HomeMy WebLinkAboutContract (2)1/1/26-1/1/27 Liability
Insurance Proposal -V2
Presented by:
Brian White, Senior Vice President
Anne Shackelford, Senior Vice President
Jamie Arnoldi, Account Executive
Date Presented December 23, 2025
City of Renton
Alliant Insurance Services, Inc.
401 Union Street, 31st Floor
Seattle, WA 98101
O 206 204 9140
F 206 204 9226
CA License No. 0C36861
www.alliant.com
CAG-25-362
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 1
Table of Contents
Your Service Team......................................................................................................................................................................................................2
Named Insured ............................................................................................................................................................................................................3
Cost Summary.............................................................................................................................................................................................................4
Liability Insurance Program Structure:.........................................................................................................................................................................5
Liability Insurance Program: Participating Carriers Financial Ratings.........................................................................................................................6
Liability Insurance Program - $25M Limit.....................................................................................................................................................................7
Disclosures ................................................................................................................................................................................................................12
NY Regulation 194..............................................................................................................................................................................................13
Privacy................................................................................................................................................................................................................13
FATCA:................................................................................................................................................................................................................13
NRRA:.................................................................................................................................................................................................................14
Guarantee Funds................................................................................................................................................................................................14
Claims Reporting:...............................................................................................................................................................................................14
Claims Made Policy:...........................................................................................................................................................................................14
Changes and Developments...............................................................................................................................................................................15
Certificates / Evidence of Insurance...................................................................................................................................................................16
Flood Disclosure........................................................................................................................................................................................................17
Optional Coverages...................................................................................................................................................................................................18
Glossary of Insurance Terms.....................................................................................................................................................................................19
Request to Bind Coverage.........................................................................................................................................................................................20
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 2
Your Service Team
Anne Shackelford
Senior Vice President
Anne.Shackelford@alliant.com Phone: 206 454 8021
Cell: 425 231 4714
Brian White
Senior Vice President
bwhite@alliant.com Phone: 206 204 9126
Cell: 415 203 5983
Kevin Miller
First Vice President
kamiller@alliant.com Phone: 206 204 9141
Austin Smith
Associate Producer
Austin.Smith@alliant.com Phone: 206 454 8032
Renee Judge
Assistant Vice President / Account Executive
rjudge@alliant.com Phone: 206 204 9174
Vicki Holaday, CRM, CIC
Assistant Vice President / Account Executive
vholaday@alliant.com Phone: 206 204 9138
J’nai Chatman, CIC, CRIS, CISR, CLCS, AINS
Account Executive
Jnai.Chatman@alliant.com Phone: 949 660 8179
Jamie Arnoldi
Account Executive
Jamie.Arnoldi@alliant.com Phone: 949 627 7000
Joyce Roberts, CISR
Account Executive
jeroberts@alliant.com Phone: 206 204 9175
Allyson Blue
Assistant Account Manager
Allyson.Blue@alliant.com Phone: 206 962 2075
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 3
Named Insured
City of Renton
NAMED INSURED DISCLOSURE
Name Insured(s) should match State of Incorporation filing. Inform Alliant if there is a difference or change
The First Named Insured policy status granted includes certain rights and responsibilities. These responsibilities do not apply to other Named Insureds on the policy. Some
examples for First Named Insured status include; (1) being designated to act on behalf of all insureds for making policy changes, (2) receiving of correspondence, (3) distributing
claim proceeds, and (4) making premium payments
Are ALL entities listed as named insureds?Coverage is not automatically afforded to all entities unless specifically named. Confirm with your producer and service team that
all entities to be protected are on the correct policy. Not all entities may be listed on all policies based on coverage line.
Additional named insured is (1) A person or organization, other than the first named insured, identified as an insured in the policy declarations or an addendum to the policy
declarations. (2) A person or organization added to a policy after the policy is written with the status of named insured. This entity would have the same rights and responsibilities
as an entity named as an insured in the policy declarations (other than those rights and responsibilities reserved to the first named insured).
Applies to Professional Liability, Pollution Liability, Directors & Officers Liability, Employment Practices Liability, Fiduciary Liability policies (this list not all inclusive). Check your
Policy language for applicability. These policies provide protection to the Named Insured for claims made against it alleging a covered wrongful act.
