AGENDA INSURANCE FUND COMMISSION CITY OF LONG BRANCH REGULAR MEETING JANUARY 28, 2025 10:00 A.M. ROLL CALL: AMANDA CALDWELL, COMMISSIONER LINDSAY DEANGELIS, COMMISSIONER CHARLES F. SHIRLEY,JR., COMMISSIONER CERTIFICATION BY RECORDING SECRETARY: Adequate notice of this meeting has been provided by correspondence to the City Clerk indicating it would be held on Tuesday, January 28, 2025 at 10:00 a.m. in the Conference Room, 344 Broadway, Long Branch, New Jersey. APPROVAL OF PREVIOUS MINUTES: Approval of the Minutes of the Regular Meeting held on December 11, 2024. PUBLIC PARTICIPATION: DISCUSSION BY COMMISSIONERS: Discussion of various Insurance and Risk Management issues. RESOLUTIONIS): LB-2025-001 Resolution approving Tara L. Okros as Corresponding Secretary and Recording Secretary to the Long Branch Insurance Fund Commission LB-2025-002 Resolution memorializing the insurance agreement with Fairview Insurance Agency Associates, Inc. to place, for the City of Long Branch, its 2025 Property and Casualty Insurance Program. LB-2025-003 Resolution memorializing the insurance agreement with Fairview Insurance Agency Associates, Inc. to place, for the City of Long Branch, its 2025 Workers Compensation Program. LB-2025-004 Resolution approving the meeting dates for the Long Branch Insurance Fund Commission. LB-2025-005 Resolution Approving Payment of Bill List for Workers Compensation LB-2025-006 List for Self Insurance Resolution Approving Payment of Bill ADJOURNMENT Motion to adjourn (so moved, second) ALL IN FAVOR...... LONG BRANCH INSURANCE FUND COMMISSION MINUTES REGULAR MEETING DECEMBER 11, 2024 The Regular Meeting of the Long Branch Insurance Fund Commission was held on Wednesday, December 11, 2024 at 3:00 p.m. in the Conference Room, 344 Broadway, Long Branch, New, Jersey. The meeting was opened at 3:00 p.m. PRESENT: Commissioner Lindsay DeAngelis Commissioner Charles F. Shirley,Jr. ABSENT: N/A OTHERS PRESENT: Amanda Caldwell, Deputy City Clerk Tara L. Okros, Insurance Fund Secretary APPROVAL OF PREVIOUS MINUTES: Approval of the minutes of the regular meeting which was held on September 18, 2024. Motion to approve was made by Commissioner De.Angelis andsecondedby Commissioner Shirley. Ayes 2 Nayes 0 PUBLIC PARTICIPATION: The public portion was opened andclosedasno one from the public was present. COMMISSIONERS COMMENTS: There was a briefdiscussion on the passing ofDr. Mary Jane Celli. She will be rememberedas an intelligent woman who was dedicatedto the betterment of the City of Long Branch. This was evidencedby her decades of service as a Councthwoman and. Insurance Fund Commissioner. RESOLUTIONS: LB-2024-013 Resolution approving the payment of the bill list for Workers Compensation. Motion to approve was made by Commissioner De.Angelis andsecondedby Commissioner Shirley. Ayes 2 Nayes O LB-2024-014 Resolution approving the payment of the bill list for Self Insurance. Motion to approve was made by Commissioner De.Angelis and was seconded by Commissioner Shirley. Ayes 2 Nayes O ADJOURNMENT Motion to adjourn was made by Commissioner De.Angelis, secondedby Commissioner Shirley. Ayes 2 Nayes O *NOTE* Next meeting date andtime is To Be Determined. This meeting was adjourned at 3:05 p.m. RESOLUTION OF THE CITY OF LONG BRANCH INSURANCE FUND COMMISSION Resolution No: Meeting Date: TITLE: LB-2025-1 January 28,2025 RESOLUTION APPROVING TARA L. OKROS AS CORRESPONDING SECRETARY AND RECORDING SECRETARY TO THE LONG BRANCH INSURANCE FUND COMMISSION COMMISSIONERS: CALDWELL, DEANGELIS AND SHIRLEY OFFERED AND MOVED ADOPTION OF THE FOLLOWING RESOLUTION: WHEREAS, the City of Long Branch has established an Insurance Fund Commission pursuant to N.J.S.A. 40A: 10-6 et seq. and WHEREAS, the Long Branch Insurance Fund Commission requires the services of a Recording and Corresponding Secretary, and WHEREAS, Tara L. Okros has the necessary experience to perform these WHEREAS, compensation for the position of Corresponding Secretary is established by the City Council of the City of Long Branch, through adoption of asalary ordinance for the year 2025 and the position of Recording Secretary services, and receives no compensation. NOW, THEREFORE, BE IT RESOLVED that the Long Branch Insurance Fund Commission hereby appoint Tara L. Okros as Corresponding Secretary and Recording Secretary to the Commission effective, January 1, 2025. Approved:. Insurance Fund Commissioners Record of Vote by Commissioners of Passage Commissioner Aye Nay N.V. Absent Caldwell DeAngelis Shirley RESOLUTION OF THE CITY OF LONG BRANCH INSURANCE FUND COMMISSION Resolution No: Meeting Date: TITLE: LB-2025-2 January 28, 2025 RESOLUTION MEMORIALIZING THE INSURANCE AGREEMENT WITH FAIRVIEW INSURANCE AGENCY ASSOCIATES, INC. TO PLACE FOR THE CITY OF LONG BRANCH ITS 2025 PROPERTY AND CASUALTY INSURANCE PROGRAM. COMMISSIONERS: CALDWELL, DEANGELIS AND SHIRLEY OFFERED AND MOVED ADOPTION OF THE FOLLOWING RESOLUTION: WHEREAS, the City ofLong Branch has established an Insurance Fund WHEREAS, the insurance broker for the City of Long Branch solicited competitive quotes from two (2) various, Joint Insurance Funds, and Commission pursuant to N.J.S.A. 40A: 10-6etseq., and WHEREAS, the City has reviewed the Joint Insurance Fund Proposals submitted by our broker, Fairview Insurance, and WHEREAS, the City is in its third year of the contract for the Trust & Indemnity Agreement which began January 1, 2023 with Statewide Joint Insurance Fund, and WHEREAS, this is the third year of the three (3) year contact, and WHEREAS, attached to this Resolution are the required Statewide Joint WHEREAS, the Chief Financial Officer of the City of Long Branch had certified, in accordance with the Certification of Funds attached hereto, that funds are available for these contracts in the 2025 Insurance Fund Accounts as Insurance Fund Agreements and Resolutions for adoption, and itemized as follows: Account Account #5-01-034-561 #5-01-034-561 $710,373.00 $102,184.00 CONTINUATION OF THIS CONTRACT IS CONTINGENT UPON PROVISION OF ADDITIONAL FUNDS THROUGH APPROPRIATION TRANSFER, EMERGENCY APPROPRIATION, AND/OR PROVISION OF ADEQUATE FUNDS IN THE 2025 BUDGET. NOW, THEREFORE, BE IT RESOLVED, that (1) The Long Branch Insurance Fund Commission approves as its broker Fairview Insurance Agency Associates, Inc. for the 2025 Property and Casualty Insurance Program. (2) The Long Branch Insurance Fund Commission approves the Package Policywhich includes Property, Boiler & Machinery, Inland Marine, Crime, General Liability, Auto Liability, Police Professional, Public Officials Liability, Pollution Legal Liability, Cyber Liability and non owned aircraft coverages at an annual premium of $710,373.00 (3) The Long Branch Insurance Fund Commission approves the Excess Liability at an annual premium of $102,184.00 Approved Insurance Fund Commissioners Record of Vote by Commissioners of Passage Commissioner CALDWELL DEANGELIS SHIRLEY Aye Nay N.V. Absent CITY OF LONG BRANCH OFFICE OF THE FINANCE DIRECTOR 344 BROADWAY LONG BRANCH, NEW. JERSEY 07740 CERTIFICATION OF CHIEF FINANCIAL OFFICER As the Chief Financial Officer of the City of Long Branch, Icertify that funds are available for the award of the following contract(s): AGREEMENT WITH THE INSURANCE BROKER FOR 2025 PROPERTY. AND CASUALTY INSURANCE PROGRAM, INCLUDING AUTO LIABILITY, GENERAL LIABILITY, CRIME, BOILER AND MACHINERY, POLICE PROFESSIONAL, PUBLIC OFFICIALS LIABILITY, POLLUTION LIABILITY INSURANCE, CYBER LIABILITY, NON OWNED AIRCRAFT AND EXCESS LIABILITY. Said contract(s) to be awarded to the following vendor(s) in the following amount(s): STATEWIDE JOINT INSURANCE FUND Said funds being available in the form of: 2025 SELF-INSURANCE FUND RESERVE Account #5-01-034-561 Account #5-01-034-561 $812,557.00 $710,373.00 $102,184.00 CONTINUATION OF THIS CONTRACT IS CONTINGENT UPON PROVISION OF ADDITIONAL FUNDS THROUGH APPROPRIATION TRANSFER, EMERGENCY APPROPRIATION, AND/OR PROVISION OF ADEQUATE FUNDS IN THE 2025 BUDGET. IALAT DATE Michael Martin, C.M.F.O. City of Long Branch (CFO) Statewide Insurance Fund FUND YEAR 2023 INSURA S 7 N 3 1994 Prepared For: City of Long Branch Issued: 12/3/2022 Page: 10 of13 City of Long Branch December3, 2022 Coverage Summary Thet following information isi intended for display purposes only and may not reflect changes madei inj policy terms and conditions prior to ori following the effective date. Please refer to actual policies for specific information regarding insurance protection. Property Coverage: The Fund will cover a member's scheduled property for "All Risks" of direct physical loss or damage (per coverage terms, exclusions and conditions). The member must have an insurable interest in the property (i.e. suffer ai financial loss in the event itis lost or damaged) and it must