FORSYTH COUNTY SCHOOLS REQUEST FOR ......1 FORSYTH COUNTY SCHOOLS REQUEST FOR PROPOSAL INSURANCE BROKER SERVICES September 12, 2019 Finance Department 1120 Dahlonega Highway Cumming,

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FORSYTH COUNTY SCHOOLS

REQUEST FOR PROPOSAL

INSURANCE BROKER SERVICES

September 12, 2019

Finance Department 1120 Dahlonega Highway

Cumming, GA 30040

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PURPOSE OF SOLICITATION Forsyth County Schools (“District”) is soliciting proposals from qualified, pre-selected insurance agents/brokers to provide professional services beginning in January of 2020. The District expects to enter into an agreement that will provide stability over a multi-year period, subject to the applicable Georgia Law governing school districts, (OCGA 20-2-506). The types of professional services requested in this Request for Proposal (RFP) are detailed in the Scope of Services. The process will involve two phases, the first of which is to select a broker(s), the second is for the broker to solicit and present insurance quotations to the District. In addition to the Terms and Conditions herein, this solicitation shall incorporate FCS Purchasing Policy and Procedure, as applicable. These can be found at: https://www.forsyth.k12.ga.us/Page/67

BACKGROUND/INTRODUCTION Forsyth County School District is located north of Atlanta. Cumming is the County Seat and the district encompasses 247 square miles. There are nearly 50,000 students in 39 schools: 21 elementary, 10 middle, one virtual 6-12 school, in seven high schools, and 1 college and career high school. The District employs approximately 5,100 FTE/7,643 full/part-time employees and substitutes. The Administrative offices are located at 1120 Dahlonega Highway, Cumming. Other administrative and support facilities are located elsewhere in the District. The District is governed by a five-member Board with a framework of policies and procedures intended to control the total cost of risk. Instructional leadership and operation support for the schools is brought together through Dr. Jeff Bearden, Superintendent. Mr. Larry Hammel is the Chief Financial Officer and has responsibility for risk management at the enterprise level. Ms. Kelly Cianciolo is the District Workers’ Compensation Coordinator. Mr. Brad Richardson, Purchasing Director and Mr. Steve Atha, Finance Director are involved in certain aspects of the risk management program. Other key Central Office Administrators with risk management responsibilities include Dr. Cindy Salloum, Human Resources and Legal Services; Mr. Todd Shirley, Operations and Safety; Mr. Matt Wark, Facilities and Maintenance; Mr. Michael Satterfield, Transportation; Ms. Valerie Bowers, Nutrition. The Principals and Assistant Principals at each campus also have essential leadership roles in the District’s approach to managing risk and sustaining a highly ready, reliable, and resilient culture.

https://linkprotect.cudasvc.com/url?a=https%3a%2f%2fwww.forsyth.k12.ga.us%2fPage%2f67&c=E,1,AF-VwmYronYfFQ5sbh7Z7PWH45pvLmJ4YbToJUUBYDVpVdjR_e21An_w98vaQ0A8QbgxGDL50P1zVHZzSK0nCqzRFxwSWwwxIAcZQqM8ApfY7w,,&typo=1

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OVERVIEW of the PROCESS The District is seeking proposals for professional services that will result in risk financing and insurance programs suitable to its needs, and not limited to its current program structure. All current insurance policies have anniversary dates of July 1, 2020. The selected Broker(s) will be assigned to obtain competitive proposals for the property and casualty coverage purchased by the District. The District may elect to assign the entire program responsibility to a single firm (preferred), it may divide the program with property lines and liability lines assigned to separate firms, choose an alternatives to insurance for some or all lines, or maintain the current insurance program structure with a separate broker solely for the Excess Workers’ Compensation. There will be a period of transition leading up to the anniversary of existing coverage during which the incumbent brokers will continue to be responsible for reporting new claims, advocating for the District on open claims, and fulfilling contractual obligations for project services. Broker of Record letters will be issued in accordance with the norms and generally accepted practices for exclusive placement arrangements. The District is not aware of any placement limitations that exist with its current underwriters. The District intends to continue its relationship and contract with Georgia Administrative Services beyond July 1, 2020 for management of self-insured workers’ compensation claims. PROPOSAL EVALUATION Broker selection will be based on knowledge and appreciation of the school district insurance coverages and risk financing needs, experience with public schools, ability to secure multiple quotes from underwriters, quality year round customer experience, and overall knowledge of school business management. The following criteria are important to the District, not necessarily in order of importance:

1. Expertise and experience in providing insurance brokerage services with Georgia public school districts.

2. Qualifications of Personnel in the area of property and casualty insurance. 3. References from public sector entities and clients, which are comparable to the

District. 4. Ability to respond efficiently to requests for services. 5. Understanding of the Scope of Work and ability to work collaboratively with the

District, its employees and other stakeholders. 6. Quality of the broker’s proposal including, responsiveness and adequacy of

information provided. 7. Fee/payment structure to service this account 8. Interview responses.

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The District and its advisors will analyze all responses and materials submitted in accordance with the instructions and deadlines. PROPOSAL DUE DATE Proposals will be due by 4:00 p.m. (Eastern Standard Time), Thursday, October 17, 2019. Proposals will be accepted if submitted in a sealed envelope, marked clearly “Broker Services Proposal” and delivered to the attention of Mr. Larry Hammel, CFO, at the Purchasing Department at 441 Canton Highway, Cumming GA 30040. The contents should only include the original proposal document(s), a duplicate paper copy and, a thumb drive with the document(s) stored for electronic access. INTERVIEWS AT THE DISTRICT Interviews of candidates selected at the District’s discretion will be held October 23 and 24 at the District offices. The District will schedule times on these dates that provide optimal conditions for the parties. NOTICE OF DECISION As soon as practical after authorization to enter into a contract has been granted, all applicants will be notified of the District’s decisions. INFORMATION FOR PROPOSAL PREPARATION Due care and diligence has been used in the preparation of information that may be helpful to candidates participating in this process. The responsibility for collecting other supporting information and verification needed for the proposal shall rest solely upon the proposer. The following is included with this RFP and can be found below, with additional supporting information in the Exhibits.

• Suggested Proposal Outline for Broker • Exposure Information • Coverage and Insurer Information • Loss Experience • Premium Information • Outline of the District’s Broker Contract • Priority Objectives for District Risk Management Development

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COVERAGE, INSURER and BROKER OVERVIEW With the exception of Workers’ Compensation excess insurance, all of the District’s coverage is currently placed by one firm, which will be referred to as Broker A. The District’s relationship with Broker A has been longstanding. These four insurance companies are currently involved in the placement:

1. Markel 2. Travelers 3. Hartford Steam Boiler & Inspection Co. 4. Hiscox

Apex Insurance, as an intermediary for Broker A, has also been involved in recent years. Apex works closely with Wright Specialty Insurance, the program manager for Markel Insurance. The lines of coverage that Markel currently writes were previously placed by other companies represented by Apex and Wright Specialty. Workers’ Compensation excess insurance is placed with Safety National by Broker B. The coverage anniversary was changed from May 1 to July 1. Responsibility for this placement was transferred in May 2018 by Broker of Record letter from another broker, which had been responsible for more than ten years. Broker B is currently engaged by the District to provide consulting services for improvement of District claims management and loss prevention. Continuation of these services beyond the current contract period will be subject to review at a later date, and therefore this RFP does not contemplate the inclusion of such services. Separately, the District is also considering whether it should create a new position for district wide workplace injury prevention. Broker A and Broker B are currently compensated solely on a fixed annual fee basis. The underwriters have agreed to net out commissions from premiums. The District recognizes that this may not always be possible in all cases. The Exhibits include detailed outlines of current limits of and deductibles/retentions and an illustration of the coverage structure. PREMIUM and LOSS SUMMARIES Data for all other lines of coverage is provided to the District from Apex Insurance Services. In the Exhibits there are the following:

• Summary of Liability and Property Claims for 2011-2019. • Loss Detail Summary for 2018 and 2019 .

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There have not been any claims by the District to its insurers in the past three years for Cyber Liability/Data Breach, Mechanical Breakdown and Explosion, and Crime/Fidelity. Data for workers’ compensation is provided to the District from its third-party claims administrator, Georgia Administrative Services. In the Exhibits there are the following:

• Summary of WC Claims for 2015-2019 • Loss Detail Summary for 2018 and 2019 • Dashboard Report as of 8/29/19

EXPOSURE DATA The District General Fund operating budget for the 2019-2020 (FY20) school year is approximately $480 MM. The District’s approved Budget and audited financial statements are available online at: https://www.forsyth.k12.ga.us/domain/4886 Exposure information is included in the Exhibits for the following:

• Current Year Payroll Estimate and Employees by Class Code • Vehicle Schedule • Buildings and Contents Schedule • Mobile Equipment Schedule

SCOPE OF SERVICES The broker will be expected to represent the District’s interests, delivering exceptional agency support for a large public entity account with service to include, but not limited to the following:

A. Develop strategies for placement that use best available risk financing approaches and methods to satisfy the District’s tolerance for volatility and interest in conservation of public assets.

B. Advise and assist the school district in assembling and accurately reporting underwriting data for renewal and rating purposes; maintain general familiarity with the structure and operations of the district.

C. Market insurance and assist the school district in evaluating and selecting coverage alternatives such as deductibles, limits, optional coverage and alternative coverage forms.

D. Review coverage documents and invoices to assure that coverage has been correctly issued and billed; collect and promptly remit premiums on behalf of the district.

E. Advise the district on potential gaps or overlaps in coverage. F. Review and offer insights on loss experience reports for correct reporting, and

appropriateness of reserves, not less than every 3 months; serve as the District’s advocate for claims under this agreement.

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G. Assist with risk improvement, safety and loss control activities, including participation with insurance company representatives and fulfillment of annual service priorities agreed upon with the District.

H. Assist the school district in identifying risk exposures and developing appropriate strategies to address those exposures.

I. Issue Certificates of Insurance to third parties on behalf of the District and maintain a complete registry.

J. Advise on contractual risk transfer policies and procedures as requested. K. Carry out a stewardship program with school district representatives that includes

regular meetings to review as aspects of risk management, claims management, developments and progress with new approaches, changes in the insurance market relevant to the district, and other issues deemed to be appropriate; an annual report is expected.

L. Advise and guide with the following: • Assist with the annual assessment report for the Georgia WCB; calculate an

experience modification that can be used for the assessment. • Evaluation of Property Appraisal needs; offer insights regarding actuary

selection factor and available firms. • Evaluation of Claims Audit needs for the third party claims administrator; offer

insights regarding actuary selection factor and available firms. • Evaluation of Loss Reserve Actuarial Study needs for workers’ compensation;

offer insights regarding actuary selection factor and available firms. • Evaluation of Loss Forecast Actuarial Study needs for worker’s compensation;

offer insights regarding actuary selection factor and available firms. • Assist with the annual budget of the District as respect costs of coverage,

deductibles, fees and other items, including an initial projection by December 1 of each year for the new fiscal year beginning July 1.

• Assist with applicable payroll or underwriting audits. • Assist with annual financial audit disclosures.

M. Perform necessary analysis, produce agendas, prepare reports, exhibits and

presentation materials needed to satisfy information requests of District administrators and assist the Finance Office in any request for reports to the Superintendent and Board of Education.

N. Provide a full accounting of commission adjustments necessary to demonstrate compliance with fee structure agreement with the District.

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INSURANCE PLACEMENT EXPECTATIONS The selected broker will approach agreed upon insurance markets to procure quotations for the District for the following coverages, including but not limited to Automobile Liability, General Liability, School Leaders Legal Liability, Cyber Liability/Data Compromise and Property including Equipment Breakdown, Terrorism, and Crime Insurance. The District expects as a minimum the following:

1. Design of deductibles to achieve best economy and ease of recovery in the event of a single loss involving multiple coverages. where applicable.

2. Design of manuscript endorsements and/or forms to the extent possible. 3. Description of coverages and available options. 4. Coordination of loss control services. 5. Construction plan reviews, as requested. 6. Description of loss reports on a quarterly basis including the following information

for each loss: the date of loss, description of loss, amount reserved, deductible amount, and amount paid.

7. Annual loss runs up to five (years) after policy expiration or until all claims are closed.

8. Information from inspection reports and recommendations used by the carrier in preparation of their quotations.

9. Insurance Coverage Summary Schedule and Premium allocation. 10. Premium payment plans available through the carrier. 11. Seventy-five day (75) Notice of Cancellation or Non-renewal of policies.

PRIORITY OBJECTIVES The Finance Department has begun a process to improve the overall risk management practices of the district and is identifying priority objectives. The district will be seeking support and guidance from its broker, along with collaboration with its independent advisor and other professionals. A document that briefly describes current priority objectives can be found in the Exhibits. QUESTIONS Questions will be accepted only via email and only during the period September 13 to October 10. All questions should be directed to the District’s independent advisor, Mr. Lee Gaby, at [email protected]. The District’s Purchasing Department web portal will be used to post questions and answers. Responses by the District that help clarify procedural or public information aspects of the process will be provided to all candidates, with notice to each by email. Questions and answers which the District determines would reveal a candidate’s particular process, approach or identity will be withheld from other candidates. Any supplemental information of the District will be posted for all candidates, with notice to each by email.