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 4
Cost Summary
Coverage Expiring Cost
$400K Self Insured Retention
Renewal Cost – Option 1
(Tentative)
Renew as Expiring except
$500K Self Insured Retention
Renewal Cost – Option 2
Restructure Placement:
Keep $400K Self Insured Retention &
2 Yr Rate Guarantee on Primary Layer
Liability Program - $25M Limit $909,033.87 $977,587.49 (+8%) $851,358.00 (-6%)
Note: Cost includes Surplus Lines Taxes and Fees. where applicable
Payment Terms
x Premium is due within 30 days of policy inception
x Agency Bill
x Payment Plan: Annual
Options:
x Metis $500,000 SIR- $776,358.00 (-15%)
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 5
Liability Insurance Program Structure:
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 6
Liability Insurance Program: Participating Carriers Financial Ratings
Market Capacity A.M. Best Ratings S&P Ratings Admitted/Non-Admitted
Safety National Casualty
Corporation 5M x SIR
A++ (Superior)
Financial Size Category: XV
(Greater than or Equal to $ 2.00 Billion)
as of November 19, 2025
A+ (Superior), as of
Sep 23, 2025 Admitted
Allied World Assurance Company
(U.S.) Inc
3M p/o 5M x 5M
5M X 20M
A (Excellent)
Financial Size Category: XV (Greater
than or Equal to USD 2.00 Billion) as of
May 22, 2025
A (Excellent), as of
Dec 04, 2023 Non-Admitted
Obsidian Insurance Company –
ASCS
Obsidan Insurance Company –
Metis
2M p/o 5M x 5M
7M x SIR
A- (Excellent)
Financial Size Category:
XII (USD 1.00 Billion to Less than 1.25
Billion) as of February 2, 2025
N/A Non-Admitted
Bowhead: Homesite Insurance
Company of Florida 2.5M x 10M
A (Excellent)
Financial Size Category:
XV (Greater than or Equal to USD 2.00
Billion) as of October 05, 2024
N/A Non-Admitted
Upland Specialty Insurance
Company 2.5M x 12.5M
A- (Excellent)
Financial Size Category:
VIII (USD 100 Million to Less than 250
Million) as of June 5, 2025
N/A Non-Admitted
Core: StarStone Specialty
Insurance Company 5M x 15M
A- (Excellent)
Financial Size Category:
XII (USD 1.00 Billion to Less than 1.25
Billion) as of October 9, 2025
N/A Non-Admitted
Palomar Excess and Surplus
Insurance Company 5M x 20M
A (Excellent)
Financial Size Category:
X (USD 500 Million to Less than 750
Million) as of September 11, 2025
N/A Non-Admitted
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 7
Liability Insurance Program - $25M Limit
Present Coverage Renewal Coverage – Option 1 (Tentative)
Primary Layer - Safety National
Renewal Coverage – Option 2
Primary Layer - Obsidian
Policy/Coverage Term January 1, 2025 to January 1, 2026 January 1, 2026 to January 1, 2027 January 1, 2026 to January 1, 2027
Excess Liability Coverages
Including
Each Occurrence/Wrongful Act/Accident for
General Liability, Automobile Liability, Law
Enforcement Liability, Public Officials and
Employment Practices Liability, Stop Gap
(Employer’s Liability)
Each Occurrence/Wrongful Act/Accident for
General Liability, Automobile Liability, Law
Enforcement Liability, Public Officials and
Employment Practices Liability, Stop Gap
(Employer’s Liability)
Each Occurrence/Wrongful Act/Accident
for General Liability, Automobile Liability,
Law Enforcement Liability, Public
Officials and Employment Practices
Liability, Stop Gap (Employer’s Liability)
Policy Form Occurrence Occurrence Occurrence
Limit of Liability $25,000,000 Occurrence
$25,000,000 Aggregate
$500,000 Damage Premises Rented to You
$25,000,000 Products-Completed
Operations Aggregate
$25,000,000 Employee Benefits Liability
$25,000,000 Law Enforcement Liability
$25,000,000 Auto Liability
$25,000,000 Public Officials Liability/
Employment Practices Liability
$25,000,000 Occurrence
$25,000,000 Aggregate
$500,000 Damage Premises Rented to You
$25,000,000 Products-Completed
Operations Aggregate
$25,000,000 Employee Benefits Liability
$25,000,000 Law Enforcement Liability
$25,000,000 Auto Liability
$25,000,000 Public Officials Liability/
Employment Practices Liability
$25,000,000 Occurrence
$25,000,000 Aggregate
$500,000 Damage Premises Rented to
