DESCRIPTION OF OPERATICNS below ' E.L.DISEIASE-POLICY LIMIT ,; T 1000 ,01jO 0 BANXhPS hR'CF LIAR '8211-6261 0613012017 06!3012018 $7,500,000 pl0 $12,500,000 F Sl $t-Up0,0UQ 1 U6758'967 06130,017 0&3012018 I $5,000,000 p{o C 12.500,000 DESCRIPTION OF OPERATIONS f LOCATIONS; VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached it more space is required) CERTIFICATE HOLDER CANCELLATION', CITY CF SANTA ANA SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE AITN', EXECUTIVE DIRECTOR OF PERSONNE:L, SVS THE EXPIRATION DATE THEREOF„ NOTICE WILL, BE DELGVERED IN 20 CIVIC CENTER PLAZA M-34 ACCORDANCE WITH THE POLICY PROVISfONS. SANTA ANA, CA 02702 AUTHORIZED R..EPRESENTATIVE. of Marsh USA Inc. MLIL=ISCri MLllchteraee U`` 1988-2016 ACORD CORPORATION. All rights reserved. ACORD 25 (20,16103) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 040356 LOC #: Washington ADDITIONAL REMARKS SCHEDULE Page 2 of 2 '..AGENCY NAMED INSURED I�ARSH USA INC 1CMA RETIREMEN1 CORP A I rq, UJUANA 1 k 10MAS POLICY NUMBER 717 NORTH CAPI FOL S1 NE WASHINGTON, DC 20002 . .. ........ CARRIER NAIL CQDE .... EFFECTIVE DATE: ACORD 101 (2008/01) @ 2008 ACORD CORPORATlON, All rights reserved. The ACORD name and logo are regnsterecl marks of ACORD Digitally signed by Anaie ACORO� ' Li CERTIFICATE OF LIABILITY H)ate:2022.08.04 D080312022DryYYn THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPbk WVCMiVICATE 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). PRODUCER MARSH USA INC, 1050 CONNECTICUT AVENUE, SUITE 700 WASHINGTON, DC 20036�5386 CONTACT NAME: PHONE FAX(MC,No EfAHIL ADDRESS: INSURERS AFFORDING COVERAGE NAM # INSURER A : Great Northern Insurance Company 20303 CN101976702-MULTI-.-22-23 INSURED MISSIONSOUARE RETIREMENT INSURER a: Federal Insurance Company 20281 INSURER C : Travelers Casualty And Surety Company Of America 31194 777 NORTH CAPITOL ST., NE WASHINGTON, DC 20002 INSURER O: INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: CLE-006901158-08 REVISION NUMBER- 10 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. INSR LTR TYPEOFINSURANCE ADOLSUSR IRM WD POUCYNUMBER POLICYEFF flummogri POLICYEXP rysvrm LIMITS A X COMMERCIAL GENERAL L[ABILITY CLAIMS -MADE OCCUR 3604-49-95 08/01/2022 080112023 EACHOCCURRENCE $ 1,000,000 DAMAGE TOR PREMISES Eaoccmedical $ 1,000,000 X MED FXP (Any oneperson) $ 10,000 CONTRACTUAL COV. INCL. PERSONAL a ADV INJURY $ 1,000,000 GENIE X AGGREGATE LIMIT APPLIES PER: POUCV PRP JECTFx_] LOC GENERAL AGGREGATE $ 2,000,000 PRODUCTS-COMP/OPAGG $ 2,000,000 $ OTHER: B AUTOMOSILELIABILITV 736045-48 08/01/2022 08/01/2023 COMBINED SINGLELIMIT Ea accident $ 1,000000 BODILY INJURY (Per person) $ ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident ( 1 $ HIRED X NON -OWNED AUTOS ONLY AUTOS ONLY X PROPERTVDAMAGE Per accident $ X UMBRELLA LIAB X OCCUR 9364-77-37 08/01/2022 08/01/2023 EACH OCCURRENCE $ 5,000,000 AGGREGATE $ 5,000,000 EXCESS LIAB CLAIM&MADE DID RETENTION$ $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY Y / N ANYPROPRIETORIPARTNERIEXECUTIVE OFFICEMMEMBEREXCLUDED? ❑N NIA 7176-36­85 08/0112023 X PER OTH- STATUTE ER E.L. EACH ACCIDENT $ 1,000,000 E.L. DISEASE - EA EMPLOYEE $ 1,000,000 (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE -POLICY LIMIT $ 1,000,000 B BANKERS PROF. LIAB. 8211-6261 06/30/2022 06/30/2023 $7,500.000 pi$12.500,000 C SIR$1,000,000 106758967 06/30/2022 06/3012023 $5,000,000 p/0$12,500,000 DESCRIPTION OF OPERATIONS / LOCATIONS I VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached If more space is required) City of Santa Ana are included as additional insured where required by written contract with respect to General Liability. Waiver of subrogation is applicable where required by written contract with respect to general liability and Workers Compensation. General abiliry insurance is primary and noncontributory over any existing insurance and limited to liability arising out of the operations of the named Insured subject to policy terms and conditions. City of Santa Ana Risk Management Division 20 Civic Center Plaza Santa Ana, CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. !E ©1988-2016 ACORD ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD Risk Management Division REVIEWED Is APPROVED BY. =1117�11iL' A+�:a Acau+�D �'. - Risk Management Specialist 01 AGENCY CUSTOMER ID: CN101976702 LOC#: Washington ,acoRo® ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY NAMED INSURED MARSH USA INC. MISSIONSOUARE RETIREMENT T77 NORTH CAPITOL ST., NE WASHINGTON, DC 20002 POLICY NUMBER CARRIER NAIC CODE EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: Certificate of Liability Insul 1ST EXCESS BANKERS PROFESSIONAL LIABILITY CARRIER: AXIS INSURANCE COMPANY POLICY: P-00"0012680403 EFFECTIVE 05/30/2022 EXPIRATION: 06f30/2023 LIMIT: $7,500,000 XS $12,500,000 2ND EXCESS BANKERS PROFESSIONAL LIABILITY CARRIER: ARCH INSURANCE COMPANY POLICY: IAX93000BM8 EFFECTIVE 061XV2022 EXPIRATION: 06/30/2023 LIMIT: $5,000,000 XS $20,000,000 3RD EXCESS BANKERS PROFESSIONAL LIABILITY PARTA CARRIER TWIN CITY FIRE INSURANCE CO (THE HARTFORD) POLICY: 10 DC 029908 22 EFFECTIVE: 06/302022 EXPIRATION: 06M2023 LIMIT: $5,000,000 P/O $10,000,000 XS $25.000,000 PART B CARRIER: BERKLEY INSURANCE COMPANY(BERKLEY) POLICY: BPRO8080943 EFFECTIVE 05130/2022 EXPIRATION: 06/302023 LIMIT: $5.000,000 PIO $10,000.000 XS $25,000,0M TOTAL LIMIT: $35,000,000 l�r REVIEWED&APPRPJm BY: 101 (2008/01) ©200B ACORD I 2(i A,4,fr;e Acavuf0 The ACORD name and logo are registered marks of ACORD 1i1NWRisk Management Speaaist CHUBB6 Liability Endorsement (continued) Under Conditions, the following provision is added to the condition titled Other insurance, Conditions Other Insurance — if you are obligated pursuant to a contract or agreement, to provide the person or organization Primary, Noncontributory shown in the Schedule with primary insurance such as is affordedby this policy, then in such case Insurance — Scheduled this insurance is primary and we will not seek contribution from insurance available to such person Person Or Organization or organization. Schedule Persons or organizations that you are obligated, pursuant to a contract or agreement, to provide with such insurance as is afforded by this policy. All other terms and conditions remain unchanged Authorized Representative \a < Liability Insurance Additional insured - Scheduled Person Or Organization Form 80-o2-2367(Rev. bu7) Endorsement „ a �'' p& RiskMwgemmtDMs1un .. Rt EWM&APMcum Br: A+•�:QA�u�uto Risk Management SpeaAln WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER For policies or exposure in Missouri: Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.) Endorsement Effective 08-01-21 Policy No. 71763685 Insured ICMA RETIREMENT CORPORATION Insurance Company Great Northern Insurance Company WC 00 03 13 (Ed. 4-84) a tgn National Council on Compensation Insurance. Countersigned By inwna Copy Endorsement No. Premium $ Incl . RialeMgnagenieettUloialon REwEwEo6 APPRovm Rr: A� Rc+Nesta Risk Management Spenalist WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY WC 00 03 13 (Ed. 4-84) WAIVER OF OUR RIGHT TO RECOVER FROM OTHERS ENDORSEMENT We have the right to recover our payments from anyone liable for an injury covered by this policy. We will not enforce our right against the person or organization named in the Schedule. (This agreement applies only to the extent that you perform work under a written contract that requires you to obtain this agreement from us.) This agreement shall not operate directly or indirectly to benefit anyone not named in the Schedule. Schedule ANY PERSON OR ORGANIZATION FOR WHOM THE NAMED INSURED HAS AGREED BY WRITTEN CONTRACT TO FURNISH THIS WAIVER For policies or exposure in Missouri: Any person or organization for which the employer has agreed by written contract, executed prior to loss, may execute a waiver of subrogation. However, for purposes of work performed by the employer in Missouri, this waiver of subrogation does not apply to any construction group of classifications as designated by the waiver of right to recover from others (subrogation) rule in our manual. This endorsement changes the policy to which it is attached and is effective on the date issued unless otherwise stated. (The information below is required only when this endorsement is issued subsequent to preparation of the policy.( Endorsement Effective08-01-21 Policy No.71763685 Endorsement No. Insured ICMA RETIREMENT CORPORATION Premium $ Incl. Insurance Company Great Northern Insurance Company Countersigned By WC 00 03 13 (Ed. 4-84) 0198314ational Council on Compensation Insurance. Risk ManaganmtDiviebn RE Ewm6 APPRO Or ® '. A+�ta Acevtda - Risk Management Spedalist C H U B B` General Liability Contract Please read the entire policy carefully. The terms and conditions of this insurance include the various sections of this contract: Coverages; Investigation, Defense And Settlements; Supplementary Payments; Coverage Territory; Who Is An Insured; limits of Insurance; Exclusions; Conditions; and Definitions, as well as the Declarations, Common Policy Conditions and any Endorsements and Schedules made apart of this insurance. 