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Home My WebLink About2018Bass Underwriters, Inc. INSURANCE QUOTE E TERMS AND CONDITIONS OF THIS QUOTATION MAY NOT COMPLY WITH THE SPECIFICATIONS SUBMITTED FOR ONSIDERATION. PLEASE READ THIS QUOTE CAREFULLY AND COMPARE IT AGAINST YOUR SPECIFICATIONS. N ACCORDANCE WITH THE INSTRUCTIONS OF THE BELOW -MENTIONED INSURER, WHICH HAS ACTED IN RELIANCE UPON THE TATEMENTS MADE IN THE RETAIL BROKERS SUBMISSION FOR THE INSURED, THE INSURER HAS OFFERED THE FOLLOWING UOTATION. DATE ISSUED: PRODUCER: INSURED MAILING ADDRESS: INSURER : COVERAGE: POLICY PERIOD: September 5, 2018 KE Insurance Agency 990 US Hwy 1 Ste A Sebastian, FL 32958 Sebastian Clambake Foundation Inc P.O. Box 780438 Sebastian, FL 32958 1'e-�rv5ara.-E,-�( 'truck AGCS Marine Insurance Company A+(Superior) AM Best Rating Admitted Inland Marine -Brokered -Gridiron Ins. 11/1/2018 TO 11/5/2018 12:01 A.M. STANDARD TIME AT THE LOCATION ADDRESS OF THE NAMED INSURED. THIS INSURANCE QUOTATION WILL BE TERMINATED AND SUPERSEDED UPON DELIVERY OF THE FORMAL POLICY(IES) ISSUED TO REPLACE IT. LIMITS: see attached DEDUCTIBLE: see attached Without Terrorism: Terrorism PREMIUM: $750.00mp +$22.00 FEES: Surplus Lines Tax: Service Office Fee: Mlsc State Tax: FHCF (Florida) , CPIE: (Florida) J TOTAL: / $750.00 $772.00 DEDUCTIBLE: see attached INSURANCE QUOTE E TERMS AND CONDITIONS OF THIS QUOTATION MAY NOT COMPLY WRH THE SPECIFICATIONS SUBMITTED FOR ONSIDEMTiON. PLEASE READ THIS QUOTE CAREFULLY AND COMPARE IT AGAINSTYOUR SPECIFICATIONS. N ACCORDANCE WITH THE INSTRUCTIONS OF THE BELOW -MENTIONED INSURER, WHICH HAS ACTED IN RELIANCE UPON THE TATEMENTS MADE IN THE RETAIL BROKER'S SUBMISSION FOR THE INSURED, THE INSURER HAS OFFERED THE FOLLOWING UOTATION. DATE ISSUED: August 27, 2018 PRODUCER: Bass Underwriters, Inc. 6951 W. Sunrise Blvd, Plantation, FL 33313 INSURED: Sebastian Clambake Foundation Inc. PO Box 780436, Sebastian, FL 32978 INSURER: AGCS Marine Insurance Company Admitted COVERAGE: Inland Marine- Misc Property Floater POLICY PERIOD: 11/1/2018 TO 1115/2018 12:01 AM. STANDARD TIME AT THE LOCATION ADDRESS OF THE NAMED INSURED. THIS INSURANCE QUOTATION WILL BE TERMINATED AND SUPERSEDED UPON DELIVERY OF THE FORMAL POLICY(IES) ISSUED TO REPLACE R. DEDUCTIBLE: $1,000 Per Claim - $2,500 Thef [VMM 5%, subject to a $5,000 minimum per occurrence Wind/Hail LIMITS OF LIABILITY: $80,000 Misc. Scheduled Property Floater - ACV -All Risk (Excluding Flood 8 Quake) -100% Coins. $20,000 Unscheduled Property ($1,000 maximum value of any one Item) 090-920-0509 Class Code without (Pollutant Clean-uD and Remdval up to $16.000 1 (Debris Removal44➢y to 25% of limit I (Preservation of Prooertv wi dluded I Without Terrorism Terrorism PREMIUM: $750.00 $22.00 FEES: Surplus Lines Tax: Service Office Fee: Misc State Tax: FHCF:(Florida) CPIE: (Florida) TOTAL: $750.00 $772.00 TERMS I CONDITIONS: (a) MINIMUM EARNED PREMIUM AT INCEPTION. ALL FEES ARE FULLY EARNED AND NON-REFUNDABLE. (b1ENDDR EMF TS: 97- olicy over- ack Page 98 - Policy Cover - Front Page 99 - AGCS Policy Jacket Letter COV SH -Cover Sheet IM TOC - Inland Marine Table of Contents TRANS DEC - Mandatory Premium Transation Form IM1000DEC - Inland Marine General Declarations (applies all stales, except