Fire Joinder Carmel/Clay Twp
ORIGINAL
2006 CONTRACT FOR FIRE PROTECTION
PAGE I
CONTRACT FOR FIRE PROTECTION
BETWEEN THE CITY OF CARMEL, INDIANA, AND
CLAY TOWNSHIP OF HAMILTON COUNTY
2006
THIS AGREEMENT, made and entered into by and between the City of Carmel, Hamilton
County, Indiana, hereinafter called the "City" and Clay Township, Hamilton County, Indiana,
hereinafter called the "Township" as of the I" day of January, 2006;
WITNESSETH:
WHEREAS, the City and Township have heretofore entered into contracts for fire
protection of the Township; and
WHEREAS, the City and Township have agreed to continue fire protection arrangements
for the additional period of one (I) year beginning as of January I, 2006, and continuing through
December 31,2006; and
WHEREAS, the City and Township have agreed that fire protection shall not be
discontinued until the 2007 Contract is negotiated and ratified between the parties or until the
Township has retained alternate fire protection.
NOW, THEREFORE, it is mutually agreed by and between the parties hereto as follows:
1. The City agrees to furnish fire protection service to the residents of the Township
outside the limits of the City, including basic and advanced life support emergency service ("life
support"), the Communication Center Service, and administer the "911 emergency service" (all the
2006 CONTRACT FOR FIRE PROTECTION
PAGE 2
foregoing collectively "Fire Protection").
2. The Township hereby agrees to leave all of its fire fighting equipment, trucks and
accessories, and life support emergency vehicles at the disposal of the City throughout the term of
this Agreement.
3. The City will continue to operate the six (6) stations now in use and to operate
advanced life support vehicles out of each station.
4. The only monetary liability of the Township for Fire Protection to the City will be
to pay the contract payments as hereinafter set forth. The proportionate share of the Township for
the 2006 Fire Department budget shall be the ratio based upon the Township's 2005 (pay 2006)
assessed valuation outside the corporate limits compared to the City's 2005(pay 2006) assessed
valuation as they relate to the total of the two. The proportionate share of the Township for the
2006 Communication Center's budget shall be one-half (]/2) of the Communication Center's
budget multiplied by the ratio based upon the Township's 2005 (pay 2006) assessed valuation
outside the corporate limits compared to the City's 2005 (pay 2006) assessed valuation as they
relate to the total of the two. The 2005 (pay 2006) assessed valuation of the Township outside the
corporate limits is certified as $],473,544,566 or 20.74% of the total assessed valuation of the
Township. The 2005 (pay 2006) assessed valuation of the City is certified as $5,632,]] 0,240 or
79.26% of the total assessed valuation. These certified values and percentages are subject to
change by the Hamilton County Auditor and the Department of Local Government Finance.
5. The City agrees to maintain a minimum of one hundred forty four (]44) full time,
sworn firefighters at all times during the continuation of this agreement, including a full-time, paid
2006 CONTRACT FOR FIRE PROTECTION
PAGE 3
Fire Chief, a minimum offorty (40) of said firefighters to be assigned to each of three (3) shifts at
all times. In the event that firefighters terminate employment during the year, the City will
continue to be in compliance with this paragraph so long as it hires replacement firefighters within
a reasonable time of the termination. The City further agrees to maintain the Communication
Center and administer Emergency "911" services and make the same available to all Township
residents. The Fire Chiefwill be appointed by the Mayor, after consultation with the Township
Trustee and the Township Board.
6. The City agrees to purchase all materials and supplies, to pay all compensation to
personnel and firemen, pay the costs of the operation of the Fire Department and the
Communication Center, to carry all necessary insurance on firefighters/personnel and on all
buildings and equipment of the City and Township, except the building known as Fire Station No.
45, and to save the Township, the Township Trustee and the Township Board harmless from any
and all liability, except as to Fire Station No. 45. A copy of the Declaration Page of the Liability
Insurance Policy carried by the City on the Fire Department and the Communication Center is
attached hereto as Exhibit "c" and a Certificate of Additional Insured is attached hereto as Exhibit
"D", naming the Township, the Township Trustee and the Township Board as additional insureds.
A copy of the Declaration Page of the Casualty and Premises Liability Policy carried by the
Township on Fire Station No. 45 is attached hereto as Exhibit "E" and a Certificate of Additional
Insured naming the City as additional insured on Fire Station No. 45 is attached hereto as Exhibit
"F",
7. The City shall provide to the Township a complete inventory of all Fire Department
2006 CONTRACT FOR FIRE PROTECTION
PAGE 4
apparatus and equipment each year.
8. The City agrees to furnish quarterly statements of all operating expenses on or
before the tenth (10'h) day following the end of each calendar quarter. All 2006 Budgeted
Amounts appropriately encumbered by the City in 2006 and expended in 2007 shall be separately
accounted for and treated as 2006 operating expense for purposes of this Contract. On or before
February 15, 2007, the City further agrees to furnish statements of all 2006 Budgetary items,
expenditures and encumbrances in a format which can be reconciled to the contract amounts. The
City shall repay to the Township its share of unspent monies contributed for Fire Protection no
later than February 15, 2007, with regard to 2006 unspent monies. In the event that the State
Board of Accounts Audit of the City of Carmel requires an adjustment of the above computations,
the Township or the City will remit any amounts due as a result of the audit within thirty (30) days
of receipt of the Audit Report.
9. The entire budget for the Fire Department of the City and of the Township in 2006
has been fixed at $16,425,583. A copy of said Budget is attached hereto as Exhibit "A2". Of that
amount, it is mutually agreed that the share of the Township should be $3,406,666 (20.74% of the
Fire Department Budget). In the event the expenditures in 2006 are less than $16,425,583, the
Township's pro rata share of the money unspent shall be refunded as set forth in Paragraph 8
above.
10. The entire budget for the Communications Center of the City and of the Township
in 2006 has been fixed at $1,990,900. A copy of said Budget is attached hereto as Exhibit "B2".
Of that amount it is mutually agreed that the share of the Township shall be $206,457 (20.74% of
2006 CONTRACT FOR FIRE PROTECTION
PAGE 5
50% of the Communications Center Budget). In the event the expenditures in 2006 are less than
$1,990,900, the Township's pro rata share of the money unspent shall be refunded as set forth in
Paragraph 8 above.
I I. In order to pay its share of the above expenses for the year 2006 in the total amount
of$3,613,123, the Township appropriated and will seek Dept. of Local Government Finance
approval ofan appropriation in its Fire Fighting Fund of$3,613, 123. By this agreement the
Township agrees to pay the entire appropriation of $3,613, 123 to the City as payment of its share
of the total costs of Fire Protection.
12. The Township further agrees to take all action necessary to seek authorization to
borrow funds, if necessary, to enable it to complete the payment of the total amount due and
payable for its share of the costs of Fire Protection required pursuant to this Agreement.
13. For and in consideration of the promises and agreements herein and subject to the
approval of all necessary state agencies the Township does hereby agree to pay the City the total
sum of$3,406,666 (2006 Fire Department Budget) and $206,457 (2006 Communication Center)
in the following manner:
$103,228.50 (Conununication Center)
on or before July 15, 2006,
or within one (I) business
day of the Township's
receipt of its tax draw
from Hamilton County,
whichever is later.