'throughout this contract the words "you" and "your' refer to the Named Insured shown in the Declarations and any other persons or organizations qualifying as a Named Insured under this contract. The words "we," "us" and "our" refer to the Company providing this insurance. In addition to the Named Insured, other persons or organizations may qualify as insureds. Those persons or organizations and the conditions under which they qualify are identified in the Who Is An Insured section of this contract. Words and phrases that appear in bold print have special meanings and are defined in the Definitions section of this contract. Coverages Bodily Injury And Subject to all of the terms and conditions of this insurance, we will pay damages that the Insured Property Damage becomes legally obligated to pay by reason of liability imposed by law or assumed in an insured Coverage contract for bodily injury or property damage caused by an occurrence to which this coverage applies. This coverage applies only to such bodily injury or property damagethat occurs during the policy period. This coverage includes bodily injury or property damage involving: • automated teller machines; • foreclosed property; • property in any trust, guardianship or estate for which you are acting in a fiduciary or representative capacity; and • property which you own and lease to others, when specific insurance, which would customarily protect your interest and which you require your lessees to carry, is non-existent, invalid, insufficient or uncollectible. Damages for bodily injury include damages claimed by a person or organization for care or loss of services resulting at any time from the bodily injury. Other than as provided under the Investigation, Defense And Settlements and Supplementary Payments sections of this contract, we have no other obligation or liability to pay sums or perform acts or services under this coverage. Advertising Injury Subject to all of the terms and conditions of this insurance, we will pay damages that the insured And Personal Injury becomes legally obligated to pay by reason of liability imposed by law or assumed in an insured Coverage contract for advertising injury or personal injury to which this coverage applies. This coverage applies only to such advertising injury or personal Injury caused by an offense that is first committed during the policy period. Lk&fily Insurance Form 17-02-3080(Rev. 401) Contract sa e, Ride Mwagenterdl)MsIon REVIEWED & APPR MRr A+.-fs A� �� auk Management Speaaxst Coverages Advertising Injury This coverage includes advertising injury or personal injury involving; And Personal Injury automated teller machines; Coverage (continued) foreclosed property; • property in any trust, guardianship or estate for which you are acting in a fiduciary or representative capacity; and • property which you own and lease to others, when specific insurance, which would customarily protect your interest and which you require your lessees to carry, is non-existent, invalid, insufficient oruncollectible. Other than as provided under the Investigation, Defense And Settlements and Supplementary Payments sections of this contract, we have no other obligation or liability to pay sums or perform acts or perform acts or services under this coverage. Medical Expenses Subject to all of the terms and conditions of this insurance, we will pay medical expenses for Coverage bodily injury caused by an accident to which this coverage applies: • that takes place on premises rented to or owned by you; or • in connection with your operations; provided that such; • accident occurs during the policy period; • expenses are incurred and reported to us within three (3) years of the date of the accident; and • person who sustained such bodily injury submits to examination, at our expense, by physicians of our choice as often as we reasonably require. We will make these payments regardless of fault. We have no other obligation or liability under this coverage. Investigation, Subject to all of the terms and conditions of this insurance, we will have the right and duty to Defense And defend any insured against a suit, even if such suit is false, fraudulent or groundless. Settlements If such a suit is brought, we will pay reasonable attorney fees and necessary litigation expenses to defend: • the hmured; and • if applicable, the indemoittee of the insured, provided the obligation to defend, or the cost of the defense of, such indemninee has been assumed by such insured in an insured contract. Such attorney fees and litigation expenses will be paid as described in the Supplementary Payments section of this contract. We have no duty to defend any person or organization against any suit seeking damages to which this insurance does not apply. LiabiTry Insurance Form 17-02-3080(Rev. 4011 Contract aEVIEwM & Amtmm Bv: A.-gu Acwrd• Risk Management Spetl 4ist C H U B B° General Liability Investigation, We may, al our discretion, investigate any occurrence or offense and settle any claim or salt Defense And Settlements Our duty to defend any person or organization ends when we have used up the applicable Limit Of (continued) Insurance. Supplementary Sub jest to all of the terms and conditions of this insurance, we will pay, with respect to a claim we Payments investigate or settle, or a suit against an insured we defend: A. the expenses we incur, B. the cost of: 1. bail bonds; or 2. bonds required to: a. appeal judgments; or b. release attachments; but only for bond amounts within the available Limit Of Insurance. We do not have to furnish these bonds. C. reasonable expenses incurred by the insured at our request to assist us in the investigation or defense of such claim or suit, including actual loss of eamings up to 1,000 a day because of time off from work. D, costs taxed against the Insured in the suit, except any: 1. attorney fees or litigation expenses; or 2. other loss, cost or expense; in connection with any injunction or other equitable relief. E. prejudgment interest awarded against the insured on that part of a judgment we pay. If we make an offer to pay the applicable Limit Of Insurance, we will not pay any prejudgment interest based on that period of time after the offer. F. interest on the full amount of a judgment that accrues after entry of the judgment and before we have paid, offered to pay or deposited in court the part of the judgment that is within the applicable Limit Of Insurance. Supplementary Payments does not include any fine or other penalty. These payments will not reduce the Limits Of Insurance. Our obligation to make these payments ends when we have used up the applicable Limit Of Insurance. Coverage Territory This insurance applies anywhere, provided the insureds responsibility to pay damages, to which this insurance applies, is determined in a suit on the merits brought in the United States of America (including Its possessions and territories), Canada or Puerto Rico, or in a settlement to which we agree. Liability Insurance Form 17-02-3080IRev. 4-01) contract RiekMmgmadnlvislan 4.101 RENEWED&APPRcvm BY: MINMEMP Risk Management specialist Who Is An Insured Sole Proprietorship If you are an individual, you and your spouse are insureds; but you and your spouse are insureds only with respect to the conduct of a business of which you are the sole owner. If you die: persons or organizations having proper temporary custody of your property are insureds; but they are Insureds only with respect to the maintenance or use of such property and only for acts until your legal representative has been appointed; and your legal representatives are insureds; but they are insureds only with respect to their duties as your legal representatives. Such legal representatives will assume your rights and duties under this insurance. Partnerships Or If you are a partnership (including a limited liability parnetship) or a joint venture, you are an Joint Ventures insured. Your members, your partners and their spouses are insureds; but they are insureds only with respect to the conduct of your business. Limited Liability If you are a limited liability company, you are an insured. Your members and their spouses are Companies insureds; but they are insureds only with respect to the conduct of your business. Your managers are insureds-, but they are insureds only with respect to their dunes as your managers. Other Organizations If you are an organization (including a professional corporation) other than a partnership, joint venture or limited liability company, you are an insured. Your directors and officers are insureds; but they are insureds only with respect to their duties as your directors or officers. Your stockholders and their spouses are insureds; but they are insureds only with respect to their liability as your stockholders. Employees