You
$25,000,000 Products-Completed
Operations Aggregate
$25,000,000 Employee Benefits Liability
$25,000,000 Law Enforcement Liability
$25,000,000 Auto Liability
$25,000,000 Public Officials Liability/
Employment Practices Liability
Self-Insured Retention All
Coverages,
Any One Occurrence or
Wrongful Act
$400,000 Self-Insured Retention $500,000 Self-Insured Retention $400,000 Self-Insured Retention
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 8
Key Endorsement & Exclusions
(including but not limited to)
x Public Entity Excess Retained Limits
Liability Insurance Policy
x Washington – Amendatory
Endorsement
x Washington Disclosure Notice for
“Large Commercial Account”
x Commercial Policy Cover
x Privacy Statement
x Schedule of Named Insured(s)
x U.S. Treasury Department’s Office of
Foreign Assets Control (“OFAC”)
Advisory Notice to Policyholders
x Fraud Statement
x Schedule of Forms and Endorsements
x Additional Insured – Scheduled
Contracts (GL, AL)
x Clash Coverage(ALL Lines)
x Common Policy Change – Stop Gap –
Employers Liability Coverage
Endorsement (Washington) (GL) –
PEM-GL 007 0123
x Employee Benefits Liability Coverage
x Primary and NonContributory - Other
Insurance Condition (GL/AL only)
x Scheduled Dams (GL)
x Scheduled Watercraft (GL, LEL)
x Waiver of Subrogation (GL/AL only)
Cap on Losses from Certified Acts of
Terrorism (if TRIA accepted)
x Disclosure Pursuant to Terrorism Risk
Insurance Act
x Exclusion – Perfluoroalkyl and
Polyfluoroalkyl Substances (PFAS)
x Public Entity Excess Retained Limits
Liability Insurance Policy
x Washington – Amendatory
Endorsement
x Washington Disclosure Notice for
“Large Commercial Account”
x Commercial Policy Cover
x Privacy Statement
x Schedule of Named Insured(s)
x U.S. Treasury Department’s Office of
Foreign Assets Control (“OFAC”)
Advisory Notice to Policyholders
x Fraud Statement
x Schedule of Forms and Endorsements
x Additional Insured – Scheduled
Contracts (GL, AL)
x Clash Coverage(ALL Lines)
x Common Policy Change – Stop Gap –
Employers Liability Coverage
Endorsement (Washington) (GL) –
PEM-GL 007 0123
x Employee Benefits Liability Coverage
x Primary and NonContributory - Other
Insurance Condition (GL/AL only)
x Scheduled Dams (GL)
x Scheduled Watercraft (GL, LEL)
x Waiver of Subrogation (GL/AL only)
Cap on Losses from Certified Acts of
Terrorism (if TRIA accepted)
x Disclosure Pursuant to Terrorism Risk
Insurance Act
x Exclusion – Perfluoroalkyl and
Polyfluoroalkyl Substances (PFAS)
x Excess of Retained Limits Dec Page
x Excess of Retained Limits Policy
x Fraud Notice
x TRIA
x Notice of Cancellation
x Schedule of Limits of Insurance
x Trade or Economic Sanctions
x Caps on Losses from Certified Acts of
Terrorism Disclosure Pursuant to Terrorism
Risk Insurance Act
x Exclusion- Perfluoroalkyl and
Polyfluoroalkyl Substances (PFAS)
x In-House Counsel Endorsement ($200 /
hour)
x Employee Auto Amendatory endorsement
x Incidental MedMal – Law Enforcement
endorsement
x Blanket Additional Insured
x Blanket Waiver of Subrogation
x Blanket Primary and non-contributory
x Amendatory Endorsement – Co Employee
x Amendatory Endorsement – Modified
Defense and Settlement (Consent to Settle)
x Punitive and Exemplary Damages Where
Allowed By Law
x Clash Coverage
x Dam Exclusion Removal
x Retained Limit / Other Insurance
Amendatory
x 90 Day Notice of Cancellation
x Exclusion - Subsidence
x Exclusion – Losses arising from EDP
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 9
x Common Policy Change – Limits of
Indemnity Apply Per Member (All
Lines) – PEM 024 0123
x Mid-Term Endorsements
x Failure to Supply Public Utilities Post
Sudden/Accidental Physical Damage
x Aircraft, unmanned aircraft, airport,
airfields, runways, hangars, buildings
or other properties - Excluded except
for access roads to parking
lots/garages
x Incidental Medical Services, as
defined in policy-Not Excluded from
GL only
x Insured vs. Insured-Not excluded from
EPL
x Amended Definition of Bodily Injury to
include Mental Anguish, Shock, etc.