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PERIOD OF SERVICE It is the District’s desire to retain the services of the selected Broker for an initial period of two years with annual extensions available as agreed between the parties and as authorized by the Board of Education. The services are expected to begin on or about January 1, 2020. BROKERAGE AGREEMENT This District’s contract form is intended as an exclusive placement agreement with the selected Broker(s) and the District. The District will make all possible attempts to keep this contract exclusive to the awarded broker. Compensation for broker services is intended to be solely on a fee basis. The district recognizes that some underwriters are unable deduct commissions due to rate filings. In such cases, the commissions earned must be applied as an offset against the agreed upon annual fee. Any contingent commissions or other form of remuneration related to services to the districts must be disclosed to the satisfaction of the district. Agreement between the parties may be terminated for cause at any time by either party upon thirty (30) days written notice whenever it is determined that either party has failed to comply with the conditions of the award. The agreement may be cancelled without cause by providing sixty (60) days written notice to the other party prior to the anniversary date of the agreement. PREPARATION COSTS The District is not responsible for any costs associated with the preparation or submittal of this RFP or any other cost associated with obtaining an insurance quote. EQUAL OPPORTUNITY The District is committed to the policy that all persons shall have equal access to its programs, facilities, and employment without regard to race, color, creed, religion, national origin, gender, age, marital status, disability, public assistance status, veteran status or sexual orientation. OPEN RECORDS and CONFIDENTIALTY of WORK PRODUCT All documents, materials and information supplied by and to the District are subject to the Georgia Open Records Act. O.C.G.A. § 50-18-70 et seq. All data collected, created, received, maintained or disseminated by the District shall be public unless otherwise classified and protected from disclosure by law. By delivering information to the District, the respondent represents that it has reviewed, to the extent it deems appropriate, and understands the provisions of the Open Records Act.

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The respondent further acknowledges that the District has no right to withhold disclosure of public data. All data provided by the respondent deemed “CONFIDENTIAL” should be so marked. If a request of disclose of such document is made, the District will make reasonable efforts to notify the respondent of such request. REJECTION The District reserves the right to reject any and all proposals if the information is incomplete and does not address all the required items, or for any other reason at its sole discretion. WITHDRAWAL OF PROPOSAL A proposal once delivered in the formal custody of the District may not be withdrawn until after the proposals are opened and acknowledged; and no proposal may be withdrawn for the period of forty-five (45) days after the opening hereof. Once the documents have been received by the District, all documents become the property of the District. When documents are opened, they become public information and any restrictions put upon the District regarding the sharing of information or duplication copies after the opening will be grounds to reject all proposals. CLOSING COMMENTS Please remember that your proposal the deadline for accepting your proposal at or office or via email is 4:00 PM, Thursday, October 17, 2019. And any questions should be directed to our independent advisor, whose contact information is shown below. Your firm’s participation in this process is greatly appreciated. Mr. Larry Hammel Chief Financial Officer Independent Advisor Contact: Mr. Lee Gaby Albert Risk Management Consultant [email protected] Direct (404) 401-7795

FORSYTHCOUNTYSCHOOLS REQUESTforPROPOSAL

EXHIBITS

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FORSYTH COUNTY SCHOOLS REQUEST for PROPOSALS

LISTOFEXHIBITS

1. Suggested Proposal Outline for Broker Candidates

2. Current Liability and Property coverage and limits policy documents

3. Current Workers’ Compensation Excess coverage and limits outline

4. Current Coverage Structure Illustration

5. P&C Premium By Line of Coverage

6. P&C Summary of Claims for 2011-2019. (Markel)

7. Worker’s Comp Summary of Claims for 2015-2019. (G.A.S.)

8. Workers Comp Loss Detail Summary for 2018 and 2019, as of 4/30/19. (G.A.S.)

9. Workers’ Comp Dashboard Report as of 8/29/19. (G.A.S.)

10. Current Year Payroll Estimate and Employees by Class Code

11. Vehicle Schedule

12. Buildings and Contents Schedule

13. Mobile Equipment Schedule

14. Current Priority Objectives of the District

15. Outline of District Insurance Broker Service Agreement

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FORSYTH COUNTY SCHOOLS REQUEST for PROPOSAL

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SUGGESTEDPROPOSALOUTLINEforBROKERCANDIDATES1.BasicInformationAbouttheFirmandOfficeAddress:Telephone:Fax:AbriefhistoryoftheGeorgiaoperation,itsevolutionandoverallcapabilities.Mentionanyrelevantwebsitesand/orsourcesofindependentinformationaboutthefirm.Locationsofanybranchoffices/affiliatesthatwillassistinservicing.

2.ServiceTeamIncluderesumes/biosummariesofallkeypeoplewhowillbeinvolvedinservicetotheDistrict.(BioinformationpreviouslysentinresponsetotheDistrict’sPre-Qualificationletterissufficient,unlesstherehasbeenachangeorachangeisexpected.)Bioinformationshouldincludethefollowing:PrimaryAccountExecutiveforthisaccountLengthofTimewithAgency/Company:LengthofCareerinInsuranceorRiskManagement:Professional/AssociationDesignations:Indicatelevelofexperiencein:CommercialUnderwritingCommercialClaimsAgencyAccountServicing,RiskManagement,AgencyMarketingPrimaryAssistantforthisaccountLengthofTimewithAgency/Company:LengthofCareerinInsuranceorRiskManagement:Professional/AssociationDesignations:Indicatelevelofexperiencein:CommercialUnderwritingCommercialClaimsAgencyAccountServicing,RiskManagement,AgencyMarketingInformationaboutindividualswhoareassignedtoClaims,RiskControlandSpecialtyPracticeareaswillbehelpful.Anorganizationchartmayalsobehelpful.

3.AgencyPublicSectorPracticeNumberandtypeofPublicEntityClientswithrelevantcharacteristicstotheDistrict,preferablyinGeorgia,andinformationaboutlineofinsuranceplaced:Property,Liability,AutomobileandWorkers’Compensationwillbehelpful.

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InformationaboutGeorgiaSchoolDistrictsand/orrelevantpublicentities/localgovernmentsserved.Namesofindividualreferencesatdistrictsmaybeincludedwithproposalorpriortointerview.

4.PlacementApproachandRelationshipswithCurrentInsurersandIntermediariesBeasspecificaspossible.Describemostlikelystructureorscenarioswithcurrentunderwritersthatwillproducebestoverallvalueanddesirable“totalcostofrisk”outcomeconsideringtheexposures,coverage,lossexperienceandcurrentindicatedcosts.IncludinginformationaboutyourrelationshipwithApexInsuranceandWrightSpecialtyInsurancewillbehelpful.

5.OtherRelationshipsThatYouDeemImportanttoPlacementoftheCoverageneededbythedistrict.Beasspecificaspossible.Describemostlikelystructureorscenarioswithcurrentunderwriters that will produce best overall value and desirable “total cost ofrisk”outcomeconsidering theexposures, coverage, lossexperienceandcurrentindicated costs. Itwill behelpful to included informationabout relationshipswithspecificinsurancecompanies,intermediariesandprogrammanagers.

6.AnyCommentsand/orSuggestionsAboutCurrentPriorityObjectivesoftheDistrictMentionanyassignmentsforotherentitiesthatmayberelevanttothedistrict’sobjectivesandincludeanyexhibits,however,bemindfulthatmaterialthatismorethan15pagesmaynotbehelpful.

7.FeesStateclearlyanannualfeeforservicestoaccomplishtheobjectivesandfulfillthescopeofworkdescribedintheRFP.Itwillbehelpfultoclearlystatehowthefeewouldbeadjustedintheeventthedistrictdecidestopursuethefollowing:• ContinuewithexistingBroker2forworkers’compensationexcessinsurance.• Assignpropertyandrelatedlinestoonebroker,andassignliabilityand

relatedlinestoanotherbroker.Itwillalsobehelpfultoreceiveafeestructureforservicestosatisfythedistrict’sneeds forguidanceandon-goingsupportunderpossible scenarioswheresomeorallliabilityandpropertycoverageistransferredfromthecommercialmarkettoself-insuranceplanoranauthorizedinter-localriskmanagementagency.

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8.StatementconcerningBrokers’Professional(E&O)LiabilityLimitsTheDistrictexpectsthelimitsofErrorsandOmissionsInsuranceAmounttobeaminimumof$5,000,000peroccurrence.Thesuccessfulcandidatewillberequiredtoprovidesatisfactoryevidenceofcoverage

9.StatementsconcerningCorporateSocialResponsibility,CodeofEthics,WorkplaceInclusionandDiversityThirdpartycertificationsorpublishedreportswillbehelpful.

10.StatementofthenatureofanycurrentorpastbusinessrelationshipbetweentheBrokerandanycurrentmemberoftheForsythCountySchoolBoardofEducation.

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Education Insurance Proposal Prepared for:

Forsyth County SchoolsPresented by:

Apex Insurance Services

Policy Term: 07/01/2019 - 07/01/2020

Date Quoted: 06/11/2019

Expires: 07/01/2019

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Policy Period: 7/1/2019 - 7/1/2020 Forsyth County Schools

Partnership beyond the policy.™

Commercial Property CoverageMarkel Insurance Company - "A" (XV) AM Best Rating

Limit Deductible PremiumBlanket Limit $1,031,829,838 $10,000 $318,818Building and Contents (TIV) @ 100% $1,031,829,838Cause of Loss SPECIAL (Includes Theft) 0Valuation Replacement Cost

Agreed Value0

Business Income/Extra Expense $1,000,000 72 hours IncludedOrdinance or Law IncludedCoverage A 110%Coverage B $250,000Coverage C $250,000

Flood $1,000,000 $25,000 IncludedEarthquake $1,000,000 5% IncludedPollutant Cleanup and Removal $100,000 $10,000 IncludedHonor Roll Elite Commercial Property Per Form $1,000 IncludedEnhancementTRIA $7,751

Property Premium $326,569

* Flood coverage excluded from Federal Flood Zones A, AE, AH, AO, A1-A30, AR, A99, V, VE or V1-V30Terrorism coverage for newly-acquired locations during the policy period must be separately underwritten.

This proposal may vary from the requested terms and conditions in your submission. Please review this proposal carefully. This proposal contains only a general description of the coverage(s) and does not constitute a policy/contract. For complete policy information, including exclusions, limitations, and conditions, refer to the policy forms. In the event of a difference between this proposal and the policy, the policy will prevail. Specimen policy forms are available upon request and through the Wright Specialty website (http://www.wrightspecialty.com). 7



Commercial Inland Marine CoverageMarkel Insurance Company - "A" (XV) AM Best Rating

Limit Deductible PremiumContractor's Equipment $53,045 $500 $50EDP Equipment (Incl Software) $10,504,598 $10,000 $6,857Miscellaneous Articles $1,207,000 $500 $1,087Mobile Equipment $11,199 $500 $22Musical Instruments $500,000 $500 $477Rented/Leased Equipment $47,924 $500 $43Valuable Papers & Records $415,000 $500 $376TRIA $179

Inland Marine Premium $9,091

Terrorism coverage for newly-acquired locations during the policy period must be separately underwritten.




Commercial General Liability CoverageMarkel Insurance Company - "A" (XV) AM Best Rating

Limit Deductible PremiumEach Occurrence $1,000,000 $47,111

Damages to Premises Rented to You $100,000Medical Expense $15,000

Personal & Advertising Injury Aggregate $1,000,000General Aggregate per Location $2,000,000Products-Completed Operations Aggregate $2,000,000Sexual Misconduct Coverage $1,000,000 $5,858Sexual Misconduct Aggregate $1,000,000Employee Benefits Liability (Claims-made) * $1,000,000 $1,000** $250EBL Aggregate $2,000,000EBL Retro Date 07/01/2001

Crisis Management And Public Relations Expense $300,000 $250- AggregateCrisis Management Expense - Each Crisis Event $300,000Public Relations Expense Resulting From Crisis

Event - Each Crisis EventPublic Relations Expense Resulting From

Adverse Event - Each Adverse Event

$50,000

$25,000 $2,500

Innocent Party Defense Coverage $300,000Innocent Party Defense Aggregate $300,000Counseling Professional Liability Coverage $1,000,000 $100Counseling Professional Liability Aggregate $1,000,000Honor Roll Elite Commercial General Liability Per Form Per Form $700EnhancementsTRIA $100

General Liability Premium $54,581

Notes:*Please refer to the applicable policy form for details regarding the terms of any available extended reporting period.**Employee Benefits deductible is per employee.






Commercial Automobile CoverageMarkel Insurance Company - "A" (XV) AM Best Rating

Limit Deductible PremiumBI/PD - Combined Single Limit $500,000 $0 $321,612Comprehensive/Glass See Schedule See Schedule IncludedCollision See Schedule See Schedule IncludedHired AutoLiability $500,000 $0 IncludedComprehensive $50,000 $1,000 IncludedCollision $50,000 $1,000 Included

Non-OwnedLiability $500,000 $0 Included

Uninsured/Underinsured Motorist $100,000 IncludedMedical Payments $5,000 IncludedHonor Roll Elite Commercial Auto Enhancements Per Form Included

Total Number of Vehicles Insured 542Automobile Premium $321,612


Policy Period: 7/1/2019 - 7/1/2020

Forsy th County Schools


Educators Legal Liability Coverage (Claims-made)Markel Insurance Company - "A" (XV) AM Best Rating

Limit Deductible PremiumEducators Legal Liability $1,000,000 $10,000 $41,277Educators Legal Liability Aggregate $1,000,000Non - Monetary Defense $100,000 $10,000 $7,885Non - Monetary Defense Aggregate $100,000Claims Made-Retro Date 07/01/2001FLSA Defense Sublimit Of Liability $100,000 $10,000 IncludedTRIA $197

Educators Legal Liability Premium $49,359

Notes:Please refer to the applicable policy form for details regarding the terms of any available extended reporting period.





