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2024-237
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2024-237
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Last modified
10/21/2024 11:45:59 AM
Creation date
10/21/2024 11:41:35 AM
Metadata
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Template:
Official Documents
Official Document Type
Agreement
Approved Date
09/24/2024
Control Number
2024-237
Agenda Item Number
8.P.
Entity Name
Davies Claims North America, Inc.
Subject
Third Party Claims Administration Services Agreement for the Self-Funded Workers’
Compensation and Liability Program
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IRC agrees to indemnify, defend and hold TPA harmless to the extent allowed by and only to the <br />extent set forth in Section 768.28 of Florida Statutes for any action resulting from TPA. <br />4.6 TPA Insurance Requirements. Prior to commencement of services under this Agreement, <br />TPA shall obtain and maintain without interruption until completion of all services required under this <br />Agreement, the insurance as outlined below. TPA agrees to furnish a fully completed certificate of <br />insurance naming IRC and its members, officers, employees, and agents as additional insured on the <br />General Liability insurance, signed by an authorized representative of the insurer providing such <br />insurance coverages. The insurance coverages and limits shall meet, at a minimum, the following <br />requirements: <br />4.6.1 Workers' Compensation/Employer's Liability Insurance. Such insurance shall be <br />no more restrictive than that provided by the Standard Workers' Compensation Policy, as <br />filed for use in Florida by the National Board on Compensation Insurance, without <br />restrictive endorsements. The minimum amount of coverage (inclusive of any amount <br />provided by an umbrella or excess policy) shall be: <br />Part One: "Statutory" <br />Part Two: $ 1,000,000 Each Accident <br />$ 1,000,000 Disease - Policy Limit <br />$ 1,000,000 Disease - Each Employee <br />4.6.2 General Liability Insurance. Such insurance shall be no more restrictive than that <br />provided by the most recent version of standard Commercial General Liability Form (ISO <br />Form CG 00 01) as filed for use in the State of Florida without any restrictive endorsements <br />other than those required by ISO or the State of Florida those described below. The <br />coverage may include restrictive endorsements which exclude coverage for liability arising <br />out of: <br />• Mold, fungus, or bacteria <br />• Terrorism <br />• Sexual Molestation <br />The minimum limits (inclusive of amounts provided by an umbrella or excess policy) shall <br />be: <br />$ 2,000,000 General Aggregate <br />$ 2,000,000 Products/Completed Operations Aggregate <br />$ 1,000,000 Personal and Advertising Injury <br />$ 1,000,000 Each Occurrence <br />IRC and its members, officers, employees, and agents shall be included as an additional <br />insured on a form no more restrictive than the most recent version of ISO Form CG 20 10 <br />(Additional Insured - Owners, Lessees, or Contractors). <br />Page 4 <br />
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