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1 FLORIDA MUNICIPAL INSURANCE TRUST <br />AUTOMOBILE LIABILITY AND PHYSICAL DAMAGE <br />DECLARATIONS <br />i <br />t DESIGNATED MEMBER: <br />Town of Indian River Shores <br />It. GOVERNMENT DESCRIPTION <br />Municipality <br />III- COVERAGE PERIOD <br />Agreement No.: FMIT #0274 <br />From 10/01/2015 to 10/01/2016 12:01 A.M. Standard Time at the address of the Designated Member <br />IV- AUTOMOBILE <br />1 Automobile Liability <br />Number of Vehicles <br />2. Uninsured Motorists Protection <br />3 Personal Injury Protection <br />1 <br />4. Automobile Medical Payments <br />5 Automobile Physical Damage <br />Premium Deductible/ Net <br />Basis Tvoe Limit prami,'m <br />Per Schedule <br />SO <br />S7,000.000 <br />S11.903 <br />22 <br />N/A <br />N/A <br />$10.000 <br />Included <br />N/A <br />NIA <br />Per Schedule <br />Per Schedule <br />N/A <br />53.145 <br />V• This Agreement includes these endorsements and schedules: See Schedule B <br />VI. ESTIMATED ANNUAL PREMIUM <br />Florida Municipal Insurance Trust (FMIT) <br />Normal <br />Premium <br />$15.048 <br />Florida League of Cities Sponsored Insurance Programs Since 1977 <br />THIS DECLARATIONS AND THE SUPPLEMENTAL DECLARATIONS. TOGETHER WITH THE COMMON <br />CONDITIONS, COVERAGE FORM(S) AND ENDORSEMENTS COMPLETE THE ABOVE NUMBERED <br />AGREEMENT. <br />FMIT AUTO DEC 1015 <br />Page 1 of 2 <br />83 <br />