Liability insurance Form 17-02-3080 (Rev. 4-01J Your employees are insureds; but they are insureds only for acts within the scope of their employment by you or while performing duties related to the conduct of your business. However, no employee is an bowed for. A. bodily injury, advertising injury or personal injury; 1, to you, to any of your directors, managers, members, officers or partners (whether or not an employee) or to any co -employee while such injured person is either in the course of his or her employment or while performing duties related to the conduct of your business, 2. to the brother, child, parent, sister or spouse of such injured person as a consequence of any injury described in subparagraph A.1. above; or 3. for which there is any obligation to share damages with or repay someone else who most pay damages because of any injury described in subparagraphs A.1, or A.2. above. With respect to bodily injury only, this limitation does not apply to: you or to your directors, managers, members, officers, partners or supervisors as Insureds; or Risk MnugewuwADMs1an A-f' Am44 �. Risk Management SpeaAut C H U B B( General Liability Who Is An Insured Employees your employees, as hrsareds, with respect to such damages caused by cardio- (continued) pulmonary resuscitation or first aid services administered by such employee. B, property damage to any property owned, occupied or used by you or by any of your directors, managers, members, officers or partners (whether or not an employee) or by any of your employees. Ibis limitation does not apply to property damage to premises while rented to you or temporarily occupied by you with permission of the owner. Volunteers Persons who are volunteer workers for you are twar, eds; but they are insureds only for acts within the scope of their activities for you and at your direction. Real Estate Managers Persons (other than your employees) or organizations acting as your real estate managers are insureds; but they are insureds only with respect to their duties as your real estate managers. Permissive Users Of With respect to mobile equipment registered in your name under a motor vehicle registration law: Mobile Equipment A. persons driving such equipment on a public mad with your permission are insureds; and B. persons or organizations responsible for the conduct of such persons described in subparagraph A. above are insureds; but they are insureds only with respect to the operation of the equipment and only if no other insurance of any kind is available to them However, no person or organization is an insured with respect to: • bodily injury to any c"mployee of the person driving the equipment; or • property damage to any property owned or occupied by or loaned or rented to you, or in your charge or the charge of the employer of any person who is an insured under this provision. Vendors Persons or organizations who are vendors of your products are insureds; but they are insureds only with respect to their liability for damages for bodily injury or property damage resulting from the distribution or sale of your products in the regular course of their business and only if this insurance applies to the products -completed operations hazard. However, no such person or organization is an insured with respect to any: • assumption of liability by them in acontract or agreement. This limitation does not apply to the liability for damages for bodily injury or property damage that such vendor would have in the absence of such contract or agreement; • representation or warranty unauthorized by you; • physical or chemical change in your products made intentionally by the vendor; • repackaging, unless unpacked solely for the purpose of inspection, demonstration or testing, or the substitution of parts under instruction from the manufacturer and then repacked in the original container, UtWfity Insurance Form 17-02-3080(Rev. 401J Contract R!skMvwgmadDMs1on REVIEWED&APPROV®liv: c®' A, fg A6w44 Ruk Management SpeaNst Who Is An Insured Vendors failure to make such inspections, adjustments, tests or servicing as the vendor has agreed to (continued) make or normally undertakes to make in the usual course of business in connection with the distribution or sale of your products; demonstration, installation, servicing or repair operations, except such operations performed at the vendors premises in connection with the sale of your products; or • of your products which, after distribution or We by you, have been labeled or relabeled or used as a container, ingredient or part of any other thing or substance by or for the vendor. Further, no person or organization from whom you have acquired your products, or any container, ingredient or pan entering into, accompanying or containing your products, is an Insured under this provision. Lessors Of Equipment Persons or organizations from whom you lease equipment are insureds; but they are insureds only with respect to the maintenance or use by you of such equipment and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an insured with respect to any: • damages arising out of their sole negligence; or • occurrence that occurs, or offense that is committed, after the equipment lease ends. Lessors Of Premises Persons or organizations from whom you lease premises are insureds; but they are insureds only with respect to the ownership, maintenance or use of that particular part of such premises leased to you and only if you are contractually obligated to provide them with such insurance as is afforded by this contract. However, no such person or organization is an insured with respect to any: • damages arising out of their sole negligence; • occurrence that occurs, or offense that is committed, after you cease to be a tenant in the premises; or • structural alteration, new construction or demolition operations performed by or on behalf of them Subsidiary Or Newly If there is no other insurance available, the following organizations will qualify as named insureds: Acquired Or Formed a subsidiary organization of the first named insured shown in the Declarations of which, at Organizations the beginning of the policy period and at the time of loss, such first named insured controls, either directly or indirectly, more than fifty (50) percent of the interests entitled to vote generally in the election of the governing body of such organization; or • a subsidiary organization of the fast named inured shown in the Declarations that such first named insured acquires or forms during the policy period if at the time of loss such first named insured controls, either directly or indirectly, more than fifty (50) percent of the interests entitled to vote generally in the election of the governing body of such organization. Liabirlty insurance Form 17.02-3080 (Rev. 4-01) Contract �. RickMn agane f DMs1on RE+ne7/Eo&Armov®Br. - Ruk Management SpedXis[ C H U B B` General Liability Who Is An Insured (continued) Limitations On Who A. Except to the extent provided under the Subsidiary Or Newly Acquired Or Formed Is An Insured Organizations provision above, no person or organization is an insured with respect to the conduct of any person or organization that is not shown as a named insured in the Declarations. B. No person or organization is an insured with respect to the: 1. ownership, maintenance or use of any assets; or 2. conduct of any person or organization whose assets, business or organization; you acquire, either directly or indirectly, for any: • bodily injury or property damage that occurred; or • advertising injury or personal injury arising out of an offense first committed; in whole or in par, before you, directly or indirectly, acquired such assets, business or organization. Limits Of Insurance The Limits Of Insurance shown in the Declarations and the rates below fix the most we will pay, regardless of the number of • insureds, • claims made or suits brought; or • persons or organizations making claims or bringing suits. The Limits Of Insurance apply separately to each consecutive annual period and to any remaining period of less than twelve (12) months, starting with the beginning of the policy period shown in the Declarations, unless the policy period is extended after issuance for an additional period of less than twelve (12) months. In that case, the additional period will be deemed part of the last preceding period for purposes of determining the Limits Of Insurance. General Aggregate Limit Products -Completed Operations Aggregate Limit Insurance Form Subject to the Each Occurrence Limit, the General Aggregate Limit is the most we will pay for the sum of: • damages for bodily injury and property damage, except damages included in the products -completed operations hazard; and medical expenm. Subject to the Each Occurrence Limit, the products -Completed Operations Aggregate Limit is the most we will pay for the sum of damages for bodily injury and property damage included in the products -completed