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Home My WebLink About2024 - 2024 Agreement. FMIT FLORIDA MUNICIPAL INSURANCE TRUST November 25, 2024 Dear Member: Protecting the Communities, We Call Home Enclosed are your agreement forms. Only the forms that apply to you are included. Please sign and date each form and return one copy to vour underwriter by 1/112025. The forms can be returned via mail or electronic mail. An additional copy has been provided for your records. This may include the following: Uninsured/Underinsured Motorist Protection — These correspond with last year's form or your request for the new year. Personal Injury Protection — These correspond with last years forms. Statement of Values —The attached schedule is correct as of 10/1/2024. Any changes will be reflected by endorsement. Return the sign off sheet and include a copy of the schedule if there are any changes. Your policies are now available online (at httos://insurance.flcities.com/member-dashboard): 1.) All Coveraoes — This is the location of the Master Policy which includes all coverages as originally issued. 2.) Policy Only — these are the individual policies by coverage line. This is the location of your policy change endorsements. If you have any questions or need assistance, please contact your underwriter Medley Johnson, miohnson(a)flcities.com or 407-367-3436, who will be happy to assist you. We will appreciate your timely response. O125 East Colonial Drive Orlando, Florida 32801 P.O. Box 538135 Orlando, Florida 32853-0065 OPhone: (407) 425-9142 Fax: (407) 425-9378 Oflcities.cam FLORIDA MUNICIPAL INSURANCE TRUST UNINSURED MOTORISTS / UNDERINSURED MOTORISTS SELECTION FORM NON STACKED YOU ARE ELECTING NOT TO PURCHASE CERTAIN VALUABLE COVERAGE WHICH PROTECTS YOU AND YOUR FAMILY OR YOU ARE PURCHASING INSURED MOTORIST LIMITS LESS THAN YOUR BODILY INJURY LIMITS WHEN YOU SIGN THIS FORM. PLEASE READ CAREFULLY AGREEMENT NO. FMIT # 0539 DESIGNATED MEMBER City of Sebastian COVERAGE PERIOD October 1, 2024 —October 1, 2025 SELECTION FORM CHECK, SIGN & DATE FOR ONLY ONE OPTION UNINSURED MOTORISTS / UNDERINSURED MOTORISTS COVERAGE - REJECTION: I/We REJECT Uninsured / Underinsured Motorists coverage and request that such coverage be eliminated from the Agreement, all renewals, and any other provisions which extends, changes, supersedes or replaces this agreement. UNINSURED MOTORISTS / UNDERINSURED MOTORISTS COVERAGE - INCREASED LIMITS: I/We accept the offer of INCREASED limits for Uninsured / Underinsured Motorists in the Combined Single Limit amount of bodily injury each accident. Limit(s) LOWER than the limit(s) of the agreement for bodily injury liability, but not less than the Financial Responsibility minimum Iimit(s) required by law. Limit. ❑ Limit(s) EQUAL to the limit(s) of the agreement limit(s) for bodily injury liability. Limit: . Authorized Signature FMIT UM 1010 phoh y Date East - Underwriter AGREEMENT NO. FMIT # FLORIDA MUNICIPAL INSURANCE TRUST DESIGNATED MEMBER City of Sebastian COVERAGE PERIOD October 1, 2024—October 1, 2025 OPTION FORM 0539 1. PERSONAL INJURY PROTECTION ® The member acknowledges and understands that the agreement identified above will provide the full no-fault Personal Injury Protection coverage required by the Florida Motor Vehicle No -Fault Law, Sections 627.730-627.7405, as amended. 