$1,703,333(Fire Department)
and
$1,703,333 (Fire Department)
on or before December 3 I,
2006, or within one (1)
business day of the
2006 CONTRACT FOR FIRE PROTECTION
PAGE 6
and
Township's receipt ofits
tax draw from Hamilton
County, whichever is later.
$103,228.50 (Communication Center)
Notwithstanding the foregoing scheduled payments, the Township may, at its option, and
in lieu of the payments due on December 31st, pay an amount which will: (a) cause the total
payments made by the Township pursuant to this Section to equal ninety-five percent (95%) of the
scheduled payments for the year; or (b) equal the total percentage of budget actually spent by the
Fire Department and Communication Center for the year, if received in writing from the City no
later than December 30, whichever amount is greater. In the event the foregoing payments shall be
less than the pro rata share of the actual expenditures by the City for the Fire Department and the
Communication Center, the Township shall pay to the City an amount necessary to reconcile the
actual payment due no later than February 15, 2007, for 2006 costs.
14. In the event that the City, based upon actual expenditures, determines that the funds
budgeted for Fire Protection will not be sufficient to provide adequate Fire Protection for the year
2006, the City shall notifY the Township in writing no later than thirty (30) days prior to the need
of additional funding. The City shall provide to the Township actual year-to-date expenditures
compared to budgeted expenditures per budget line item. Both the City and the Township shall
review these figures to determine whether savings are possible within the total budget or whether
an additional appropriation for the year is necessary.
If an additional appropriation is mutually found to be necessary, the Township shall, if
funds are available, appropriate sufficient funds to pay for its share pursuant to paragraph 4 above
2006 CONTRACT FOR FIRE PROTECTION
PAGE 7
within thirty (30) days. In the event that the Township does not have sufficient funds available in
the current year's budget, and the Township is unable to obtain an emergency loan, despite its best
efforts, the Township shall include the additional funds needed in the subsequent year's budget and
shall promptly pay when funds are then available.
The Township shall be entitled to a refund of its pro rata share of any unspent additional
funds contributed to the City pursuant to Paragraph 14 in the form of a cash refund as set forth in
paragraph 8 above.
15. In anticipation of a Contract for Fire Protection between the City and the Township
in 2007 and to assist the Township in its budgeting process, the City agrees to include the
Township in its 2007 budget discussions and send to the Township copies of completed budgets as
proposed by the Mayor for the Fire Department and the Communication Center by the later of July
1, 2006, or at least seven (7) days before the joint budget meetings, and the final budgets as
approved by the Department of Local Government Finance by February 28, 2007, or within thirty
(30) days after receipt offinal budget approval. All budget meetings shall take place at a location
mutually agreeable to the parties.
16. The parties acknowledge that in consideration of the Communication Center
providing back-up 911 emergency service for the County, Hamilton County has agreed to pay a
portion of the salary of the Communication Center's director for the year 2006 in the amount of
Forty-Five Thousand Dollars ($45,000.00) per year ("County's Salary Supplement"). The City
agrees to submit claims to the County for the County's Salary Supplement on or before December
31, 2006. The County's Salary Supplement for the year 2006 shall be applied to reduce the total
2006 CONTRACT FOR FIRE PROTECTION
PAGE 8
operating expense for the Communications Center under Paragraph 10 of this Contract.
17. The parties agree that all requests for payments and/or adjustments to payments
pursuant to this Fire Contract shall be placed upon a form approved by the Indiana State Board of
Accounts and certified according to Indiana Statute with respect to the amount contained therein.
18. This agreement shall be in full force and effect as of the l't day ofJanuary 2006, and
continue through the 31" day of December, 2006, provided, however, that the City shall continue
to provide the fire protection services set forth above until the next contract for 2007 is negotiated
and ratified between the City and Township or until the Township has retained alternate fire
protection. In the event this Agreement is terminated, all jointly owned fire apparatus and
equipment shall be divided between the parties in a mutually agreed upon manner and in
proportions equal to the average share of monies contributed by each party in the 5 prior calendar
years immediately preceding the year of contract termination. In the event that the City has
provided Fire Protection in 2007 and a mutually acceptable contract is not reached between the
City and the Township for 2007, the Township shall reimburse the City based upon the same
formula utilized in this agreement based upon 2005 (pay 2006) assessed valuation.
2006 CONTRACT FOR FIRE PROTECTION
PAGE 9
City of Carmel
Hamilton County, Indiana
J':':rai!ar~ ~ayor' ~
Date: 1-;< tJ - 0 t
Sandra M. Johnson,
Deputy Clerk for
Approved Date:
~ ;)..S: :\.ooc.
CLAY TOWNSHIP BOARD
-
Paul . Bolin, Member
CLAY TOWNSHIP
Hamilton County, Indiana
~ . -~
~. J,rl /-. ~
Ju Ith . Hagan, Trustee \
Date:
~
J... ~oo(,o
.
EXHIBIT A
FIRE
DEPARTMENT
BUDGET 2006
FOLLOWS THIS PAGE
1120-FIRE DEPARTMENT 2006
ACCOUNT -- - - - TITLE - -- --
4110000 FULL TIME REGULAR
4111000 PART-TIME
4112000 OVERTIME
4112002 UNSCHEDULED OVERTIME
4112003 SHEDULED OVERTIME
4112004 CIVILIAN OVERTIME
4120000 DEFERRED COMPENSATION
4121000 CITY'S SHARE OF FICA
4122000 CITY'S SHARE OF H-INS
4122100 DISABILITY INSURANCE
4122200 LIFE INSURANCE CONTRIBUTI
4123001 UNIFORMED PERF
4123002 CIVILIAN PERF
4124000 CITY'S SHARE OF MEDICARE
4126000 RETIREMENT-FULL TIME
4127000 RETIREE HEALTH INSURANCE
4230100 STATIONARY & PRNTD MATERL
4230200 OFFICE SUPPLIES
4231100 BOTTLED GAS
4231300 DIESEL FUEL
4231400 GASOLINE
4231500 OIL
4232000 TIRES & TUBES
4232100 GARAGE & MOTOR SUPPlES
4235000 BUILDING MATERIAL
4236300 BITUMINOUS MATERIALS
4236400 PAINT
4236500 SALT & CALCIUM
4237000 REPAIR PARTS
4238000 SMALL TOOLS & MINOR EQUIP
4238900 OTHER MAl NT SUPPLIES
4239001 LINENS & BLANKETS
4239002 REFERENCE MANUALS
4239010 AMMUNITIONS & ACCESSORIES
4239011 SPECIAL DEPT SUPPLIES
4239012 SAFETY SUPPLIES
4239013 ELECTRONICS
4239020 FIRE PREVENTION SUPPLIES
BUDGET
9,218,965.00
30,000.00
707,431.00
0.00
0.00
0.00
300,000.00
779,900.00
1,776,869.00
1,320.00
13,34500
1,690,574.00
28,059.00
0.00
123,000.00
234,674.00
3,550.00
10,000.00
9,450.00
35,000.00
25,00000
500.00
100.00
1,000.00
5,000.00
0.00
600.00
2,000.00
39,000.00
2,90000
12,366.00 .