be identified as a subject of coverage on the member's A. POLICY LIMIT: $200,000,000 per the latest Statement of Values or other Property schedule. documentation on file with the Fund B. LIMITS OF INSURANCE: Buildings, in any one occurrence Business Interruption Per Occurrence for Spoilage Per Occurrence for Debris Removal Per Occurrence for Accounts Receivable Per Occurrence for Civil or Military Authority Per Occurrence for Contractor's Equipment on file with Per Occurrence for Demolition and Increased Cost of Construction: Demolition Coverage A, B,&C Per Occurrence for Electronic Data Processing (EDP) Per Occurrence for Electronic Data Processing (EDP) Media, Data, Programs and Software Per Occurrence for Errors and Omission Extended Period of Indemnity Per Occurrence for Expediting Expenses Per Occurrence for Extra Expense Per Occurrence for Fine Arts Per Occurrence for Fire Brigade Charges Per Occurrence for Ingress/Egress. Insured Physical per schedule per schedule $10,000,000 with 72 hr waiting period for Cat Included 25% of loss $5,000,000 30 days Included Included Included $5,000,000 $1,000,000 Unlimited $2,500,000 $10,000,000 $1,000,000 Included 30 days Business Personal Property, in any one occurrence Company Systems Page: 2of13 City ofl Long Branch December: 3, 2022 $500,000 Each location Blanket Per Occurrence Leasehold Interests Per Occurrence and Annual Aggregate for Limited Pollution Coverage Per Occurrence for Miscellaneous Unnamed locations excludes Flood occurring wholly or partially within Special Flood Hazard Areas (SFHA), Per Occurrence for Mobile Equipment Per Occurrence and Annual Aggregate for Mold/Fungus Resultant Damage Per Occurrence for Newly Acquired Property for a period of 180 days, excludes Flood Occurring wholly or partially within Special Flood Hazard Areas (SFHA), $5,000,000 Per Occurrence for Outdoor Property Per Occurrence for Unscheduled Outdoor Property Per Occurrence for Property in the Course of Per Occurrence for Professional Fees Per Occurrence for Soft Costs Per Occurrence for Service Interruption Per Occurrence for Transit Per Occurrence for Underground Pipes Per Occurrence for Upgrade to Green Per Occurrence for Valuable Papers and Records Per Occurrence for Vehicles including Automobile Per Occurrence for Watercraft Physical Damage Per Occurrence and Annual Aggregate for peril of Earth Per Occurrence and Annual Aggregate for the peril of $50,000 per location Blanket $1,000,000 Included $250,000 Per Schedule $500,000 $5,000,000 $100,000 $1,000,000 $500,000 per conveyance/occ $1,000,000 Included $5,000,000 $5,000,000 per schedule $100,000,000 $10,000,000 $10,000 each drone not to exceed $100,000 each occurrence Construction $25,000 per location Blanket Physical Damage Movement Flood Drones owned by the member Page 3of13 City of Long Branch December. 3, 2022 Deductibles: Fund Deductibles: amount is shown below. Member Deductible: The Fund's deductible for each claim for loss or damage under the property policy shall be subject to a per occurrence deductible of $200,000 unless a specific deductible $1,000 for each claim for loss or damage under the property policy shall be subject to a per occurrence deductible unless a specific deductible amount is shown below applies: Flood Deductible: (a) Ina any one occurrence except for locations wholly or partially within the Special Flood Hazard Areas (SFHA), areas of 100 year flooding as defined by the Federal (b) In any one occurrence for locations wholly or partially within Special Flood Hazard Areas (SFHA), areas of 100 year flooding, as defined by the Federal Emergency Management Agency (if these locations are not excluded elsewhere in the policy with respect to the peril of flood), the deductible is $500,000 for Buildings and $500,000 for Contents, per location involved in the loss or damage. Emergency Management Agency: $2,500 per occurrence (b) Windstorm or Hail Deductible: (a) $1,000 per occurrence except as follows: (b) For locations and property located in Atlantic, Ocean, Monmouth and Burlington Counties located East of the Garden State Parkway and Cape May County: 2% of Total Insurable Values at the time of loss at each location invoived in the loss or damage subject to a minimum of $250,000 for each premises for any one occurrence. (c) For alll locations and property: 2% of Total Insurable Values at thei time ofl loss at each location involved int the loss or damage arising out of a Named Storm (a storm that has been declared by the National Weather Service or other Worldwide Recognized Meteorological Authority to be a Hurricane, Typhoon, Tropical Cyclone, Tropical Storm or Tropical Depression) subject to a minimum of $250,000 for each premises for any one occurrence. Page 4of13 City of! Long Branch December 3, 2022 Member Deductible: $1,000 for each claim for loss or damage under the property policy shall be subject to a per occurrence deductible unless a specific deductible amount is shown below applies: Flood Deductible: (a) In any one occurrence except for locations wholly or partially within the Special Flood Hazard Areas (SFHA), areas of 100 year flooding as defined by the Federal Emergency Management Agency: $2,500 per occurrence. (b) In any one occurrence for locations wholly or partially within Special Flood Hazard Areas (SFHA), areas of 100 year flooding, as defined by the Federal Emergency Management Agency (if these locations are not excluded elsewhere in the policy with respect to the peril of flood), the deductible is $500,000 for Buildings and 500,000 for Contents, per location involved int the loss or damage. Windstorm: 2% of Total Insurable Values at the time of loss at each location involved int the loss or damage arising out of a Named Storm and subject to a minimum of $250,000 any one occurrence. Auto Physical Damage coverage is included under the property coverage. This is for Physical loss or damage to a member owned vehicles resulting from collision, or other covered perils. Emergency Vehicle claim valuation is replacement cost 15 years or newer, or actual cash value. $1,000 for each claim for loss or damage Member Deductible: Page! 5of13 City of Long Branch December3,2022 Boiler & Machinery / Equipment Breakdown: Jurisdictional inspections are included. The Fund has arranged coverage for losses involving the sudden and accidental breakdown of electrical, mechanical and/or air condloningrengeration equipment. A. POLICY LIMIT: $100,000,000 Combined Property Damage Business Interruption (Ordinary Payroll Included) $Combined Blanket Limit Including: Expediting Expense Electronic Data Water Damage Public Safety Service Charge Spoilage - Scheduled locations Spoilage - Utility Owned Equipment Pollutant Clean Up or removal - Property Damage Pollutant Clean Up or removal Business Income $250,000 $100,000 $50,000 $50,000 $50,000 $100,000 $100,000 Loss of Utilities Fungus Clean Up Ammonia Contamination Dependent Business Income Valuation: Repair or Replacement Deductible: $10,000-/ Applicable to Property Damage 24 hours - With respect to Business Income/Extra Expense/Service interuptionSpolage Page 6of13 City of Long Branch December3, 2022 Crime Coverage: To assist members in satisfying their legal obligations to the State of New Jersey, the Fund offers a comprehensive Crime program which includes coverage for statutory positions. In addition to Faithful Performance coverage, employee dishonesty, computer fraud, forgery and alteration are included. Coverage Employee Dishonesty Forgery & Alteration Money & Securities -Inside Robbery & Safe Burglary - Inside Outside the Premises Computer Fraud Funds Transfer Fraud Money Orders and Counterfeit Paper Treasurers & Tax Collectors Faithful Performance Limit $2,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 Deductible $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded $7,500 Ded. $7,500 ded. $7,500 ded. Bonded employees are included in the coverage, within the limit. Workers' Compensation Coverage: New Jersey law requires that all employees be covered by) Workers' Compensation. It is generally defined as medical treatment, temporary disability, and a schedule of benefits payable to an employee for permanent injury, disability, dismemberment, or death as a result of occupational hazard. The payments are a liability of the entity. Workers' Compensation Benefits: Employer's Liability Limit: Statutory Limits $2,000,000 Page 70 of13 City of Long Branch December3, 2022 Liability Coverages General Liability Coverage: A form ofi insurance designed to protect the member from a wide variety of liability exposures. These exposures could include liability arising out of accidents resulting from the premises or the operations of an entity, and some types of contractual liability. Liability