x Use of Watercraft – Use of onshore
only; less than 26’ for non-owned;
liability assumed under an insured
contract
x Medical Expense Coverage-Excluded
x Organic Pathogens-Excluded from
$2.5Mx$10M and upward
x Biometric Identifiers, Biometric Info
and Data Privacy- Excluded from
$5Mx$5M and upward
x Modified SIR – Periodic Claim
Reporting- Quarterly Reporting
Requirement
x Cyber Coverage-Excluded
x ERISA Coverage-Excluded
x Common Policy Change – Limits of
Indemnity Apply Per Member (All
Lines) – PEM 024 0123
x Mid-Term Endorsements
x Failure to Supply Public Utilities Post
Sudden/Accidental Physical Damage
x Aircraft, unmanned aircraft, airport,
airfields, runways, hangars, buildings
or other properties - Excluded except
for access roads to parking
lots/garages
x Incidental Medical Services, as
defined in policy-Not Excluded from
GL only
x Insured vs. Insured-Not excluded from
EPL
x Amended Definition of Bodily Injury to
include Mental Anguish, Shock, etc.
x Use of Watercraft – Use of onshore
only; less than 26’ for non-owned;
liability assumed under an insured
contract
x Medical Expense Coverage-Excluded
x Organic Pathogens-Excluded from
$2.5Mx$10M and upward
x Biometric Identifiers, Biometric Info
and Data Privacy- Excluded from
$5Mx$5M and upward
x Modified SIR – Periodic Claim
Reporting- Quarterly Reporting
Requirement
x Cyber Coverage-Excluded
x ERISA Coverage-Excluded
x Exclusion – Aircraft Liability except for GL in
public areas open to public of entering,
leaving or using airport facilities
x Exclusion -
Fungi/Bacteria/Silica/Asbestos/Lead
x Exclusion – Criminal, fraudulent, dishonest
or malicious acts including intentional,
willful, reckless violation of federal, state or
local statute.
x Exclusion – Electromagnetic field related
losses
x Exclusion – Eminent domain,
condemnation, inverse condemnation, etc.
x Exclusion – Administration of Employee
Benefits Plan
x Exclusion – Liability arising out of failure to
supply gas, oil, electricity, steam or biofuel;
does not apply to failure to supply water.
x Exclusion – Liability arising investing or
management of fiduciary capacity under
ERISA
x Exclusion - Any costs, civil fines, penalties
or expenses levied or imposed against an
Insured arising from a complaint or
enforcement action from any federal, state,
or local government regulatory agency.
x Exclusion – Any costs for claims handling
within a retention
x Exclusion – Ownership, operation of
hospital, emergency room, convalescent
home, nursing home or healthcare facility;
exclusion does not apply to Incidental
Medical Services
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 10
x Fungi/Bacteria/Silica/Asbestos/Lead-
Excluded
x Nuclear Energy Liability
x Mace, Tear Gas, Pepper Spray or
Similar used in Law Enforcement
Activities- Not Excluded from LEL only
x War, warlike action, insurrection-
Excluded
x TCPA, CAN-SPAM, FCRA and
FACTA acts or omissions violations-
Excluded
x Moonlighting (Written approval only)-
Not Excluded
x Total Pollution Exclusion except for
Hostile Fire Exception-Not Excluded
x Punitive Damages-Excluded
x Incidental Medical Services, as
defined in policy- Not Excluded from
GL only
x Claims or suits arising out of hospital,
emergency room, convalescent home,
nursing home or other healthcare
facility-Excluded
x Costs, fines, penalties or expenses
arising from complaint or action from
federal, state or local gov’t. regulatory
agency-Excluded
x Claims/suits arising out of eminent
domain, condemnation, inverse
condemnation, etc. Excluded
x Electromagnetic fields related claims-
Excluded
x Fungi/Bacteria/Silica/Asbestos/Lead-
Excluded
x Nuclear Energy Liability
x Mace, Tear Gas, Pepper Spray or
Similar used in Law Enforcement
Activities- Not Excluded from LEL only
x War, warlike action, insurrection-
Excluded
x TCPA, CAN-SPAM, FCRA and
FACTA acts or omissions violations-
Excluded
x Moonlighting (Written approval only)-
Not Excluded
x Total Pollution Exclusion except for
Hostile Fire Exception-Not Excluded
x Punitive Damages-Excluded
x Incidental Medical Services, as
defined in policy- Not Excluded from
GL only
x Claims or suits arising out of hospital,
emergency room, convalescent home,
nursing home or other healthcare
facility-Excluded
x Costs, fines, penalties or expenses
arising from complaint or action from
federal, state or local gov’t. regulatory
agency-Excluded
x Claims/suits arising out of eminent
domain, condemnation, inverse
condemnation, etc. Excluded
x Electromagnetic fields related claims-
Excluded
x Exclusion – Insured vs. Insured; except for
EPL
x Exclusion – Nuclear Energy, Hazardous
Properties, Nuclear Material
x Exclusion - The actual, alleged or
threatened discharge, dispersal, seepage,
migration, release or escape of Pollutants
in any way, at any time, or at any place.
