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HomeMy WebLinkAboutADVANCED RISK MANAGEMENT TECHNIQUES, INC. - 2007City of Santa Ana C. ~ ~/ .= Clerk of the Council ,,. AGREEMENT TERMINATION FORM __ _..... COTC Office Use Only Please complete this form when the attached agreement and all amendments (if any ~ ~ ~" ~~~ ~' ~~ are no longer in effect. fti ' - [ ~ ~ . , Return form to the Clerk of the Council Office (M-30). ~~ The agreement with y//I/Gfn!'rd ~ i c IL ll,luv~a~~.~~~.~ 1.i~,I~.n No. ~~?~~ "Q~b was completed on b D9 and final payment has been made. (List II amendments. Use space below if needed.) Department: ~ L Phone/Ext.: ~~ ~6 .. Signature: Date: ~ // ~~10 Revised 07-22-09 INSURANCE ON rilE ~~~~ ~~~~~~~~~PIRES 6~/-oj_ ClERK OF COUNCil ..,...>=. ~.~K,,07 .~ ..e.\ (2) CONSULTANT AGREEMENT O'.I~l\.. "1\ ~ THIS AGREEMENT, made and entered into this 1 st day of July, 2007 by and between Advanced Risk Management Techniques, Inc., a California corporation (hereinafter "Consultant"), and the City of Santa Ana, a charter city and municipal corporation organized and existing under the Constitution and laws of the State of California (hereinafter "City"). N-2007 -090 RECIT ALS A. The City desires to retain a consultant having special skill and knowledge in the field of auditing to conduct an independent actuarial audit of its Self-Funded Workers' Compensation and Liability Programs. B. Consultant represents that Consultant is able and willing to provide such services to the City. C. In undertaking the performance ofthis Agreement, Consultant represents that it is knowledgeable in its field and that any services performed by Consultant under this Agreement will be performed in compliance with such standards as may reasonably be expected from a professional consulting firm in the field. NOW THEREFORE, in consideration of the mutual and respective promises, and subject to the terms and conditions hereinafter set forth, the parties agree as follows: 1. SCOPE OF SERVICES Consultant shall perform those services as set forth in Exhibit A to this Agreement. 2. COMPENSATION a. City agrees to pay, and Consultant agrees to accept as total payment for its services, the rates and charges identified in Exhibit A. The total sum to be expended under this Agreement shall not exceed $12,000.00 during the term of this Agreement. b. Payment by City shall be made within thirty (30) days following receipt of proper invoice evidencing work performed, subject to City accounting procedures. Payment need not be made for work which fails to meet the standards of performance set forth in the Recitals which may reasonably be expected by City. 3. TERM This Agreement shall commence on the date first written above and terminate on June 30, 2009, unless terminated earlier in accordance with Section 12, below. The term of this Agreement may be extended upon a writing executed by the Executive Director of Personnel Services and the City Attorney. 4. INDEPENDENT CONTRACTOR Consultant shall, during the entire term of this Agreement, be construed to be an independent contractor and not an employee of the City. This Agreement is not intended nor shall it be construed to create an employer-employee relationship, a joint venture relationship, or to allow the City to exercise discretion or control over the professional manner in which Consultant performs the services which are the subject matter of this Agreement; however, the services to be provided by Consultant shall be provided in a manner consistent with all applicable standards and regulations governing such services. Consultant shall pay all salaries and wages, employer's social security taxes, unemployment insurance and similar taxes relating to employees and shall be responsible for all applicable withholding taxes. 5. INSURANCE Prior to undertaking performance of work under this Agreement, Consultant shall maintain and shall require its subcontractors, if any, to obtain and maintain insurance as described below: a. Worker's Compensation Insurance. In accordance with the provisions of Section 3300 ofthe Labor Code, Consultant, if Consultant has any employees, is required to be insured against liability for worker's compensation or to undertake self-insurance. Prior to commencing the performance of the work under this Agreement, Consultant agrees to obtain and maintain any employer's liability insurance with limits not less than $1,000,000 per accident. b. Professional liability (errors and omissions) insurance, with a combined single limit of not less than $5,000,000 per claim. c. The following requirements apply