NC, SC) IL0017 - Common Policy Conditions IM8002 - Fungi Limitation Endorsement IM8008 - Protective Safeguards Endorsement (Fire extinguishers must be kept In the trailer at all times; It Is a condition of this Insurance that any trailer Insured under this policy shall be equipped with a locking device on the trailer -hitch and it should be In place at all times when trailer is parked and/or not in use.) IM8009 - Locked Vehicle Endorsements IMS012 - Deductible Clause Endorsement IM8013 - Pollutant Removal Endorsement NIM1050 - Commercial Inland Marine Conditions SA5011 - Scheduled Property Floater Coverage Form SA5011 DEC - Scheduled Property Floater Declarations TER9020PHN - Important Notice Regarding Terrorism Coverage TER9021PHN - Important Notice Regarding Terrorism Coverage CL9601 PHN - Complaint Notice - FL CLO602PHN - Policyholder Message - FL IL0255 - FL Changes -Cancellation and Nan -Renewal TER 9000 - Certified Acts of Terrorism Exclusion If TRIA is elected, this form will be replaced with TER 9005 Ilivi LOSS PAYABLE PROVISION ENDORSEMENT (c) ATTACHMENTS I SUBJECT TO: Signed completed Acord application Serial numbers for equipment Where is the equipment stored overnight? What type of protection Is provided? Verification of Clean Losses (d) ALL OTHER TERMS AND CONDITIONS APPLY PER FORM (e) QUOTE IS VALID FOR 30 DAYS (f) COVERAGE CANNOT BE ASSUMED TO BE BOUND WITHOUT. WRITTEN CONFIRMATION FROM AN AUTHORIZED REPRESENTATIVE OF GRIDIRON INSURANCE UNDERWRITERS. RHIS QUOTE IS ISSUED BASED UPON THE INSURER'S AGREEMENT TO QUOTE AND IS ISSUED BY THE UNDERSIGNED WITHOUT M fY.UBIUrY WHATSOEVER AS AN INSURER. THIS QUOTE MAYBE WITH -DRAWN BY THE INSURER AT ANY TIME PRIOR TO BINDING. I1 INSURED: Sebastian Clambake Foundation Inc. DATE ISSUED: August 27, 2018 Account Executive: Jeff Graceffo Reference p: 06753MA TERMS I CONDITIONS: (a) 25% MINIMUM EARNED PREMIUM AT INCEPTION - See attached. ALL FEES ARE FULLY EARNED AND NON-REFUNDABLE. PREMIUM FOR ADDITIONAL INSURED'S ARE FULLY EARNED AND NON-REFUNDABLE. (b) SUBJECT TO: Please see attached for terms and conditions (c)D0RSEMFN7S: ease see aHHachhed for endorsements and exclusions (d) All other terms and conditions apply per form. (e) Quote Is valid for 30 days. (f) Coverage can not be backdated or assumed to he hound without written confirmation from an authorized representative of Bass Underwriters. COMMISSION: 10% RHIS QUOTE IS ISSUED BASED UPON THE INSURERS AGREEMENT TO QUOTE AND IS ISSUED BY THE UNDERSIGNED WITHOUT AN'f RITYWHATSOEVER AS AN INSURER. THIS QUOTE MAYBE WITHDRAWN BY THE INSURER AT ANYTIME PRIOR TO BINDING. INSURED: Sebastian Clambake Foundation Inc DATE ISSUED: September 5, 2018 Account Executive: Pamela Winn Team: Orlando Reference R: 2251404A Bass Underwriters, Inc. INSURANCE QUOTE E TERMS AND CONDITIONS OF THIS QUOTATION MAY NOT COMPLY WITH THE SPECIFICATIONS SUBMITTED FOR ONSIDERATION. PLEASE READ THIS QUOTE CAREFULLY AND COMPARE IT AGAINSTYOUR SPECIFICATIONS. N ACCORDANCE WITH THE INSTRUCTIONS OF THE BELOW -MENTIONED INSURER, WHICH HAS ACTED IN RELIANCE UPON THE TATEMENTS MADE IN THE RETAIL BROKER'S SUBMISSION FOR THE INSURED, THE INSURER HAS OFFERED THE FOLLOWING UOTATION. DATE ISSUED: August 30, 2018 PRODUCER: KE Insurance Agencyjy'� 990 US Hwy 1 Ste A