Proposal Premium SummaryLines of Coverage PremiumCommercial Property Coverage (EPP) $326,569Commercial Inland Marine (EPP) $9,091Commercial General Liability Coverage (EPP) $54,581Commercial Auto $321,612Educators Legal Liability Coverage $49,359

Premium $761,212

Proposal Conditions

Coverage cannot be bound until the following items are received, reviewed and accepted by Underwriting:

· Signed TRIA Forms· Signed Statement of Values· Copy of fleet safety manual· Building update information for all buildings constructed over 20 years ago· Year of Construction for missing buildings· Driver list including date of birth· Most recent audited financial statement· Signed & fully completed WSI Renewal Application· Loss Control Recommendation Response· Timeline for new school location construction

This proposal may vary from the requested terms and conditions in your submission. Please review this proposal carefully. This proposal contains only a general description of the coverage(s) and does not constitute a policy/contract. For complete policy information, including exclusions, limitations, and conditions, refer to the policy forms. In the event of a difference between this proposal and the policy, the policy will prevail. Specimen policy forms are available upon request and through the Wright Specialty website (http://www.wrightspecialty.com).

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Partnership beyond the policy.™ Writing Company: MARKEL INSURANCE COMPANY

Form DescriptionCommercial Property Coverage (EPP)CP 00 10 10 12 Building & Personal Property Coverage FormCP 00 30 10 12 Business Income (And Extra Expense) Coverage FormCP 00 90 07 88 Commercial Property ConditionsCP 01 31 03 13 Georgia ChangesCP 01 40 07 06 Exclusion of Loss Due to Virus or BacteriaCP 04 05 09 17 Ordinance or Law CoverageCP 04 11 09 17 Protective SafeguardsCP 10 30 09 17 Causes of Loss-Special FormCP 10 45 10 12 Earthquake & Volcanic Eruption Endorsement-Sub-Limit FormCP 12 18 10 12 Loss Payable ProvisionsCP 15 25 10 12 Business Income Changes-Educational InstitutionsIL 00 03 09 08 Calculation of PremiumIL 00 17 11 98 Common Policy ConditionsIL 02 62 02 15 Georgia Changes-Cancellation & NonrenewalIL 09 35 07 02 Exclusion of Certain Computer-Related LossesIL 09 52 01 15 Cap On Losses From Certified Acts Of Terrorism EndorsementIL 12 01 11 85 Policy ChangesMCP 1240 10 16 Honor Roll Elite Commercial Property EnhancementMCP 1241-GA 10 16 Georgia Special School Property Protection Flood Coverage Excluding Zones A and

VMCP 1300 04 13 Fungus, Wet Rot, Dry Rot and Bacteria ExclusionMCP-TERR-1 01 15 Confirmation Of Certified Acts Of Terrorism Coverage – Terrorism Risk Insurance ActMD 001 07 02 Commercial Lines Policy Declarations PageMDCP 2001 10 16 Commercial Property Policy DeclarationsMDIL 1002 01 10 Schedule Of TaxesMIL 1214 09 17 Trade Or Economic SanctionsMJIL 1000 06 10 Markel Insurance Company Policy JacketCommercial Inland Marine (EPP)CM 00 01 09 04 Commercial Inland Marine ConditionsIH 00 68 07 99 Contractors Equipment Coverage FormIH 00 75 07 99 Computer Systems Coverage FormIH 00 79 07 99 Miscellaneous Articles Coverage FormIH 75 02 07 99 Personal Portable ComputersIH 99 07 01 15 Replacement Cost CoverageIL 09 52 01 15 Cap On Losses From Certified Acts Of Terrorism EndorsementMD 012 09 00 Commercial Inland Marine Coverage Part DeclarationsMD 031 11 99 Computer Systems DeclarationsMD 035 11 99 Contractors Equipment DeclarationsMD 037 11 99 Miscellaneous Articles DeclarationsMIL 1214 09 17 Trade Or Economic SanctionsMIM 115 05 10 Mold ExclusionMIM 123 05 10 Water ExclusionMIM-TERR-1 01 15 Confirmation Of Certified Acts Of Terrorism Coverage – Terrorism Risk Insurance ActMJIL 1000 06 10 Markel Insurance Company Policy JacketCommercial General Liability Coverage (EPP)CG 00 01 04 13 Commercial General Liability Coverage FormCG 04 35 12 07 Employee Benefits Liability Coverage


CG 20 28 04 13 Additional Insured-Lessor of Leased EquipmentCG 21 06 05 14 Exclusion-Access or Disclosure of Confidential or Personal Information & Data-

Related Liability-With Limited Bodily Injury ExceptionCG 21 47 12 07 Employment Related Practices ExclusionCG 21 67 12 04 Fungi or Bacteria ExclusionCG 21 70 01 15 Cap on Losses from Certified Acts of TerrorismCG 21 96 03 05 Silica or Dust Related ExclusionCG 24 22 04 13 Amendment of Coverage Territory-WorldwideCG 25 04 05 09 Designated Location(s) General Aggregate LimitIL 00 03 09 08 Calculation of PremiumIL 00 17 11 98 Common Policy ConditionsIL 00 21 09 08 Nuclear Energy Liability ExclusionIL 02 62 02 15 Georgia Changes-Cancellation & NonrenewalMD 001 07 02 Commercial Lines Policy Declarations PageMDGL 1501 10 16 Commercial General Liability Policy DeclarationsMGL 1248-GA 10 16 Georgia Counseling Professional Liability CoverageMGL 1275-GA 10 16 Georgia Honor Roll Elite Commercial General Liability EndorsementMGL 1278 10 16 Electronic Chatrooms or Bulletin BoardsMGL 1280 10 16 Trampoline LimitationMGL 1281-GA 10 16 Georgia Sexual Misconduct Coverage and Innocent Insured Defense Only CoverageMGL 1288 04 17 Limited Coverage For Designated Unmanned AircraftMGL 1310 10 16 Exclusion - Students Medical PaymentsMGL 1321 02 19 Exclusion - Firearms or Conducted Energy DevicesMGL 1322 10 16 Amendment Of Expected Or Intended Injury Exclusion - Restraint Or Removal Of

StudentsMGL 1324 10 16 Limited Exclusion - Professional Services with Exceptions for Student Interns and

Certain Medical ServicesMGL 1541 02 19 Crisis Management And Public Relations Expense CoveragesMGL-TERR-1 01 15 Confirmation Of Certified Acts Of Terrorism Coverage – Terrorism Risk Insurance ActMIL 1207 05 15 Two or More Coverage Forms or Policies Issued By UsMIL 1214 09 17 Trade Or Economic SanctionsMIL 1301 03 14 Exclusion - Fungi or BacteriaMIL 1303 05 15 Exclusion - AsbestosMIL 1304 05 15 Exclusion - LeadMIL 1305 05 15 Exclusion - Punitive DamagesMJIL 1000 06 10 Markel Insurance Company Policy JacketCommercial AutoCA 00 01 10 13 Business Auto Coverage FormCA 01 09 10 13 Georgia ChangesCA 20 01 10 13 Lessor-Additional Insured & Loss PayeeCA 20 54 10 13 Employee Hired AutosCA 20 55 10 13 Fellow Employee CoverageCA 21 11 10 13 Georgia Uninsured Motorists CoverageCA 23 01 10 13 ExplosivesCA 23 94 10 13 Silica or Silica-Related Dust Exclusion For Covered Autos ExposureCA 31 37 10 13 Georgia Uninsured Motorists Coverage-Added on to At-Fault Liability LimitsCA 99 03 10 13 Auto Medical Payments CoverageCA 99 33 10 13 Employees as InsuredsCA 99 34 10 13 Social Service Agencies - Volunteers as InsuredsIL 00 03 09 08 Calculation of PremiumIL 00 17 11 98 Common Policy ConditionsIL 00 21 09 08 Nuclear Energy Liability ExclusionIL 02 62 02 15 Georgia Changes Cancellation and NonrenewalMCA 1219 10 16 Honor Roll Elite Commercial Auto EnhancementMCA 1220 10 16 Amended Deductible - Loss To Multiple Autos from Single EventMCA 1229 10 16 Amended Exception - Who is an InsuredMCA 1301 05 15 Exclusion - Abuse or MolestationMDCA 1008 10 16 Commercial Auto Policy Declarations


MIL 1214 09 17 Trade Or Economic SanctionsMJIL 1000 06 10 Markel Insurance Company Policy JacketMPIL 1007 03 14 Privacy NoticeMPIL 1083 04 15 U.S. Treasury Departments Office Of Foreign

Assets Control ("OFAC") Advisory Notice To PolicyholdersEducators Legal Liability CoverageMDPL 1000 10 16 Educators Legal Liability Policy DeclarationsMIL 1214 09 17 Trade Or Economic SanctionsMJIL 1000 06 10 Markel Insurance Company Policy JacketMPIL 1007 03 14 Privacy NoticeMPIL 1083 04 15 U.S. Treasury Departments Office Of Foreign

Assets Control ("OFAC") Advisory Notice To PolicyholdersMPL 0001 10 16 Educators Legal Liability Coverage FormMPL 1204 10 16 Deductible Applicable to Defense ExpensesMPL 1206 10 16 Amendment Of Notice Requirement For Public School DistrictsMPL 1215 10 16 Cap On Losses From Certified Acts Of TerrorismMPL 1263 02 19 Notice of Wrongful ActsMPL 1303 10 16 Exclusion – Crisis Management CoverageMPL 1325 02 19 Exclusion - Firearms or Conducted EnergyMPL 1411-GA 10 16 Georgia AmendatoryMPL 1700 10 16 ELL Coverage Form Table of ContentsMPL-TERR-1 01 15 Confirmation Of Certified Acts Of Terrorism Coverage – Terrorism Risk Insurance Act


Effective with UNDERWRITERS AT LLOYD'S, LONDONAdministered by Hiscox Inc.520 Madison Avenue 32nd Floor, New York, NY 10022(646) 452-2353

CyberClear – Cyber, Data Risk, and Media InsuranceDECLARATIONS

TPCCYB D0001 CW (05/16) Page 1 of 3

CYSDECSLREN22

This contract is registered and delivered as a surplus line coverage under the Surplus Line Insurance Law, O.C.G.A. Chapter 33-5.

Broker No.: US 0002624 American Public Risk, LLCPolicy No.: MPL2269018.19Renewal of: MPL2269018.18

9020 Stony Point Parkway Ste 455Richmond, VA 23235

1. Named Insured:Address:

Forsyth County BOE1120 Dahlonega HwyCumming, GA 30040-4536

2. Policy Period: Inception Date: 07/01/2019 Expiration Date: 07/01/2020Both dates at 12:01 A.M. (Standard Time) at the address of the Named Insured.

3. Retroactive Date: Full Prior ActsMedia Liability: Full Prior Acts

4. Policy Limit of Liability: $ 1,000,000 Each Claim or Event / $ 1,000,000 Aggregate

5. Retention: $ 5,000 Each Claim or Event

6. Waiting Period: 10 hours

7. Notification ofClaims to:

Hiscox Claims520 Madison Avenue, 32nd floorNew York, NY 10022Fax: 212-922-9652Email: [email protected]

Additional NotificationRequirements:

For any event resulting in business interruption costs or data recovery costs, or any extortionthreat, you must also notify the breach coach at 1-855-447-2627

17




CYSDECSLREN22

8. Policy Premium: $ 21,878 Administration Fee: N/A

Portion of PremiumAllocated to TRIA: $ 202

9. Policy Form: TPCCYB P0001 CW (05-16)

10. Endorsements: E6015.7 - Lloyd’s Syndicate (3624) EndorsementE6016.1 - Service of SuitE6018.2 - Applicable Law EndorsementE8088.1 - War and Civil War Exclusion EndorsementE8089.1 - Nuclear Incident Exclusion Clause-Liability-Direct (Broad) EndorsementE9999.2 - Cap on Losses from Certified Acts of Terrorism EndorsementE8006.1 - Amend Definition of Subsidiary Endorsement (15%)E8008.1 - Amend Hammer Clause Endorsement (Percentages)E8011.1 - Amend Notice of Claims Endorsement (60 Days)E8057.1 - Optional Extended Reporting Period Percentages Endorsement (E8059.1 - Amend Cancellation Provision Endorsement (Pro Rata Return of Premium)E8079.1 - Amend Definition of Advertising Endorsement (Including Written/Printed)E8117.1 - Amend Extortion Threat for Rogue Employees EndorsementE8112.1 - Customers’ Accounts Coverage EndorsementE8099.1 - Telephone Toll Fraud EndorsementE8118.1 - Reputational Harm Coverage EndorsementE8103.2 - Cyber Crime & Cyber Deception EndorsementE9997.4 - Policyholder Disclosure Notice of Terrorism Insurance Coverage

Specified Terms for Cyber Insuring Agreement

Specified Terms for Media Liability Insuring AgreementCovered Professional Services: Board of Education

All Limits of Liability applicable to individual insuring agreements are a part of, and not in addition to, the Policy Limit ofLiability stated in Item 4 above.

In accordance with the authorization granted to Hiscox Inc. under Contract No.B1234HisInc2019 by certain Underwriters at Lloyd's,London, whose names and the proportions underwritten by them can be ascertained by reference to the said Contract, which bearsthe Seal of Lloyd's Policy Signing Office and is on file at the office of the said Agency and in consideration of the premium specifiedherein, the said Underwriters do hereby bind themselves, each for their own part and not one for another, their heirs, executors andadministrators, to insure as follows in accordance with the terms and conditions contained or endorsed hereon.

18




CYSDECSLREN22

The Certificate terms and conditions contained herein or endorsed hereon and such other provisions, agreements or conditions asmay be endorsed hereon or added hereto are hereby incorporated in this Certificate. No representative of the Underwriters shallhave the power to waive or be deemed to have waived any provision or condition of this Certificate unless such waiver, if any, shallbe written upon or attached hereto; nor shall any privilege or permission affecting the insurance under this Certificate exist or beclaimed by the Insured(s) unless so written or attached.

IN WITNESS WHEREOF this Certificate has been signed at New York, New York

Authorized RepresentativeKevin KerridgeJune 25, 2019Hiscox Inc.