arising from the use, maintenance and/or operation of member-owned vehicles Covers administrative errors and omissions such as neglecting to add someone to the entity's health insurance plan, providing individual instead of family coverage, etc. This The insurance provides coverage for bodily injury, personal injury or property damage caused by a wrongful act committed by oron behalf of a public entity while conducting law enforcement activities or operations for those members with this Automoblle Liability: are covered under this portion of the program. Employee Benefit Administration Liabllity: is covered within the Fund's Public Entity Liability coverage form. Law Enforcement Liability: exposure. Excess Liability: The Fund offers up to $15,000,000 in additional Liability limits per occurrence, excess of the Fund's underlying Liability coverages. This is optional coverage. Primary Limit: $10,000,000 General Liability CSL per Fund occurrence $10,000,000 Automobile Liability per occurrence $10,000,000 Law Enforcement Liability Each person/each $1,000 per claim on Employee Benefits Liability Only** occurrencelannual aggregate **Coverage is claims made Member Deductible: Excess Limit: Higher limits available for GL, AL, LE, POL, EPL,V WC Employers Liability. See quote page for details. Page 8 of13 City of Long Branch December3,2 2022 Public Officlals/Employment Practices Liability other insuring agreements or available limit of liability. Each oft these coverages under the Statewide model placed through Ace, has its own limit of liability. Therefore, the POL or EPL coverage experience, this will not affect the Public Officials Liability: This protects the entity for claims or suits alleging the wrongful acts and/or errors and omissions of the member's governing body, employees and/or volunteers. Limit of Liability: Upi to $10,000,000 Available See Quote Page Claims made form See Quote Page $25,000 Per wrongful act/annual aggregate, per member Deductible: Crisis Management Fund Includes Land Use Planning and Zoning and defense limit of 50% oft the policy period aggregate limit of liability up to $500,000 for injunctive relief matters. Includes coverage for compensatory damages for land use claims up to the coverage limit. Employment Practices Llability: This coverage is designed to protect the Member for claims brought by employees (current, future and/or past) for damages arising from negligent employment practices such as wrongful termination or hiring, harassment, sexual harassment, and/or whistleblower allegations. Limit of Liability Upt to $10,000,000 Available See Quote Page Claims made form See Quote Page Per wrongful act/annual aggregate, per member Deductible Please note: Includes Extended EPLI coverage options: Mental Anguish EEOC Front Wages & Back Wages retro date (inception) - policy limit Page 9of13 City ofLong Branch December 3, 2022 Cyber and Technology Liability: The cyber cover coverage protects for liability for a data breach in which members have personal information of employees or the public, such as Social Security or credit card numbers, that is exposed or stolen by a hacker or other criminal who has gained access data. Liability Expense Liability Costs PCICosts Regulatory Costs First Party Expense BreachFund Data Restoration Costs Extortion Costs Business Impersonation Costs Repl Harm Expense First PartyLoss Business Interruption Contingent Business Interruption System Failure Contingent Business Failure Cyber Crime Bricking Costs Criminal Rewards Endts General Data Protection Regulation Media Utility Fraud Attack Claims-Made Policy form Member deductible: Limit Retention 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 1,000,000 2,000,000 2,000,000 2,000,000 2,000,000 250,000 1,000,000 100,000 2,000,000 2,000,000 100,000 See Quote Page 25,000 25,000. 25,000 25,000 25,000 25,000 25,000 12hours 25,000 25,000 25,000. 25,000 25,000 25,000 0. 25,000 25,000 2,500 Limit Retention Limit Retention 12hours 12hours 12hours 12hours Limit Retention Page: 10of13 City of Long Branch December: 3, 2022 Environmental Legal Liability: This protects the entity for claims or suits that arise from liability and cleanup costs associated with pollution. This Coverage is optional. LIMIT OF LIABILITY Per Incident Limit Fund Aggregate Limit Deductible: Retroactive Date: $1,000,000 and $IM excess $10,000,000 and$10 M excess $50,000 See Quote Page Non Owned Aircraft Liability: The non-owned aircraft liability policy provides bodily injury, property damage and medical expense coverages for the liability arising out oft the use of non-owned aircraft by or on behalf of members. This Coverage Is optional. Coverage Aircraft Seating Capacity: Territory: Uses: Additional Coverages: Non-owned premises: Personal Effects: Fellow Employee: Standard Airworthiness Extension: Contractual Liability: Medical Payments: $5,000,000 Not to exceed 50 seats Woridwide As required $5,000,000 each occurrence $500 each person/$25,000 occurrençe $5,000,000 each occurrence $5,000 per passenger Included Included Page: 11 of13 City of Long Branch December 3, 2022 Statewide Insurance Fund One Syvan Way, Suite 100 Parsippany, NJ07054 862.260.20501 Fax 862.260.2058 swfund.com January 24, 2025 Fund Year 2025 Dear City of Long Branch, The 2025. Assessment Breakdown is as follows: Workers Compensation: $1,263,246 All Lines: $812,557 Total: $2,075,802 Sincerely, Statewide Insurance Fund Office oft the Administrator One Sylvan Way, Suite 100 Parsippany, NJ 07054 862-260-2050 6 of 3 3 e 5E - a - CITY OF LONG BRANCH COUNTY OF MONMOUTH RESOLUTION R--25 A RESOLUTION APPOINTING A FUND COMMISSIONER AND ALTERNATE FUND COMMISSIONER WHEREAS, the City ofLong Branch is a member oft the Statewide Insurance Fund (hereinafter Fund"), aj joint insurance fund as defined in N.J.S.A. 40A: 10-36 et seq.; and WHEREAS, the Fund's Bylaws require participating members to appoint a Fund THEREFORE, BE: IT RESOLVED, that the City Council of the City ofLong Branch that Charles F. Shirley Jr. is hereby appointed as the Fund Commissioner for the Local Unit for Commissioner; the Fund year 2025; and BE IT FURTHER RESOLVED that Lindsay DeAngelis is hereby appointed as the BE ITI FURTHER RESOLVED that the Local Unit's Fund Commissioner is authorized Alternate Fund Commissioner for the Local Unit for the Fund Year 2025; and and directed to execute all such documents as required by the Fund. MOVED: SECONDED: AYES: NAYS: ABSENT: ABSTAIN: State of New. Jersey County of Monmouth City ofl Long Branch ,Amanda Caldwell, Deputy City Clerk of the City of Long Branch, do hereby certify the foregoing to be a true, complete and correct copy of a resolution adopted by the City Council at a Regular Meeting held on February 12, 2025. Deputy City Clerk Statewide Insurance Fund One Sylvan Way, Suite1 100 Parsippany, NJ07054 862.260.2050Fax 862.260.2058 swiund.com Let Statewide Insurance Fund better serve you by reaching the right people in your Entity. Please, provide information for the individuals we should contact regarding the following Statewide Insurance Fund membership benefits: Entity Name Primary Contact Primary Contact! Name Primary Contact Professional Title Primary Contact Phone Primary Contact Email Address Fund Commissioner Fund Commissioner Name Fund Commissioner Email Alternate Fund Commissioner Alternate Fund Commissioner Name Alternate Commissioner Fund Billing Contact Bling Contacti Name Billing Contact Professional Title Billing Contact Phone Biling Contact Email Address Clalm Contact Claim Contact Name Claim Contact Professional Title Claim Contact Phone Claim Contact Email Address Contact IC ContactName IfVendor, IT Vendor Company Name IT Contact! Phone IT Contact Email Address Cily OF Long Branch Charles F. Shide Jr. Busincss Admiaitbher 732. 222- 7o00 eshicleye longbronch.o Chadles F Shirky Jr. eshirley @ long branch. org The Altemnate Fund Commissioneri Is the backup for the Fund Commissioner governing body, appointed via resolution by the governing Ldeangelic e langbmnch.ory The Primary Contact Is the main point of contact for communicationt from The Fund Commlssloner Is the person who represents members for officlal Fund business and is appointed by the member's governing body via resolution. DAngulic Lindiay Email The Biling Contact will receive michaal Markin 732-222-7D00 mmartin @ longbrnch.0rg The Claim Contact receives clalms related Tom oKros Adniibnhi 732. 