3,600.00
500.00
1,500.00
1,800.00
2,245.00
600.00
12,500.00
4239099 OTHER MISCELLANOUS
4340000 LEGAL FEES
4340400 CONSULTING FEES
4340701 MEDICAL EXAM FEES
4340702 SHOTS & INOCULATIONS
4340703 MENTAL HEALTH COUNSELING
4340799 OTHER MEDICAL FEES
4341901 FILM DEVELOPMENT
4341903 SOFTWARE SUPPORT FEES
4341910 PROMOTIONAL TESTING FEES
4341954 INTERPRETER FEES
4341999 OTHER PROFESSIONAL FEES
4342100 POSTAGE
4343001 TRAVEL FEES & EXPENSES
4343002 EXTERNAL TRAINING TRAVEL
4343003 TRAVEL & LODGING
4343004 TRAVEL PER DIEMS
4344000 TELEPHONE LINE CHARGES
4344100 CELLULAR PHONE FEES
4344500 FAX LINE CHARGES
4345001 INTERNAL MATERIALS
4345002 PROMOTIONAL PRINTING
4346000 CLASSIFIED ADVERTISING
4347000 WORKMEN'S COMPENSATION
4347500 GENERAL INSURANCE
4348000 ELECTRICITY
4348500 WATER & SEWER
4349000 GAS
4350000 EQUIPMENT REPAIRS & MAINT
4350070 COMPUTER REPAIRS/MAINT
4350100 BUILDING REPAIRS & MAINT
4350101 TRASH COLLECTION
4350400 GROUNDS MAINTENANCE
4350500 RADIO MAINTENANCE
4350600 CLEANING SERVICES
4350900 OTHER CO NT SERVICES
4351000 AUTO REPAIR & MAINTENANCE
4351501 EQUIPMENT MAINT CONTRACTS
4351502 SOFTWARE MAINT CONTRACTS
4352500 BLDG MORTGAGE-CIVIC SQ
4353003 POSTAGE METER
4353099 OTHER RENTAL & LEASES
4355200 SUBSCRIPTIONS
8,450.00
0.00
2,000.00
91,320.00
1,600.00
3,000.00
500.00
500.00
2,000.00
0.00
0.00
0.00
6,000.00
0.00
20,050.00
2,000.00
850.00
34,750.00
36,000.00
0.00
1,500.00
2,000.00
3,000.00
205,000.00
88,500.00
67,000.00
15,888.00
51,500.00
4,50000
1,500.00
104,860.00
4,800.00
5,750.00
5,00000
. 26,250.00
76,955.00
90,000.00
24,500.00
34,000.00
6,000.00
700.00
14,680.00
4,505.00
4355300 ORGANIZATION & MEMBER DUE
4356001 UNIFORMS
4356002 UNIFORM ACCESSORIES
4356003 SAFETY ACCESSORIES
4357001 INTERNAL TRAINING FEES
4357002 EXTERNAL TRAINING FEES
4357003 INTERNAL INSTRUCT FEES
4357004 EXTERNAL INSTRUCT FEES
4358300 OTHER FEES & LICENSES
4359000 SPECIAL PROJECTS
4463000 FURNITURE & FIXTURES
4463100 COMMUNICATION EQUIPMENT
4463200 COMPUTER EQUIPMENT
4463201 HARDWARE
4463202 SOFTWARE
4463203 INTERNET HARDWARE
4463204 MOBILE DATA COMPUTER/CPO
4463300 APPLIANCES
4463500 GROUNDS MAINT EQUIPMENT
4464000 OFFICE EQUIPMENT
4467002 WATER RESCUE EQUIPMENT
4467003 FIREARMS
4467004 HAZARDOUS MATERIALS
4467005 CONFINED SPACE RESCUE
4467006 EMS EQUIP
4467007 TRAINING EQUIPMENT
4467099 OTHER EQUIPMENT
4469000 LIBRARY REF MATERIALS
2,595.00
75,450.00
2,000.00
141,262.00
11,225.00
0.00
35,000.00 .
27,19500
100.00
10,000.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
TOTAL
FIRE DEPARTMENT
16,425,583.00
EXHIBIT B
COMMUNICATION
CENTER
BUDGET 2006
FOLLOWS THIS PAGE.
1115-COMMUNICA TIONS CENTER 2006
ACCOUNT -- - -- TITLE -- -- -
4110000 FULL TIME REGULAR
4111000 PART-TIME
4112000 OVERTIME
4120000 DEFERRED COMPENSATION
4121000 CITY'S SHARE OF FICA
4122000 CITY'S SHARE OF H-INS
4122100 DISABILITY INSURANCE
4122200 LIFE INSURANCE CONTRIBUTI
4123002 CIVILIAN PERF
4124000 CITY'S SHARE OF MEDICARE
4127000 RETIREE HEALTH INSURANCE
4230000 OFFICIAL FORMS
4230100 STATIONARY & PRNTD MATERL
. 4230200 OFFICE SUPPLIES
4231100 BOTTLED GAS
4231300 DIESEL FUEL
4231400 GASOLINE
4231500 OIL
4232000 TIRES & TUBES
4232100 GARAGE & MOTOR SUPPlES
4237000 REPAIR PARTS
4238000 SMALL TOOLS & MINOR EQUIP
4238900 OTHER MAINT SUPPLIES
4239002 REFERENCE MANUALS
4239012 SAFETY SUPPLIES
4239013 ELECTRONICS
4239099 OTHER MISCELLANOUS
4340400 CONSULTING FEES
4340701 MEDICAL EXAM FEES
4341903 SOFTWARE SUPPORT FEES
4341999 OTHER PROFESSIONAL FEES
4342100 POSTAGE
4343002 EXTERNAL TRAINING TRAVEL
4343004 TRAVEL PER DIEMS
4344000 TELEPHONE LINE CHARGES
4344100 CELLULAR PHONE FEES
4344200 INTERNET LINE CHARGES
4345001 INTERNAL MATERIALS
BUDGET
1,018,000.00
15,000.00
97,000.00
15,000.00
70,000.00
161,000.00
4,300.00
2,000.00
97,000.00
16,500.00
2,00000
300.00
500.00
4,50000
0.00
700.00
3,500.00
300.00
500.00
500.00
17,500.00
1,500.00
700.00
1,200.00
300.00
700.00
2,500.00
2,500.00
300.00
0.00
2,00000
1,000.00
5,000.00
2,000.00
29,500.00
2,500.00
14,000.00
300.00
4346000 CLASSIFIED ADVERTISING
4347000 WORKMEN'S COMPENSATION
4347500 GENERAL INSURANCE
4348000 ELECTRICITY
4348500 W..;..TER & SEWER
4349000 GAS
4350000 EQUIPMENT REPAIRS & MAl NT
4350100 BUILDING REPAIRS & MAl NT
4350101 TRASH COLLECTION
4350500 RADIO MAINTENANCE
4350600 CLEANING SERVICES
4350900 OTHER CONT SERVICES
4351000 AUTO REPAIR & MAINTENANCE
4351100 CAR CLEANING
4351501 EQUIPMENT MAINT CONTRACTS
4351502 SOFTWARE MAINT CONTRACTS
4352600 AUTOMOBILE LEASE
4352700 RIGHT-OF-WAY LEASE
4353099 OTHER RENTAL & LEASES
4355100 PROMOTIONAL FUNDS
4355200 SUBSCRIPTIONS
4355300 ORGANIZATION & MEMBER DUE
4355500 USER FEES