operations hazard. p Ram e �' RA Management Spedaast Limits Of Insurance (continued) Advertising lnjury And The Advertising Injury And Personal Injury Aggregate Limit is the most we will pay for the sum of Personal Injury damages for advertising injury and personal injury. Aggregate Limit Each Occurrence Limit The Each Occurrence Limit is the most we will pay for the sum of: • damages for hadgy injury and property damage; and • medical expenses; arising out of any one occurrence. Any amount paid for damages or medical expenses will reduce the amount of the applicable aggregate limit available for any other payment If the applicable aggregate limit has been reduced to an amount that is less than the Each Occurrence Limit, the remaining amount of such aggregate limit is the most that will be available for any other payment. Damage To Premises Subject to the Each Occurrence Limit, the Damage To Premises Rented To You Limit is the most Rented To You Limit we will pay for the sum of damages for property damage to any one premises while rented to you or temporarily occupied by you with permission of the owner. Medical Expenses Limit Subject to the Each Occurrence Limit, the Medical Expenses Limit is the most we will pay for the sum of medical expenses, under Medical Expenses coverage, for bodily injury sustained by any one person. Bodily Injury/Property None of the following exclusions, except "Contracts", "Expected or Intended Injury" and "Loss In Damage Exclusions Progress", apply to property damage to premises while rented to you or temporarily occupied by you with permission of the owner. Aircraft, Autos Or This insurance does not apply to bodily injury or property damage arising out of the ownership, Watercraft maintenance, use (use includes operation andloading or unloading) or entrustment to others of any: aircraft; • auto; or • watercraft; owned or operated by or loaned or rented to any insured. This exclusion does not apply to: A. a watercraft while ashore on premises owned by or rented to you; B. a watercraft you do not own, provided that it: I. is less than fifty-five (55) feet long; and 2. does not transport persons or cargo for a charge; Liability Insurance Form 17-02-3080 (Rev. +01) Contract �n•.g ,� n 1tld Muogemmtixvidwt AenEwEosnrraav®sr: 4,gu A Risk Management SpenAist C H U B B` General Liability Bodily Injury/property Damage Exclusions Aircraft, Autos Or C. the parking of an auto on premises owned by or rented to you, provided the autos not Watercraft owned by or loaned or rented to you or the insured (continued) D. the liability for damages assumed in an insured contract resulting from the ownership, maintenance or use, by others, of an aircraft or watercraft; E. the operation of the equipment described in subparagraphs F.2. or F.3. of the definition of mobile equipment; or F. an aircraft you do not own, provided that: l . the pilot in commend holds a currently effective certificate, issued by the duly constituted authority of the United States of America or Canada, designating that person as a commercial or airline transport pilot; 2, it is rented with a trained, paid crew; and 3. it does not transport persons or cargo for a charge. Alcoholic Beverage Type Businesses Contracts Damage To Alienated Premises Liability Insurance Form 17-02-3080(Rev. 4-01J This insurance does not apply to bodily injury or property damage for which any insured may be held liable by reason of: causing or contributing to the intoxication of any person; • famishing alcoholic beverages to a person under the legal drinking age or under the influence of alcohol; or • any statute, ordinance or regulation relating to the sale, gift, distribution or use of alcoholic beverages. This exclusion applies only if you are in the business of manufacturing, distributing, selling, serving or furnishing alcoholic beverages. This insurance does not apply to bodily injury or property damage for which the insured is obligated to pay damages by reason of assumption of liability in a contract or agreement. This exclusion does not apply to the liability for damages: • that such insured would have in the absence of such contract or agreement; or assumed in an oral or written contract or agreement that is an insured contract, provided the bodily injury or property damage, to which this insurance applies, occurs after the execution of such contract or agreement. This insurance does not apply to property damage to any premises you sell, give away or abandon, if the property damage arises out of any part of those premises. This exclusion does not apply if the premises are your work and were never occupied rented or held for rental by you. RiskMmugomadDMElm e "�q REMFWm&APPROV®BY: Allp A 91IMMM Risk Management Specialist (continued) Damage To Impaired Property Or Property Not Physically Injured Damage To Owned Property Damage To Various Property Of Others (Care, Control Or Custody) Damage To Your Product This insurance does not apply to property damage to: impaired property; or property that has not been physically injured; arising out of any: defect, deficiency, inadequacy or dangerous condition in your product or your work; or delay or failure by you or anyone acting on your behalf to perform a contract or agreement in accordance with its terms and conditions. This exclusion does not apply to the loss of use of other tangible property resulting from sudden and accidental physical injury to your product or your work after it has been put to its intended use. This insurance does not apply to property damage to any property owned by you. This insurance does not apply to property damage to any: • personal property loaned or rented to you; • property held by you or on your behalf for sale or entrusted to you for safekeeping or storage; • property on your premises for purposes of performing operations on such property by you or on your behalf-, • tools or equipment used by you or on your behalf in performing operations; or • property in your care, control or custody that will be erected, installed or used in construction operations by you or on your behalf. This exclusion does not apply to the liability for damages assumed in a sidetrack agreement. This insurance does not apply to property damage to your product arising out of it or any part of it. Damage To Your Work This insurance does not apply to property damage to your work arising out of it or any pan of it and included in the products -completed operations hazard. This exclusion does not apply if the damaged work or the work causing the damage was performed on your behalf by a subcontractor. Employer's Liability A. This insurance does not apply to bodily injury to an employee of the Insured arising out of and in the course of. 1. employment by the insured; or 2. performing duties related to the conduct of the insured's business. Liability Insurance Form 17-02-3080(Rev. 401l contract ��e RiakMnvgementDiuisian -" REwEwm &APPROVED BY: a, a A+ uAcWaa ® Risk Managemen[Spedatkt CHUBS, General Liability Bodily Injury/Property Damage Exclusions Employer's Liability B. This insurance does not apply to bodily injury to the brother, child, parent, sister or spouse (continued) of such employee as a consequence of any injury described in paragraph A. above. This exclusion applies: • whether the insured may be liable as an employer or in any other capacity; and • to any obligation to share damages with or repay someone else who most pay damages because of any injury described in paragraphs A. or B. above. This exclusion does not apply to the liability for damages assumed by the insured in an insured contract. Expected Or Intended 'Ills insurance does not apply to bodily injury or property damage arising out of an act that Injury is intended by the insured; or • would be expected from the standpoint of a reasonable person in the circumstances of the insured; to cause bodily injury or property damage, even if the actual bodily injury or property damage is of a different degree or type than intended or expected. This exclusion does not apply to bodily injury or property damage resulting from the use of reasonable force to protect persons or tangible property. Loss In Progress This insurance does not apply to bodily injury or properly damage that is a change, condonation or resumption of any bodily injury or property damage known by you, prior to the beginning of the policy period, to have occurred Bodily injury or property damage will be deemed to be known to you: A. if such injury or damage is known by, or should have been known from the standpoint of a reasonable person in the circumstances of 1. you; 2. any of your directors, managers, members, officers (or their designees) or partners (whether or not an employee); and B. when any person described in paragraph A. above: 1. reports all, or any pan, of any such injury or damage to us or any other insurer; 2. receives a claim or a demand for damages because of any such injury or damage; or 3. becomes aware that any such