19

The Hartford Steam Boiler Inspection and Insurance Company

EQUIPMENT INSURANCE QUOTATION

HSB TECHADVANTAGE™ Equipment Breakdown and Technology Insurance Coverage

Coverage HighlightsRapidly evolving technology drives the systems, equipment and operations of all businesses today. Small electronic components are at the core of virtually all modern equipment. Today’s equipment is increasingly susceptible to breakdown and becoming more portable. Data is vital to any business, and businesses are using cloud computing more and more to help them be more productive. With these changes arise new and different equipment breakdown and reputation risks.

New HSB TechAdvantage™ is equipment breakdown and technology coverage that protects against losses caused by these increasingly common technology-related exposures, in addition to HSB’s already market-leading equipment breakdown coverages

HSB TechAdvantage™ Equipment Breakdown Insurance Coverage now includes:

• Microelectronics Coverage – a groundbreaking new coverage adding a second cause of loss formicroelectronics failures when physical damage is not detectable or when firmware or software failure causesnon-physical damage

• Cloud Computing Service Interruption (for equipment breakdowns at Cloud Computing providers)• Service Interruption Data Restoration• Off Premises Business Income, Extra Expense and Data Restoration• Public Relations Coverage• And all of HSB’s existing market-leading equipment breakdown coverages and services.

ADDITIONAL INSURANCE AVAILABLE

Data Compromise Coverage (DC)Designed to help small and mid-sized businesses respond to the financial burden and service obligations in the event of a data breach of the personal data of employees, clients and others

• Response Expenses coverage responds to the cost burden and service obligations arising from a data breach • Notifications and services to affected individuals• Credit monitoring and identity restoration service• Defense and Liability coverage responds to actions brought against the insured by an affected individual

Identity Recovery Coverage (IDR)Combines identity theft insurance with services that help victims restore their credit history and identity records to pre- theft status

• Provides reimbursement for certain out of pocket expenses• Restoration service does not erode the available limit• Uses licensed investigators and a limited Power of Attorney to perform much of the work for the insured

Please CLICK HERE to link to our Coverage Highlights document for more detailed information.

The Hartford Steam Boiler Inspection and Insurance Company (HSB) is the leading provider of Equipment Breakdown insurance in North America. HSB offers claim mitigation, inspection services and engineering-based risk management that sets the standard for excellence worldwide. We anticipate risks and provide forward-thinking solutions that render tomorrow’s world insurable. Visit us at www.hsb.com.

The Hartford Steam Boiler Inspection and Insurance is rated A++ (Superior) by A.M. Best Company.

© 2015, Insurance coverage underwritten by The Hartford Steam Boiler Inspection and Insurance Company. All rights reserved.HSB Quotation Ed. 07/2015 Page 1 of 6 20

http://www.hsb.com/AppResource/uploadedFiles/Client_Connection/InstantQuote/TechAdvantage_Coverage_Highlights.pdf

http://www.hsb.com/


EQUIPMENT INSURANCE QUOTATION

Issue Date: June 6, 2019 Quotation ID: FBP-0143363-00(37)Erinn OwensPublic Risk UnderwritersPhone: 770-441-1888Email:Fax: ( ) -

Named Insured/ApplicantForsyth County Board of Education

TermCoverage Effective Date .................................................. July 1, 2019Quotation Expiration Date ................................................ July 1, 2019

Equipment Breakdown CoverageEquipment Breakdown Limit ............................................ $100,000,000Business Income Limit ..................................................... $1,000,000Additional Limits, Deductibles, Other Conditions ............. See Attached

Data Compromise and Identity Recovery CoverageData Compromise Coverage Limit (DC) .......................... $50,000Identity Recovery Coverage Limit (IDR) .......................... $15,000

Premium SummaryTotal Premium including Taxes and Surcharges ............. $17,738.00

This insurance quotation is for the HSB TechAdvantage™ Equipment Breakdown Coverage Form and optional additional insurance coverage endorsements. This quotation is based upon information on file with the company as of the issue date. It is subject to adjustment or rescission should any information on file change. There is no insurance in effect as a result of the issuance of this document. An order of acceptance must be received by HSB prior to the Quotation Expiration Date of this quote for the insurance to be effective. Our offer to insure the captioned account will be considered null and void and is rescinded on the date indicated as the Quotation Expiration Date unless an order of acceptance is received by the company prior to such date. Thank you for the opportunity to provide you with a quote for this account. We appreciate your business.

Sincerely,Valorie D. Parker for Deirdra Burrell-Jones

Production Underwriter(770) [email protected]



EQUIPMENT INSURANCE QUOTATION, continued

EQUIPMENT BREAKDOWN COVERAGE

Coverage Effective Date: July 1, 2019 Quotation Expiration Date: July 1, 2019Quotation ID: FBP-0143363-00(37)

Named Insured/Applicant: Forsyth County Board of EducationLocation(s): Per Statement of Values submitted on April 26, 2018

Total of 46 locations

Covered Cause of LossAccident IncludedElectronic Circuitry Impairment Included

Coverage Applies To: All Locations

Coverages LimitsEquipment Breakdown Limit $100,000,000

Property Damage IncludedBusiness Income $1,000,000Extra Expense Combined with Business IncomeCivil Authority Combined with Business IncomeContingent Business Income ExcludedData Restoration $100,000Demolition $100,000Expediting Expenses $100,000Green $25,000Hazardous Substances $100,000Mold $25,000Newly Acquired Locations $1,000,000Off Premises Equipment Breakdown $100,000Ordinance or Law $100,000Perishable Goods $100,000Public Relations $5,000Service Interruption Combined with Business Income

DeductiblesDirect Coverages ...................................................... $10,000Indirect Coverages .................................................... 24 Hours




Other Conditions

Newly Acquired Locations: 90 DaysExtended Period of Restoration: 15 DaysInterruption of Service Waiting Period: 24 HoursCovered Services as defined under “interruption of service” includes “cloud computing service”.

ADDITIONAL INSURANCE COVERAGE

Data Compromise Coverage

Coverages LimitsResponse Expenses $50,000 Annual Aggregate

Legal and Forensic InformationTechnology Review $5,000 any one “Personal Data Compromise”

Defense and Liability $50,000 Annual Aggregate

DeductiblesResponse Expenses $1,000 each “Personal Data Compromise”Defense and Liability $1,000 each “Data Compromise Suit”

Identity Recovery Coverage

Coverages LimitsExpense Reimbursement Coverage $15,000 Annual Aggregate per “Identity Recovery Insured”

Lost Wages and Child and Elder Care $5,000Miscellaneous Unnamed Costs $1,000

DeductiblesExpense Reimbursement Coverage $250 each “Identity Recovery Insured”




Terrorism Risk Insurance Act Disclosure

Applicable Premium

The portion of your annual premium that is attributable to coverage for acts of terrorism is $0, and does not include any charges for the portion of losses covered by the United States government under the Act.

Informational Notice

The following notice does not change your coverage under this quoted policy, but is provided for your information in compliance with the Terrorism Risk Insurance Act, as amended.

Coverage for acts of terrorism is included in your policy. You are hereby notified that under the Terrorism Risk Insurance Act, as amended in 2015, the definition of act of terrorism has changed. As defined in Section 102(1) of the Act: The term “act of terrorism” means any act or acts that are certified by the Secretary of the Treasury—in consultation with the Secretary of Homeland Security, and the Attorney General of the United States—to be an act of terrorism; to be a violent act or an act that is dangerous to human life, property, or infrastructure; to have resulted in damage within the United States, or outside the United States in the case of certain air carriers or vessels or the premises of a United States mission; and to have been committed by an individual or individuals as part of an effort to coerce the civilian population of the United States or to influence the policy or affect the conduct of the United States Government by coercion. Under your coverage, any losses resulting from certified acts of terrorism may be partially reimbursed by the United States Government under a formula established by the Terrorism Risk Insurance Act, as amended. However, your policy may contain other exclusions which might affect your coverage, such as an exclusion for nuclear events. Under the formula, the United States Government generally reimburses 85% through 2015; 84% beginning on January 1, 2016; 83% beginning on January 1, 2017; 82% beginning on January 1, 2018; 81% beginning on January 1, 2019 and 80% beginning on January 1, 2020, of covered terrorism losses exceeding the statutorily established deductible paid by the insurance company providing the coverage. The Terrorism Risk Insurance Act, as amended, contains a $100 billion cap that limits U.S. Government reimbursement as well as insurers’ liability for losses resulting from certified acts of terrorism when the amount of such losses exceeds $100 billion in any one calendar year. If the aggregate insured losses for all insurers exceed $100 billion, your coverage may be reduced.

Includes copyrighted material of National Association of Insurance Commissioners with its permission.



EQUIPMENT INSURANCE COVERAGE HIGHLIGHTS

Equipment Breakdown covers the physical and financial damage that can result from an accidental equipment breakdown. Hartford Steam Boiler’s Equipment Breakdown insurance is among the broadest in the industry, and our newest coverages included in HSB TechAdvantage™ are among the first of their kind. We offer a broad range of coverages and insure many types of equipment that other companies exclude. The highlights below summarize HSB’s Equipment Breakdown and Technology coverages. Refer to the quoted policy for all coverage details, terms and exclusions.

HSB TECHADVANTAGE™ Equipment Breakdown and Technology Highlights- Property Damage - cost to repair or replace damaged equipment- Off Premises Equipment Breakdown - coverage for portable equipment taken off-site- Business Income - business income lost due to an interruption caused by a breakdown- Extra Expense - cost to maintain normal operations (e.g. equipment rental)- Expediting Expenses - costs to make temporary repairs and expedite permanent repairs or replacement- Perishable Goods - loss due to spoilage, including contamination by refrigerant, caused by a breakdown- Data Restoration - cost to restore data that is lost or damaged due to a breakdown- Green Coverage - pays for repair or replacement with environmentally friendly options

HSB TECHADVANTAGE™ Selected Coverage Highlights- Microelectronics Coverage – A groundbreaking new coverage that responds to modern technology embedded in

all types of equipment. A second cause of loss is added for microelectronics failures when physical damage is notdetectable or when firmware or software failure causes non-physical damage. Triggered when covered equipment suddenly stops functioning as it had been and that equipment or a part containing electronic circuitry must be replaced. No special sublimits or deductibles – pays just as if there had been an equipment breakdown accident.

- Cloud Computing Service Interruption – Adds cloud computing services to service interruption coverage – paysfor business interruption and extra expense when insured’s service provider experiences an outage due to an accident.

- Service Interruption Data Restoration – Adds data restoration coverage for data lost when there is a coveredservice interruption, such as a loss of electrical power, due to an accident (triggering outage must exceed applicable waiting period). Data may be at the insured location or in the custody of the insured’s cloud computing service provider.

- Off-Premises Business Income, Extra Expense and Data Restoration Coverage – Extends payment for off-premises equipment breakdown to include business income, extra expense and data restoration, in addition tophysical damage.

- Public Relations Coverage – Pays for public relations assistance to help manage a reputation that may bedamaged by an interruption of business – applies if there is a covered loss of business income.

Coverage Benefits- Covers a wide range of types of equipment including new technologies- HSB provides market leading jurisdictional inspection service for boilers and pressure vessels as an integral

element of our Equipment Breakdown policies to help insureds prevent loss and comply with local inspectionrequirements, where applicable. With inspectors across the United States, we can service clients’ inspection needs in a timely manner

- HSB Inspection Hot Line toll-free at 1-800-333-4677 (1-800-333-INSP)- HSB Client Connection offers agents access to a secure, password-protected portion of HSB’s web site for policy

related information- HSB’s claim service can help insureds reduce down time, recover faster from loss and keep operations up and

running


http://www.hsb.com/clientconnect/

ForsythCountySchoolsEmployeeCrimeandFidelity7-1-19to7-1-20TravelersInsurance Limit Deductible NetPremiumSuperintendentBond $50,000 $-0- $EmployeeTheft $250,000 $2,500 $6,938ComputerProgramRestoration $100,000 $2,500 Incl.ForgeryorAlteration $100,000 $2,500 Incl.ComputerFraud $100,000 $2,500 InclClaimExpense $5,000 $-0- Incl.

26

Safety National Casualty CorpForysth County Schools

Liablity Period 7/1/2019 -7/1/2020Payroll $333,178,500Manual Premium $2,574,050Experience Modification Factor 1.000Standard Premium $3,003,916Self-Insured Retention $600,000Specific Limiit StatutoryEmployers Liability Limit $1,000,000Premium Rate 0.0651Deposit Premium $215,899Commission 0.00%Play Plan Annual PaymentAudit Type Voluntary

The District has been with Safety National for 10+ years.

27

MARKELAuto

PhysicalDamage

ForsythCountySchoolsExistingCoverageProgramStructure

NOTES:

MARKEL

PROPERTY

$600,000SELF–INSURED

RETENTIONPEREVENT/LOSS

MARKELGL

MARKEL

AutoLiability

DEDUCTIBLE

Statutory

1M/2M

REPLACEMENTCOST

SAFETYNATIONAL

ExcessCover 500K

HISCOX

CyberLiability

MARKEL

SBLL

1M/1M

TRAVELERS

Crime&Fidelity

HSB

EquipmentBreakdown

DEDUCTIBLE

Flood&QuakeSublimit

ExtraExpenseSublimit 1M/1M

MobileEquipmentVariousSublimits

250K

Sublimitsanddeductiblesforcertaincoveragefeaturesarenotshown.Refertofulldescriptionandpolicyforalldetails.