4356002 UNIFORM ACCESSORIES
4357001 INTERNAL TRAINING FEES
4357004 EXTERNAL INSTRUCT FEES
4358200 SPECIAL INVESTIGATION FEE
4358400 REFUNDS AWARDS & INDEMITY
4359000 SPECIAL PROJECTS
4460100 TREES & SHRUBS
4461002 COMM CENTER RENOVATIONS
4463000 FURNITURE & FIXTURES
4463100 COMMUNICATION EQUIPMENT
4463200 COMPUTER EQUIPMENT
4463201 HARDWARE
4463202 SOFTWARE
4463203 INTERNET HARDWARE
4464000 OFFICE EQUIPMENT
4465001 CARS & TRUCKS
4467099 OTHER EQUIPMENT
4469000 LIBRARY REF MATERIALS
600.00
1,790.00
17,110.00
10,000.00
1,500.00
3,000.00
18,000.00
25,000.00
1,000.00
20,000.00
8,80000
18,000.00
0.00
100.00
57,000.00
27,000.00
15,000.00
3,000.00
76,000.00
1,000.00
200.00
600.00
15,900.00
0.00
3,000.00
12,000.00
500.00
0.00
1,000.00
0.00
0.00
3,500.00
20,000.00
0.00
15,000.00
9,000.00
0.00
2,000.00
0.00
12,000.00
200.00
TOTAL
COMMUNICATIONS CENTER
1,990,900.00
EXHIBIT C
DECLARATION PAGE
OF CITY'S
LIABILITY INSURANCE
POLICY
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8 PUBLIC ENTITY liBIIERAL LIABILITY PROTECTION
COVERAGE SUMMARY
lboStRIIJI
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This Coverage Summary shows the limits of
coveraga that apply to your Public Entity
General Liability Protection. It also lists those
endorsements. If any. that must have certain
information shown for them to apply.
IMPORTANT NOTE: Your agreement
may contain an endorsement that
reduces certain coverage limits
shown below for damages subject
to state statutory caps.
..
>-
o
o
o
Um ilS Of Coverage
IlIpDrtanl NDte: Only endorsements that must have certain Information shown for them to apply
are named In this table. The required information follows the name of each such endorsement.
Other endorsements may apply too. If so, they're listed on the Policy Forms List,
Professional Services Endorsement - Described Professions:
NURSES
PARAHEDICS/EMT'S
PSS Sexual Abuse Limitation Endt - With General Total Sublimit
Sexual Abuse Total Limit
$250,000
Sexual Abuse Each Person Limit
$ 50,000
PSS Described Person Or Organization Endt - Add! Protected Persons
Described Person or Organization
CLAY TOWNSHIP TRUSTEES AS RESPECTS FIRE PROTECTION, COMMUNICATIONS CENTER,
AND OPERATIONS OF PARKS DEPARTMENT AFFORDED BY CITY OF CARMEL.
Described Person or Organization
CARMEL CLAY SCHOOLS WITH REGARD TO PARKS DEPARTMENT DAY CAMP.
Name Df Insured
CITY OF CARMEL
PDllcy Number GP09311918 EffecUve Dale 01/01/06
PrDcessing Date 01/19/06 09:48 001
G0208 Ed.10-97 Printed In U.S.A. Coverage Summary
eSI.Paul Fire and Marine Insurance Co.1997 All Rights Reserved
Page
EXHIBIT D
CITY'S CERTIFICATE
OF TOWNSHIP NAMED AS
ADDITIONAL INSURED
ACORD_ CERTIFICATE OF LIABILITY INSURANCE OPIC ~4 DATE IMMlOOlYYY'YI
CMMEBO 06/05/06
PRODuCER THIS CERTIACATE IS ISSUED AS A MATTER OF INFORMATION
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
Bylant of Indianapolis 1 LLC HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR
501 Congressional Blvd ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Indianapolis IN 46032
Phone: BOO-678-0361 Fax: 317-817-5151 INSURERS AFFORDING COVERAGE NAlCt
INSURED INSURER A: I~. hill Fi~' K:Ir1n. In.. Co 24767
INSURER 8:
Ci fa of Carmel INSURER C:
At : Steve Engelking
One Civic Smra INSURER D:
Carme~ IN 4 32
tNSURER E:
COVERAGES
THE POUClES OF INSURANCE U51'ID BELOW HAVE BEEN ISStJED TO THE INSURED NAAAeO AOOVe FOR THE POLICY PERIOD Itt:I>>CATEO. NOTWITHSTANDING
AJot'( RECUIREMENT, raw OR COPOTlONOF ANYCX1NTRACT OR OTHER oaCUUENT WITH RESPECT TO WHlCH THIS CERTIFICATE W,VBa ~EOOA
MAY PERTAIN. THE INSURANCEAFFOROeD BY THE POUOES OESCRlBEO HEREIN IS SUBJECT 10 AlL THEiERMS.. exa.USIONS AND CONOlTIONSOF SUCH
POLICES. AGlJREGATE L.1WT9 SHOWN flMY HAVE BEEN Rl!DIJCa) BY PAID ClAIMS.
I~ .... TYPE OF INSURANCE POLICY NUMBER OATiHuUlDD ~ L.IMITS
~NERAL UABlllTV EACH OCCURREHCI; . 2 000 000
A X .!. 13....'00'" GENERAL UABlUTY GP093U918 01/01/06 01/01/07 PREUJSES rEa ~.l . 50 000
_ ClAIUS MADE ~ OCCUR MED EXP (Ally on. pen.on) . 0
PERSONAL & MN INJURY . 2 000 000
. GENERAl AGGREGATE . 2 000 000
- 2,000 000
~l AGGREGATEUMfT nPER: PRODUCTS . (::()a,P~p AGG .
,n""o.
POUCY JEeT we
~OMOBILE UA8IJTY COMBINED SINGLE UMIT S
(ea'cciclelll)
- _ AUTO
- All OWNED AUTOS BODL Y INJURV .
(Pwpvrson)
I- SCHEDUlED AUTOS
-- HIREOAUTOS BOOLY INJURY .
(PetIl.CddenlJ
I- NON~WNEO AUTOS
I- PROPeRTY ON.lI\GE .
(Per.ocllJenl)
RRAGE .....LITY AlIfOONLY. EA I\CClOENT .
_""TO OTHER THAN ",.-cc .
AUTO ONLY: AGG .
EXCESSAJt.tBR8UA llABlLlTY EACI< OCOJRRENCE .
tJ OCCUR 0 C""NS """" AGGREGATE .
.
R DEDUCTIBlE $
RETENTION . .
WORKeRS COMPENSATION AND I TORl~,~}j!,; I I v...
EMPUOYERS'UASUJTY EL EACH ACCIDENT .