222 -70c0 eyt. tokpos @ longbmnch.org Willom Bahamonde 732 - 222-70c0 GIAY The IT Contact recelves IT related correspondence and Is breach wbohamonde @ long branch. - og CITY OF LONG BRANCH COUNTY OF MONMOUTH RESOLUTION R-14-25 AI RESOLUTION APPOINTING Al RISK MANAGEMENT CONSULTANT WHEREAS, the City ofLong] Branch has joined in the Statewide Insurance Fund (hereinafter "Fund"), ajoint insurance fund as defined in N.J.S.A. 40A:10-36 et seq; and WHEREAS, the Bylaws require participating members to appoint a Risk Management Consultant, at those positions are defined in the Bylaws, if requested to do sol by the Fund";and WHEREAS, the Local Unit has complied with relevant law with regard to the WHEREAS, the "Fund" has requested its members to appoint individuals or NOW, THEREFORE, BE IT RESOLVED by the City Council of the City of appointment ofal Risk Management Consultant; and entities to that position. Long Branch, in Monmouth County, New. Jersey, as follows: 1. The City of Long Branch hereby appoints Foundation Risk Partners, Corp. DBA Fairview Insurance Agency Associates as its Risk Management 2. The Business Administrator and Risk Management Consultant are hereby authorized to execute the Risk Management Consultant's Agreement for the Consultant; year 2024 in the form attached hereto. MOVED: SECONDED: Voogt AYES: NAYS: ABSTAIN: 0 Widdis 3 0 State of New Jersey County of! Monmouth City ofl Long Branch I, Amanda Caldwell, Deputy Gity Cerk oft the City ofl Long Branch, do hereby certify the foregoing to be a true, complete and correct copy ofar resolution adopted by the Cty Coundila ata a Regular bpk Cuclu Meeting/ held on. January 22, 2025. ABSENT: 2(Dangler & Vieira) Deputy City Clerk 2025 FUND YEAR STATEWIDE INSURANCE FUND RISK MANAGEMENT CONSULTANT'S AGREEMENT THIS AGREEMENT entered into this 22nd day of January 20_25 among the Statewide Insurance Fund ("FUND"), aj joint insurance fund of the State of New Jersey, CITY OF LONG BRANCH ("MEMBER"): and Foundation Risk AA/CONSULTANT? through a fair and open process, pursuant to N.JSA19:44A-20.4. Corp. dbal Fairview Insurance Agency WHEREAS, the CONSULTANT has offered to the MEMBER professional risk management WHEREAS, the CONSULTANT has advised the FUND that he/she is familiar with the terms, WHEREAS, the MEMBER desires these professional services from the CONSULTANT;and WHEREAS, the MEMBER has complied with relevant law in regard to the appointment ofal Risk WHEREAS, the Bylaws of the FUND require that members engage a CONSULTANT and that NOW, THEREFORE, the parties in consideration of the mutual promises and covenants set forth 1. Forand in consideration oft the amount stated hereinafter, the CONSULTANT shall: (a) assist in evaluating the MEMBER'S exposures and advise on matters relating to (b) explain to the MEMBER, or its representatives, the various coverages available (c) explain to the MEMBER, or its representatives, the terms of the member's (d) explain to the MEMBER, or its representatives the operation of the FUND. (e) prepare applications, statements of values, etc., on behalf of the MEMBER, if () review the MEMBER'S assessment and assist in the preparation of the (g) review losses and engineering reports and provide assistance to the MEMBER'S (h) assist int the claim settlement process, ifre required, by MEMBER or FUND. () attend the majority of meetings of the Fund Commissioners or Executive consulting services as required by the Bylaws oft the FUND; and conditions and operations oft the FUND; and Management Consultant; and the CONSULTANT comply with certain requirements set forth therein. herein, agree as follows: the! Member's operation and coverage. from the FUND. commitment and obligations tot the FUND. required by the FUND. MEMBER'S insurance budget. safety committee, ifr required. Committee, if requested, and perform such other services as required by the () comply with the obligations imposed upon Risk Managers in the FUND's Bylaws. () perform other duties for the FUND as may be required from time to time by the 2. In exchange for the above services, the CONSULTANT shall be compensated in the MEMBER or the FUND. (k) act in good faith andi fair dealing to the FUND. FUND. following manner: (a) The CONSULTANT shall be! paid! byt the FUND, on behalf oft the MEMBER, at fee as compensation for services rendered. Said fee, an apportionment of the MEMBER's assessment: 6% of workers' compensation (excluding any fees, PLIGA, and loss ratio apportionment); 7.5% of all lines assessment (excluding any fees, PLIGA, and loss ratio apportionment); For members who have an annual assessment in excess of $1,000,000for Worker's Compensation or All Lines, not a combined assessment, the risk management fees will be calculated as follows: () Up to $1,000,000 assessment, the standard applicable fee applies; (i) On the assessment amounti in excess of$1,000,000 thet fee is negotiable between the member and the Producer to a maximum of the standard applicable commission. The Fund should be notified of any negotiated fee amounts by. January 1st of the fund year, or at the time the contract is entered into, whichever is (b) The CONSULTANT shall be entitled to compensation for services provided during any calendar year only if the CONSULTANT has been appointed and holds the position of Risk Management Consultant, as of January 31 of the said calendar year for counties and municipalities holding general elections and July 30 for municipalities holding regular elections. (c) For any insurance coverages authorized by the MEMBER to be placed outside the FUND, the CONSULTANT shall receive as compensation the normal brokerage commissions paid by the insurance company. The premiums for said policies shall not be addedi to the FUND's assessment (d) Ifthe MEMBER shall require of the CONSULTANT extra serviçes other than those outlined above, the CONSULTANT shall be paid by the MEMBER: ai fee at ai rate to be negotiated by the parties. sooner. incomputing thei fee set forth in 2(a). 3. Thet term of this Agreement shall bet from January 1, 2025 to January 1, 2026. However, this Agreement may be terminated by either party at any time by mailing to the other thirty (30) days written notice, certified mail return receipt. 4. The CONSULTANT shall comply with all laws applicable to producers who provide insurance products to publice entities and shall comply with alla applicable statutes and regulations relating 5. The CONSULTANT agrees to comply with all affirmative action laws applicable in accordance with Exhibit A and to submit all necessary documentation establishing compliance within toj joint insurance funds. seven (7) days oft this Agreement. ATTEST: Member Representative ATTEST: Mamull Mdh Risk Management Consultant Corporate Officer Ap ATTEST: Statewidel Insurance Fund Chairperson EXHIBIT A STATEWIDE INSURANCE FUND MANDATORY EQUAL EMPLOYMENT OPPORTUNITY NOTICE (N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 etseq.) GOODS. PROFESSIONAL SERVICES AND GENERAL SERVICE CONTRACTS This form is a summary of the successful professional: service entity's requirement to comply with The successful professional service entity shall submit to the Statewide Insurance Fund, after notification of award but prior to execution of this contract, one of the following three documents as the requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq. forms of evidence: (a) date oft the letter); OR (b) OR (c). Ap photocopy of a valid letter that the vendor is operating under an existing Federally approved or sanctioned affirmative action program (good for one year from the Ap photocopy of a Certificate of Employee Information Report approval, issued in Aphotocopy of a completed Employee Information Report (Form AA302) provided by the Division of Contract Compliance and completed by the vendor in The successful professional service entity may obtain the Employee Information Report (AA302) The undersigned professional service entity certifies that he/she is aware of the commitment to comply with the requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq. and The undersigned professional service entity further understands that his/her submission shall be rejected as non-responsive ifs said professional service entity fails to comply with accordance with N.J.A.C. 17:27-1.1 et seq.; accordance with N.J.A.C. 17:27-1.1 et seq. from the Statewide Insurance Fund during normal business hours. agrees to furnish the required forms of evidence. the requirements of N.J.S.A. 10:5-31 et seq. and N.J.A.C. 17:27 et seq. COMPANY-Foundation Risk Partners Corp. dba Fairview Insurance Agency Risk Management Consultant SIGNATURE: h PRINT NAME: Michael Graham TITLE: C.O.O. DATE: /4/2035 Page 5ofs POLITICAL CONTRIBUTION AFFIDAVIT State of New Jersey County of Esses I Michael Graham in the County of Essex lam, COO ss: residing in Montclair and State of New Jersey (name ofafiant) (peme omunicpaliy of fullage, being duly sworn according to law on my oath depose and say that: of the firm of Foundation Risk Partners, Corp. (tu tiorp position) (nameof firm) DBA Fairview Insurance Agency