100MM

ACV

DEDUCTIBLE

HSB

Explosion

Limitsnotdrawntoscale

BrokerB BrokerA

28

ForsythCountySchoolsPREMIUMSbyLOB2014-2019-NETBASISCurrrentYr

GeneralLiability Cyber&DataBreach7/1/19-7/1/20 $54,581 $23,013 GL $54,5817/1/19-7/1/19 $51,051 $23,013 Cyber $23,0137/1/19-7/1/18 $42,033 -7/1/19-7/1/17 $46,585 -7/1/19-7/1/16 $43,945 -7/1/19-7/1/15 $44,606 -7/1/19-7/1/14 $45,050 -

SchoolLegalLiability7/1/19-7/1/20 $49,359 SLL $49,3597/1/19-7/1/19 $44,5547/1/19-7/1/18 $44,3437/1/19-7/1/17 $42,3777/1/19-7/1/16 $42,5007/1/19-7/1/15 $41,0937/1/19-7/1/14 $40,000

AutoLiability7/1/19-7/1/20 $321,612 AUTO $321,6127/1/19-7/1/19 $279,9257/1/19-7/1/18 $210,1677/1/19-7/1/17 $214,7827/1/19-7/1/16 $165,6457/1/19-7/1/15 $184,0337/1/19-7/1/14 $179,752

Property $326,569AutoPhysicalDamage MobileEquip $9,0917/1/19-7/1/20 inclinAL EquipBreakd $17,7387/1/19-7/1/19 Crime/Bond $6,9387/1/19-7/1/187/1/19-7/1/177/1/19-7/1/167/1/19-7/1/157/1/19-7/1/14

Property MobileEquip EquipBreakdown Crime/Bond7/1/19-7/1/20 $326,569 $9,091 $17,738 $6,9387/1/19-7/1/19 $271,411 $8,646 $17,652 $6,9387/1/19-7/1/187/1/19-7/1/177/1/19-7/1/167/1/19-7/1/157/1/19-7/1/14 NETTOTAL $808,901

29

30

31

32

33

Loss Summary Report

0Policy Count

900,000.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$9,000.00$8,757.03$242.97Totals

$0.00$0.00$0.00Legal

$1,500.00$1,500.00$0.00Expense

$0.00$0.00$0.00Indemnity

$7,500.00$7,257.03$242.97Medical

Total IncurredReservesPaid

Claim Payment Info

3Total

0Closed

3Open

Claim Counts

Treaty Year: 2020

As of Date: 7/31/2019 11:00:00 PM

Forsyth County Public Schools

0Policy Count

105,575,889.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$1,055,758.89$675,588.60$380,170.29Totals

$43,061.27$6,500.00$36,561.27Legal

$74,503.61$47,495.16$27,008.45Expense

$136,957.24$91,890.71$45,066.53Indemnity

$801,236.77$529,702.73$271,534.04Medical


Claim Payment Info

182Total

119Closed

63Open

Claim Counts

Treaty Year: 2019

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

65,621,813.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$656,218.13$69,501.47$586,716.66Totals

$5,093.50$0.00$5,093.50Legal

$19,287.15$3,529.57$15,757.58Expense

$115,993.45$6,951.78$109,041.67Indemnity

$515,844.03$59,020.12$456,823.91Medical


Claim Payment Info

339Total

335Closed

4Open

Claim Counts

Treaty Year: 2018

As of Date: 7/31/2019 11:00:00 PM


34

Loss Summary Report

0Policy Count

78,167,812.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$781,678.12$0.00$781,678.12Totals

$25,191.54$0.00$25,191.54Legal

$9,106.82$0.00$9,106.82Expense

$105,283.71$0.00$105,283.71Indemnity

$642,096.05$0.00$642,096.05Medical


Claim Payment Info

292Total

292Closed

0Open

Claim Counts

Treaty Year: 2017

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

45,999,738.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$459,997.38$0.00$459,997.38Totals

$1,234.00$0.00$1,234.00Legal

$5,463.52$0.00$5,463.52Expense

$82,262.62$0.00$82,262.62Indemnity

$371,037.24$0.00$371,037.24Medical


Claim Payment Info

279Total

279Closed

0Open

Claim Counts

Treaty Year: 2016

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

70,123,552.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$701,235.52$38,694.40$662,541.12Totals

$52,903.06$0.00$52,903.06Legal

$19,311.59$342.35$18,969.24Expense

$245,443.30$0.00$245,443.30Indemnity

$383,577.57$38,352.05$345,225.52Medical


Claim Payment Info

253Total

252Closed

1Open

Claim Counts

Treaty Year: 2015

As of Date: 7/31/2019 11:00:00 PM


35

Loss Summary Report

0Policy Count

95,932,209.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$959,322.09$0.00$959,322.09Totals

$173,058.28$0.00$173,058.28Legal

$7,480.47$0.00$7,480.47Expense

$338,242.15$0.00$338,242.15Indemnity

$440,541.19$0.00$440,541.19Medical


Claim Payment Info

266Total

266Closed

0Open

Claim Counts

Treaty Year: 2014

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

89,266,611.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$892,666.11$0.00$892,666.11Totals

$149,223.61$0.00$149,223.61Legal

$26,476.81$0.00$26,476.81Expense

$282,956.15$0.00$282,956.15Indemnity

$434,009.54$0.00$434,009.54Medical


Claim Payment Info

256Total

256Closed

0Open

Claim Counts

Treaty Year: 2013

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

61,382,332.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$613,823.32$0.00$613,823.32Totals

$98,698.23$0.00$98,698.23Legal

$13,373.48$0.00$13,373.48Expense

$68,750.29$0.00$68,750.29Indemnity

$433,001.32$0.00$433,001.32Medical


Claim Payment Info

261Total

261Closed

0Open

Claim Counts

Treaty Year: 2012

As of Date: 7/31/2019 11:00:00 PM


36

Loss Summary Report

0Policy Count

129,993,182.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$1,299,931.82$0.00$1,299,931.82Totals

$103,256.82$0.00$103,256.82Legal

$8,342.92$0.00$8,342.92Expense

$254,451.58$0.00$254,451.58Indemnity

$933,880.50$0.00$933,880.50Medical


Claim Payment Info

266Total

266Closed

0Open

Claim Counts

Treaty Year: 2011

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

77,466,052.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$774,660.52$0.00$774,660.52Totals

$76,749.47$0.00$76,749.47Legal

$7,794.65$0.00$7,794.65Expense

$311,328.67$0.00$311,328.67Indemnity

$378,787.73$0.00$378,787.73Medical


Claim Payment Info

273Total

273Closed

0Open

Claim Counts

Treaty Year: 2010

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

67,937,070.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$679,370.70$0.00$679,370.70Totals

$22,629.19$0.00$22,629.19Legal

$17,074.09$0.00$17,074.09Expense

$181,054.38$0.00$181,054.38Indemnity

$458,613.04$0.00$458,613.04Medical


Claim Payment Info

210Total

210Closed

0Open

Claim Counts

Treaty Year: 2009

As of Date: 7/31/2019 11:00:00 PM


37

Loss Summary Report

0Policy Count

91,805,587.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$918,055.87$0.00$918,055.87Totals

$105,897.56$0.00$105,897.56Legal

$11,238.20$0.00$11,238.20Expense

$352,511.01$0.00$352,511.01Indemnity

$448,409.10$0.00$448,409.10Medical


Claim Payment Info

167Total

167Closed

0Open

Claim Counts

Treaty Year: 2008

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

20,389,484.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$203,894.84$0.00$203,894.84Totals

$1,766.60$0.00$1,766.60Legal

$319.39$0.00$319.39Expense

$37,994.54$0.00$37,994.54Indemnity

$163,814.31$0.00$163,814.31Medical


Claim Payment Info

121Total

121Closed

0Open

Claim Counts

Treaty Year: 2007

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

31,116,389.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$311,163.89$0.00$311,163.89Totals

$82,588.70$0.00$82,588.70Legal

$3,183.84$0.00$3,183.84Expense

$58,095.44$0.00$58,095.44Indemnity

$167,295.91$0.00$167,295.91Medical


Claim Payment Info

111Total

111Closed

0Open

Claim Counts

Treaty Year: 2006

As of Date: 7/31/2019 11:00:00 PM


38

Loss Summary Report

0Policy Count

63,095,323.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$630,953.23$0.00$630,953.23Totals

$103,062.33$0.00$103,062.33Legal

$7,787.41$0.00$7,787.41Expense

$250,110.88$0.00$250,110.88Indemnity

$269,992.61$0.00$269,992.61Medical


Claim Payment Info

86Total

86Closed

0Open

Claim Counts

Treaty Year: 2005

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

14,420,238.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$144,202.38$0.00$144,202.38Totals

$377.60$0.00$377.60Legal

$344.25$0.00$344.25Expense

$31,593.70$0.00$31,593.70Indemnity

$111,886.83$0.00$111,886.83Medical


Claim Payment Info

77Total

77Closed

0Open

Claim Counts

Treaty Year: 2004

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

16,168,831.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$161,688.31$0.00$161,688.31Totals

$741.40$0.00$741.40Legal

$0.00$0.00$0.00Expense

$29,091.61$0.00$29,091.61Indemnity

$131,855.30$0.00$131,855.30Medical


Claim Payment Info

87Total

87Closed

0Open

Claim Counts

Treaty Year: 2003

As of Date: 7/31/2019 11:00:00 PM


39

Loss Summary Report

0Policy Count

51,332,215.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$513,322.15$0.00$513,322.15Totals

$20,800.12$0.00$20,800.12Legal

$2,187.75$0.00$2,187.75Expense

$214,955.91$0.00$214,955.91Indemnity

$275,378.37$0.00$275,378.37Medical


Claim Payment Info

99Total

99Closed

0Open

Claim Counts

Treaty Year: 2002

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

20,965,041.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$209,650.41$0.00$209,650.41Totals

$9,659.92$0.00$9,659.92Legal

$291.09$0.00$291.09Expense

$178,723.21$0.00$178,723.21Indemnity

$20,976.19$0.00$20,976.19Medical


Claim Payment Info

93Total

93Closed

0Open

Claim Counts

Treaty Year: 2001

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

19,524,448.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$195,244.48$0.00$195,244.48Totals

$4,714.34$0.00$4,714.34Legal

$1,182.70$0.00$1,182.70Expense

$142,934.13$0.00$142,934.13Indemnity

$46,413.31$0.00$46,413.31Medical


Claim Payment Info

85Total

85Closed

0Open

Claim Counts

Treaty Year: 2000

As of Date: 7/31/2019 11:00:00 PM


40

Loss Summary Report

0Policy Count

4,454,032.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$44,540.32$0.00$44,540.32Totals

$2,907.76$0.00$2,907.76Legal

$0.00$0.00$0.00Expense

$8,605.27$0.00$8,605.27Indemnity

$33,027.29$0.00$33,027.29Medical


Claim Payment Info

73Total

73Closed

0Open

Claim Counts

Treaty Year: 1999

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

10,950,662.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$109,506.62$0.00$109,506.62Totals

$17,083.45$0.00$17,083.45Legal

$3,175.58$0.00$3,175.58Expense

$34,527.06$0.00$34,527.06Indemnity

$54,720.53$0.00$54,720.53Medical


Claim Payment Info

64Total

64Closed

0Open

Claim Counts

Treaty Year: 1998

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

5,016,774.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$50,167.74$0.00$50,167.74Totals

$0.00$0.00$0.00Legal

$38.61$0.00$38.61Expense

$12,578.72$0.00$12,578.72Indemnity

$37,550.41$0.00$37,550.41Medical


Claim Payment Info

59Total

59Closed

0Open

Claim Counts

Treaty Year: 1997

As of Date: 7/31/2019 11:00:00 PM


41

Loss Summary Report

0Policy Count

11,483,149.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$114,831.49$0.00$114,831.49Totals

$0.00$0.00$0.00Legal

$109.15$0.00$109.15Expense

$20,366.50$0.00$20,366.50Indemnity

$94,355.84$0.00$94,355.84Medical


Claim Payment Info

61Total

61Closed

0Open

Claim Counts

Treaty Year: 1996

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

31,932,154.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$319,321.54$0.00$319,321.54Totals

$6,905.13$0.00$6,905.13Legal

$16,077.83$0.00$16,077.83Expense

$118,502.52$0.00$118,502.52Indemnity

$177,836.06$0.00$177,836.06Medical


Claim Payment Info

135Total

135Closed

0Open

Claim Counts

Treaty Year: 1995

As of Date: 7/31/2019 11:00:00 PM


0Policy Count

30,000,000.00 %Loss Ratio

$0.00Total Premium

$0.00Earned Premium

Policy Info

$300,000.00$182,576.00$117,424.00Totals

$0.00$0.00$0.00Legal

$300,000.00$182,576.00$117,424.00Expense

$0.00$0.00$0.00Indemnity

$0.00$0.00$0.00Medical


Claim Payment Info

1Total

0Closed

1Open

Claim Counts

Treaty Year: 1955

As of Date: 7/31/2019 11:00:00 PM


42

Loss Summary Report

All Treaty Year Totals

4199Total

4127Closed

72Open

Claim Counts


$13,110,205.87$975,117.50$12,135,088.37Totals

$1,107,603.88$6,500.00$1,101,103.88Legal

$555,650.91$235,443.08$320,207.83Expense

$3,613,314.04$98,842.49$3,514,471.55Indemnity

$7,833,637.04$634,331.93$7,199,305.11Medical


Claim Payment Info

0Policy Count

48,556,318.04 %Loss Ratio

$0.00Estimated Premium

$0.00Earned Premium

Policy Info

As of Date: 7/31/2019 11:00:00 PM

43

Report as of: 04/30/2019Forsyth County Public Schools

Loss Detail Report

Employer: Forsyth County Public Schools

127-2018Total for Policy:

Total $8,775.17$0.00

$211.09$2,300.00$6,264.08

Paid This Month

TotalClosedOpen


$664,443.74$5,093.50

$23,054.38$124,863.95$511,431.91

$102,664.26$0.00

$7,920.71$21,224.06$73,519.49

LegalExpenseIndemnityMedical

339332339

$561,779.48$5,093.50

$15,133.67$103,639.89$437,912.42

Tuesday, May 28, 2019Printed: 44


Loss Detail Report

Employer: Forsyth County Public Schools

127-2019Total for Policy:

Total $44,667.01$9,171.06$7,365.57$7,495.06

$20,635.32

Paid This Month

TotalClosedOpen


$809,257.78$33,000.00$65,276.40

$112,457.24$598,524.14

$557,130.18$16,436.53$44,402.19$78,536.38

$417,755.08

LegalExpenseIndemnityMedical

159101159

$252,127.60$16,563.47$20,874.21$33,920.86

$180,769.06



Loss Detail Report

Paid This Month

Total $53,442.18

$9,171.06$7,576.66

$9,795.06

$26,899.40

Grand Totals:

TotalClosedOpen


$38,093.50$88,330.78

$237,321.19

$1,109,956.05

$659,794.44

$16,436.53$52,322.90

$99,760.44

$491,274.57

LegalExpense

Indemnity

Medical

$813,907.08

$21,656.97$36,007.88

$137,560.75

$618,681.48

$1,473,701.52

65433498


Forsyth County Public Schools Treaty Year 2019

Dashboard Report

817$17,456.45DESANA MIDDLE SCHOOL13013$40,673.10WEST FORSYTH HIGH

817$28,889.46FORSYTH CENTRAL HIGH716$53,857.24RIVERWATCH MIDDLE

716$29,980.99DENMARK39534$56,408.78TRANSPORTATION

211$33,000.00BIG CREEK ELEMENTARY15015$65,665.14COAL MOUNTAIN ELEMENTARY

303$33,251.93ALLIANCE ACADEMY14212$75,501.61SOUTH FORSYTH MIDDLE

615$33,611.18NORTH FORSYTH MIDDLE17215$110,183.06NORTH FORSYTH HIGH

202$34,222.98BRANDYWINE ELEMENTARY SCHOOL523$112,349.34LITTLE MILL MIDDLE SCHOOL

707$36,280.40LIBERTY MIDDLE817$249,578.68LAMBERT HIGH

TotalLTMOIncurredNameTotalLTMOIncurredName

Claims By Location

26%$892,666.112013

17%$959,322.092014

60%$701,235.522015

145%$459,997.382016

44%$781,678.122017

71%$656,232.032018

71%$1,124,832.00

ChangeCurrent Total Incurred

Total Incurred VS Prior Years

7> 2 weeks

22 weeks

10Same week

25Next day

274Same day

Lag Time

$79,982.9912$93,352.30123$173,335.29135Closed Claims

$523,917.74183$427,578.97183$603,900.73183Open Claims

$603,900.7323$520,931.27295$1,124,832.00318# of Claims

IncurredCountIncurredCountIncurredCount

LTMOTotal

SUMMARY

$33,000.00$24,726.85$8,273.15O4/11/2019JEWETT, COURTNEY127-2019-000271

$33,000.00$28,774.90$4,225.10O4/16/2019HAMPTON, ERIC127-2019-000287

$33,000.00$29,955.85$3,044.15O4/29/2019DOZETOS, ANGELA127-2019-000308

$33,000.00$14,209.62$18,790.38O5/3/2019LOVELESS, MATTHEW127-2019-000294

$33,500.00$29,845.10$3,654.90O1/15/2019HOFFMAN, KATHLEEN127-2019-000187

$33,500.00$9,051.32$24,448.68O4/11/2019MIRACLE, MARY127-2019-000278

$49,430.16$0.00$49,430.16C9/6/2018NUKIC, AJNA127-2019-000074

$57,000.00$48,311.59$8,688.41O8/13/2018ROBAR, TRACY127-2019-000032

$64,500.00$10,435.24$54,064.76O7/11/2018OSMANBASIC, FATIMA127-2019-000006

$215,000.00$203,582.08$11,417.92O5/17/2019WATERS, WENDELL127-2019-000304

IncurredReservesPaidStatusDOIClaimantClaim Number

Top 10 Claims - By Incurred

$36,715.477Parapro

$44,339.6425Bus Driver

$49,709.4024Sped Parapro

$81,688.3832Food Service Asst.

$213,038.4343Custodian

$220,102.616Head Custodian

$350,201.5696TEACHER

IncurredCNTOccupation

Top Occupations - By Incurred

$0.00000Sunday

$21,578.97011Saturday

$168,988.1754752Monday

$173,031.4135861Tuesday

$192,133.9567379Wednesday

$257,733.6166470Thursday

$311,365.8935255Friday

IncurredLTMOCNTDay of Week

Daily Breakdown - By Incurred

Thursday, August 29, 2019 03:21 PM Page 1 of 147

ClassCode FY20Estimate EmployCt. FY19Actual Increase PCTChange

738313,980,152.14 48513,600,196.92 379,955.22 2.79%

8868275,287,936.11 4347252,624,955.33 22,662,980.78 8.97%910123,607,775.17 71323,148,268.79 459,506.38 1.99%

GrandTotal312,875,863.42 5,545289,373,421.04 23,502,442.38 8.12%

asof8/29/19

FORSYTHCOUNTYSCHOOLS-CURRENTYEARPAYROLLESTIMATEandEMPLOYEESCOUNTbyCLASSCODE

48

Forsyth County Schools Policy Number: 1002WSI037105-2

1120 Dahlonega Highway Effective Date: 7/1/2019

Cumming, GA 30040 Expiration Date: 7/1/2020

SCHEDULE OF VEHICLES

Vehicle

Key Class Year Make Model VIN

Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium

Garage Location: 1 1120 Dahlonega Highway

1 06183 1998 International Thomas 1HVBBAAN4WH607283 $55,754 $1,000 $1,000 $612



8 06183 1999 International Blue Bird 1HVBBAAN0XH208310 $59,907 $1,000 $1,000 $612

13 06183 2000 Freightliner Thomas 4UZ6CJAA5YCG42110 $59,382 $1,000 $1,000 $612



16 06183 2001 Freightliner Thomas 4UZAAXAK21CH90989 $49,580 $1,000 $1,000 $612





21 06183 2002 Freightliner Thomas 4UZAAXAKX2CJ75430 $58,054 $1,000 $1,000 $612

22 06183 2002 Freightliner Thomas 4UZAAXAK12CJ75431 $58,054 $1,000 $1,000 $612



25 06183 2003 Freightliner Thomas 4UZAAXAK83CK82266 $59,009 $1,000 $1,000 $612

26 06183 2003 Freightliner Thomas 4UZAAXAKX3CK82267 $65,809 $1,000 $1,000 $625

27 06183 2004 Freightliner Thomas 4UZAAXAK64CM13924 $59,628 $1,000 $1,000 $612




31 06184 2005 Freightliner Thomas 4UZAAXDC95CN77495 $58,773 $1,000 $1,000 $712





36 06184 1999 Freightliner Blue Bird 4UZ6CJFA0XCA44823 $51,781 $1,000 $1,000 $712





41 06184 1999 Freightliner Blue Bird 4UZ6CJFAXXCA44828 $51,781 $1,000 $1,000 $712



44 06184 1999 Freightliner Blue Bird 4UZ6CJFAXXCA44831 $51,781 $1,000 $1,000 $712

49 06184 1999 International Thomas 1HVBBAAN6XH208294 $51,230 $1,000 $1,000 $712

51 06184 1999 International Thomas 1HVBBAANXXH208296 $51,230 $1,000 $1,000 $712

Schedule of Vehicles 6/11/2019Page 1 of 1549





Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium






59 06184 2000 International Thomas 1HVBBAAN2YH278392 $50,208 $1,000 $1,000 $712




63 06184 2000 International Thomas 1HVBBAANXYH278396 $50,208 $1,000 $1,000 $712





68 06184 2000 International Thomas 1HVBBAANXYH278401 $50,208 $1,000 $1,000 $712








76 06184 2000 Freightliner Thomas 4UZ6CJAAXYCG71148 $48,708 $1,000 $1,000 $712










89 06184 2001 Freightliner Thomas 4UZAAXAKX1CH91016 $49,580 $1,000 $1,000 $712












Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium




























122 06184 2002 Freightliner Thomas 4UZAAXAKX2CK16476 $50,472 $1,000 $1,000 $712

















Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium















147 06184 2004 Freightliner Thomas 4UZAAXAKX4CM12856 $53,944 $1,000 $1,000 $712











158 06184 2005 Freightliner Thomas 4UZAAXDCX5CN77506 $53,944 $1,000 $1,000 $712


160 06184 2005 Freightliner Thomas 4UZAAXDC86CV02174 $55,390 $1,000 $1,000 $712



163 06184 2005 Freightliner Thomas 4UZAAXDCX6CV02161 $55,390 $1,000 $1,000 $712














Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium















185 06184 2005 Freightliner Thomas 4UZAAXDCX6CV02175 $55,390 $1,000 $1,000 $712








193 07398 1992 Ford Crow n Vic 2FACP74W9NX213012 $20,000 $1,000 $1,000 $397

194 07398 1992 Ford Crow n Vic 2FALP71WXRX141585 $20,000 $1,000 $1,000 $397

195 07398 1997 Ford Crow n Vic 2FALP73W3VX222872 $20,000 $1,000 $1,000 $397

196 07398 2000 Ford Crow n Vic 2FAFP74W4YX168997 $20,000 $1,000 $1,000 $397

197 01499 1998 Dodge Ram 1B7HF16Y3WS739106 $25,000 $1,000 $1,000 $607

198 01499 1993 Ford F150 1FTDF15Y8PNA57192 $25,000 $1,000 $1,000 $607

199 01499 1988 Chevrolet c30 1GBHR34K6JJ145582 $25,000 $1,000 $1,000 $607

200 01499 2002 Ford F250 1FTRX18WX2NB61088 $25,000 $1,000 $1,000 $607

201 01499 2002 Ford E350 1FTSS34L42HB10532 $25,000 $1,000 $1,000 $607

202 01499 2002 Ford E350 1FTSS34L62HB10533 $25,000 $1,000 $1,000 $607

203 01499 2000 Ford E350 1FTSS34L44HB46143 $25,000 $1,000 $1,000 $607

204 01499 2000 Ford E350 1FTSS34L7YHA74120 $25,000 $1,000 $1,000 $607

205 01499 2000 Ford E350 1FTSS34L9YHA74121 $25,000 $1,000 $1,000 $607

206 01499 2000 Ford E350 1FTSS34L0YHA74122 $25,000 $1,000 $1,000 $607

207 01499 1998 Ford F150 1FTZX1767WNA95669 $25,000 $1,000 $1,000 $607

208 01499 1998 Ford F150 1FTZX1763WNA95670 $25,000 $1,000 $1,000 $607

211 01499 1997 Ford F250 1FTEF2767VNC95280 $25,000 $1,000 $1,000 $607






Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium


212 01499 1997 Ford F250 1FTHE2421VHC03452 $25,000 $1,000 $1,000 $607

213 01499 2002 Ford E350 1FTSS34L92HB09540 $25,000 $1,000 $1,000 $607

214 01499 2000 Ford E350 1FTJE34HXTHB59640 $25,000 $1,000 $1,000 $607

215 01499 2000 Ford E350 1FTJE34H3THB59639 $25,000 $1,000 $1,000 $607

216 01499 2000 GMC 3500 1GTGG35K5TF507323 $25,000 $1,000 $1,000 $607

217 07398 1996 Ford Van 1FBJS31H9THB59615 $20,000 $1,000 $1,000 $397

218 07398 1996 Ford Van 1FBJS31HOTHB59616 $20,000 $1,000 $1,000 $397

219 07398 1996 Ford Van 1FBJS31H2THB59617 $20,000 $1,000 $1,000 $397

220 07398 1997 Ford Taurus 1FALP52U7VA320252 $20,000 $1,000 $1,000 $397

221 01499 1997 Ford E250 1FTHE2422VHA59961 $25,000 $1,000 $1,000 $607

222 01499 1996 Ford Ranger 1FTCR10A1TPB20239 $25,000 $1,000 $1,000 $607

223 01499 1996 Ford Ranger 1FTCR10AXTPB20238 $25,000 $1,000 $1,000 $607

225 01499 1992 LN 800 Truck 1FDWR82A7NVA08915 $25,000 $1,000 $1,000 $607

226 01499 2000 Ford F550 1FDAF56F7XEE73642 $25,000 $1,000 $1,000 $607

227 01499 1986 Chevrolet Drump truck 1GBE6D1A4GV119433 $25,000 $1,000 $1,000 $607