ANY PRDPRIETORlPARTNERlEXfCUTM! EL OISEASE. EA eMPlOYEE S
OFACE~EMBER EXCLUDeD?
g~~~VI~NSb"OW E.L DISEASE. POLICY LIJ.lIT .
.0,"",
DESCRJPTlON OF OPERATtOHS' LOCATIONS 1 VEHICleS 1 exCLUSIONS ADDED BY ENDORSEMENT 1 SPECW. PROVlSJONS
Certificate Holder is an Add! tional Insured as respeots to firQ protecti.on'
provided by the Ci.ty of Carmel Fire Dep.tlrtment
CERTIFICATE HOLDER
CLAYT-2
CANCELLATION
SHOULD APN OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPiRATlON
DATE THEREOF, THE: ISSUING INSURER WILL ENDEAVOR TO ...AIL ~ DAYS WRnTEN
HOTlCE TO -mE CERTIFICATE HOLDER NAUeo TO TIt! LEFT, BUT FAILURE TO DO so SHALL
IMPOSe NO OBLlOA.TION OR UABn.1TY OF AHV KIND UPON THI!' INSUReR, ITS AGf!HTS OR .
C~ay Township Trustee
10701 N. College
Indianapolis IN 46280
RO CORPORATION 19B8
ACORO 25 (200110B)
ACORI).
EVIDENCE OF COMMERCIAL PROPERTY INSURANCE OPW 5
06
THIS IS EVIDENCE THAT INSURANCE AS IDENTIFIED BELOW HAS BEEN ISSUED,IS IN FORCE. AND CONVEYS ALL THE RIGHTS AND
PRIVILEGES AFFORDED UNDER THE POLICY,
PROOUCERN~e, ACT 800-678-0361
P8tS0N AND ACDRf$S
H7-817-515i
COMPANY NAME AND ADDRESS
HAle NO:
AOORE$S:
Hylant of Indianapolis,
501 Congressional Blvd
Indiana olis IN 46032
cooe
MER 10 f': CA.lUI5:B 8 0
NAMED "'SUREO AND ADDRESS
LLC
St. Paul Fire & Marine Ins.
Attnz Stephanie Tomczyk
540 Lake Cook Road, Ste 400
Deerfield IL 60015
Co
sua CO~
IF MUL llPLE COMPANIES, COMPLETE SEPARATE FOfW FOR EACH
LOAH NUMBER
City of Carmel
Due Civic Square
Carmel IN 46032
AOOlTlONAL h'AMfD INSUREDIBJ
EFFECTIVE DATE
CONTlHUEO UNTIL
TERMlHAtEO IF CI1ECKED
PROPERTY INFORMATION (Use additional sheets If more space Is required)
lOCATIOHtDESCRlP1lC>>I ......ra "<a"",on*,,,J.-.
001
3610 Ne~~ ~~~i~ Street
COVERAGE INFORMATION CAUSE OF LOBS FORN I I BASe I IIIROAO I X I s..cw. I I OTl<ER
COtoWERCIAL PROPSrrf COVERAGE AMClC..NT OF LNSUAAHCE: . 2.673.689 om, 5,000
YES NO
8I.J.SN:8S INCOME J RENTAl VAlUE 'YEs. l....rr: I , Acfuoll.ou Sustained .ol~
BlANKET COVERAGE '~ "YES.~~lfJf~onptq)eflalcleAlll!odabow: $
TERRORfS"'C~ ~~~~~~N~a/~C
IS COVERAGE PROVIOEO FOR ""'1:;t'C IIt"II:UAcrs" ONt Y? <YES. SUBLMl: oeD;
IS COVERAGE A ST,l,tt,D A.L.OHE POlICY7 . YES, UMrr: om
DOES COVERAGE INClUDE. OONESTIC TERRORISM? 'YES, SUBUWIT: om
COVERAGE FOR MOlD JfYES, UMlT: OECk
MOlD EXCLUSlOHOf~. ~~llon'sfarmulCd)
RER..ACEIoENT COST
AGREED AIilOUN'T
COINSlJRAHCE -va ..
ECXlLPUENT BREAKDOwN (If A.ppigble) "YES. LIMIT: DeCk
LAW AND ORDINANCE . Cowetage krlau 10 LI~ portion dbullcllng .va LWIT: DED:
-DelD;AUanCo.sIs -- LINrT: OED:
-Irr;;r. C05l d Ca\IlNdion -- lij,llT: om,
EARThQUAKE Of ~cabI.) If YES, lIWT: OED:
FLOOD (H ,I,p~jc:abl8l 'YES, LIMIT: OED:
WIIC)IHAll(lf~PoICyI afyES. LiMIT: OED'
PERMSSlON TO WANE SU8ROGA.11QH MIOR TO LOSS
REMARKS . Including SpecJaI Conditions (Use sddltlonal sheets If mOnll Splice I.s required)
I
CA><CELLATlON
THE POLICY lS SUB.Ja;T' TO lliE PREMIUMS. FORMS, AND RUleS IN ~ECT FOR EACH POUCY PERJOD. SHOULD THE POUCV B!! TERMINATED, THE
COllPANYWllL GlVl!THEADDf1'1ONAL INTEREST IOENTIfED SlILOw 30 DAYS WRITTEN NOTICE" ANDWtLl6END NOTFICAnoN OF ANY CHANGES TO
THE POUCYTHAT 'WOU1.D NTECT THAT INTEREST,IN ~CORDAHCe WITH TljE POUC'fPROVlSIONS DRAS REQUIRED BY LAW.
ADD ITIONAL INTEREST
~~ AAD ADDRESS
I
N
!NT N.AAE AND AOtlReSS
C1ay Township Trustee
10701 N. College
Indianapolis IN 46280
WORTGAGEE
lOSS PAYEE
ACORD 28 (2003110)
ENTf, A .
ACORD. EVIDENCE OF COMMERCIAL PROPERTY INSURANCE Of' 10 5~ DATE (WNODrl'YYY)
06/05/2006
THIS IS EVIDENCE THAT INSURANCE AS IDENTlAEO BELOW HAS BEEN ISSUEO,IS IN FORCE, AND CONVEYS ALL THE RIGHTS AND
PRIVILEGES AFFORDED UNDER THE POLICY.
PROOUcm NAME, CONTACT ~..., 800-678-0361 COWANY NAME AND ADDR~ I NAl(; NO,
P~N AND ADl:lReS5
""'No" . 317-817-5151 St. Paul Fire & Marine rna. Co
I~: Attn: Stephanie Tomczyk
Rylant of Indianapol~s, LLC 540 Lake Cook Road. St.. 400
501 Congressional Blvd Deerfie1d IL 60015
Indianapolis IN 46032
= I BUS cooe:
CUSTOMER 10 t':: CAlllIll8 C If IMUL TlPLE COMPAJrIe.S,. COMPurre sePARATE FORM FOR EACH
trjA.l,lED UoOSUREO AND ADDRESS Lo.AN HUMBER !IPOUCY NUMBER
Ci ty of Carmel GP09311918
One Civic Square EFFECTIVE DATE ~RATION DATE.
Carmel IN 46032 In CONTNlJED ""'.