x Exclusion - Any liability arising out of duties
performed by an Insured for anyone other
than the Named Insured; except for Law
Enforcement in course of moonlighting but
with specific written prior approval
x Exclusion - TCPA, CAN-SPAM, FCRA and
FACTA acts or omissions violations
x Exclusion – War, including undeclared civil
war
x Exclusion – Watercraft exposures, except
watercraft while ashore on owned
premises; unowned watercraft less than 25
feet in length; liability assumed under
insured contract
x Exclusion – Any liability, Claim or Suit for
which you may be held liable under any
workers compensation law, unemployment
law, unemployment compensation law,
disability benefits law, or attributable to any
obligations pursuant to any worker's
compensation, disability benefits,
unemployment compensation,
unemployment insurance, retirement
benefits, social security benefits or similar
law.
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 11
x Loss of data, personal records, trade
secrets, health information-Excluded
x Subsidence-Excluded
x Failure to Supply Public Utilities Post
Sudden/Accidental Physical Damage-
Excluded
x Loss of data, personal records, trade
secrets, health information-Excluded
x Subsidence-Excluded
x Failure to Supply Public Utilities Post
Sudden/Accidental Physical Damage-
Excluded
Risk Management Subsidy $10,000 $10,000 $10,000
Total Cost for Program $909,033.87 $977,587.49 (+8%)$851,358.00 (-6%)- $400,000 SIR
$776,358.00 (-15%) $500,000 SIR
Binding Conditions No Longer Applicable x A written request to bind coverage
x All Surplus Lines Taxes/Fees are Fully
Earned
x Receipt of signed terrorism form prior
to binding.
x 2-year Rate Guarantee on Obsidian primary
$7M Layer
x A written request to bind coverage
x All Surplus Lines Taxes/Fees are Fully
Earned
x Receipt of signed terrorism form prior to
binding.
See Disclaimer Page for Important Notices and Acknowledgment
Acknowledgment
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 12
Disclosures
This proposal of insurance is provided as a matter of convenience and information only. All information included in this proposal, including but not
limited to personal and real property values, locations, operations, products, data, automobile schedules, financial data and loss experience, is based
on facts and representations supplied to Alliant Insurance Services, Inc. by you. This proposal does not reflect any independent study or investigation
by Alliant Insurance Services, Inc. or its agents and employees.
Please be advised that this proposal is also expressly conditioned on there being no material change in the risk between the date of this proposal
and the inception date of the proposed policy (including the occurrence of any claim or notice of circumstances that may give rise to a claim under
any policy which the policy being proposed is a renewal or replacement). In the event of such change of risk, the insurer may, at its sole discretion,
modify, or withdraw this proposal, whether or not this offer has already been accepted.
This proposal is not confirmation of insurance and does not add to, extend, amend, change, or alter any coverage in any actual policy of insurance
you may have. All existing policy terms, conditions, exclusions, and limitations apply. For specific information regarding your insurance coverage,
please refer to the policy itself. Alliant Insurance Services, Inc. will not be liable for any claims arising from or related to information included in or
omitted from this proposal of insurance.