to the insurance to be provided by Consultant pursuant to this section: (i). Consultant shall maintain all insurance required above in full force and effect for the entire period covered by this Agreement. (ii). Certificates of insurance shall be furnished to the City upon execution of this Agreement and shall be approved in form by the City Attorney. (iii). Certificates and policies shall state that the policies shall not be canceled or reduced in coverage or changed in any other material aspect without thirty (30) days prior written notice to the City. 2 d. If Consultant fails or refuses to produce or maintain the insurance required by this section or fails or refuses to furnish the City with required proof that insurance has been procured and is in force and paid for, the City shall have the right, at the City's election, to forthwith terminate this Agreement. Such termination shall not effect Consultant's right to be paid for its time and materials expended prior to notification of termination. Consultant waives the right to receive compensation and agrees to indemnify the City for any work performed prior to approval of insurance by the City. 6. INDEMNIFICATION Consultant agrees to and shall indemnify and hold harmless the City, its officers, agents, employees, consultants, special counsel, and representatives from liability: (1) for personal injury, damages, just compensation, restitution, judicial or equitable relief arising out of claims for personal injury, including health, and claims for property damage, which may arise from the direct or indirect operations of the Consultant or its contractors, subcontractors, agents, employees, or other persons acting on their behalf which relates to the services described in section 1 of this Agreement; and (2) from any claim that personal injury, damages, just compensation, restitution, judicial or equitable relief is due by reason of the terms of or effects arising from this Agreement. This indemnity and hold harmless agreement applies to all claims for damages, just compensation, restitution, judicial or equitable relief suffered, or alleged to have been suffered, by reason of the events referred to in this Section or by reason of the terms of, or efTects, arising from this Agreement. The Consultant further agrees to indemnify, hold harmless, and pay all costs for the defense of the City, including fees and costs for special counsel to be selected by the City, regarding any action by a third party challenging the validity of this Agreement, or asserting that personal injury, damages, just compensation, restitution, judicial or equitable relief due to personal or property rights arises by reason of the terms of, or effects arising from this Agreement. City may make all reasonable decisions with respect to its representation in any legal proceeding. 7. CONFIDENTIALITY If Consultant receives from the City information which due to the nature of such information is reasonably understood to be confidential and/or proprietary, Consultant agrees that it shall not use or disclose such information except in the performance of this Agreement, and further agrees to exercise the same degree of care it uses to protect its own information of like importance, but in no event less than reasonable care. "Confidential Information" shall include all non public information. Confidential information includes not only written information, but also information transferred orally, visually, electronically, or by other means. Confidential information disclosed to either party by any subsidiary and/or agent of the other party is covered by this Agreement. The foregoing obligations of non-use and nondisclosure shall not apply to any information that (a) has been disclosed in publicly available sources; (b) is, through no fault of the Consultant disclosed in a publicly available source; (c) is in rightful possession of the Consultant without an obligation of confidentiality; (d) is required to be disclosed by operation oflaw; or ( e) is independently developed by the Consultant without reference to information disclosed by the City. 3 8. CONFLICT OF INTEREST CLAUSE Consultant covenants that it presently has no interests and shall not have interests, direct or indirect, which would conflict in any manner with performance of services specified under this Agreement. 