228 01499 2002 Ford Van 1FTSS34L82HB10534 $25,000 $1,000 $1,000 $607

229 01499 2006 Ford E350 1FTSS34L26HB27142 $25,000 $1,000 $1,000 $607

230 01499 2006 Ford E350 1FTSS34L46HB27143 $25,000 $1,000 $1,000 $607

231 01499 2006 Ford E350 1FTSS34L66HB27144 $25,000 $1,000 $1,000 $607

232 01499 2006 Ford E350 1FTSS34L86HB27145 $25,000 $1,000 $1,000 $607

233 01499 2006 Ford E350 1FTSS34LX6HB27146 $25,000 $1,000 $1,000 $607

234 06184 2006 Thomas Bus 4UZAAXDC97CX12106 $60,339 $1,000 $1,000 $712









243 06184 2006 Thomas Bus 4UZAAXDCX7CX12115 $60,339 $1,000 $1,000 $712













Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium




253 06184 2007 Thomas Bus 4UZABRDCX8CY55849 $60,339 $1,000 $1,000 $712

254 06184 2007 Thomas Bus 4UZABRDC68CY55850 $60,339 $1,000 $1,000 $712








































Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium







294 01499 2001 Chevrolet Van 1GCFG15R511106927 $25,000 $1,000 $1,000 $607

298 06183 2006 Bluebird Bus 1BAKBCKA67F242514 $64,317 $1,000 $1,000 $612


301 01499 2008 Ford Ranger 1FTYR10U58PA31099 $11,635 $1,000 $1,000 $599

302 01499 2008 Ford Van 1FTSS34L58DA25375 $18,017 $1,000 $1,000 $604

303 01499 2008 Ford Van 1FTSS34L68DA25384 $18,017 $1,000 $1,000 $604

304 01499 2008 Ford Van 1FTSS34L78DA25376 $18,017 $1,000 $1,000 $604

305 01499 2008 Ford Van 1FTSS34L48DA25383 $18,017 $1,000 $1,000 $604

306 01499 2008 Ford Van 1FTSS34L28DA25382 $18,017 $1,000 $1,000 $604

307 01499 2008 Ford Van 1FTSS34L08DA25378 $18,017 $1,000 $1,000 $604

308 01499 2008 Ford Ranger 1FTYR10U38PA31098 $11,635 $1,000 $1,000 $599

309 01499 2008 Ford E350 Van 1FTSS34L08DA25381 $18,017 $1,000 $1,000 $604





314 01499 2008 Ford F150 1FDNF21588EC87687 $24,226 $1,000 $1,000 $607

315 06184 2008 Freightliner Thomas 4UZABRDJ68CZ17942 $68,424 $1,000 $1,000 $730


317 06184 2008 Freightliner Bus 4UZABRDJX8CZ17944 $68,424 $1,000 $1,000 $730



















Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium


331 06184 2008 Freightliner Thomas 4UZABRDJX8CZ17958 $68,424 $1,000 $1,000 $730



334 06184 2008 Freightliner Thomas 4UZABRDJX8CZ17961 $68,424 $1,000 $1,000 $730










344 06183 2009 Freightliner Bus 4UZABRDJ89CZ73706 $81,962 $1,000 $1,000 $625



347 01499 2008 Ford E350 Van 1FTSS34LX8DA29096 $18,017 $1,000 $1,000 $604

348 06184 2009 Bluebird Bus 1BAKGCKAX9F263029 $81,693 $1,000 $1,000 $730

349 06184 2009 Bluebird Bus 1BAKGCKA69F263030 $81,693 $1,000 $1,000 $730

























Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium





374 31499 2008 Ford F650 3FRWF65T08V044066 $70,900 $1,000 $1,000 $731

375 01499 2009 Ford Ranger 1FTYR10DX9PA23811 $11,098 $1,000 $1,000 $599

376 01499 2009 Ford Ranger 1FTYR10E09PA23812 $13,263 $1,000 $1,000 $599











387 01499 2008 Ford F250 1FTNX20549EA00625 $17,390 $1,000 $1,000 $604

395 06183 2010 Bluebird Bus 1BAKBCPA9AF270050 $89,804 $1,000 $1,000 $639





400 06183 2010 Bluebird Bus 1BAKBCPAXAF270056 $89,804 $1,000 $1,000 $639








408 06184 2010 Bluebird Bus 1BAKGCPA0AF270066 $73,556 $1,000 $1,000 $749













Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium








422 06184 2010 Bluebird Bus 1BAKGCPAXAF270074 $73,556 $1,000 $1,000 $749



425 06184 2012 Freightliner Bus 4UZABRDT2CCAZ7629 $73,318 $1,000 $1,000 $768





430 06183 2009 Freightliner Bus 4UZABRDJ79CAA6695 $81,786 $1,000 $1,000 $625

431 06184 2011 Freightliner Bus 4UZABRDT9BCAZ7545 $74,000 $1,000 $1,000 $759








439 06184 2012 Freightliner Bus 4UZABRDTXCCAZ7586 $74,000 $1,000 $1,000 $768





444 07398 2005 Ford Taurus 1FAFP53U05A262450 $0 $358

445 06183 2015 Thomas Bus 4UZABRDT7FCFW6931 $94,845 $1,000 $1,000 $680




449 06183 2015 Thomas Bus 4UZABRDT7FCGJ0491 $94,845 $1,000 $1,000 $680



452 01499 2011 Transit Van 537LS7D45BT041797 $25,000 $1,000 $1,000 $624

453 01499 2015 Chevrolet 3500 1GCZGUCG5F1164334 $25,570 $1,000 $1,000 $672






Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium


454 01499 2015 Chevrolet 3500 1GCZGUCG4F1164843 $25,570 $1,000 $1,000 $672





459 06184 2015 Thomas Bus 4UZABRDT0GCGS4217 $80,474 $1,000 $1,000 $797








467 06184 2015 Thomas Bus 4UZABRDTXGCGS4225 $80,474 $1,000 $1,000 $797
















483 01499 2015 Ford F150 1FTMF1C87FKD12241 $18,000 $1,000 $1,000 $642

484 06184 2015 Thomas Bus 4UZABRDT9GCGX4811 $80,474 $1,000 $1,000 $797






490 21499 2016 Freightliner M2106 1FVACXDT7GHHP4581 $84,730 $1,000 $1,000 $756

491 01499 2016 Ford Transit 1FTYE2CG1GKA32429 $27,195 $1,000 $1,000 $686






Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium


492 01499 2016 Ford Transit 1FTYE2CGXGKA32431 $27,195 $1,000 $1,000 $686

493 01499 2016 Ford Transit 1FTYE2CG8GKA32430 $27,195 $1,000 $1,000 $686

494 01499 2016 Ford F150 1FTMF1C86GFC00797 $18,400 $1,000 $1,000 $651

495 06184 2017 Thomas Bus 4UZABRDT7HCHS7605 $81,350 $1,000 $1,000 $825










505 06184 2017 Thomas Bus 4UZABRDTXHCHS7615 $81,350 $1,000 $1,000 $825














519 06184 2017 Thomas Bus 4UZABRDT4HCHM7035 $94,845 $1,000 $1,000 $831



522 06184 2017 Thomas Bus 4UZABRDTXHCHS7632 $94,845 $1,000 $1,000 $831







529 01499 2016 Chevrolet Express 1GCZGHFG6G1275057 $27,192 $1,000 $1,000 $686






Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium


530 01499 2017 Ford F250 1FDBF2B64HEB54063 $36,229 $1,000 $1,000 $693

531 01499 2017 Ford Pickup 1FDBF2B66HEB18102 $36,229 $1,000 $1,000 $693

532 01499 2017 Chevrolet Express 1GCZGHFF3H1229534 $27,192 $1,000 $1,000 $693

533 01499 2017 Chevrolet Express 1GCZGHFF8H1225981 $27,192 $1,000 $1,000 $693

534 01499 2017 Ford F150 1FTMF1C85HFA88480 $18,252 $1,000 $1,000 $657

535 06184 2018 Thomas Bus 4UZABRFCXJCJG2830 $95,754 $1,000 $1,000 $843

536 06184 2018 Thomas Bus 4UZABRFC1JCJG2831 $95,754 $1,000 $1,000 $843



































Vehicle


Cost

New

Comp

Ded.

Coll

Ded.

Annual

Premium






570 06181 2014 Freightlin M2 106 1FVACWDT6EHFS0089 $32,000 $1,000 $1,000 $519

571 01499 2018 Chevrolet Silverado 1GCNKNEC1JZ244432 $34,092 $1,000 $1,000 $700

572 01499 2018 Chevrolet Silverado 1GCNKNECXJZ245899 $34,092 $1,000 $1,000 $700

573 01499 2018 Chevrolet Silverado 1GCMKNEC4JZ283726 $34,092 $1,000 $1,000 $700

574 01499 2019 Ford T150 1FTYE2CGXKKA23978 $52,500 $1,000 $1,000 $753

575 01499 2019 Ford Transit 1FTYE2CG8KKA23977 $52,500 $1,000 $1,000 $753

576 01499 2019 Ford F150 1FTEW1C40KFA41835 $31,143 $1,000 $1,000 $700

577 01499 2019 Freightliner Bus 4UZABRFC6LCLU2765 $125,000 $1,000 $1,000 $896

Total Number of Vehicles: 542





Markel Insurance CompanySTATEMENT OF VALUES

Location Building Address Building Value Contents Value

1 - 1 Admin Bldg 1120 Dahlonega Hw y Cumming, GA 30040 $6,644,877 $2,028,131

2 - 1 S. Forsyth HS 581-586 Peachtree Pkw y Cumming, GA 30041 $36,574,874 $2,559,354

2 - 2 SF Bat Bldg 581-586 Peachtree Pkw y Cumming, GA 30041 $105,060 $0

2 - 3 Portable Classrooms 581-586 Peachtree Pkw y Cumming, GA 30041 $559,970 $0

2 - 4 South Forsyth HS Addition 581-586 Peachtree Pkw y Cumming, GA 30041 $28,106,814 $283,106

3 - 1 N. Forsyth HS 3635 Coal Mountain Dr Cumming, GA 30040 $39,536,515 $2,931,677

3 - 2 Modular Classrooms (Various Locations) 3635 Coal Mountain Dr Cumming, GA 30040 $2,296,527 $408,680

3 - 3 Modular Storage Bldgs (Various Loc) 3635 Coal Mountain Dr Cumming, GA 30040 $598,036 $0

4 - 1 S. Forsyth MS 2865 Old Atlanta Rd Cumming, GA 30041 $19,589,400 $928,818

4 - 2 South Forsyth MS Addition 2865 Old Atlanta Rd Cumming, GA 30041 $13,084,592 $163,535

5 - 1 F. Central HS 518-520 Tribble Gap Rd Cumming, GA 30040 $40,002,478 $2,196,574

6 - 1 Otw ell MS 605 Tribble Gap Rd Cumming, GA 30040 $19,385,280 $928,818

6 - 2 Portable Classrooms 605 Tribble Gap Rd Cumming, GA 30040 $189,108 $0

7 - 1 Vickry Crk MS 6240 Post Rd Cumming, GA 30040 $18,823,140 $928,818

8 - 1 Liberty MS 7465 Wallace Tatum Rd Cumming, GA 30028 $19,452,590 $928,818

9 - 1 Riverw atch MS 610 James Burgess Rd Suw anee, GA 30024 $19,764,297 $928,818

9 - 2 Portable Classrooms 610 James Burgess Rd Suw anee, GA 30024 $472,770 $0

9 - 3 Riverw atch MS Addition 610 James Burgess Rd Suw anee, GA 30024 $11,511,184 $62,156

10 - 1 Big Creek Elem 1994 Peachtree Pkw y Cumming, GA 30041 $10,662,539 $492,935

11 - 1 Chatt. Elem 2800 Holtzclaw Rd Cumming, GA 30041 $15,444,435 $525,300

12 - 1 Chestatee Elem 6945 Keith Bridge Rd Gainesville, GA 30506 $19,977,720 $829,550

13 - 1 Coal Mtn Elem 3455 Coal Mountain Dr Cumming, GA 30028 $10,444,278 $405,303

14 - 1 Cumming Elem 540 Dahlonega St Cumming, GA 30040 $19,102,975 $619,213

15 - 1 Daves Creek Elem 3740 Melody Mizer Ln Cumming, GA 30041 $14,507,856 $495,368

15 - 2 Portable Classrooms 3740 Melody Mizer Ln Cumming, GA 30041 $229,619 $0

16 - 1 Mashburn Elem 3777 Samples Rd Cumming, GA 30041 $10,066,980 $374,339

17 - 1 Matt Elem 7455 Wallace Tatum Rd Cumming, GA 30028 $19,972,617 $633,400

Statement of Values 5/30/2019Page 1 of 3

64






18 - 1 Midw ay Elem 4805 Atlanta Hw y Alpharetta, GA 30004 $8,393,243 $470,577

19 - 1 Saw nee Primary 1655 Spot Rd. Cumming, GA 30040 $9,032,239 $420,240

20 - 1 Saw nee Elem 1616 Canton Hw y Cumming, GA 30040 $10,825,382 $619,213

21 - 1 Stls Brdg Elem 600 James Burgess Rd Suw anee, GA 30024 $15,234,173 $1,319,008