2. Deductible Amount Applicable to Personal Injury Protection - Optional (select only one) ❑ $250 ❑ $2,000 ❑ $500 ❑ $1,000 3. No Deductible Applicable to Personal Injury Protection - Optional ® No Deductible THE MEMBER HAS READ THE ABOVE APPLICATION & DECLARES THAT MEMBER HEREBY ELECTS THE OPTIONS MARKED ABOVE AND REQUESTS THEY BE MADE A PART OF THE AGREEMENT ABOVE. *uth�onzed Signature Date FMIT PIP 1024 East - Underwriter FLORIDA MUNICIPAL INSURANCE TRUST MEMBER'S STATEMENT OF VALUES Member City of Sebastian FMIT # 0539 Headquarters Address 1225 Main Street Sebastian, FL 32958 Format M Blanket ❑ Specific Form of Coverage Agreed Amount applies to Items Replacement Cost applies to Items Coinsurance ❑ 90% ❑ 100% The total insured value of the buildings listed on the Property schedule reflects 100% of the fully appraised value as previously selected by the member. Causes of loss for which rates are requested: ❑ Basic ❑ Other (Specify) Special ❑ Other (Specify) Basic Coverage may apply to specified locations. Refer to the Schedule of Property Locations. This Statement of Values form must be filed annually. Coverage Period: October 1. 2024 — October 1, 2025 Important Note: For Members with Blanket and/or Agreed Amount coverage, an Asset Valuation is periodically performed at no charge. Resulting value adjustments to insured property will be reflected in the policy by endorsement. Resulting premium charges or reductions will be reflected in the next installment billing. MEMBER: All valuessubmittedare accurate to the best of my knowledge and belief. - (f� #K J-00AY Authorized Signature Date PROP-STMTVAL (10/19) East - Underwriter Property Schedule City of Sebastian, FMIT #0539 October 1, 2024 - October 1, 2025 Location a Address Occupancy Construction Type Lee Bid Cause of Loss - Building Limit Cause of Lass- Personal Property Limit 001 001 1225 Main Street Sebastian, FL Sebastian Elementary School - Old City Joisted Masonry Hall Special Farm 52.369,000 $0 001 005 1225 Main Street Sebastian, FL New City Hall Masonry Non -Combustible Special Form $6,945.000 Special Farm $1,320,700 002 001 1130 Louisiana Avenue Sebastian, FL Traffic Engineering Building Joistetl Masonry Special Form $162,500 Special Form $50 000 003 001 1805 N Central Avenue Sebastian, FL Community Center Joisted Masonry Special Form $821.920 Special Form $50,000 004 001 1921 N Central Avenue Sebastian, FL OfficesiStorage- Cemetary Frame Special Form $90,000 $0 004 002 1921 N Central Avenue Sebastian, FL Cemetery Storage & Garage Building Joisted Masonry Special Form $50,000 Special Form $2000 004 003 1921 N Central Avenue Sebastian, FL Gazebo: Octagon: Wood Frame Special Form $21,100 so 005 001 100 Veterans Memorial Way Sebastian, FL Offices Building Joisted Masonry Special Form 5261,000 Special Form $15,000 005 002 100 Veterans Memorial Way Sebastian, FL Garage Building Joisted Masonry Special Farm $352,800 Special Form 5122 400 005 003 100 Veterans Memorial Way Sebastian, FL Compound Metal Building Non -Combustible Special Form $300.000 Special Form $75,000 005 004 100 Veterans Memorial Way Sebastian, FL Compound Generator Building Frame Special Form $77.100 $0 006 001 600 US 1 Sebastian, FL Restrooms Building Joisted Masonry Special Farm $104.780 $0 006 003 600 US 1 Sebastian, FL Playground Equipment (2): MetalB Frame Plastic Special Form $65,000 $0 006 004 600 US 1 Sebastian, FL Pavilion: Playground: 70 ft z 15 ft: Wood Frame & Metal Special Farm $90.000 $0 006 005 600 US 1 Sebastian, FL Pavilion k2: Riverfronl: 19 ft x 16 it: Wood Frame Special Form $13,500 $0 007 001 820 Indian River Drive Sebastian, FL Yacht Clubhouse Frame Special Form $303,400 50 008 002 101 E Airport Drive Sebastian, FL Restroom Building: Front 9 Joisted Masonry Special Farm 539.960 $0 008 003 101 E Airport Drive Sebastian, FL Restroom Building: Back 9 Joisted Masonry Special Farm $39,960 $0 009 002 1101 Barber Street Sebastian,FL BSSC RestroomslRefreshment Stand Joisted Masonry (Includes Cooking Equipment) Special Form $186,450 Special Farm $5.000 009 003 1101 Barber Street Sebastian, FL Restrooms: BSSC Creative Playground Joisted Masonry Special Form $87,450 $0 009 005 N01 Barber Street Sebastian, FL Storage Shed Frame Special Form $24,200 Special Form $6,500 009 006 1101 Barber Street Sebastian, FIL Dugouts (8): Baseball: Wood Frame Special Form $84,000 $0 PR-SCHED 1014 Page 1 of 4 Location # Address Loc Bid Cause of Loss - Building 009 007 1101 Barber Street Sebastian, FL Special Form 009 008 1101 Barber Street Sebastian, FL Special Form 009 010 1101 Barber Street Sebastian, FL Special Form 010 003 1121 Barber Street Sebastian, FL Special Form 010 004 1121 Barter Street Sebastian, FL Special Form 010 006 1121 Barker Street Sebastian, FL Special Form oll 001 1201 Main Street Sebastian, FL Special Form 011 002 1201 Main Street Sebastian, FL Special Form 011 003 1201 Main Street Sebastian, FL Special Form 011 004 1201 Main Street Sebastian, FL Special Form 011 005 1201 Main Street Sebastian, FL Special Form 012 062 1096 Schumann Drive Sebastian, FL Special Form 012 003 1096 Schumann Drive Sebastian, FL Special Form 012 004 1096 Schumann Drive Sebastian, FL Special Form 013 001 530 Barber Street Sebastian, FL Special Form 013 002 $30 Barber Street Sebastian, FL Special Form 014 001 202 Airport Drive Sebastian, FL Special Form 014 002 202 Airport Drive Sebastian, FL Special Form 014 003 202 Airport Drive Sebastian, FL Special Form 015 001 1440 Friendship Lane Sebastian, FL Special Form 015 002 1440 Friendship Lane Sebastian, FL Special Form PR-SCHED 1014 Property Schedule City of Sebastian, FMIT #0539 October 1, 2024 - October 1, 2025 Occupancy Limit Cause of Loss - Personal Property Baseball Press/Announcer Buildings (4) $32.000 Creative Park Pavilion: 20 It x 25: Wood $22,500 Lights (16): Baseball: 55 fl: Concrete $288,000 Skate Facility Office $62.700 Special Form Skate Park: Concrete $185,000 Football Field Concession/Restrooms Building $400,200 Special Form Police Station $4.366.710 Special Farm Communications Tower $135,000 Evidence Building $324,000 Special Form Police Generator Building $117,500 Special Farm Volunteers Office Construction Type Limit Frame $0 Frame $0 Masonry Non -Combustible so Joisted Masonry $3,000 Joisted Masonry $0 Joisted Masonry $10,000 Modified Fire Resistive $1,078,100 Non -Combustible $0 Joisted Masonry $100.000 Joisted Masonry $116,800 Masonry Non -Combustible $70,200 Special Form $1.000 Schumann Park Tennis Court Restroom Joisted Masonry Building $116,500 $0 Hexagonal Pavilion: Metal Non -Combustible S26,500 so Lights (6): Tennis/Basketball: 45 R: Masonry Concrete Non -Combustible $125, 200 $0 Restrooms Building Joisted Masonry $83.200 $0 Playground Equipment (2): Metal & Frame Plastic $34,000 $0 Ai -field Electric Vault Fire Resistive $70,300 Special Form $100.000 Airport Administration Building Joisted Masonry $2.544.000 Special Form $18,000 Airport Storage Tank: Fuel Facility Non -Combustible S182,300 so Restrooms Building Joisted Masonry $176,400 $0 Tennis Courts Office -Friendship Park Joisted Masonry $176,900 Special Form $5,000 Page 2 of 4 Property Schedule City of Sebastian, FMIT #0539 October 1, 2024 - October 1, 2025 Location If Address Occupancy Construction Type Lee Bid Cause of Loss - Building Limit Cause of Loss - Personal Property Limit 015 003 1440 Friendship Lane Sebastian, FL Pavilion 1: 28 ft x 38 ft: Wood Frame Special Form $51,900 $0 015 004 1"0 Friendship Lane Sebastian, FL Pavilion 2: 28 it x 38 ft: Wood Frame Special Form $51,900 $0 .016 001 78 Taxiway Drive Sebastian, FL Airport Security House Frame Special Farm $288,000 $0 017 001 303 Airport Drive Sebastian, FL Airport Storage Maintenance Building Non -Combustible Special Form $428,000 Special Farm S194,600 018 001 210 Airport Drive Sebastian, FL HangarA Non -Combustible Special Form $1,500,000 so 019 001 1540 Indian River Drive Sebastian, FL Hurricane Harbor Restaurant/Museum Frame Special Farm $1.339 600 $0 021 001 210 Airport Drive Sebastian, FL Public Facilities Building at Airport Non -Combustible Special Form $310,800 Special Form $67.200 022 001 1255 Main Street Sebastian, FL Senior Center Building Joisted Masonry Special Form $522,000 Special Form $27,100 UY3 UQ'I "'Ij UU.. SUeu¢Sebastian. F.