injury or damage has occurred or has begun to occur. Mobile Equipment 'Phis insurance does not apply to bodily injury or property damage arising out of the Transportation transportation of mobile equipment by an auto owned or operated by or loaned or rented to any insured. VabiRy Insurance Form 17.02-2090 (Rev. 4-01 J Contract _� •=a Risk MwagementDiWIon RfiFMfi &APPROVm BY: A+�fkwrfo RIEW' Risk Management5pedrist Personal In Exclusions Breach Of Contract This insurance does not apply to advertising injury or personal injury arising out of breach of contract. Continuing Offenses This insurance does not apply to advertising injury or personal injury that arises out of that part of an offense that continues or resumes alter the later of the end of the policy period of: A. this insurance; or B. a subsequent, continuous renewal or replacement of this insurance, that: 1. is issued to you by us or by an affiliate of ours; 2. remains in force while the offense continues; and 3. would otherwise apply to advertising injury and personal injury. Contracts This insurance does not apply to advertising injury or personal injury for which the insured is obligated to pay damages by reason of assumption of liability in a contract or agreement. This exclusion does not apply to the liability for damages: • that such inured would have in the absence of such contract or agreement; or • assumed in a written contract or agreement that is an insured contract provided the advertising injury or personal injury, to which this insurance applies, is caused by an offense lust committed after the execution of such contract or agreement. Crime Or Fraud This insurance does not apply to advertising injury or personal injury arising outer any criminal or fraudulent conduct committed by or with the consent or knowledge of the insured. Expected Or This insurance does not apply to advertising injury or personal injury arising out of an offense, Intended Injury committed by or on behalf of the Insured, that: • is intended by such insured; or • would be expected from the standpoint of a reasonable person in the circumstances of such Inured; to cause injury, . Failure To Conform To This insurance does not apply to advertising injury or personal injury arising out of the failure of Representations Or goods, products or services to conform with any electronic, oral, written or other representation or Warranties warranty of durability, fitness, performance, quality or use. LinUffly Insurance Form 17-02-3080(Rev. 4-01) Contract ,r,� ',.,�{ RideMnssganmtDMsfun e rt A, fa Acweda . '® Rnk Management Specialist C H U B B` General Liability Advertising Injury/ Personal Injury Exclusions (continued) Internet Activities 'ibis insurance does not apply to advertising injury or personal injury arising out of: • controlling, creating, designing or developing, of another's Intcmct site: controlling, creating, designing, developing, determining or providing the content or material of another's Internet site; controlling, facilitating or providing, or failing to control, facilitate or provide, access to the Internet or another's Internet site; or publication of content or material on or from the Internet, other than content or material developed by you or at your direction, Media Type Businesses This insurance does not apply to advertising injury or personal injury arising out of an offense committed by or on behalf of an insured whose business is advertising, broadcasting, cablecasting, publishing, telecasting or telemarketing. This exclusion does not apply to personal injury caused by an offense described in subparagraphs A., B. or C. of the definition of personal injury. Prior Offenses This insurance does not apply to advertising injury or personal injury arising outof any offense first committed before the beginning of the policy period Publications With This insurance does not apply to advertising injury or personal injury arising out of any Knowledge Of Falsity electronic, oral, written or other publication of content or material by or with the consent of the Insured: • with knowledge of its falsity, or if a reasonable person in the circumstances of such insured would have known such content or material to be false. Wrong Description Of This insurance does not apply to advertising injury or personal injury arising out of the wrong Prices description of the price of goods, products or services. Medical Expenses Exclusions Athletic Activities This insurance does not apply to medical expenses arising out of bodily injury to any person injured while taking pan in athletics. Uabifity Insurance Form 17-p2-3030(Rev. 401) Contract WekMou mtadDMelan 4 ... Y. REVIEWED&APPRD Sr Risk Management Spedalist Of 41-MIM Medical Expenses Exclusions (continued) Injury To Insureds This insurance does not apply to medical expenses arising out of bodily injury to any insured, except a volunteer worker. Nuclear Enerqy This insurance does not apply to medical expenses arising out of bodily injury in any way related to the: • nuclear hazardous properties of nuclear material; and • operation of a nuclear facility by any person or organization. Products -Completed This insurance does not apply to medical expenses arising out of bodily injury included in the Operations Hazard products -completed operations hazard. Workers' Compensation This insurance does not apply to medical expenses arising out of bodily injury to any person. Or Similar Laws whether or not an employee of any insured, if benefits for such bodily injury are payable or must be provided under any workers' compensation, disability benefits or unemployment compensation law or any similar law. Policy Exclusions Asbestos A. 11iis insurance does not apply to bodily injury, property damage, advertising injury or personal injury arising out of the actual, alleged or threatened contaminative, pathogenic, toxic or other hazardous properties of asbestos. & This insurance does not apply to any loss, cost or expense arising out of any: request, demand, order or regulatory or statutory requirement that any insured or others test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of asbestos; or claim or proceeding by or on behalf of a governmental authority or others for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of asbestos. Employment -Related A. This insurance does not apply to any damages sustained at any time by any person, whether Practices or not sustained in the course of employment by any insured, arising out of any employment -related act, omission, policy, practice or representation directed at such person, occurring in whole or in part at any time, including any: 1. arrest, detention or imprisonment; 2. breach of any express or implied covenant; 3. coercion, criticism, humiliation, prosecution or retaliation; 4. defamation or disparagement; Liability Insurance Form 17-02-3080 (Rev. 4-01) Contract RiAMamgemmtDiriSIM ;�ji,.i_, tf fr�neueo&Avazov®Br. �' A4 fi AC444 Risk Management Specialist CHUE3B` Policy Exclusions General Liability Employment -Related 5, demotion, discipline, evaluation or reassignment; Practices 6. discrimination, harassment or segregation; (continued) 7, a. eviction; or b, invasion or other violation of any right of occupancy; S. failure or refusal to advance, compensate, employ or promote; 9. invasion or other violation of any right of privacy or publicity; 10. termination of employment; or 11. other employment -related act, omission, policy, practice, representation or relationship in connection with any insured at any time. B. 'lhix insurance does not apply to any damages sustained at any time by the brother, child, parent, sister or spouse of such person at whom any employment -related act, omission, policy, practice or representation is directed, as described in paragraph A. above, as a consequence thereof. This exclusion applies: • whether the insured may be liable as an employer or in any other capacity; and • to any obligation to share damages with or repay someone else who must pay damages because of any of the foregoing. Enhancement, This insurance does not apply to any loss, cost or expense incurred by you or others for any: Maintenance Or A. enhancement or maintenance of any property; or Prevention Expenses B. prevention of any injury or damage to any: 1. person or organization; or 2. property you own, rent or occupy. Financial Instruments This insurance does not apply to loss of use of financial instrumenu that have not been physically injured. Insurance And Related This insurance does not apply to bodily injury, property damage, advertift injury, or Operations personal injury arising out of, or directly or indirectly related to: A. any obligation assumed by any insured or the failure to discharge, or the improper discharge of, any obligation or duty, contractual or otherwise, with respect to any: 1. contract or treaty of insurance, self-insurance, reinsurance or suretyship; 2. annuity; 3. endowment; or 4. benefit plan, including any