Associates a professional firm intending to do business with the City of Long Branch, andlhereby certify that the firm is in full compliance with Long Branch Ordinance #18-05, entitled An Ordinance Requiring Public Contracting Reform", annexed hereto, that the firm has not given any political contribution that would bari it from entering into contract with the City of Long Branch, and further, for the life of the contract, will adhere to the requirements of Ordinance Foundation Risk Partners, Corp. DBA Fairview Insurance Agency Associates #18-05 relative to future donations. (Nameof firm) Subscribed and swom to before mei this day, neay4.225 Lhb wa Signature of Notary Public (Seal) My Commission expires min (Sighatured of affiant) 124/2025 Michael Grakaus, C.0.a (Type or print name of affiant under signature) MARTHAE. FAVA Nolary Public, State of New. Jersey Comm. #50226539 My Commission Expires 102/2029 CONTRACT LANGUAGE FOR For Procurement (Goods and Services)Contracts lincluding Purchase Orders) BUSINESS REGISTRATION CERTIFICATE COMPLAINCE N.J.S.A. 52:32-44 imposes thei following requirements on contractors and all subcontractors that knowingly provide goods or perform services for a contractor fulfiing this contract: 1)the contractor shall provide written notice to Its subcontractors to submit proof of business registration tot the contractor; 2) prior to receipt off final payment from the contracting agency. a contractor must submit to the contracting agencya an accurate list of all subcontractors or attest that none was used; 3)c during the term of this contract, the contractor and its affillates shall collecta and remit, and shall notify all subcontractors andt their affiliates that they must collect andi remit to the Director, New. Jersey Division of Taxation, the use tax due pursuant tot the Sales and Use Tax Act, (N.JS.A.54:32B-11 et seq.) on all sales of tangible personal property delivered into this State. Acontractor, subcontractor or supplier who fails to provide proof of business registration or provides false business registration! information shall be liable to a penalty or $25 for each day of violation, not to exceed $50,000 for each business registration not properly provided or maintained under a contract with the contracting agency, Information of thel law and its requirements is available by calling (609)292-9292. Mul Vendor Signature ilalaoas Date Michael Graham,C.0.0 STATE OF NEW JERSEY BUSINESS REGISTRATION CERTIFICATE Taxpayer Name: Tradel Name: Address: Certificate Number: Effectivel Date: Date ofIssnance: For Office Use Only: 20200825162203010 FOUNDATION RISK PARTNERS, CORP. FAIRVIEW INSURANCE. ANGENCY. ASSOCIATES 2AQUARIUMI DR, STE200 CAMDEN. NJ 08103 2116491 March 03, 2017 August 25, 2020 EXHIBITA MANDATORY, AFFIRMATME ACTION LANGUAGE PL. 1975,0.1 127, (NAC.17:27) PROCUREMENT, PROFESSIONAL AND SERVICE CONTRACTS STATE OF NEW. JERSEY AFFIRMATIVE ACTION REQUIREMENTS The contractor or subcontractor, where applicable, willr noto dieciminale agains! any employee or applicant for employment! because ofraca, religion, sex, nationalo origin, croad, color ancestry, age,marital stalus, affectionald or ses orlentation, familal status, Wabilty! fors servioesk In the Amed Forces ofthel Uniteds States, or nationalily. Excepty with respect to affoctional ora sexual orlentation, the contracior will take afimalive action to ensure that such applicants ar recrulled and employed, and! thate employees aret tresiedd duringe employment, withoutr regard tot their race, religlon, sex, national origin, croed, color ancestry, age, marltal status, afleclional or sexual orlentation, famlial status, labilly for services int the Amed Forces of the Unlted Sleles, or nationality. Such acions shall Include, but not! bel limlled tot the following: emplayment, upgrading, demollion, or transfer; recrulment or recrultment advertising; layoff or lermination; rates ofp pay or other forms of compensation; and selection for training, inckuding apprenticeship. The contractor agreesto post hnc conspicuous places, avallable toe employoes and applicants for empioyment, nolicos tot be providedbyt the Public The contractor or subcontracior, where applicable, wil, In de solicitations or advertisements for employees placed! byor on behalf of the contractor, slate that all qualifledi applicanta wilr receive consideration for employment without regad to race, religlon, sax, natonal origin, creed, color ancestry, age, marital stalus, affectlional or sesual orientation, familal The contractor ors subcontractor, where applicable, wil send toeach! labor unlon or represenlative olw workens withy which khas a collectivel bargalning agreement ord other contracto or understanding, an nolice, tol be provided! by the agency contracting oficer, advising the labor union or workers' representatve oft the contractors commitments undert thisa actand shall poet coples of the noticel Inc consplcuous places avallable toe employees and applicants for employment. The contractor or subcontractor, where applicable, agreas to comply with the regulations promuigatad byt thel Traasurer pursuant toP.L.1 1975, c.1 127, as amended: and supplemented fromt timet to time, and the Americans with Disabliies Act The contractoro ors suboontracior agrenst toi attemptin goodfaltha o6 employ minority andi femaies workers consietenty with the applicable county employment goals prescribed byl NJAC. 1727-52promugalasi byt the Treasurer pursuantlo P.L.1 1975, C. 127, as amended and supplemented from tme tot time, ork In accordance with at binding deteminstionofne applicable counlye employment goals determined! byt the Aflimalive Action Orce pursuant to! NJ.A.C. 17:27-5.2 promuigated byt the1 Treasurer pursuant! toP.1 1975,c.127, as amended from Ume lot time. The contractor or subcontractor agrees lok Inform, in wilting, appropriate recruitment agencies In thes area, Including employment agencies, placement buraaui, colleges, universlles, labor unlons, thath Idoes not discriminate on! he basis ofrace, religion, sax, national oripin, creed, color ancesty, age, marital status, aflectional or senual orlentation, famiial status, labiys for services Int the Armed Forces oft the Unlled Slales, orr nationalily, and thatl Mwlic discontinuel theu use of anyrecruiment: agency whiche engages ind direct ork indirect discriminatory practices. Thec contractor ors subcontractor: agrees tor rovise any oflis Mesingproodures, Hnecossary, to assure thal all personnal testing conform wih thep principles of job-relatedt testng, as established by! the statutes and court decisions ofthe State df New. Jersey, andi as establlahed by applicable Federall law andi applicable Federal court decisions. Thec contractor ors subcontractor agreest ton review al procedures rlatingt tot transfer, upgrading, downgrading andlayolf toensure thal alls such actions are takeny withouts regardt tor race, religion, s8X, natlonal origin, creed, colors ancesty, ago. marital status, allectional ors sewual orientation, familalcius, ablily fors services Int the Armed Forces of thel Unitad States, ornationality, and conform with the applicable employment goals, consisiant witht the statules ando courte decision othe State of New. Jersey, and applicable Federall low and applicable Federal court declslons. The contractor andl ls subcontractor B shall fumish such reports ord othere documents 1o1 the Aflirmativel Action Oflice as may! ber requested byt the oflice from time tot timel Inc order to cany out thep purposed oftheser regulations, andp public agencies shal fumishs such information as may be requesled by the Affirmalive Action Office for conductiona complance invesigation pursuant tos Subchacter: 1Dofthe Administralive Code NJAC.17:27 The contracloris required tos submit, prior too oratthe umet thet contractie submitied for signing byt thel Public Agency, L Appropriate evidence thatt the contracton operalingunders ane existingf federally. approved or sanctioned Acertificale ofe employoelntomasont report approvall ina accordanca with! N.J.A.C. 17:27-4. Ank inital employee Information reporto consleting ofk foms providedt by the affirmative actionc oflica and completed by1 the cantractori inaccordancey with N.J.A.C.1 17:27-4. A Michael Graham, COO Duringt the perlormance of1 this contract, the contractor agrees ast follows: Agency Compllance Oflcer, setting forth provisions ofthis non-discitiminatione clause. stalus, Mabityf fore servioes Int the Amed Foroes ofthel Unllad Slalas, or nationality. one oft thet following Ihree documents: aflimative: actiong program. /alaas Date Corufication63176 CERTIFICATE OF EMPLOYEE INFORMATION REPORT This le lo certify that the contractor listeg) Sow las Lammidin Entoyee Information Report pursuantto N.J.A.C. 17:27-1.1 