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1. Value: $1,010,444.00 (as per survey) <br />Coverage 909,400.00 - 90% Blanket Building <br />and contents under the Public <br />and Institutional Property Form, <br />subject to a $100.00 deductible, <br />Includes automotive coverage for <br />additional property & coverage <br />away from premises <br />2. Contractors Equipment Floater for 187, 813 <br />and $100,000.00 Voting Machine <br />Schedule <br />3. Automobile Liability and Physical damage <br />Coverage - $100,000.00 per person <br />Bodily 300,000.00 per accident <br />Injury <br />Property <br />Damage 25,000.00 <br />Comp. &$50.00 Ded. on Private. Passenger Vehicles <br />Fire, theft and $100.00 Ded. - all other Vehicles , <br />No physical damage on any vehicles over 7 years old <br />(Figure includes coverage on all equipment <br />including Fire Trucks) <br />4. Comp. General Liability coverages in the <br />amounts of $100,000.00 / $300,000.00 / $25,000.00 <br />on an occurrence basis as per schedule <br />5. Workmen's Compensation Coverage <br />- Statutory - <br />Retrospective Rating Plan I <br />3 yr. premium <br />Minimum $20,796.67 <br />Standard 29,127.00 <br />Maximum 34,952.40 <br />Annual Basis <br />Minimum 6,925.06 <br />Standard 9,709.00 <br />Maximum 11,639.01 <br />A <br />$1,426.00 <br />1,556.00 <br />4,555.00 <br />3,122.00 <br />* Participating Plan <br />Premium Modification .70` <br />Premium Discount 9.5 <br />Maximum Dividend 9.5# <br />Deposit Premium 8,836.00 <br />* Dividend figured at end of the year) <br />after annual audit, in addition <br />The Association, after much deliberation <br />and consideration recommends the.participating <br />plan. <br />600111) PAGE 2841 <br />TOTAL $19.495.00 <br />