applications, endorsements, amendments, receipts, or binders; Liability Insurance Form 17-02-3080 4-01J Contract Fl--�A ll 444 Risk Management SpeoAht Policy Exclusions Insurance And Related Il. membership or participation in, contribution to, or management of any plan, pool, Operations association, insolvency or guarantee fund or any other similar fund, organization or (continued) association, whether voluntary or involuutary; or C. advising, reporting or making reconineendations, or the failure to do any of the foregoing, in the insureds capacity as an insurance company, insurance broker or agent, insurance consultant or insurance representative. Intellectual Property This insurance does not apply to any actual or allegedbodily injury, property damage, Laws Or Rights advertising injury or personal injury arising out of, giving rise to or in any way related to any actual or alleged: • assertion; or • infringement or violation; by any person or organization C'mduding any insured) of any Intellectual property law or right regardless of whether this insurance would otherwise apply to all or part of any such actual or alleged injury or damage in the absence of any such actual or alleged assertion, infringement or violation. This exclusion applies, unless such injury: • is caused by an offense described in the definition of advertising injury; and • does not arise out of, give rise to or in any way relate to any actual or alleged assertion, infringement or violation of any intellectual property law or right other than one described in the definition oradvertising injury. Nuclear Energy A. This insurance does not apply to bodily injury, nuclear property damage, advertising injury or personal injury: 1. with respect to which any insured under this policy also has status as an insured under a nuclear energy liability policy issued by Nuclear Energy Liability Insurance Association, Mutual Atomic Energy Liability Underwriters, Nuclear Insurance Association of Canada or any of their successors, or would have had status as an , insured under any such policy but for its termination upon exhaustion of its limit of insurance; or 2. arising out of the nuclear hazardous properties of nuclear material and with respect to which: a. any person or organization is required to maintain financial protection pursuant to the United States of America Atomic Energy Act of 1954, or any law amendatory thereof; or b. the Insured is, or had this policy not been issued would be, entitled to indemnity from the United States of America, or any agency thereof, under any agreement entered into by the United States of America, or any agency thereof, with any person or organization. R. This insurance does not apply to bodily injury, nuclear property damage, advertising injury or personal injury arising out of the nuclear hazardous properties of nuclear material: Rt EwEo&MPa Br. Alf "41 Ruk Management Specialist C H U B B° General Liability Policy Exclusions Nuclear Energy 1. if the nuclear material: (continued) a. is at any nuclear facility owned by, or operated by or on behalf of, any insured; b. has been discharged or dLspersed therefrom; or C. is contained in nuclear spent fuel or nuclear waste at any time transported handled, stored, disposed of, processed treated possessed or used by or on behalf of any insured; or 2. in any way related to the furnishing by any insured of services, materials, parts or equipment in connection with the planning, construction, maintenance, operation or use of any unclear facility. But if such facility is located within the United States of America (including its possessions or territories) or Canada, this subparagraph 2. applies only to nuclear property damage to such nuclear facility and any property thereat. Pollution A. This insurance does not apply to bodily injury, property damage, advertising injury or personal injury arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of pollutants: 1. at or from arty premises, site or location which is or was at any time owned or occupied by, or loaned or rented to, any insured; 2. at or from any premises, site or location to which any insured has perfected their right to possession, or which was at any time acquired by foreclosure, repossession or deed in lieu of foreclosure by any insured; 3, at or from any premises in any trust, guardianship or estate for which any insured is currently, or did act in a fiduciary or representative capacity; 4. at or from any premises, site or location which is or was at any time used by or for any insured or others for the handling, storage, disposal, processing or treatment of waste; 5. which are or were at any time transported, handled stored disposed of, processed or created as waste by or for any: a. insured; or b. person or organization for whom any insured may be legally responsible; or 6. at or from any premises, site or location on which any insured or any contractor or subcontractor working directly or indirectly on any insured's behalf is performing operations, if the: a. pollutants are brought on or to the premises, site or location in connection with such operations by such insured, contractor or subcontractor; or b. operations areto test for, monitor, clean up, remove, contain, neat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants. -�'kkt aEwEu+eo&nraaav®ar. Risk Management Specialist Policy Exclusions Pollution Subparagraph A.6.a. above does not apply to bodily injury or property damage caused by (oontlnusd) the escape of fuels, lubricants or other operating fluids which are needed to perform the normal electrical, hydraulicormechanical functions necessary for the operation of mobile equipment or its parts, if such operating fluids escape directly from that particular pan of such mobile equipmeutdesigned by its manufacturer to hold, store or receive them. But, this exception does not apply if such bodily injury or property damage arises out of any discharge, dispersal, seepage, migration, release or escape of pollutants, that: • was intended by the insured; • would have been expected from the standpoint of a reasonable person in the circumstances of the insured; • was a necessary part of operations performed by any insured, contractor or subcontractor; or • occurred during the process of fueling the mobile equipment or changing or replenishing any operating fluid. Subparagraph A.6.a. above does not apply to bodily injury or property damage if sustained within a building and caused by the release of gaseous irritants or contaminants from materials brought into that building, in connection with the operations being performed by you or on your behalf by the contractor or subcontractor. Subparagraph A.1. above does not apply to bodily injury if sustained within a building and caused by the escape of gaseous irritants or contaminants from equipment used to heat that building. Subparagraphs A.1. and A.6.a. above do not apply to bodily injury or property damage caused by heat, smoke or fumes from ahostile fire. B. This insurance does not apply to any loss, cost or expense arising out of any: 1. request, demand, order or regulatory or statutory requirement that any insured or other: test for, monitor, clean up, remove, contain, treat, detoxify or neutralize, or in any way respond to, or assess the effects of pollutants, or 2. claim or proceeding by or on behalf of a governmental authority or others for damages because of testing for, monitoring, cleaning up, removing, containing, treating, detoxifying or neutralizing, or in any way responding to, or assessing the effects of pollutants. Paragraph B. above does not apply to the liability for damages, for property damage, that the insured would have in the absence of such request, demand, order or regulatory or statutory requirement, or such claim or proceeding by or on behalf of a governmental authority. 