et. seq. andt the Sye reosurer has approved angport This approvel wil semeinl In RENEWAL effect for the periodof 15-AUN-2023 to 15-3pN-2026 FOUNDATION RISK PARTNERA BORP 1540 CORNERETONE BLVD STK 230 DAYTONA BEACH 75 32112 chormda EUPABETMMAMERIVOO Stats Treasurer W-9 Form (Rev. October 2018) Department altheT Treasury Internal Revenues Service Request for Taxpayer Identification Number and Certification > Got tos www.rs-powFormwo fork instructions: and thel latesti information. Givel Form tot the requester. Do not send to thel IRS. 1 Nama (ass shown ony your incomet tax return). Namel is required ont this line; don not leavet this Inet blank. Foundation Risk Partners, Corp. 26 Business name/disregarded entityn name, ifdifferent froma above Fairview Insurance Agency Associates followings seven boxes. single-r member LLC 3 Check appropriate boxf forf federalt taxo classification ofthe persony whose name is entered on) line 1.0 Checko onlye one ofthe 4 Exemptions (codes apply onlyto certain entities, notir individuals; see instructions onp page 3: Exemptp payee code (lany)_ Individual/sole proprietoro or CCorporation OsCorporation L Partnership Limited! liability company. Enter thet taxc classification (C-C corporation, S-S corporation, P-Partnership)P. Note: Check thea appropriate! boxi int thel linea abovef forthet tax cassification oft the single- member owner. Donoto check Exemption fromF FATCAr raporting LLCifthel LLCis classified asas single-member LLC thatiso disregardedi from thec owner unless the owner oft theLLCis cade another! LLCthati isnotd disregarded fromt the ownerf for U.S. federalt taxp purposes. Otherwise, as single- member LLCthan (fa any) ls disregarded fromt thec owners shouldo checkt the appropriate! box forthet tax classifications ofits owner. Trust/estate Other (seek InsbuctionglP Address (numbe, streel. anda apt.c ors suiter no.)Seek instructions. 780 W. Granada Blvd. City, state, andz ZIP code Ormond Beach, FL: 32174 7Usta account numberfs) here (optiona) Partt Taxpayer Identification Number MIN) hevs) Requester's name anda address (optiora) Enter your TINI int the appropriate! box. Thel TINF provided mustr matchi the name given on line1 to avoid Socia! security number backup withholding. Fori individuais, thisi is generally your social security number (SSN). However, fora resident alien, sole proprietor, or disregarded entity, see thei instructions forF Parti, later. For other entities, Itis your employer identification number (EIN). lfyoud dor noth have a number, seel How togeta Note: If1 the accounti isin more than oner name, seet thei instructions for line 1. Also see What Name and Employer identification number Number To Give the Requester forg guidelines on whose number to enter. TIN, later. Partll Certification Under penalties ofp perjury, Icertify that: nok longers subjectt tobackupy withholding; and 3.lam aU.S.C citizen or othert U.S. person (defined below); and 1.Ther number shown ont thisf formi isr my correct taxpayeri identification number (orl lam waitingf for anumber tot bei issued tor me); and 2.lam not subjectt to backup withholdingt because: (a)! ame exempt from backup withholding, or (p)! have not been notified by the Interal Revenue Service (IRS) thatl ams subject tot backup withholding as ar result ofafailuret tor report alli interest ord dividends, or (c)t the! IRSI has notified met thatl lam Certification instructions. Your must cross outit item2 abovei ify youl havet been notilied! byt thell IRS that) yous are currently subject tol backup withholding because your nave failedt to reporta alli interest ando dividends ony your taxr retum. Forr reale estate transactions, item 2 does not apply. For mortgagei interest paid, acquisition ora abandonment ofs secured property, cancellation ofo debt, contributions toa anindividual retirement arrangement (RA), andg generally, payments other thanh interest ando dividends, youa arer notr required tos signt thec cerlification, buty your must providey youro correct TIN. Seethei instructions for Partll I, later. 4.T The FATCA code(s) entered ont this1 form( (fa any) indicating that! lam exemptf from FATGA reportingi is correct. Sign Signature of Here us. personP General Instructions noted. Date) 09.19.2023 Form 1099- DIV( (dividends, Includingt from stocks or mutual funds) Form 1099-MISC (various types ofi income, prizes, awards, org gross proceeds) Form 1099-B (stocko or mutualf fund sales andcertainother transactions! byt brokers) Form1 1099-S( (proceedsf from reale estatet transactions) Form 1099-K (merchant card andt third party network transactions) Form 1098 (homer mortgagei interest), 1098-E (student loani interes:), 1098-T (tuition) Form 1099- C (canceled debt) Form 1099-A( (acquisitionc ora abandonment of secured Use Form W-90 onlyi ify youa are aU.S. person (includinga ar resident alien). top provide) your correct' TIN. Ifyou do notn retum! Form W-9tot the requester witha al TIN, your might bes subject tot bachupy withholding. See Whati is backup withholding, those CLLIELL Section references aret tot the! Internai Revenue Codet unless otherwise Future developments. Fort thel latesti information: about developments related to Form W-9 andi itsi instructions, such ask legislation enacted aftert they were published, got to www.agovFommws. Purpose of Form Ani individual ore entity Form W-9, requester) whoi is requiredt tof filea an information return witht thel IRSI must obtain your correct taxpayer identification number (TIN) which mayt be) your soçials security number (SSN), individualt taxpayeri identification number (TIN), adoption taxpayeri semtralbmnumbeATw. ore employer identification number (EIN), lor report on anl Information retum the amount paidt toy you, ord other amountr reportable ona ani information retum. Examples ofi information retums Include, buta arer noti limited to,t thef following. Form 1099-INT( (nterest eamed or pald) property) later. Cat No.1 10231X Form W-9 Rev. 10-2018) RESOLUTION OF THE CITY OF LONG BRANCH INSURANCE FUND COMMISSION Resolution No: Meeting Date: TITLE: LB-2025-3 January 28, 2025 RESOLUTION MEMORIALIZING THE INSURANCE AGREEMENT WITH FAIRVIEW INSURANCE AGENCY ASSOCIATES, INC. TO PLACE FOR THE CITY OF LONG BRANCH ITS 2025 WORKERS COMPENSATION PROGRAM. COMMISSIONERS: CALDWELL, DEANGELIS AND SHIRLEY OFFERED AND MOVED ADOPTION OF THE FOLLOWING RESOLUTION: WHEREAS, the City of Long Branch has established an Insurance Fund Commission pursuant to N.J.S.A. 40A: 10-6 ets seq., and WHEREAS, the Commission approved the Trust & Indemnity Agreement for three (3) years, beginningJanuary 2023 with Statewide. Joint Insurance Fund, and WHEREAS, this is the third year of a three (3) year contract, and WHEREAS, the Chief Financial Officer of the City of Long Branch has certified, in accordance with the Certification of Funds attached hereto, that funds are available for these contracts in the 2025 Self Insurance Fund Account 5-01-034-562 in the amount of $1,263,246.00 CONTINUATION OF THIS CONTRACT IS CONTINGENT UPON PROVISION OF ADDITIONAL FUNDS THROUGH APPROPRIATION TRANSFER, EMERGENCY APPROPRIATION AND/OR PROVISION OF ADEQUATE FUNDS IN THE 2025 BUDGET. NOW, THEREFORE, BE IT RESOLVED, that (1) The Long Branch Insurance Fund Commission approves Fairview Insurance Agency Associates, Inc. as its broker for 2025 Workers Compensation Program. (2) The Long Branch Insurance Fund Commission approves the Workers Compensation Insurance at an annual premium of $1,263,246.00. (3) Payments for this insurance will be paid to the Statewide Joint Insurance Fund directly. Approved Insurance Fund Commissioners Record of Vote by Commissioners of Passage Commissioner CALDWELL DEANGELIS SHIRLEY Aye Nay N.V. Absent CITY OF LONG BRANCH OFFICE OF THE FINANCE DIRECTOR 344 BROADWAY LONG BRANCH, NEW, JERSEY 07740 CERTIFICATION OF CHIEF FINANCIAL OFFICER As the Chief Financial Officer of the City of Long Branch, I certify that funds are available for the award of the following contract(s): ANNUAL CONTRACT WORKERS COMPENSATION INSURANCE FOR 2025 Said contract(s) to be awarded to the following vendor(s) in the following amount(s): STATEWIDE, JOINT INSURANCE FUND Said funds being available in the form of: $1,263,246.00 2025 SELF INSURANCE FUND RESERVE Account #5-01-034-562 $1,263,246.00 CONTINUATION OF THIS CONTRACT IS CONTINGENT UPON PROVISION OF ADDITIONAL FUNDS THROUGH APPROPRIATION TRANSFER, EMERGENCY APPROPRIATION, AND/OR PROVISION OF ADEQUATE FUNDS IN THE 2025 BUDGET. MMAb Nls DATE Michael Martin, C.M.F.O. City of Long Branch (C.F.O.) Statewide Insurance Fund FUND YEAR 2023 IBURIN S F 37 t 1994 Prepared For: City of Long Branch Issued: 12/3/2022 Page1of13 City of Long Branch December3,2 2022 Coverage Summary Thet following information! isi intended for display