Alliant embraces a policy of transparency with respect to its compensation from insurance transactions. Details on our compensation policy, including
the types of income that Alliant may earn on a placement, are available on our website at www.alliant.com. For a copy of our policy or for any inquiries
regarding compensation issues pertaining to your account you may also contact us at: Alliant Insurance Services, Inc., Attention: General Counsel,
701 B Street, 6th Floor, San Diego, CA 92101.
Analyzing insurers' over-all performance and financial strength is a task that requires specialized skills and in-depth technical understanding of all
aspects of insurance company finances and operations. Insurance brokerages such as Alliant Insurance typically rely upon rating agencies for this
type of market analysis. Both A.M. Best and Standard and Poor's have been industry leaders in this area for many decades, utilizing a combination
of quantitative and qualitative analysis of the information available in formulating their ratings.
A.M. Best has an extensive database of nearly 6,000 Life/Health, Property Casualty and International companies. You can visit them at
www.ambest.com. For additional information regarding insurer financial strength ratings visit Standard and Poor's website at
www.standardandpoors.com.
Our goal is to procure insurance for you with underwriters possessing the financial strength to perform. Alliant does not, however, guarantee the
solvency of any underwriters with which insurance or reinsurance is placed and maintains no responsibility for any loss or damage arising from the
financial failure or insolvency of any insurer. We encourage you to review the publicly available information collected to enable you to make an
informed decision to accept or reject a particular underwriter. To learn more about companies doing business in your state, visit the Department of
Insurance website for that state.
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 13
NY Regulation 194
Alliant Insurance Services, Inc. is an insurance producer licensed by the State of New York. Insurance producers are authorized by their license to
confer with insurance purchasers about the benefits, terms and conditions of insurance contracts; to offer advice concerning the substantive benefits
of particular insurance contracts; to sell insurance; and to obtain insurance for purchasers. The role of the producer in any particular transaction
typically involves one or more of these activities.
Compensation will be paid to the producer, based on the insurance contract the producer sells. Depending on the insurer(s) and insurance contract(s)
the purchaser selects, compensation will be paid by the insurer(s) selling the insurance contract or by another third party. Such compensation may
vary depending on a number of factors, including the insurance contract(s) and the insurer(s) the purchaser selects. In some cases, other factors
such as the volume of business a producer provides to an insurer or the profitability of insurance contracts a producer provides to an insurer also
may affect compensation.
The insurance purchaser may obtain information about compensation expected to be received by the producer based in whole or in part on the sale
of insurance to the purchaser, and (if applicable) compensation expected to be received based in whole or in part on any alternative quotes presented
to the purchaser by the producer, by requesting such information from the producer.
Privacy
At Alliant, one of our top priorities is making sure that the information we have about you is protected and secure. We value our relationship with you
and work hard to preserve your privacy and ensure that your preferences are honored. At the same time, the very nature of our relationship may
result in Alliant’s collecting or sharing certain types of information about you in order to provide the products and services you expect from us. Please
take the time to read our full Privacy Policy posted at www.alliant.com, and contact your Alliant service team should you have any questions.
Other Disclosures / Disclaimers
FATCA:
The Foreign Account Tax Compliance Act (FATCA) requires the notification of certain financial accounts to the United States Internal Revenue
Service. Alliant does not provide tax advice so please contact your tax consultant for your obligation regarding FATCA.
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 14
Other Disclosures / Disclaimers - Continued
NRRA:
The Non-Admitted and Reinsurance Reform Act (NRRA) went into effect on July 21, 2011. Accordingly, surplus lines tax rates and regulations are
subject to change which could result in an increase or decrease of the total surplus lines taxes and/or fees owed on this placement. If a change is
required, we will promptly notify you. Any additional taxes and/or fees must be promptly remitted to Alliant Insurance Services, Inc.
Guarantee Funds
Established by law in every state, guaranty funds are maintained by a state's insurance commissioner to protect policyholders in the event that an
insurer becomes insolvent or is unable to meet its financial obligations. If your insurance carrier is identified as ‘Non-Admitted’, your policy is not
protected by your state’s Guaranty Fund.
Claims Reporting:
Your policy will come with specific claim reporting requirements. Please make sure you understand these obligations. Contact your Alliant Service
Team with any questions.