01/01/06 01/01/07 TERNlHATEO IF OECl<EO
AOOmONAI.. NANEO IHlMJ~SI THlS REPl.AC~ . DAreD, --
PROPERTY INFORMATION (Use additiONlI sheets if more space Iii ruquired)
LOCATIONIDESCRlPTlON nre ~<.a","on -tr-'1'-
001
540 West 136th Street
IN 46032'
COVERAGE INFORMATION """"" OF LOSS FORIl I IIlASIC 1 lOR""" .1 xl SPECIAL I I OllER
COMMERCIAL PROPERTY COVERAGe AMOUNT OF HSURANCE: . 2.673.689 oeD: 5,000
YES NO
BUSINESS INCOME 'RENTAl VAlUE II YES, LIMIT: I I AcIulIIlUM SuRilned .olmlO_
BlANKET COVERAGE If YEs. IndQIe IPlOI.Il'll 0/ irlll.nnat on ~.. ldenUled a&Nwe:: $
TEAAOR1SM COVERAGE NblI1l slgled Dildoa... NoiOllI DEe
IS COVERAGE PROYIOEO FOR "CERTFJEDACTS" ONl. Y'? . . YES. SlI8 UIoIIT: OED:
IS COVERAGe A STAN) ALONE POUCY't '''''s. LIMIT: oeD<
DCES COVERA<* INCt.UOE 00MESTlC TERRORJSM7 .ves. SU8LIMIT: OED:
COVERAGE FOR UOI.O lives. LIMIT: OED:
~LO EXCLUSION (l'''YES''.~frDrglll1_lIt1r1''.rormu:sed)
REPlACEMENT COST
AGREED AMOUNT
COlNSURAN(::E 'YES. ..
eoUlPJ.CENT BREAKDOWN {If A,pplil;able} ,YES. l.JNIT: OED:
LAW AND ORDINANCE . Cowel1llpl! ftr Iou IlIlndamaged por1lon or bUldinll lrves. LIMIT: 060,
.00000001ionCostl .ves. ur"IT: DB>
. Ina. eo. or ConslNclion II YES. Lu.uT: oeo,
EARTHQUAKE (If ~catJl4I) !rYES. LIMIT: DEI>
FLOOD (It ,6,pphcable) II YES. LIMIT: DED:
WWO I HAl\.. [If SepatPle POicv) If YES. LIMIT: OED:
PEFUUSSION TO WAIVE SUBROGATION PRIOR TO lOSS
REMARKS. Including Special Conditions (Use additk>nal..hvet& "more apace Is required)
I
CANCELLATION
Tl-E POUCY IS SUBJECTTO lliE PREIIUM8, FORMS./WD RULES aN EFfECT FOR EACH POUCY PERIOD. SHOULD TH!! F'OUCY I5l!! TeRMINATED, THE
COUf'AN('Mu. GIVE THENJDmONALiNTERE!3T ~ BELOW 30 DAYSWRITTBJ NOTICE, N4DWILL SENOHOTFICATiON OF AHYCMANGES TO
TliE POUC'Y THAT WOULD AFFECT THAT 1NTERE5T. ~ ACCORtwlIC! WITH THe POUCY p~ OR AS REQUIRED BY l.I\W.
ADDITIONAL' INTEREST
NAME AHD ADDRESS
LENDER SER\IIClHO AGENT NAME ADDRESS
Clay Township Trustee
10701 N. College
Indianapolis IN 46280
MORTGAGEE
LOSS PAYEE
ACORD 28 (2003/10)
E~fr A .
EXHIBIT E
DECLARATION PAGES
OF TOWNSHIP
CASUAL TY AND PREMISES
LIABILITY POLICY ON
STATION #45
EIGHTEEN WEATHER WARNING
SIRENS
PERSONAL PROPERTY & TOWERS
STATION #42 & 46
THE CINCINNATI INSURANCE COMPANY
P.O. BOX 145496, CINCINNATI, OHIO 45250-5496
(513) 870-2000
A Stock Insurance Company
CPP 071 29 91
Previous. Policy No.
COMMON POLICY DECLARATIONS
DECLARATIONS POLICY NUMBER CPP 091 68 81
NAMED INSURED CLAY CIVIL TOWNSHIP &
CLAY TOWNSHIP REGIONAL WASTE DISTRICT ATIMA
ADDRESS 10701 NORTH COLLEGE AVE
(Number & Street, INDIANAPOLIS IN 46280
Town, County,
State & Zip No.)
Policy Period: Al 12:01 A.M.; STANDARD TIME AT YOUR MAILING ADDRESS SHOWN ABOVE
All coverages except Automobile and/or Garage
Policy number: CPP 091 68 81 FROM: 01-12-2005 TO: 01-12-2008
Automobile and/or Garage
Policy number: . FROM: TO:
A~ency FEARRIN INSURANCE AGENCY 13-784
City CARMEL. IN
Legal Entity/Business Description
GOVERNMENTAL ENTITY
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS
POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
FORMS APPLICABLE TO ALL COVERAGE PARTS (show numbers) .
REFER TO IA901
RENEWAL
SKD WS5
02-09-2005
Countersigned
rv1MG( 11.0 LGcS
(Date)
By
d., (, i ,
. J (\~~ 1\'~l~L',"
( Authorized R resentative)
IN WITNESS WHEREOF, this policy has been signed by our President and Secretary iri the City of Fairfield,
Ohio, but this policy shall not be binding upon us unless countersigned by an authorized representative of
ours. This provision does not apply in Arizona, Virginia and Wisconsin. .
&/ ./1
v ~ N J9iift>
,17
Secretary
President
ORIGINAL
IA 501 02 01
Page 1 of 2
THE CINCINNATI INSURANCE COMPANY
COMMERCIAL PROPERTY COVERAGE PART DECLARATIONS
Attached to and forming part of POLICY NUMBER: CPP 091 68 81 Effective Date: 01-12-2005
Named Insured: IS THE SAME AS IT APPEARS ON THE COMMON POLICY DECLARATION
11em T ocatlon (address\
REFER TO IA904
OPTIONAL COVERAGES
COVERAGE PROVIDED Applicable only when an entry is
made
l1em Coverage Limits Coin- Covered Business Income
surance Cause Indemnitv
of Loss I A A A
N E E G
F P P A
L L L I E
A A A N E
T C C C 0
I E E L
0 M M V
N E E S A
N N T L
G T T 0 U
U C E
A C C K
A 0 0
0 s S
T T
('Yo) (x) (X) (X) Monlhly Ma.>cimum E.o:leMIIKl
Limit P;~od P...,oa
ll'ilICtJon (0.",
1-1 BUILDING 3.000.000 90% SPECIAL X
EQ
1-1 BUSINESS PERSONAL 400.000 90% SPECIAL X
PROPERTY EQ
1-2 BUILDING 11,400 90% SPECIAL X
EQ
1-3 BUILDING 26,000 90% SPECIAL X
EQ
1-4 BUILDING 25,000 90% SPECIAl X
EQ
1-5 BUSINESS PERSONAL 5,150 90% SPECIAL X
PROPERTY EQ
CONTINUED ON FM401
DEDUCTIBLE: $25000 unless otherwise stated $ 500
EARTHQUAKE DEDUCTIBLE 5%
MORTGAGE HOLDER Item:
FORMS AND/OR ENDORSEMENTS APPLICABLE TO THIS COVERAGE PART. . .