9. NOTICE Any notice, tender, demand, delivery, or other communication pursuant to this Agreement shall be in writing and shall be deemed to be properly given if delivered in person or mailed by first class or certified mail, postage prepaid, or sent by telefacsimile or other telegraphic communication in the manner provided in this Section, to the following persons: To City: Clerk of the City Council City of Santa Ana 20 Civic Center Plaza (M-30) P.O. Box 1988 Santa Ana, CA 92702-1988 telefacsimile (714) 647-6956 With courtesy copies to: Personnel Services Agency, Risk Manager City of Santa Ana 20 Civic Center Plaza (M-28) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-5311 Attn: Jeff Stevens and City Attorney City of Santa Ana 20 Civic Center Plaza (M-29) P.O. Box 1988 Santa Ana, California 92702 telefacsimile (714) 647-6515 To Consultant: Advanced Risk Management Techniques, Inc. 23701 Birtcher Drive Lake Forest, California 92630 Attn: Mujtaba Datoo A party may change its address by giving notice in writing to the other party. Thereafter, communication shall be addressed and transmitted to the new address. If sent by mail, communication shall be effective or deemed to have been given three (3) days after it has been deposited in the United States mail, duly registered or certified, with postage prepaid, and addressed as set forth above. If sent by telefacsimile, communication shall be effective or 4 deemed to have been given twenty-four (24) hours after the time set forth on the transmission report issued by the transmitting facsimile machine, addressed as set forth above. For purposes of calculating these time frames, weekends, federal, state, County or City holidays shall be excluded. 10. EXCLUSIVITY AND AMENDMENT This Agreement represents the complete and exclusive statement between the City and Consultant, and supersedes any and all other agreements, oral or written, between the parties. In the event of a conflict between the terms of this Agreement and any attachments hereto, the terms of this Agreement shall prevail. This Agreement may not be modified except by written instrument signed by the City and by an authorized representative of Consultant. The parties agree that any terms or conditions of any purchase order or other instrument that are inconsistent with, or in addition to, the terms and conditions hereof, shall not bind or obligate Consultant nor the City. Each party to this Agreement acknowledges that no representations, inducements, promises or agreements, orally or otherwise, have been made by any party, or anyone acting on behalf of any party, which are not embodied herein. 11. ASSIGNMENT Inasmuch as this Agreement is intended to secure the specialized services of Consultant, Consultant may not assign, transfer, delegate, or subcontract any interest herein without the prior written consent of the City and any such assignment, transfer, delegation or subcontract without the City's prior written consent shall be considered null and void. Nothing in this Agreement shall be construed to limit the City's ability to have any of the services which are the subject to this Agreement performed by City personnel or by other consultants retained by City. 12. TERMINATION This Agreement may be terminated by the City upon thirty (30) days written notice of termination. In such event, Consultant shall be entitled to receive and the City shall pay Consultant compensation for all services performed by Consultant prior to receipt of such notice of termination, subject to the following conditions: a. As a condition of such payment, the Executive Director may require Consultant to deliver to the City all work product completed as of such date, and in such case such work product shall be the property of the City unless prohibited by law, and Consultant consents to the City's use thereof for such purposes as the City deems appropriate. b. Payment need not be made for work which fails to meet the standard of performance specified in the Recitals of this Agreement. 13. DISCRIMINATION Consultant shall not discriminate because of race, color, creed, religion, sex, marital status, sexual orientation, age, national origin, ancestry, or disability, as defined and prohibited 5 by applicable law, in the recruitment, selection, training, utilization, promotion, termination or other employment related activities. Consultant affirms that it is an equal opportunity employer and shall comply with all applicable federal, state and local laws and regulations. 14. JURISDICTION - VENUE This Agreement has been executed and delivered in the State of California and the validity, interpretation, performance, and enforcement of any of the clauses of this Agreement shall be determined and governed by the laws of the State of California. Both parties further agree that Orange County, California, shall be the venue for any action or proceeding that may be brought or arise out of, in connection with or by reason of this Agreement. 