purposes only and may not reflect changes made inj policy terms and conditions prior to or following the effective date. Please refert to actual policies for specific information regarding insurance protection. Property Coverage: The Fund will cover a member's scheduled property for "All Risks" of direct physical loss or damage (per coverage terms, exclusions and conditions). The member must have an insurable interest int the property (i.e. suffer ai financial loss ini the event it is lost or damaged) and it must be identified as a subject of coverage on the member's A. POLICY LIMIT: $200,000,000 per the latest Statement of Values or other Property schedule. documentation on file with the Fund B. LIMITS OF INSURANCE: Buildings, in any one occurrence Business Interruption Per Occurrence for Spoilage Per Occurrence for Debris Removal Per Occurrence for Accounts Receivable Per Occurrence for Civil or Military Authority Per Occurrence for Contractor's Equipment on file with Per Occurrence for Demolition and Increased Cost of Construction: Demolition Coverage A, B,&C Per Occurrence for Electronic Data Processing (EDP) Per Occurrence for Electronic Data Processing (EDP) Media, Data, Programs and Software Per Occurrence for Errors and Omission Extended Period of Indemnity Per Occurrence for Expediting Expenses Per Occurrence for Extra Expense Per Occurrence for Fine Arts Per Occurrence for Fire Brigade Charges Per Occurrence for Ingress/Egress. Insured Physical per schedule per schedule $10,000,000 with 72 hr waiting period for Cat Included 25% of loss $5,000,000 30 days Included Included Included $5,000,000 $1,000,000 Unlimited $2,500,000 $10,000,000 $1,000,000 Included 30 days Business Personal Property, in any one occurrence Company Systems Page 2of13 City of! Long Branch December3,2022 $500,000 Each location Blanket $50,000 per location Blanket Per Occurrence Leasehold Interests Per Occurrence and Annual Aggregate for Limited Pollution Coverage Per Occurrence for Miscellaneous Unnamed locations excludes Flood occurring wholly or partiallywithin Special Flood Hazard Areas (SFHA), Per Occurrence for Mobile Equipment Per Occurrence and Annual Aggregate for Mold/Fungus Resultant Damage Per Occurrence for Newly Acquired Property for a period of 180 days, excludes Flood Occurring wholly or partially within Special Flood Hazard Areas (SFHA), $5,000,000 Per Occurrence for Outdoor Property Per Occurrence for Unscheduled Outdoor Property Per Occurrence for Property in the Course of Per Occurrence for Professional Fees Per Occurrence for Soft Costs Per Occurrence for Service Interruption Per Occurrence for Transit Per Occurrence for Underground Pipes Per Occurrence for Upgrade to Green Per Occurrence for Valuable Papers and Records Per Occurrence for Vehicles including Automobile Per Occurrence for Watercraft Physical Damage Per Occurrence and Annual Aggregate for peril of Earth Per Occurrence and Annual Aggregate for the peril of $1,000,000 Included $250,000 Per Schedule $500,000 $5,000,000 $25,000 per location Blanket $100,000 $1,000,000 $500,000 per conveyance/occ $1,000,000 Included $5,000,000 $5,000,000 per schedule $100,000,000 $10,000,000 $10,000 each drone not to exceed $100,000 each occurrence Construction Physical Damage Movement Flood Drones owned by the member Page 3 of13 City of Long Branch December3,2022 Deductibles: Fund Deductibles: amount is shown below. Member Deductible: The Fund's deductible for each claim for loss or damage under the property policy shall be subject to a per occurrence deductible of $200,000 unless a specific deductible $1,000 for each claim for loss or damage under the property policy shall be subject to a per occurrence deductible unless a specific deductible amount is shown below applies: Flood Deductible: (a) In any one occurrence except for locations wholly or partially within the Special Flood Hazard Areas (SFHA), areas of 100 year flooding as defined by the Federal (b) In any one occurrence for locations wholly or partially within Special Flood Hazard Areas (SFHA), areas of 100 year flooding, as defined by the Federal Emergency Management Agency (if these locations are not excluded elsewhere in the policy with respect to the peril of flood), the deductible is $500,000 for Buildings and $500,000 for Contents, per location involved in the loss or damage. Emergency! Management Agency: $2,500 per occurrence (b) Windstorm or Hail Deductible: (a) $1,000 per occurrence except as follows: (b) For locations and property located in Atlantic, Ocean, Monmouth and Burlington Counties located East of the Garden State Parkway and Cape May County: 2% of Total Insurable Values at the time of loss ate each location involved in the loss or damage subject to a minimum of $250,000 for each premises for any one (c) For all locations and property: 2% of Total insurable Values at the time ofl loss at each location involved in the loss or damage arising out of al Named Storm (a storm that has been declared by the National Weather Service or other Worldwide Recognized Meteorological Authority to be al Hurricane, Typhoon, Tropical Cyclone, Tropical Storm or Tropical Depression) subject to a minimum of $250,000 for each occurrence. premises for any one occurrence. Page 4of13 City of Long Branch December3,2 2022 Member Deductible: applies: $1,000 for each claim for loss or damage under the property policy shall be subject to a per occurrence deductible unless a specific deductible amount is shown below Flood Deductible: (a) In any one occurrence except for locations wholly or partially within the Special Flood Hazard Areas (SFHA), areas of 100 year flooding as defined by the Federal Emergency Management Agency: $2,500 per occurrence. (b) In any one occurrence for locations wholly or partially within Special Flood Hazard Areas (SFHA), areas of 100 year flooding, as defined by the Federal Emergency Management Agency (if these locations are not excluded elsewhere in the policy with respect to the peril of flood), the deductible is $500,000 for Buildings and 500,000 for Contents, per location involved int the loss or damage. Windstorm: 2% of Total Insurable Values at the time of loss at each location involved in the loss or damage arising out of a Named Storm and subject to a minimum of $250,000 any one occurrence. Auto Physical Damage coverage is included under the property coverage. This is for Physical loss or damage to a member owned vehicles resulting from collision, or other covered perils. Emergency Vehicle claim valuation is replacement cost 15 years or newer, or actual cash value. $1,000 for each claim for loss or damage Member Deductible: Page! 5of13 City of Long Branch December3,2022 Boiler & Machinery /E Equipment Breakdown: Jurisdictional inspections are included. The Fund has arranged coverage for losses involving the sudden and accidental breakdown of electrical, mechanical and/or air condltoningrefrigeration equipment. A. POLICY LIMIT: $100,000,000 Combined Property Damage Business Interruption (Ordinary Payroll Included) $ Combined Blanket Limit Including: Expediting Expense Electronic Data Water Damage Public Safety Service Charge Spoilage - Scheduled locations Spoilage - Utility Owned Equipment Pollutant Clean Up or removal - Property Damage Pollutant Clean Up or removal - Business Income $250,000 $100,000 $50,000 $50,000 $50,000 $100,000 $100,000 Loss of Utilities Fungus Clean Up Ammonia Contamination Dependent Business Income Valuation: Repair or Replacement Deductible: $10,000- - Applicable to Property Damage 24 hours - With respect to Business Income/Extra Expense/Service interruptionSpolage Page 60 of13 City of Long Branch December 3, 2022 Crime Coverage: To assist members in satisfying their legal obligations to the State of New. Jersey, the Fund offers a comprehensive Crime program which includes coverage for statutory positions. In addition to Faithful Performance coverage, employee dishonesty, computer fraud, forgery and alteration are included. Coverage Employee Dishonesty Forgery & Alteration Money & Securities -Inside Robbery & Safe Burglary - Inside Outside the Premises Computer Fraud Funds Transfer Fraud Money Orders and Counterfeit Paper Treasurers & Tax Collectors Faithful Performance Limit $2,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 $1,000,000 Deductible $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded. $7,500 Ded $7,500 Ded. $7,500 ded. $7,500 ded. Bonded employees are included in the coverage, within the limit. Workers' Compensation Coverage: New Jersey law requires that all employees be covered by) Workers' Compensation. It is generally defined as medical treatment, temporary disability, and a schedule of benefits payable to an employee for permanent injury, disability, dismemberment, or