FM401 08/94 FA4S0 01/98 FM101 01/98 FA499IN 06/99
FA237 01/98 FA240 01/98 FA244 03/99 FA216 10/01
.
FM 501 0694
THE CINCINNATI INSURANCE COMPANY
A Stock Insurance Company
CONTRACTORS' EQUIPMENT COVERAGE PART
DECLARA TIONS
Attached to and forming part of POLICY NUMBER: CPP 091 68 81 Effective Date: 01-12-2005
Named Insured: IS THE SAME AS IT APPEARS ON THE COMMON POLICV.DECLARATION
TYPE OF COVERAGE
0 Broad 00 Special
COVERAGE PROVISIONS
Descrition (Year Built~ Limit of Insurance
Identi ying Marks and umbers
l. SRNT OUTDOOR SIREN 18 a 5.436 UNIT 97.848
2. DEFCTH SIREN CONTROL 18 a 3.960 UNIT 71.280
3. TR TRANSFORMER RECTIFIER 18 a 1,089 19,764
4. VAGI 1 VAGI ATENNA W/CABLE VHF 18 a 144 2,592
5. SS1000-STATUS ENCODER 2,160
6. SSP575 PRINTER FOR SS1000 360
Total $ 194,004
Leased or Rented Property $
RATES AND PREMIUM
Rate $ INCL Premium$ INCL
DEDUCTIBLE
The Deductible amount is $250 unless otherwise stated $ 500
FORMS ANDIOR ENDORSEMENTS APPLICABLE TO CONTRACTORS' EQUIPMENT
MA135 11/99 MA 108 02/91
SPECIAL PROVISIONS (if any)
MA 508 01 97
Page 1 of 2
NATIONAL FIRE & CASUALTY CO.
PROPERTY
COVERAGE PART
SUPPLEMENTAL DECLARATIONS
Coverage Part Number: NFC02 4 7 3 PR
473
Agent#
DESCRIPTION OF PREMISES:
Premo Bldg,
No No.
002 001
002
002
Location, Fire Protection/Construction and Occupancy
3610 WEST 106TH STREET CARMEL, IN
FIRE STATION CONTENTS
PC 04 NON-COMBUSTIBLE
3610 WEST 106TH STREET CARMEL, IN
COMMUNICATIONS TOWER
PC 04 NON-COMBUSTIBLE
COVERAGES PROVIDED: Insurance at the described premises applies only for coverages lor which a limit 01 liability
is shown or for which an entry is made.
Pram Bldg. Coverage Limitol Causes 01(1) Coinsurance(2) Ded
No. No. Liability Loss Form
002 001 YOUR PERSONAL PROPERTY 72,100 SPECIAL 100% 250
002 002 BUILDING 23,175 SPECIAL 100% 250
OPTIONAL COVERAGES:
Premo . Bldg.
No, No.
Coverage
Agreed Value
Amount Expiration Date
Replacemen1 Cost
tncl. Stock
Inilation
Guard
002
002
001
002
YOUR PERSONAL PROPERTY
BUILDING
(X)
(XI
Pram
No
Bldg.
No.
Agreed Value
Dale
Agreed Value
Amount
Monthly Limit of
Indemnity (Fraction)
Maximum Period of
Indemnity
Extended Period at
Indemnity (Days)
MORTGAGE HOLDERS:
Refer To Mortgagee/Loss Payee Schedule.
Deductible Exceptions:
(1) EO (;1 shown) =Earthquake
(2) Coinsurance %, Extra Expense %, Limits on Loss Payment or Value Reporting Form Symbol.
MAE
F01 S014 10/98
NATIONAL FIRE & CASUAL TV CO.
. .
PROPERTY.
COVERAGE PART
SUPPLEMENTAL DECLARATIONS
Coverage Part Number: NFC02473PR
473
. Agent#
DESCRIPTION OF PREMISES:
. Premo Bldg.
No. No. Location, Fire Protection/Construction and Occupancy
001 001 540 WEST 136TH STREET CARMEL, IN
FIRE STATION CONTENTS
PC 04 NON-COMBUSTIBLE
001 002 540 WEST 136TH STREET CARMEL, IN
COMMUNICATIONS TOWER
PC 04 NON-COMBUSTIBLE
COVERAGES PROVIDED: Insurance al the described premises applies only for coverages lor which a limit 01 liability
is shown or jor which an entry is'made.
Premo Bldg. Coverage Limite! Causes 01(1), Coinsurance(2). Oed
No No. liability Loss Form
001 001 YOUR PERSONAL PROPERTY 72,100 SPECIAL 100% 250
001 002 BUILDING 15,450 SPECIAL 100% 250
OPTIONAL COVERAGES:
Premo Bldg.
No. No.
Coverage
Agreed Value
Amount Expiration Date
Replac:"ement Cost
Incl..Slock
Inflation
Guard
001
001
001
002
YOUR PERSONAL PROPERTY
BUILDING
(x)
(X)
Premo
No
Bldg.
No: '
Agreed Value
Date
Agreed Value
Amount
Monthly Umit of
Indemnity (Fraction)
Maximum Perioo of .
Indemnity
Extended Period oi
Indemnity (Days)
MORTGAGE HOLDERS:
ReIer To Mortgagee/Loss Payee Schedule.
D.eductible EXceptions:
(1) EO (iI shown) =Earthquake
(2) Coinsurance %, Extra Expense %, limits on.Loss .payment or Value Reporting Form Symbol.
MAB
F01 S014 10/98
[GIEI,~ GOVERNMENTAL INTERINSURANCE EXCHANGE
Bloomington, Illinois
A Reciorocallnsurer hereinafter called the :'Coffioanv"
COMMON POLICY DECLARA TIONS
GIE00943
Policv Number
.
GIE00771
Prior Policv Number
I. The Named Insured and its Mailing Address The Named Insured is a:
(No. Street, Town or City, County, State, Zip Code)
. CLAY TOWNSHIP [X ] Public Agency
. 10701 NORTH COLLEGE AVENUE [ ] Public Agency conso0ium,
. INDIANAPOLIS, HAMILTON CO. , IN 46280 partnership, or joint venture.
.
II, The Policy Period is
From: JANUARY 12, 2006 ] at 12:01 A. M. standard time at
To: JANUARY 12, 2007 your mailing address shown above.
III, Only those Coverage Parts for and opposite which an estimated premium or "INCLUDED" is entered in the following
schedule are included in this Policv. The estimated premium lS sub'ect to adjustment.
COVERAGE PARTS , ESTlMA TED PREMIUM
PUBLIC AGENCY MULTI-CLASS LIABILITy.... ......... ....... $ 1,854
"DESIGNATED WRONGFUL EMPLOYMENT
PRACTICES" LIABILITY. ....... ............ ............. ...... $
"EMPLOYEE BENEFITS ERRORS OR
OMISSIONS" LIABILITY ........ .................. ........ . $
.. AUTO. ............... ......... $
PROPERTY... .............. ....... ................. ........... $
INLAND.MARlNE . ...... ... .". . . . . . . . . . . . . ..... ......... ............... "..... $ .