Claims Made Policy:
This claims-made policy contains a requirement stating that this policy applies only to any claim first made against the Insured and reported to the
insurer during the policy period or applicable extended reporting period. Claims must be submitted to the insurer during the policy period, or applicable
extended reporting period, as required pursuant to the Claims/Loss Notification Clause within the policy in order for coverage to apply. Late reporting
or failure to report pursuant to the policy’s requirements could result in a disclaimer of coverage by the insurer.
Any Employment Practices Liability (EPL) or Directors & Officers (D&O) with EPL coverage must give notice to the insurer of any charges / complaints
brought by any state / federal agency (i.e. EEOC and similar proceedings) involving an employee. To preserve your rights under the policy, it is
important that timely notice be given to the insurer, whether or not a right to sue letter has been issued.
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 15
Other Disclosures / Disclaimers - Continued
Changes and Developments
It is important that we be advised of any changes in your operations, which may have a bearing on the validity and/or adequacy of your insurance.
The types of changes that concern us include, but are not limited to, those listed below:
Changes in any operations such as expansion to another state, new products, or new applications of existing products.
Travel to any state not previously disclosed.
Permanent operations outside the United States, Canada or Puerto Rico.
Mergers and/or acquisition of new companies and any change in business ownership, including percentages.
Any newly assumed contractual liability, granting of indemnities or hold harmless agreements.
Any changes in existing premises including vacancy, whether temporary or permanent, alterations, demolition, etc. Also, any new premises
either purchased, constructed or occupied
Circumstances which may require an increased liability insurance limit.
Any changes in fire or theft protection such as the installation of or disconnection of sprinkler systems, burglar alarms, etc. This includes any
alterations to the system.
Immediate notification of any changes to a scheduled of equipment, property, vehicles, electronic data processing, etc.
Property of yours that is in transit, unless previously discussed and/or currently insured.
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 16
Other Disclosures / Disclaimers - Continued
Certificates / Evidence of Insurance
A Certificate or Evidence is issued as a matter of information only and confers no rights upon the certificate holder. The certificate does not
affirmatively or negatively amend, extend or alter the coverage afforded by a policy, nor does it constitute a contract between the issuing insurer(s),
authorized representative, producer or recipient.
You may have signed contracts, leases or other agreements requiring you to provide this evidence. In those agreements, you may assume
obligations and/or liability for others (Indemnification, Hold Harmless) and some of the obligations that are not covered by insurance. We
recommend that you and your legal counsel review these documents.
In addition to providing a Certificate or Evident of Insurance, you may be required to name your landlord, client or customer on your policy as a loss
payee on property insurance or as an additional insured on liability insurance. This is only possible with permission of the insurance company,
added by endorsement and, in some cases, an additional premium.
By naming the certificate holder as additional insured, there are consequences to your risks and insurance policy including:
Your policy limits are now shared with other entities; their claims involvement may reduce or exhaust your aggregate limit.
Your policy may provide higher limits than required by contract; your full limits can be exposed to the additional insured.
There may be conflicts in defense when your insurer has to defend both you and the additional insured.
An additional insured endorsement will most likely not provide notification of cancellation. Some insurance companies use a “blanket”
additional insured endorsement that provides coverage automatically when it is required in a written contract. Most insurance companies do
not want to be notified of all additional insureds when there is a blanket endorsement on the policy. If a notice of cancellation is required for
the additional insured party, you must notify us immediately and we will request an endorsement from your insurance company. There may
be an additional premium for adding a notice of cancellation endorsement for an additional insured.
See Request to Bind Coverage page for acknowledgement of all disclaimers and disclosures.
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 17
Flood Disclosure
Flooding is a serious threat to both personal and commercial clients. Flooding can happen anywhere, not just zone referred to as high-risk areas
(Special Flood Hazard Area). Your Alliant team is ready to explain how it works and the associated costs.
Basic Facts
Congress created the NFIP in 1968 in response to the rising cost of taxpayer-funded disaster relief for flood victims and the increasing amount of
damage caused by floods. The NFIP makes federally backed flood insurance available in communities that agree to adopt and enforce floodplain
management ordinances to reduce future flood damage. The NFIP is self-supporting for the average historical loss year. This means that unless
there is a widespread disaster, operating expenses and flood insurance claims are financed through premiums collected.
