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1.
<br />N o a 'r fI C A R o f_ I N A NCACC Risk Management Pools
<br />AssoctrrrtoN OF COUNTY CO h1MISSI O NER S Liability and Property
<br />Please return this form with your confirmation indicating your deductible choices. If we do not receive the
<br />completed form, we will process your renewal using the standard deductibles (shown in bold, italics typ_).
<br />LEE COUNTY JULY 1, 2011 -JULY 1, 2012
<br />LIABIILTY AND PROPERTY DEDUCTIBLE OPTIONS
<br />COVERAGE
<br />X
<br />DEDUCTIBLE
<br />COVER
<br />X
<br />e DEDUCTIBLE
<br />Property
<br />X
<br />$1,000
<br />Inland Marine
<br />X
<br />$1,000
<br />$2,500_
<br />$2,500
<br />$5,000
<br />r
<br />rte- $5,000
<br />$10,000
<br />$1 0,000
<br />$25,000
<br />$2 5,000
<br />$50,000
<br />$5 0,000
<br />$75,000
<br />L�-
<br />$75,000
<br />$100,000
<br />$100,000
<br />Coastal county members only --
<br />You may select a 2% Wind Deduct.
<br />Your proposal includes the standard deductible for wind coverage for all
<br />property exposures. To accept a 2% wind deductible for the savings
<br />shown in your proposal, check the block at the left.
<br />Crime
<br />$1,000
<br />General Liability
<br />X
<br />_
<br />$0
<br />.$2,500
<br />�- $500
<br />$5,000
<br />_ $1,000
<br />$10,000
<br />$2,500
<br />$25,000
<br />$5,000
<br />$50,000
<br />$17000
<br />$75,000
<br />$25,000
<br />$100,000
<br />�®
<br />$50,000
<br />Automobile Liability
<br />$0
<br />_
<br />Auto Phy. Damage
<br />X
<br />®- $1,000
<br />X
<br />$500
<br />$2,500
<br />$1,000
<br />_ $5,000
<br />$2,500
<br />_
<br />$1 0,000
<br />$5,000
<br />$25,000
<br />$10,000
<br />$50,000
<br />$25,000
<br />$75,000
<br />$50,000
<br />$100,000
<br />Law Enforcement
<br />X
<br />$5,000
<br />_
<br />Public Officials
<br />$5,000
<br />$10,000
<br />X
<br />$10,000
<br />$25,000
<br />$25,000
<br />$50,000
<br />$50,000
<br />$75,000
<br />_
<br />$75,000
<br />$100,000
<br />�-
<br />Employment Practices
<br />X
<br />$5,000
<br />_$100,000
<br />Boiler and Machinery Coverage - -�_
<br />$10,000
<br />` The deductible for Boiler and Machinery is $1,000 for
<br />(Direct Damage and 24 hours for Indirect Damage at the
<br />of the reinsurer. Other options are not available
<br />for Boiler &Machinery.
<br />$25,000
<br />$50,000 'request
<br />$75,000
<br />$100,000
<br />NCACC 4/12/2011
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