'this exclusion does not apply to the liability for damages, for property damage, to premises while rented to you or temporarily occupied by you with permission of the owner and caused by a hostile fire, explosion, smoke or leakage from fire protective equipment. This exclusion applies regardless of whether or not the pollution was accidental, expected, gradual, intended, preventable or sudden. tiaWty Insurance Form 17-02-3080(Rev. 4-01) Contract r=a.,�g liieleManagemmtl7irisfun RimEwEn6APmovm RY: A4f" "44 �' RM Management SpedAmt CHUBB` Policy Exclusions (continued) General Liability Recall Of Products, Work Ibis insurance does not apply to any damages claimed for any loss, cost or expense incurred by you Or Impaired Property or others for the loss of use, withdrawal, recall, inspection, repair, replacement, adjustment, removal or disposal of: your product; your work; or impaired property; if such product, work or property is withdrawn or recalled from the market or from use by any person or organization because of a known or suspected defect, deficiency, inadequacy or dangerous condition in it. Workers' Compensation This insurance does not apply to any obligation of the insured under any workers compensation, Or Similar Laws disability benefits or unemployment compensation law or any similar law. Conditions Arbitration We are entitled to exercise all of the insured's rights in the choice of arbitrators and in the conduct of any arbitration proceeding, except when the proceeding is between us and the inured. Bankruptcy Bankruptcy or insolvency of the inured or of the insureds estate will not relieve us of our obligations under this insurance. Disclosures And We have issued this insurance: Representations based upon representations you made to us; and • in reliance upon your representations. Unintentional failure of an employee of the insured to disclose a hazard or other material information will not violate this condition, unless an officer (whetter or not an employee) of any insured or an officer's designee knows about such hazard or other material information. Duties In The Event Of A. You must see to it that we and any other insurers are notified as soon as practicable of any Occurrence, Offense, occurrence or offense that may result in a claim, if the claim may involve as or such other Claim Or Suit insurers. To the extent possible, notice should include: 1. how, when and where the occurrence or offense happened; 2. the names and addresses of any injured persons and witnesses; and 3. the nature and location of any in jury or damage arising out of the occurrence or Offense. LkWlty Insurance Contract �raov®er. RenEWEo && A� Risk Management Specialist Conditions Duties In The Event Of B. if a claim is made or suit is brought against any insured you must: Occurrence, Offense, Claim Or suit 1. immediately record the specifics of the claim or suit and the date received; (continued) 2. notify us and other insurers as soon as practicable; and 3. see to it that we receive written notice of the claim or suit as soon as practicable. C. You and any other involved insured must: L immediately send us copies of any demands, notices, summonses or legal papers received in connection with the claim or Snit; 2, authorize us to obtain records and other information; 3, cooperate with us and other insurers in the: a. investigation or settlement of the claim; or b. defense against the suit-, and 4. assist us, upon our request, in the enforcement of any right against any person or organization that may be liable to the insured because of loss to which this insurance may also apply. D. No insureds will, except at that insured's own cost, [Hake any payment, assume any obligation or incur any expense, other than for first aid, without our consent. L. Notice given by or on behalf of: 1, the insured; 2. the injured person; or 3. any other claimant; to a licensed agent of ours with particulars sufficient to identify the insured shall be deemed notice to us. F. Knowledge of an occurrence or offense by an agent or employee of the insured will not constitute knowledge by the insured, unless an officer (whether or not an employee) of any insured or an officers designee knows about such occurrence or offense. G. Failure of an agent or employee of the insured, other than an officer (whether or not an employee) of any insured or an officer's designee, to notify us of an occurrence or offense that such person knows about will not affect the insurance afforded to you. 11. If a claim or loss does not reasonably appear to involve this insurance, but it later develops into a claim or loss to which this insurance applies, the failure to report it to us will not violate this condition, provided the insured gives us immediate notice as soon as the insured is aware that this insurance may apply to such claim or loss. Legal Action Against Us No person or organization has a right under this insurance to: join us as a party or otherwise bring us into a suit seeking damages from an insured; or sue us on this insurance unless all of the terms and conditions of this insurance have been fully complied with. mae m�agemo¢ UMM tnaafBnCe R7 EwED&APPRovmft, 1-02-3080 (Rev. 4-01) Contract e :, Afl aLV ��=Risk Management SpedXst C H U BB' General Liability Conditions Legal Action Against Us A person or organization may sue us to recover on an agreed settlement or on a final judgment (continued) against an h=red obtained after an actual: • trial in a civil proceeding; or • arbitration or other alternative dispute resolution proceeding; but we will not be liable for damages that are not payable under the terms and conditions of this insurance or that are in excess of the applicable Limits Of Insurance. Other Insurance If other valid and collectible insurance is available to the ho red for loss we would otherwise cover under this insurance, our obligations are limited as follows. Primary Insurance This insurance is primary except when the Excess Insurance provision described below applies, If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will stare with all that other insurance by the method described in the Method of Sharing provision described below. Excess Insurance This insurance is excess over any other insurance, whether primary, excess, contingent or on any other basis: A. that is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar insurance for your work; B. that is insurance that applies to property damage to premises rented to you or temporarily occupied by you with permission of the owner, C. if the loss arises out of aircraft, autos or watercraft (to the extent not subject to the Aircraft, Autos Or Watercraft exclusion); D. that is insurance: provided to you by any person or organization working under contract or agreement for you; or 2. under which you are included as an insured; or E. that is insurance under any Properly section of this policy. When this insurance is excess, we will have no duty to defend the insured against any suit if any other lower has a duty to defend such insured against such suit If no other insurer defends, we will undertake to do so, but we will be entitled to the insured's rights against all those other insurers. When this insurance is excess over other insurance, we will pay only our share of the amount of loss, if any, that exceeds the sum of the total: • amount that all other insurance would pay for loss in the absence of this insurance; and of all deductible and self -insured amounts under all other insurance. Liability Insurance .�AA ,w.v-------. a+( IIN REMEwED&APPR Mft. ' . `"'�;a A41u Ate, Form 17-02-3080 (Rev. 4-01) Contract _gmlw=—. Ruk Management Specialist Conditions Other Insurance We will share the remaining loss, if any, with any other insurance that is not described in this (continued) Excess Insurance provision and was not negotiated specifically to apply in excess of the Limits Of Insurance shown in the Declarations of this insurance. Method of Sharing If all of the other Insurance permits contribution by equal shares, we will follow this method also. Under this method each insurer contributes equal amounts until it has paid its applicable limits of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limits of insurance to the total applicable limits of insurance of all insurers. Premium Audif We will compute all premiums for this insurance in accordance with our rules and rates. In accordance with the Estimated Premiums section of the Premium Summary, premiums shown with an asterisk (*) are estimated premiums and are subject to audit. In addition to or in lieu of such designation in the Premium Summary, premiums may be designated as estimated premiums elsewhere in this policy. In that case, these premiums will also be subject to audit, and the second paragraph of the Estimated Premiums section of the Premium Summary will apply. Separation Of Insureds Except with respect to the Limits Of Insurance, and any rights or dudes specifically assigned in this insurance to the first named insured, this insurance applies: • as if each named insured were the only named insured; and • separately to each insured against whom claim is trade or suit is brought. Transfer Or Waiver Of We will waive the right of recovery we would otherwise have had against another person or Rights Of Recovery organization, for loss to which this insurance applies, provided the insured has waived their rights Against Others of recovery against such person or organization in a contract or agreement that is executed before such loss. To the extent that the insureds rights to recover all or pan of any payment made under this insurance have not been waived, those rights are transferred to us. The insured must do nothing after loss to impair them At our request, the insured will bring suit or transfer those rights to us and help us enforce them. This condition does not apply to medical expenses. Insurance 17-02-3080(Rev. 4-01) Contract RE,Aew & APPRovED Sr A,.gu Aoeautc Risk Management Speaetist C H U BB' General Liability Definitions WHEN USED WITH RESPECT TO INSURANCE UNDER THIS CONTRACT, WORDS AND PHRASES THAT APPEAR