Sebastian, FL 32958 - INSURED MAILING Sebastian Clambake Foundation Inc ADDRESS: P.O. Box 780436 $4,741.00 Sebastian, FL 32958 INSURER: Burlington Insurance Cc A (Excellent) AM Best Rating Policy Fee $35.00 Non -Admitted COVERAGE: QB-Speclal Events-IFG POLICY PERIOD: 11/1/2018 TO 1 1/512 01 8 12:01 A.M. STANDARD TIME AT THE LOCATION ADDRESS OF THE NAMED INSURED. THIS INSURANCE QUOTATION WILL BE TERMINATED AND SUPERSEDED UPON DELIVERY OF THE FORMAL POLICY(IES) ISSUED TO REPLACE IT. LIMITS: SEE ATTACH Without Terrorism: Terrorism PREMIUM: $4,741.00 + FEES: Policy Fee $35.00 Policy Fee $35.00 Surplus Lines Tax: $238.80 $238.80 Service Office Fee: $4.78 $4.78 Mise State Tax: FHCF (Florida) CPIE: (Florida) TOTAL: $5,019.58 $5,019.58 DEDUCTIBLE: SEE ATTACH IV Date : Producer / MGA: Attention : Applicant: DBA: Principal Address: Quote Number: Insurance Company Proposed Policy Period Agency License q : COMMERCIAL PACKAGE POLICY QUOTE 08/30/2018 0630 - Bass Underwriters, Inc., 1005 S. Dillard Street, Winter Garden, FL Jodi Delaporte- KE Insurance Agency Sebastian Clambake Foundation Inc PO Box 780436, Sebastian, FL 32958, USA OUT393186 The Burlington Insurance Company 11/0112018 To 1 110 612 01 8 A128903 SL Broker License N General Liability Premium Liquor Liability Premium Policy Fee : Surplus Lines Tax Stamping Fee : Advance Premium (for policy period) Total Including TRIA (If accepted) Retail Agent Commission: PREMIUM SUMMARY TRIA Accept $ 2,491.00 TBD $ 2,250.00 $ 35.00 $ 238.80 S 4.78 $ 5,018.58 $ 5,268.67 % 10 A128903 TRIA Premium TRIA Tax $ 237.00 '$ 12.09 This Quote Is valid for 30 days from the date of this quote or until the policy effective date, whichever occurs first. THIS QUOTE IS SUBJECT TO THE FOLLOWING Subject To Due By ❑ Recelpt of the completed Acord Application signed and dated by the Insured 12/01/2018 ❑ Receipt of the completed TRIA selection/rejection form signed and dated by the insured, 12/01/2018 Form C 0 15 (completed/signed to reflect insureds decision to elect or reject terrorism coverage). COMMERCIAL GENERAL LIABILITY LIMITS OF LIABILITY General Aggregate $ 2,000,000 Products Completed Ops Aggregate Limit $ 2,000,000 Personal Advertising Injury $ 1,000,000 Each Occurrence $ 1,000,000 Damages to Premises Rented to You $ 100,000 Medical Expense $ 5,000 Deductible None Deductible Type/Deductible Basis N/A COMMERCIAL GENERAL LIABILITY CLASSIFICATIONS Locations - Building 1 l _ US1 & Riverview Park (Hardston St), SEBASTIAN, FL 32858 k� yLA,- Class Description StetrerlTe Rate Exposure Basis Limit Premium 42102 Festivals and FL/6 03 Each $ 2,391.00 rem/Ops Celebrations - NOC Activity 11/012018 to Day 11/032018 g Products Class Description Starerre Rate Exposure Basis Limit Premium 49950 Additional Insured- 01 FLAT $ 100,00 Within MP Lessor Of Leased (SEL) `Equipment (ClassCode: 49960) $ GL Premium Subject to Minimum Premium $ 2491,00 General Liability Premium Subject to Minimum Premium $ 2491.00 Premium for Coverages In Addition to Minimum Premium $ 0.00 Total General Liability Premium $ 2,491.00 -R COMMERCIAL LIQUOR LIABILITY-0- UNITS IABILITY-0- UNITS OF LIABILITY General Aggregate $ 2,000,000 Each Common Cause $ 1,000,000 COMMERCIAL LIQUOR LIABILITY CLASSIFICATIONS Locationt - Building 1 USI & Riverview