22 - 1 Sharon Elem 3595 Old Atlanta Rd Suw anee, GA 30024 $21,482,929 $1,052,804

23 - 1 Vckry Crk Elem 6280 Post Rd Cumming, GA 30040 $14,738,080 $472,770

24 - 1 PDMNT Lrn Ctr 1130 Dahlonega Hw y Cumming, GA 30040 $3,153,901 $436,601

25 - 1 Food Srvc Cnt 1140 Dahlonega Hw y Cumming, GA 30040 $2,164,488 $587,694

26 - 1 Transport Dep 3560 Matt Hw y Cumming, GA 30028 $1,016,834 $665,597

26 - 2 Bus Shop 3560 Matt Hw y Cumming, GA 30028 $1,201,592 $0

27 - 1 Warehouse 441 Canton Rd Cumming, GA 30040 $1,852,208 $371,527

28 - 1 Hill Edu Cntr 136 Elm St Cumming, GA 30040 $6,198,540 $348,263

29 - 1 Slvr City Elem 6200 Dahlonega Hw y Cumming, GA 30028 $18,559,200 $787,950

30 - 1 Shiloh Pt Elem 8145 Majors Rd Cumming, GA 30041 $21,143,900 $787,950

31 - 1 Lit'l Mill MS 6800 Little Mill Rd Cumming, GA 30041 $21,875,180 $928,730

32 - 1 W Forsyth HS 4155 Drew Rd Cumming, GA 30040 $48,654,877 $2,101,200

32 - 2 Portable Classrooms 4155 Drew Rd Cumming, GA 30040 $283,662 $0

33 - 1 Piney Gr MS 8135 Majors Rd Cumming, GA 30041 $21,296,345 $928,730

33 - 2 Portable Classrooms 8135 Majors Rd Cumming, GA 30041 $370,935 $0

34 - 1 Johns Crk Ele 6205 Old Atlanta Rd Suw anee, GA 30024 $21,893,753 $787,950

35 - 1 N Forsyth MS 3645 Coal Mountain Dr Cumming, GA 30028 $18,283,440 $928,730

36 - 1 Whitlow Elem 3655 Castleberry Rd Cumming, GA 30040 $19,309,444 $787,950

37 - 1 Bus Garage 3591 Old Atlanta Rd Suw anee, GA 30024 $1,882,675 $315,180

38 - 1 Lambert HS 805 Nichols Rd Suw anee, GA 30024 $45,240,610 $2,626,500

38 - 2 Portable Classrooms 805 Nichols Rd Suw anee, GA 30024 $559,970 $0

38 - 3 Synthetic Turf 805 Nichols Rd Suw anee, GA 30024 $798,456 $0

38 - 4 Lambert HS Addition 805 Nichols Rd Suw anee, GA 30024 $7,247,080 $47,032


65






39 - 1 Brookw ood Elem 2980 Vaughan Dr Cumming, GA 30041 $19,635,150 $787,950

40 - 1 Haw Creek Elem 2555 Echols Rd Cumming, GA 30041 $21,399,525 $787,950

41 - 1 Lakeside MS 2565 Echols Rd Cumming, GA 30041 $22,966,116 $928,730

42 - 1 Kelly Mill Elementary 1180 Chamblee Gap Rd Cumming, GA 30040 $21,237,450 $840,480

42 - 2 Portable Classrooms 1180 Chamblee Gap Rd Cumming, GA 30040 $114,810 $0

43 - 1 Desana Middle School 625 James Rd Alpharetta, GA 30004 $32,602,660 $488,293

44 - 1 Brandyw ine Elementary School 175 Martin Dr Alpharetta, GA 30004 $21,426,522 $421,148

45 - 1 Denmark Building 645 Mullinax Rd Alpharetta, GA 30004 $76,735,000 $1,728,303

46 - 1 Alliance Academy 1100 Lanier 400 Parkw ay Cumming, GA 30040 $30,385,000 $2,100,177

$986,301,900 $45,527,938

* Not Included In Blanket TIV @ 100% $1,031,829,838

Authorized Officer Date

Please sign and date the form.


66




SCHEDULE OF INLAND MARINE

Category Item Coverage Limit Deductible Written Premium

Contractor's Equipment $500 $50

$53,045

EDP Equipment (Incl Softw are) $10,000 $6,857

$10,504,598

Miscellaneous Articles $500 $1,087

Radios and Cameras $200,000

$200,000

JROTC Equipment $150,000

Rented Costumes $15,000

JROTC Equipment $642,000

Mobile Equipment $500 $22

2017 KAF620VHF Mule ATV #1374 $11,199

Musical Instruments $500 $477

incl Band Uniforms $500,000

Rented/Leased Equipment $500 $43

Baseball/Softball Scoreboard etc. $47,924

Valuable Papers & Records $500 $376

$415,000

Total Annual Premium: $9,091

Schedule of Inland Marine 5/30/2019Page 1 of 167

FORSYTHCOUNTYSCHOOLS EXHIBIT

1

PRIORITYOBJECTIVESLiabilityandPropertyA. InsurancePlanAdequacyandCoverage. TheAgencyshould take the initiative

andprovidesupportthatwillrespondtothesepriorities:

1. Property Valuation Program: The District needs the cost of independentappraisalsforvariousoptionsandavaluationprogramimplementationplan.

2. Extra Expense: The limit for loss arising from property damage did notchangefromtheprioryear.Astudyisneededtoidentifytheexposurethatexistsunderdifferentscenarios.

3. Clarifyand/or improvecoverage:Addresseachof thesuggestions inB.1-9and any other items that the Agency feels should be included.

B. SuggestedCoverageClarificationand/orImprovement:

1. Each of the special Markel forms identified with MGL are important for

Liabilitycoverageandshouldbedescribedinwriting.Severalsub-limitsforGeneral Liability coverage exist. The language of the Sexual MisconductcoverageisparticularlyimportanttoreviewwiththeDistrictandmakesureitisunderstood.

2. Premises Medical Payments – It has been suggested that the payment ofmedicalexpensesmayconstitutean indirectgratuity. Anypaymentsmadeare likely to have an impact on the loss history and potentially futurepremiums. Pending an opinion of District legal counsel for clarification,written guidance available from other districts or opinions of school riskmanagementthoughtleaderswouldbehelpful.

3. Adverse Event Response - The value and options for selection of Public

RelationsfirmsthatmaybeavailabletotheDistrictshouldbediscussed.

4. Non-Monetary Relief Defense – Clear communication with all internalstakeholders is important to coverage attachment and reimbursement. AnexplanatoryguidefortheDistrictcabinetwouldbehelpfulasastartingpoint.

5. The Honor Roll Elite property coverage form is provided, however a

complete description of its features was not included in the most recentrenewalproposal.

6. AutomobilePhysicalDamage–Thecurrentmethodofcoveragefordamage

and replacement is typical for small fleets of buses. An alternative toconsiderisblanketcoverageasanextensionofthepropertyinsurancewith

68


2

the deductible on an ‘occurrence’ basis rather than a per vehicle basis.Blanketcoveragewouldeliminatetheneedforschedulingthevehicles.

7. Terrorismfornewlyacquiredlocationsduringthepolicymustbeseparately

underwritten. NewadditionsthatwillbecomepartoftheDistrictcoverageinthecoverageperiodcanbeidentified.TheexpectationsoftheunderwritershouldbemadeavailabletotheDistricts.

8. Crime coverage includes Dishonesty and Faithful Performance protection

according to presentations. The limit of the Blanket Bond should bereviewedandexposurestudyperformed.

9. Earthquake deductible is 5%, however the method of calculation is not

described in therecentrenewalproposal. FloodCoverage isnot indicatedformobileequipmentandother“inlandmarine” items. AsingledeductibleforFlood&Earthquakemightbedesirable.

C. RiskControl. TheAgencyshouldworkcollaborativelywiththeDistrictand its

independent consultant Albert Risk to develop plans for support that willrespondtoeachissuenotedinthethesepriorities:

1. Transportation: Begin identifying the strengths and vulnerabilities in the

selectionandtrainingofbusdriversandcrossingguards.2. Athletics: Prepare a risk management guide similar in scope to examples

from other districts and recognized sources. Support in this subject areashould include an ongoing inventory of resources and evidenced basedprograms for prevention of cardiac arrest, heat illness, brain trauma andhazing, along guidance in medical care, emergency response preparation,sportsfacilitysafetyandTitleIXcompliance.

3. Property Perils Control: Provide guidance and assistance to develop

strategies to address the exposure of these five dynamic elements in eachbuildingitowns:Arson,Chemicals,Renovation,ElectricalandSecurity.

4. Liability Risk Control: Assist as needed with the suggested liability risk

controlimprovementsandrecommendotheritemsthattheAgencybelievesshouldbeincluded.SeeD.1-7.

D. SuggestedLiabilityRiskControlImprovement:

1. Employment Practices: Expansion, inclusion policies and new work/lifeattitudes present challenges for sustaining healthy, welcoming, highly

69


3

reliable culture and protecting the civil rights of every employee. Anassessment of existing strategies to reduce risk may be helpful. ExternalresourcesavailablethroughMetroRESA,GASPA,AASPAandSHRMareoftenhelpful, however, theymay need to be deployed differently or augmentedwith others. Specific online education programs have improved in recentyearsandcanbepartofthedistrict’sTalentriskcontrolblueprint.

2. ContractualLiability: ProtectionoftheDistrict’sfinancialinterestsdepends

onsound,practicalpoliciesandadministratorsworkingcarefullythroughthecontract development process with suppliers, service providers andprofessional firms. Riskmanagement beginswith an understanding of theDistrict’sappetiteforrisk,andreliesonskillsinapplyingindemnityandrisksharingcontract languagecombinedwitheffective,pragmaticcollaboration.Assuranceof vendor compliancewith agreedupon insuranceandDistrict’sdeliveryofcoverageevidencedocumentstothirdpartiesistime-consumingandoftenpronetogapsandmissinginformation. Useofnewsoftwareandoutsourcing some aspects of coverage verification can reduce theDistrict’sexposuretolossandadverseimpactonitsinsuranceunderwriters.

3. LawEnforcement:Liabilityunderwritersmayexpectinformationaboutthe

SROservicesagreementwiththeSheriffDepartment.Theymayalsoexpectan analysis of the Sheriff Department’s policies and procedures related to“Use of Force.” The current agreement does not address expectations orresponsibilities for legal defense and indemnity arising from bodily injury,personalinjuryandwrongfulacts.

4. HighHazardStudentActivities:Thereareseveralbenefitsofawell-designed

process for assessment of activities and clear guidance to all schoolprincipals aboutwhenan activity is tobe avoidedor allowedwith specificconditions. Insurance coverage exclusions may determine whether anactivity is outright prohibited or whether exceptions can be made. Aneffectiveprocessshouldbeestablishedtoauthorizeandobtainspecialeventsliabilityinsuranceunderappropriatecircumstances.

5. Community Use of Facilities: An annual review of the registry of

organizations that have used facilities during the course of the past yearprovidesdata thatcanbeused forpreventionof injuries. TheDistrictcanhostaT.U.L.I.P.–aspecialtypeofinsuranceprogramthatmakesiteasyforsmall organizationsand certain individuals tomeet theDistrict’s insurancerequirements.

6. StudentExtendedTravel: Theprocessofcontrollingrisksthatareinherent

in overnight travel is typically affected by limitations on time andmoney.Thecycleofpreparationisoftencompressedforunanticipatedinvitationsorchanges prompted by circumstances that arise in the course of an activity.Formal training for administrators, faculty and chaperones should include

70


4

role-playingandaccountforsocalled“blackswans”-eventsthatwithsevereconsequences andnoprecedence. In spite of the inherent challenges thatextendedtravelpresents,theDistrictcanaugmentpre-tripplanningcontrolsby drawing on the experience gleaned from “after action reports” and byintroducing all participants to the practices of risk intelligent enterprisemanagement.

7. Educator Sexual Misconduct Prevention: A carefully designed, multi-part

approachisessentialtosafeguardstudentsfromsexualboundaryviolationsby school employees. A well-crafted survey can provide a means tounderstandtheDistrict’scurrentapproachtoprevention.

Workers’CompensationTheAgencyshouldtaketheinitiativeandprovidesupporttoensurethat:

1. At least four regular Claims Review meetings are held and agendas arecirculatedatleastfivedaysinadvancemeetings.

2. Loss experience reports are provided on regular intervals and include a

narrativeoverviewandsummaryofkeyitemsforreviewand/ordiscussion.3. The Agency Engagement Manager and/or the Agency’s Claims Manager is

alwayspresentforscheduledreviewmeetings.4. After-meetingnotesfromtheclaimsreviewmeetingarepreparedinorderto

keeptrackofopenclaimsandriskcontrolmeasuresforDistrictandAgencyfollowup.

71

Insurance Broker Services Agreement FORYSTH COUNTY SCHOOS

1

FORSYTH COUNTY SCHOOLS

INSURANCE BROKER SERVICE AGREEMENT

INSURANCE BROKER SERVICE AGREEMENT ......................................................................................... 1

1. Service Period/Term .......................................................................................................................... 2 2. Purpose .............................................................................................................................................. 2 3. Scope of Services .............................................................................................................................. 2 4. Principal Offices, Subsidiaries and Service Delivery ....................................................................... 2 5. Compensation for Services ............................................................................................................... 2 6. Broker Intermediaries/Managing General Agents (MGAs) .............................................................. 3 7. Affiliates of Broker ........................................................................................................................... 3 8. Institutional Fees, Surplus Lines or Other Premium Taxes ........................................................... 3 9. Insurance Market Security Requirements ......................................................................................... 3 10. Material Change in District Operations ............................................................................................ 4 11. Confidentiality ................................................................................................................................... 4 12. Termination of Agreement ................................................................................................................ 4 13. Inspection of Records ........................................................................................................................ 5 14. Evidence of Insurance ....................................................................................................................... 5 15. Entire Agreement .............................................................................................................................. 5 16. Injunctive Relief ................................................................................................................................ 5 17. Applicable Law; Binding Effect; Severability .................................................................................. 5

SCHEDULE A – INSURANCE PROGRAMS .................................................................................................. 7 SCHEDULE B – SCOPE OF SERVICES ......................................................................................................... 8

1. Base Services .................................................................................................................................... 8 2. Consulting Services (if any) ............................................................................................................ 10 3. Extended Services ........................................................................................................................... 10

SCHEDULE C - COMPENSATION ............................................................................................................... 12

1. Service Fee and Payment Schedule ................................................................................................. 12 2. Disclosure of Fees, Commissions or Consideration Received from Third Parties ......................... 13 3. Commissions Credited Against Service Fee ................................................................................... 13 4. Compensation for Local Placements of Insurance for Foreign Operations .................................... 13 5. Adjustments to Annual Service Fee ................................................................................................ 13 6. Right to Withhold Compensation .................................................................................................... 13

SCHEDULE D - CONFIDENTIALITY .......................................................................................................... 14

1. Nondisclosure of Confidential Information .................................................................................... 14 2. Scope ............................................................................................................................................... 15

72

Documents

FORSYTH COUNTY SCHOOLS REQUEST FOR ......1 FORSYTH COUNTY SCHOOLS REQUEST FOR PROPOSAL INSURANCE BROKER SERVICES September 12, 2019 Finance Department 1120 Dahlonega Highway Cumming,