- Art Curter BmIUVng wllhConnectlny „luls:va A.a,u.:aiy Breezeway Special Form $662.500 Special Farm $50,000 023 002 1245 Main Street Sebastian, FL Restrooms Building Joisted Masonry Special Form $62.000 $0 Ii UO 6Q+11JHI:1'i Dii',o SbbaStiJrl, FL S-ei:al+T-I'.d'Jlgirl ,1 UIbl.U:61)JY:de Special Form $1 410,000 $0 024 002 60 Airport Drive Sebastian, FL Sheltair T-Hangar2 Non -Combustible Special Form $1 410,000 $0 cc.d UJ2 '."u,d.ridian hiv_r D+ uSubuc;iaul, F_ hyorking Haterhoin R',>i,icwru Euilcur:g juh,:i'c Special Form $121.920 $0 026 001 710 Harrison Street Sebastian, FL Restrooms - Riverview Park Splash Pad Fire Resistive Special Form 583,600 $0 026 002 710 Harrison Street Sebastian, FL Splash Pad Joisted Masonry Special Form $205,300 $0 026 003 710 Harrison Street Sebastian, FL Solar Canopies (2): Splash Pad: 58 ft x 20 Non -Combustible ft: Metal Special Form $232.000 50 026 004 710 Harrison Street Sebastian, FL Covered Picnic Tablesl8enches (12): 4 ft Frame & 6 ft Wood Special Form $6,600 $0 027 001 700 Main Street Sebastian, FL Chamber of Commerce Joisted Masonry Special Farm S456,000 so 028 001 1300 Indian River Drive Sebastian, FL Restrooms Building Joisted Masonry Special Form $42,200 so 029 001 212 Airport Drive Sebastian, FL Aircraft Storage & Maintenance Non -Combustible Special Form S1,500,000 50 030 001 245 Keen Terrace Sebastian, FL Restrooms Building Joisted Masonry Special Form $44,080 $0 031 001 101 Brush Foot or Sebastian, FL Golf Course Pro Shop & Club House Joisted Masonry Special Form $997,900 Special Form $111.900 PR-SCHED 1014 Page 3 of 4 Property Schedule City of Sebastian, FMIT #0539 October 1, 2024 - October 1, 2025 Location # Address Loc Bid Cause of Loss- Building 031 002 101 Brush. Foot or Sebastian, FL Special Form 031 003 101 Brush Foot or Sebastian, FL Special Form 031 004 101 Brush Foot or Sebastian, FL Special Form 032 001 209 E Airport Drive East Sebastian, FL Special Form 032 002 209 E Airport Drive East Sebastian, FL Special Form 033 001 60 Airport Drive Sebastian, FL Special Form 033 002 60 Airport Drive Sebastian, FL Special Form 039 001 200 W. Airport Drive Sebastian, FL Special Form 040 001 214Airport Drive Sebastian, FL Special Form 041 001 1215 Indian River Drive Sebastian, FL Special Form 043 001 106 EAirportDrive Sebastian, FL Special Form 044 001 505 Airport Drive West Sebastian, FL Special Form 045 001 402 Airport Drive East Sebastian, FL Special Form Total: 9 Occupancy Construction Typo Limit Cause of Loss - Personal Property Limit Cart Barn Frame $313,820 Special Form $300,000 Starter Shack Frame $16,800 so Snack Shack Frame $30,000 Special Form S1,000 Golf Course Storage Building (IGM Masonry Chemical Storage) Non -Combustible $46,300 Special Form $10,000 Maintenance Building (IGM Building) Non -Combustible $456,000 Special Form $75,000 Hangar E: Open Shelter: 290 ftx 36 ft: Non -Combustible Metal $682,500 $0 Hangar F: Open Shalcu,: <96 I n 15. MuL4, Nun-Cufnbusuhle $682.500 $0 Hangar V (Velocity) Non -Combustible $960,000 $0 Hangar C (Paradise) Non -Combustible 1.600 000 $0 $400.400 $30.000 (Vacant) Harbor Lights/Unoccupied Building Pickleball Restroom Public Works Complex $8,250,000 Special Form Airport Hangar (Hangar D) $2,313, 889 S49,539,739 so Masonry Non -Combustible $0 Masonry Non -Combustible $1,500.000 Non -Combustible so $5,415,300 PR-SCHED 1014 Page 4 of 4