2018/19 Earthquake Insurance Policy BreakdownBINDER ISSUED: 06 -Feb -2018
Terra Mullins
AmWINS Insurance Brokerage of California -
Santa Ana, CA
1551 N Tustin Ave Ste 700
Santa Ana, CA 92705-8636
BINDER
We are pleased to offer the following Binder for the above captioned account as per the quotation
dated 06 -Feb -2018.
Policy Number: W14D19180501
Renewal of: W14D19170401
Insurer: Syndicate 2623/623 at Lloyd's.
Beazley Lloyd's Syndicate 2623 - 82%
Beazley Lloyd's Syndicate 623 - 18%
Unique Market Reference: B6012BUSA18
Insured's Name: City of La Quinta
Insured's Address: 78-495 Calle Tampico
La Quinta, CA 92253
Location(s): 78-495 Calle Tampico
La Quinta, CA 92253
As per schedule on file with Underwriter
Policy Period: From: 07 -Feb -2018
To: 07 -Feb -2019
Both dates at 12:01 a.m. Standard Time at the Insured's Address
Limit Peril(s)
Coverage(s)
$10,000,000 Each Occurrence Earthquake
Real Property
and in the Annual Aggregate in
Personal Property
respect of Earthquake
Valuable Papers
Electronic Data Processing
Media
Business Income
Extra Expense
Rental Income
Ordinance or Law - Undamaged
Portion (Cov A)
Location: All/All
$2,500,000 Sub -Limit
Ordinance or Law - Demolition
(Cov B) and Increased Cost of
Construction (Cov C)
combined
Location: All/All
1321634_1 Page 1 of 3
Deductible Peril(s)
5.00 % Values Per Unit of Insurance Earthquake
$25,000 Minimum Per Occurrence
Coinsurance Valuation Coverage(s)
Nil Replacement Cost Real Property
Personal Property
Nil Actual Loss Sustained Business Income
Extra Expense
Rental Income
Total Insurable Value: $70,475,172
Premium: $98,700
Min. Earned Prem.%: 25
T. R.I.A.: Declined
Inspection Fees: $0
Binder Comments: Contingent Tax Revenue Endorsement included as expiring.
Business Income includes Bond Rental Income.
Conditions: Ordinance or Law coverage included for loss to the undamaged portion of the
Building (Cov A) within the limit of insurance applicable to Real Property (FS
C 488).
FS C 494: Optional Valuation, Section 9. is amended to show Replacement
Cost applies to Real Property and Personal Property.
FS C 494: Limits of Insurance , Section 7. Item B. is deleted in it's entirety.
Forms and Endorsements Effective at Inception:
LMA3102A
Lloyd's Certificate
(amended)
FS C 422 01 13
General Cover Declarations Page
FS C 426 12 12
Supplemental Declarations Page
FS C 424
Schedule of Forms and Endorsements
FS C 494 05 17
Beazley Earthquake Policy
FS C 493 10 12
Statement of Deductible for Earthquake and/or Flood if Covered By This
Policy
FS C 513 06 13
Time Element Endorsement to Beazley Earthquake Policy
USES0114-004
Contingent Tax Revenue Interruption Extension
FS C 488 10 12
Ordinance or Law Endorsement
FS C 500 10 12
Valuable Papers and Records Extension
LSW1135B
Lloyd's Privacy
LMA3100
Sanction Limitation and Exclusion Clause
LMA5219
TRIA Not Purchased Clause
COMMISSION PERCENTAGES SHOWN ARE FOR DIRECT COMMISSION ONLY AND DO NOT INCLUDE
ANY APPLICABLE CONTINGENT .COMMISSION OR OTHER FORMS OF COMPENSATION.
1321634_1 Page 2 of 3
THIS RISK IS BOUND ON THE BASIS SHOWN ABOVE. IT DOES NOT NECESSARILY PROVIDE THE
TERMS AND/OR COVERAGES REQUESTED. WE ARE NOT RESPONSIBLE FOR INACCURACIES ABOUT
WHICH THE INSURED DOES NOT NOTIFY US OF IMMEDIATELY.
THIS BINDER WILL BE TERMINATED AND SUPERSEDED UPON DELIVERY OF THE FORMAL POLICIES
OR CERTIFICATES ISSUED TO REPLACE IT. IF THERE IS ANY CONFLICT BETWEEN THE TERMS AND
CONDITIONS OF THIS BINDER AND THE TERMS AND CONDITIONS OF THE POLICY (OR
CERTIFICATE), WHEN ISSUED, THE TERMS AND CONDITIONS OF THE POLICY (OR CERTIFICATE)
SHALL GOVERN.
THE SURPLUS LINES INSURERS (CERTAIN UNDERWRITERS AT LLOYD'S, LONDON) WITH WHICH THE
COVERAGE IS BEING QUOTED ARE NOT LICENSED TO DO INSURANCE BUSINESS IN THIS STATE AND
ARE NOT SUBJECT TO SUPERVISION BY THIS STATE. IN THE EVENT OF THE INSOLVENCY OF A
SURPLUS LINES INSURER, LOSSES WILL NOT BE COVERED BY ANY STATE INSOLVENCY FUND. IF
THIS QUOTE IS BOUND, THE POLICY MAY NOT BE SUBJECT TO ALL OF THE REGULATIONS OF THE
SUPERINTENDENT PERTAINING TO RATES AND POLICY FORMS.
ErLck ja
Beazley Insurance Services
CA License Number OG55497
725 S. Figueroa Street, Suite 2050
Los Angeles, CA 90017
1321634_1
Page 3 of 3