Park (Harriston St), SEBASTIAN, FL 32958 Class Description State/Terr Rate Exposure Basis 154282 Special Events - LiquorLiability FL/6 0.0001 03Gross Sales I IA'.r-L war- 4I�'as o0 Premium $ 2,250.00 rem/Ops Products - Liquor Premium Subject to Minimum Premium Premium for Coverages in Addition to Minimum Premium $ 2250.00 $ 0.00 Total Liquor Liability Premium $ 2,250.00 POLICY ENDORSEMENTS/EXCLUSIONS IFG-1-0002 0318 Policy Cover Page IFG-1-0101 03 18 Common Policy Declarations IFG-1-0150 0303 Listing of Forms and Endorsements IFG-1-0402 1100 Service of Suit Amendment GL ENDORSEMENTS/lEXCLUSIONS BG -G-004 0317 Exclusion - Lead -Bearing Substance BG -G-005 0317 Exclusion- Punitive Damages BG -G-007 0317 Exclusion -Asbestos, Silica or Other Toxic Substances BG -G -039a 03 17 Amendment Of Premium Conditions BG -G -446 -ST 0317 Amendment- Section l Insuring Agreement BG -1-026 03 17 Fully Earned Premium CG 00 01 0413 Commercial General Liability Coverage Form CG 0220 0312 FL- Cancellation and Nonrenewal CG 2147 1207 Employment Practices Exclusion CG 21 67 1204 Fungi or Bacteria Exclusion CG 2426 0413 Amend- Contract Definition GSG-G-016 03 17 Excl-Aircraft Products & Grounding IFG-G-0002-DL 0503 Commercial General Liability Declarations IFG-G-0086 03 17 Total Pollution Exclusion IFG-G-0190 03 17 Amendment- Exclusion g. IFG-G-0192 0317 Personal And Advertising Injury Amended _ IFG-G-0194 1015 Excl-Confd Info & Comp Syst Uab. IFG-G-0197 0515 Amentlment- Employers Liability Exclusion IFG-1-0170 0317 Two or More Coverage Forms/Policies IL 00 17 1198 Common Policy Conditions It. 0021 0908 Nuclear Energy Liability Exclusion IL P 001 01 04 OFAC - Notice to Policyholder GL CLASS SPECIFIC ENDORSEMENTSIEXCLUSIONS. BG -G-074 1211 Exclusions and Redefinition Described Hazards (Special Events Liability) FG -G-0051 0317 Exclusion -Liquor Liability LIQUOR ENDORSEMENTS/EXCLUSIONS BG -L-502 03 17 Definition - Each Common Cause Limit CG 00 33 0413 Liquor Liability Coverage Form CG 24 06 04 13 Liquor Liability - Bring Your Own Alcohol Establishments CG 28 06 0196 Limitation Of Coverage To Insured Premises IFG-LL-0101 01 11 Liquor Liability Declarations OPTIONAL ENDORSEMENTS/EXCLUSIONS BG -G-042 0317 Exclusion - Assault/Battery BG -L-231 03 17 Exclusion Assault, Battery Or Other Physical Altercation CG 20 28 0413 Al - Lessor- Leased Equipment TERMS / CONDITIONS: (a) 25 MINIMUM EARNED PREMIUM AT INCEPTION -See attached. ALL FEES ARE FULLY EARNED AND NON-REFUNDABLE. PREMIUM FOR ADDITIONAL INSURED'S ARE FULLY EARNED AND NON-REFUNDABLE. (b) SUBJECT TO: Please see attached for Terms and Conditions (c) ENDORSEMENTS: Please see attached for Endorsements and Exclusions (d) All other terms and conditions apply per form. (e) Quote is valid for 30 days. (f) Coverage can not be backdated or assumed to be bound without written confirmation from an authorized representative of Bass Underwriters. COMMISSION: 10 IS QUOTE IS ISSUED BASED UPON THE INSURER'S AGREEMENT TO QUOTE AND IS ISSUED BY THE UNDERSIGNED WITHOUT ANJ (ABILITY WHATSOEVER AS AN INSURER THIS QUOTE MAYBE WITHDRAWN BY THE INSURER ATANY TIME PRIOR TO BINDING. INSURED: Sebastian Clambake Foundation Inc DATE ISSUED: August 30, 2018 Account Executive: Pamela Winn Team: Orlando Reference 0: 2251394/3