POLICY TOT AL $ 1,854 .
IV. These Common Policy Declarations together with the Common Policy Form, those Coverage Partes) designated above (and
forms and endorsements designated in the specific Coverage Part Declarations), and the following listed forms and
endorsements, if any. complete the above numbered Policy. .
L99U100(9/97) L99S103(9/97) L99UI09(02/03) GDK MOC(9/97)
;
I
I
I
I V, This Policv shall not be effective unless sioned below bv an authorized agent of the Comnanv.
ThiS Policy!s executed as of the first day of the Policy Period set forth above.
Named Insured's Agent and ,Representative
BLISS MC~NIGHT OF INDIANA, INC.
Authonzed Agent of Company
b)' --T ~ rP e,Jt- ,
~... -'- <- .~~
Signature of Company's AutHorized Agent
FEARRIN INSURANCE AGENCY
by.
Signature of Named "Insured's Agent
12/28/05 MEG/KC
GDK COM 01/98 Copynght@ 1996, 1997 BlissMcKnight Concepts, [nc.. used with permission.
~orm Number Includes copyrigh1ed material of Insurance Services Office. Inc. used with permission
Poge.1 of,
.-
GOVERNMENTAL INTERINSURANCE EXCHANGE
PUBLIC AGENCY MULTI-CLASS LIABILITY - OCCURRENCE BASIS'
COVERAGE PART AND DECLARATIONS
\amed Insured:
CLAY TOWNSHIP
Coverage Part Number: . GIE00943ML
Prior Number: GIE00771ML
L . COVERAGE, COVERAGE FORMS, AND OTHER FORMS' IN COVERAGE PART
i
The Public Agency Multi-Class Liability coverageafforded is only those coverages described in this
Public Agency Multi-Class Liability Coverage Part to this Policy. - Unless otherwise provided by
Endorsement to this Coverage Part, the Public Agency Multi-Class Liability Coverage Part includes only
the Public.Agency Multi-Class Liability Coverage Form which is attached hereto and made a part hereof
and the other forms and endorsements that are listed in paragraph II. B., below.
II. '\IUL TI-CLASS LIABILITY DECLARA nONS
A. Limits of Liability
The Company's Limit of Liability for all sueh coverage is:
1. Coverage Part Aggregate: $ 1, 000 , 000 : ,-
2. General Liability Per Occurrence: $ 1, 000 , 000
3. Fire Damage Per Occurrence: $ 50, 000
subject to all the terms and conditions of this Policy having reference hereto.
B. Form numbers of fomls, endorsements and schedules forming a part of this Coverage Pan al Its
inception: - . -.
L17U200(01/98) L17U2b8(9/97) L17U219(9/97) LPE206a(2/86)
,
I
I
I
. i
I.
,
"
j
i, -
c.
Deductible: The indicated Deductible is applicable to coverages for which a Deductible amount ,s
entered opposite the coverage in the following list of coverages. Absence of an entry means no
deductible applies to that coverage: Amount of Deductible
'Bodily Injury Liability" $ -0-
'Property Damage Liability" $ - 0-
"Personal Inju,ry" and "Advertising Injury" Liability $ -0-
"Errors Or Omissions" Liability $ 2 , 5 0 0
Civil Ri~hts Liability $' 2,500
D.
E.
Premium: $ 1,854
This is an estimated
Listing of Consortia, Partnerships and Joint Ventures (see Section II - Who Is An Insured)
. '
"/:
.//_ 1;.11: 1'/1;' ('//. (:";i~ r,'//;.
f' I:. {- f
'IJ, 'Ii: '//. "/f,
(,'// t,,;/;, ('://; r'l( (:/f:' {'II:' r./,;
.{,' "If '-',If:;' ('//:' {'if:' ('II:' f:/!:,
(', f', r,' t, ,'. (
'//._ '1/:' 'I/~, 'I" '1/:. ",'t. 'If..
(:"t. (''1/:. <'j/:- (fl:' ("/1:' 'Il
(, ('11. (Ii' <:'i/. r,/..i
'.1, 'J,
1;", (;1, ,.
'/,
, " r'Jf , '';t' , , , , I/l: , '// , '/<
/I' '/1;' '/1,' 'I:' / ,,.
, "/' I /, "/i , /, I. , I, ./
.. I, ./,
GOK MOC 9/97
- .. ,
, Co~X~!,~~~ '~?~'?~hl~_:Yp~.~~"I'\;'Sr~~~~~~~t~~~i~~~~\~i~!~~'~ ~J;;~ '.~p~th n~;:'~}i;~ion.
Piigc'] or I
EXHIBIT F
TOWNSHIP'S
CERTIFICATE OF CITY NAMED.
AS ADDITIONAL INSURED
ON STATION #45
ACORD. CERTIFICATE 0FRt:LIABILlTY INSURANCE CSRTM I o.n'.....'llQIV'Y'Y'rl
, ~ . - CLAYC-2 05131106
.QOO"'U OO~@~OW~fTII THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION
Fearrin Insurance Agency ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
III N, Rangeline Road 1--' ) HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND DR
.I~
P.O. Box 126 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW.
Carmel IN 46082 ) UN ~. 0 006 I NAIC #
.1 i.
Phone: 317-846-4275 Fax: 317-848-4246 INSURERS AFFORDING COVERAGE
,~S~~(O '''SURER'' Cincinnati In~uranco Co. r 10677
'NSURERG I
Clay Civil Township , Clay "'SlJRERC I
Township Regional Waste Distr.
10701 North College Avenue 'HSUREAO I
Indianapolis IN 46280 I ..
'N5\,IRl;RE ". .--... .... --
, ..
COVERAGES
. ~. ., '.
'~f f'OI.iClU 01 'NSUIU.><CE LISTED IoEI.OW....ve ICE" 'SSUED TO THe !"SURED NAAlEO .oJlOV'l! 'OR THE "CIlley PERIllO ONO<C,UEO NOTW'THST....O..,G
.... REOlJ'Arr..E..,. TEA.. ()Ol COf<DITION 01'....1 CONTItt.CT 011 on.EA OOCIIWENT WIT" REsPECT TOW"oo. THIS CERTIJICATE.....1 SE ISSUED Oft
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It ~s agreed and understood that the City ot Carmel iB listed as an
additional insured on Fire Station '45.
REVISION
CERTIFICATE HOLDER
CANCELLATION
CITYO-l
IMOULD....lO'fNI....OVI OUCII..O ",lOCllIN CAHCll~IOIlUOIU! THE UI"lItA1'ION
O.T'(....lllf:Of.....EINUING'..IUR!Il....'lll..OU\o>ORTOWAA.
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HOTlCITOn<lCU!TIl'OC.T'(H(lLOl!Il.......EDTO...I..En.Iif!....UII1TOOOilO5t<Al.
CITY OF CARMEL
CIVIC CENTER, 1 CITY SQUARE
CARMEL IN 46032
""'I'ClII ~O OIlIGAno.. OR ~"",lLlT\' O,....~ ~'NO U_ ....llN.UII[R.ITI.o.GEI<n OR
RVllflV<f.rrvu
ACORD 2512001108)
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@A
RD CORPORATION 1988