death as a result of occupational hazard. The payments are a liability of the entity. Workers' Compensation Benefits: Employer's Liability Limit: Statutory Limits $2,000,000 Page 7of13 City of Long Branch December 3, 2022 Liability Coverages General Liabllity Coverage: At form ofi insurance designed to protect the member from a wide variety of liability exposures. These exposures could include liability arising out of accidents resulting from the premises or the operations of an entity, and some types of contractual liability. Liability arising from the use, maintenance and/or operation of member-owned vehicles Covers administrative errors and omissions such as neglecting to add someone to the entity's health insurance plan, providing individual instead of family coverage, etc. This The insurance provides coverage for bodily injury, personal injury or property damage caused by a wrongful act committed by or on behalf of a public entity while conducting law enforcement activities or operations for those members with this The Fund offers up to $15,000,000 in additional Liability limits per occurrence, excess oft the Fund's underlying Liability coverages. This is optional coverage. Automoblle Liability: are covered under this portion of the program. Employee Benefit Administration Liability: is covered within the Fund's Public Entity Liability coverage form. Law Enforcement Llability: exposure. Excess Liability: Primary Limit: $10,000,000 General Liability CSL per Fund occurrence $10,000,000 Automobile Liability per occurrence $10,000,000 Law Enforcement Liability Each person/each $1,000 per claim on Employee Benefits Liability Only** occurrencelannual aggregate **Coverage is claims made Member Deductible: Excess Limit: Higher limits available for GL, AL, LE, POL, EPL, WC Employers Liability. See quote page for details. Page 80 of13 City of Long Branch December3,2 2022 Public Olicals/Employment Practices Liability other insuring agreements or available limit of liability. Each of these coverages under the Statewide model placed through Ace, has its own limit of liability. Therefore, the POL or EPL coverage experience, this will not affect the Public Officials Liability: This protects the entity for claims or suits alleging the wrongful acts and/or errors and omissions of the member's governing body, employees andlor volunteers. Limit of Liability: Up to $10,000,000 Available See Quote Page Claims made form See Quote Page $25,000 Per wrongful act/annual aggregate, per member Deductible: Crisis Management Fund Includes Land Use Planning and Zoning and defense limit of 50% of the policy period aggregate limit of liability up to $500,000 for injunctive relief matters. Includes coverage for compensatory damages for land use claims up to the coverage limit. Employment Practices Liability: This coverage is designed to protect the Member for claims brought by employees (current, future and/or past) for damages arising from negligent employment practices such as wrongful termination or hiring, harassment, sexual harassment, and/or whistleblower allegations. Limit ofl Liability Up to $10,000,000 Available See Quote Page Claims made form See Quote Page Perv wrongful actlannual aggregate, per member Deductible Please note: Includes Extended EPLI coverage options: Mental Anguish EEOC Front Wages & Back Wages retro date (inception). -policy limit Page 9 of13 City of Long Branch December 3,2022 Cyber and Technology Liability: The cyber cover coverage protects for liability for a data breach in which members have personal information of employees or the public, such as Social Security or credit card numbers, that is exposed or stolen by a hacker or other criminal who has gained access data. Llabllity Expense Liability Costs PCICosts Regulatory Costs First Party! Expense Breach Fund Data Restoration Costs Extortion Costs Business Impersonation Costs Repl Harm Expense First PartyLoss Business Interruption Contingent Business Interruption System Failure Contingent Business Failure Cyber Crime Bricking Costs Criminal Rewards Endts General Data Protection Regulation Media Ultility Fraud Attack Claims-Made Policy form Member deductible: Limit Retention 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 2,000,000 1,000,000 2,000,000 2,000,000 2,000,000 2,000,000 250,000 1,000,000 100,000 2,000,000 2,000,000 100,000 See Quote Page 25,000 25,000 25,000 25,000 25,000 25,000 25,000 12hours 25,000' 25,000 25,000 25,000 25,000 25,000 0- 25,000 25,000 2,500 Limit Retention Limit Retention 12 hours 12 hours 12 hours 12 hours Limit Retention Page 100 of13 City of Long Branch December3,2022 Environmental Legal Liability: This protects the entity for claims or suits that arise from liability and cleanup costs associated with pollution. This Coverage is optional. LIMIT OF LIABILITY Per Incident Limit Fund Aggregate Limit Deductible: Retroactive Date: $1,000,000 and $IM excess $10,000,000 and$10 M excess $50,000 See Quote Page Non Owned Aircraft Liability: The non-owned aircraft liability policy provides bodily injury, property damage and medical expense coverages for the liability arising out of the use of non-owned aircraft by oron behalf of members. This Coverage is optional. Coverage Aircraft Seating Capacity: Territory: Uses: Additional Coverages: Non-owned premises: Personal Effects: Fellow Employee: Standard Airworthiness Extension: Contractual Liability: Medical Payments: $5,000,000 Not to exceed 50 seats Worldwide As required $5,000,000 each occurrence $500 each person/525,000 occurrence $5,000,000 each occurrence $5,000 per passenger Included Included Page 11of13 City of Long Branch December 3, 2022 Statewide Insurance Fund One Sylvan Way, Suite 100 Parsippany, NJ07054 862.260.2050 Fax 862.260.2058 swfund.com January 24, 2025 Fund Year 2025 Dear City ofl Long Branch, The 2025 Assessment Breakdown is as follows: Workers Compensation: $1,263,246 All Lines: $812,557 Total: $2,075,802 Sincerely, Statewide Insurance Fund Office of the Administrator One Sylvan Way, Suite 100 Parsippany, NJ07054 862-260-2050 - 3 - 3 - - DE 8 RESOLUTION OF THE CITY OF LONG BRANCH INSURANCE FUND COMMISSION Resolution No: LB-2025-4 Meeting Date: January 28, 2025 TITLE: RESOLUTION APPROVING MEETING DATES FOR THE LONG BRANCH INSURANCE FUND COMMISSION COMMISSIONERS: CELLI, DEANGELIS AND SHIRLEY OFFERED AND MOVED ADOPTION OF THE FOLLOWING RESOLUTION: WHEREAS, the City of Long Branch has established an Insurance Fund Commission pursuant to N.J.S.A.40A: 10-6 et seq. and WHEREAS, the Long Branch Insurance Fund Commission is required to WHEREAS, the Long Branch Insurance Fund Commission has designated NOW, THEREFORE, BE IT RESOLVED that the following dates will be scheduled meeting dates of the Long Branch Insurance Fund Commission send out notice of it's meeting dates: and the following meeting dates unless otherwise noted. March 12, 2025 (3:00 p.m.) June 11, 2025 (3:00 p.m.) Sept. 10, 2025 (3:00 p.m.) Dec. 10, 2025 (3:00 p.m.) All meetings will take place in the Municipal Building, 344 Broadway, Second Floor Conference Room, Long Branch, New, Jersey. Approved:- Insurance Fund Commissioners Record of Vote by Commissioners of Passage Commissioner Caldwell DeAngelis Shirley Aye Nay N.V. Absent Indicate Vote RESOLUTION #LB-2025-005 Resolution Approval Payment of Bills WHEREAS, the Insurance Fund Commission of the City of Long Branch have examined the attached bill list for Workers Compensation. NOW THEREFORE, BE IT RESOLVED, by the Insurance Fund Commission of the City of Long Branch that the payment of these bills set forth on the attached list are hereby approved. MOVED: SECONDED: AYES: NAYES: ABSENT: ABSTAIN Ihereby certify the foregoing to be a true copy of a resolution adopted by the Insurance Commission at their Regular meeting IN WITNESS WHEREOF, 1 have hereunto set my hand and affixed the official seal of the City of Long Branch, Monmouth County, New. Jersey, this day ofJ January, 2025. held on. January 28, 2025 Taral L. Okros Recording Secretary RESOLUTION LB-2025-006 Resolution Approval Payment of Bills WHEREAS, the Insurance Fund Commission of the City of Long Branch have examined the attached bill list for Self Insurance. NOW THEREFORE, BE IT RESOLVED, by the Insurance Fund Commission of the City of Long Branch that the payment of these bills set forth on the attached list are hereby approved. MOVED; SECONDED: AYES: NAYES: ABSENT: ABSTAIN: Ihereby certify thet foregoing to be a true copy ofa resolution adopted by the Insurance Commission at their Regular meeting IN WITNESS WHEREOF, I have hereunto set my hand and affixed the official seal of the City of Long Branch, Monmouth held onJ January: 28, 2025 County, New Jersey, this Taral L. Okros Recording Secretary day of January, 2025. 5