Commercial buildings or residential dwellings owned by commercial entities are considered commercial property. All others are residential dwellings
The FEMA Summary for Commercial Property and FEMA Standard Summary of Coverage provides information on the following:
x Types of Flood Insurance Coverage
x What is a Flood- “a General and temporary condition of partial or complete inundation of two or more acres of normally dry land area”…
x Deductibles – various options to meet your financial needs
x What is Covered and What is Not
x The valuation of the Property – Actual Cash Value or Replacement Cost
Additional Information
x Flood Zones
o https://www.fema.gov/flood-zones
x Excess Flood Insurance (contact your Producer for additional information)
o Increased limits over the maximum flood limit provided by NFIP
FEMA Glossary of Flood Terms
https://www.fema.gov/national-flood-insurance-program/definitions
Please indicate your selection:
տ I would like to receive a flood quote
տ I do NOT wish to purchased flood insurance
Signature:Date:
Name Printed / Typed:
Company Name:
/s/ 12/23/2025
to purchased flood insu
Krista Kolaz, Risk Manager
City of Renton
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 18
Optional Coverages
The following represents a list of insurance coverages that may not be included in this proposal but are optional and may be available with further
underwriting information. This list is not inclusive of all coverages and if you have questions contact your Alliant representative. If you would like
addition quotes please check Yes/No across from the coverage below, sign and return.
Target Coverages
Yes No
CRIME
Employee Dishonesty ܆܆
Computer Fraud ܆܆
Social Engineering ܆܆
Increased Limits ܆܆
CYBER R ISK ܆܆
FLOOD INSURANCE ܆܆
MANAGEMENT L IABILITY
Directors & Officers Liability ܆܆
Employment Practices Liability ܆܆
Fiduciary Liability ܆܆
Selecting the “Reject All or Accept All” option will override any selections you have made above ܆ Reject All
܆ Accept All for Consideration
Signature of Authorized Insurance Representative Date
Title
Printed / Typed Name
Authorized Insurance
Reject All or Accept Al
/s/
Risk Manager
Krista Kolaz
12/23/2025
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 19
Optional Coverages – Continued
Other Coverage Options
Note some of these coverages may be included with limitations or insured elsewhere. This is a partial listing as you may have additional risks not
contemplated here which are unique to your organization.
x Business Income/Extra Expense
x Earthquake
x Employed Lawyers
x Employee Benefits Liability
x Equipment Breakdown
x Food Borne Illness
x Foreign Insurance
x Garagekeepers Liability
x Hired Auto Physical Damage
x Kidnap & Ransom
x Law Enforcement Liability
x Media and Publishers Liability
x Network Security / Privacy Liability and Internet Media Liability
x Non-Owned & Hired Automobile Liability
x Pollution Liability
x Owned/Non-Owned Aircraft
x Owned Watercraft
x Professional Liability
x Property in Transit
x Property of Others (Clients, Employees, Other)
x Special Events Liability
x Spoilage
x Student Accident
x Volunteer Accidental Death & Dismemberment (AD&D)
x Workers Compensation & Employers Liability
x Workplace Violence
Glossary of Insurance Terms
Below are links to assist you in understanding the insurance terms you may find within your insurance coverages:
http://insurancecommunityuniversity.com/university-resources/insurance-glossary-free
https://consumers.ambest.com/content.aspx?rec=261613
http://www.irmi.com/online/insurance-glossary/default.aspx
Alliant Insurance Services, Inc. | www.alliant.com | CA License No. 0C36861 Page 20
Request to Bind Coverage
City of Renton January 1, 2026 to January 1, 2027
We have reviewed the proposal and agree to the terms and conditions of the coverages presented. We are requesting coverage to be bound as outlined
by coverage line below:
Coverage Line Bind Coverage for
1/1/26-1/1/27
Liability Program - $25,000,000
x Metis/Obsidian Led - $400K SIR ܆
x Metis/Obsidian Led - $500K SIR ܆
x Safety National Led - $500K SIR ܆
Did you know that Alliant works with premium financing companies? Are you interested in financing your annual premium?
Yes, please provide us with a financing quote. No, we do not wish to finance our premium.
տտ
This Authorization to Bind Coverage also acknowledges receipt and review of all disclaimers and disclosures, including exposures used to develop
insurance terms, contained within this proposal.
Signature of Authorized Insured Representative Date
Title
Printed / Typed Name
This proposal does not constitute a binder of insurance. Binding is subject to the final carrier approval. The actual terms and conditions of the policy will prevail.
Mayor, City of Renton
Armondo Pavone
12/29/2025
Attest:____________________________
Jason Seth, City Clerk