IN BOLD PRINT HAVE THE SPECIAL MEANINGS DESCRIBED BELOW; Advertisement Advertisement Mans an electronic, oral, written or other notice, about goods, products or services, designed for the specific purpose of attracting the general public or a specific market segment to use such goods, products or services. Advertisement does not include any e-mail address, Internet domain name or other electronic address or metalanguage. Advertising Injury Advertising injury menus injury, other thanboddy injury,property damage orpersonal injury, sustained by a person or organization and caused by an offense of infringing, in that particular part of your advertisement about your goods, products or services, upon their: • copyrighted advertisement; or • registered collective mark, registered service mark or other registered trademarked name, slogan, symbol or title. Agreed Settlement Agreed settlement means a settlement and release of liability signed by us, the imiaed and the claimant or the claimant's legal representative. Asbestos Asbestos means asbestos in any form, including its presence or use in any alloy, by-product or other material or waste. Waste includes material to be recycled, reconditioned or reclaimed. Auto Auto means a land motor vehicle, trailer or semi -trailer designed for travel on public roads, including any attached machinery or equipment. But auto does not include mobile equipment Bodily Injury Bodily injury means physical: • injury; • sickness; or • disease; sustained by a person, including resulting death, humiliation, mental anguish, mental injury or shock at any time. All such loss shall be deemed to occur at the time of the physical injury, sickness or disease that caused it. Customer Customer means a person, corporation, partnership or other entity which: • is applying for, or requesting, your products or services; • has applied for, or has requested, your products or services; • is presently using your products or services; or • has used your products or services, Liability Insurance Form 17-02-3080(Rev. 4-01J contract R AMuiage nadDMelan =+.\� REVIEWED&APPKD By: A+.�:e Auvufo Ruk Management Specialist Definitions WHEN USED WITH RESPECT TO INSURANCE UNDER THIS CONTRACT, WORDS AND PHRASES THAT APPEAR IN BOLD PRINT HAVE THE SPECIAL MEANINGS DESCRIBED BELOW: Customer and who makes a claim or brings a suit which arises out of, or is directly or indirectly related to, {continued) any of the above. Employee Employee includes a leased worker. Employee does not include a temporary worker. Financial Instruments Financial Instruments means: • currency, coins, bank notes, and bullion: • travelers checks, registered checks, food stamps, and money orders held for sale to the public: • all negotiable and non-negotiable instruments or contracts that represent either money or other property held by you in any capacity; • revenue and other stamps in current use, tickets and tokens; • property of others that you hold as a pledge or as collateral for a loan; • commodities, jewelry, precious and semi-precious stones and precious metals in any form; • insurance policies; and • certificates of origin or title, deeds, mortgages and abstracts of title. Foreclosed Property Foreclosed properly means property to which you have perfected your right to possession, or to which you have been given the deed or title, because the property was security for a loan you owned or serviced and there was a default on that loan. Hostile Fire Hostile fire means one which becomes uncontrollable or breaks out from where it was intended to be. impaired Property Impaired property means tangible property, other than your product or your work, that cannot be used or is less useful because: • it incorporates your product or your work that is known or thought to be defective, deficient, inadequate or dangerous; or • you have failed to fulfill the terms or conditions of a contract or agreement; if such property can be restored to use by: • the repair, replacement, adjustment or removal of your product m your work; or • your fulfilling the terms or conditions of the contract or agreement. Insured Insured means a person or an organization qualifying as an Insured in the Who Is An Insured section of this contract. Liahlrity Insurance Form 17-02-3080(Rev. 4-01) Contract ,�, 0 twkl�,uganauotwdat -. REVIEWED&APPROVED BY: A,. , Acwedo �. Risk Management Specialist -. C H U B B' General Liability Definitions WHEN USED WITH RESPECT TO INSURANCE UNDER THIS CONTRACT, WORDS AND PHRASES THAT APPEAR IN BOLD PRINT HAVE THE SPECIAL MEANINGS DESCRIBED BELOW: Insured Contract Insured contract A. means: 1. a lease of premises; 2. a sidetrack agreement; 3. an easement or license agreement: 4, an obligation, as required by ordinance, to indemnify a municipality, except in connection with work for a municipality; S. an elevator maintenance agreement; or 6, any other contract or agreement pertaining to your business (including an indemnification of a municipality in connection with work performed for such municipality) in which you assume the tort liability of another person or organization to pay damages, to which this insurance applies, sustained by a third person or organization. B. does not include that part of any contract or agreement that indemnifies an architect, engineer or surveyor for damages arising out of: 1. preparing, approving or failing to prepare or approve maps, drawings, opinions, reports, surveys, field orders, change orders, designs or specifications; or 2. Riving directions or instructions, or failing to give them Intellectual Property Law Intellectual property law or right means any: Or Right certification mark, copyright, patent or trademark (including collective or service marks); • right to, or judicial or statutory law recognizing an interest in, any trade secret or confidential or proprietary non -personal information: • other right to, or judicial or statutory law recognizing an interest in, any expression, idea, likeness, name, slogan, style of doing business, symbol, fide, trade dress or other intellectual property; or • other judicial or statutory law concerning piracy, unfair competition or other similar practices. Leased Worker Leased worker means a person leased to a party by a labor leasing firm, in a contract or agreement between such party and the labor leasing firm, to perform duties related to the conduct of the party's business. Leased worker does not include a temporary worker. Form 17-02-3080(Rev. 4-01) Contract Rwerreo & APPROJm nr: A-, ju Acwrdc Risk Management SpeaAht Definitions WHEN USED WITH RESPECT TO INSURANCE UNDER THIS CONTRACT, WORDS AND PHRASES THAT APPEAR IN BOLD PRINT HAVE THE SPECIAL MEANINGS DESCRIBED BELOW: Loading Or Unloading Loading or unloading: A. means the handling of property: after it is moved from the place where it is accepted for movement into or onto an aircraft, auto or watercraft; 2. while it is in or on an aircraft, auto or watercraft, or 3. while it is being moved from an aircraft, auto or watercraft to the place where it is finally delivered. B. does not include the movement of property by means of a mechanical device, other than a hand truck, that is not attached to the aircraft, auto or watercraft. Medical Expenses Medical expenses means reasonable expenses for necessary: • fast aid administered at the time of an accident; medical, surgical, x-ray and dental services, including prosthetic devices; and ambulance, hospital, professional nursing and funeral services. Mobile Equipment Mobile equipment means any of the following types of land vehicles, including any attached machinery or equipment: A. bulldozers, farm machinery, forklifts and other vehicles designed for use principally off public roads; B. vehicles maintained for use solely on premises owned by or rented to you; C. vehicles that travel on crawler treads; D. vehicles, whether self-propelled or not, maintained primarily to provide mobility to permanently mounted: 1. power cranes, shovels, loaders, diggers or drills, or 2. road construction or resurfacing equipment such as graders, scrapers or rollers; E. vehicles not described in subparagraphs A., B.. C. or D. above that are not self-propelled and are maintained primarily to provide mobility to permanently attached equipment of the following types: 1. air compressors, pumps and generators, including spraying, welding, building cleaning, geophysical exploration, lighting and well servicing equipment; or 2. cherry pickers and similar devices used to raise or lower workers; and F. vehicles not described in subparagraphs A., B., C. or D. above maintained primarily for purposes other than the transportation of persons or cargo. Mobile equipment does not include self-propelled vehicles with the following types of permanently attached equipment, and such vehicles will be considered autos: equipment designed primarily for: a. snow removal; LAN Insurance s REvexm&APPRmED8r Form 17-02-3080 (Rev. 4-011 Contract La A Acav44 ® Risk Management Speoahst