15. PROFESSIONAL LICENSES Consultant shall, throughout the term of this Agreement, maintain all necessary licenses, permits, approvals, waivers, and exemptions necessary for the provision of the services hereunder and required by the laws and regulations of the United States, the State of California, the City of Santa Ana and all other governmental agencies. Consultant shall notify the City immediately and in writing of her inability to obtain or maintain such permits, licenses, approvals, waivers, and exemptions. Said inability shall be cause for termination of this Agreement. 16. MISCELLANEOUS PROVISIONS a. Each undersigned represents and warrants that its signature hereinbelow has the power, authority and right to bind their respective parties to each of the terms of this Agreement, and shall indemnify City fully, including reasonable costs and attorney's fees, for any injuries or damages to City in the event that such authority or power is not, in fact, held by the signatory or is withdrawn. b. All Exhibits referenced herein and attached hereto shall be incorporated as if fully set forth in the body of this Agreement. II II II II II II 6 IN WITNESS WHEREOF, the parties hereto have executed this Agreement the date and year first above written. ATTEST: CITY OF SANTA ANA - P A TRICIf"\. E. HEALY Clerk of the Council (4/J1z DAVID N. REAM City Manager , "---/ " ,/ , 'r ,-<<-"--_.- /~ ; '~/J;f../t:. APPROVED AS TO FORM: JOSEPH W. FLETCHER City Attorney ^ ~k By: ^.1 'AAkJ;iul Laur~ Sheedy" I Assistant City Attorney , RECOMMENDED FOR APPROVAL: CONSULTANT /Ynv~ \-w~ D~N MUJT ABAJDA TOO Consulting Actuary TaxID# S3-0/t/-lt/!;; 7 .. EXHIBIT A SCOPE OF SERVICES Consultant shall develop reasonable funding and management guidelines for the City's Workers' Compensation and Liability Programs. Separate information will be provided for each program. This will provide important data for the City's comprehensive annual financial report, GASB Statement No. 10 requirements, budgeting and strategic planning. Consultant's specific scope of work is as follows: A. Estimate Outstanding Losses: Estimate outstanding losses including allocated loss adjustment expenses (ALAE) and 4850 benefits as of June 30, 2007, June 30, 2008, and June 30, 2009. Outstanding losses will be shown on a discounted present value basis including separate calculations for incurred but not reported (IBNR) claims. B. Project Financial Position: Project the financial position as of June 30, 2007. The projected financial position is a comparison of funds available with the estimated outstanding losses. C. Project Future Losses: Project future losses including ALAE for 2007/08,2008/09 and 2009/1 0 fiscal years. Projected future losses will be shown on a discounted present value basis. The present value reflects future investment income earned on funds held to pay losses. D. Project Losses Paid: Project losses paid (claims disbursements) during fiscal years 2007/08,2008/09 and 2009/1 O. E. Recommend Funding: Recommend funding for fiscal years 2007/08, 2008/09 and 2009/10. The recommended funding is based on the projected future losses, investment income, expenses and the projected financial position. F. Discuss Loss Experience: Discuss loss experience trends and compare the City to similar programs. G. Develop a workers' compensation cost allocation system and a liability cost allocation system for City departments. Consultant shall deliver a complete written draft report to City as soon as practicable and the final report shall be delivered to City by September 30,2007, except for item G above, which shall be completed and delivered to City prior to June 30, 2009. 8 .. COMPENSATION City agrees to pay, and Consultant agrees to accept Six Thousand Five Hundred Dollars ($6,500.00) as total compensation for services pursuant to items A through F above. Compensation for work performed to complete item G, developing a workers' compensation cost allocation system and a liability cost allocation system, shall not exceed Five Thousand Five Hundred Dollars ($5,500.00). Total compensation to Consultant pursuant to this Agreement shall not exceed Twelve Thousand Dollars ($12,000.00) during the term ofthis Agreement. 9 PRODUCER Serial # 3919 AON RISK SERVICES, INC. OF ILLINOIS 1000 N. MILWAUKEE AVENUE GLENVIEW, IL 60025 PHONE - 1-866-283-7122 FAX - 847-953-5390 COMPANY CONTINENTAL CASUALTY COMPANY A COM~ANY TRANSPORTATION INSURANCE COMPANY INSURED ~ . .;lOC" .0 GO AON CORPORATION AND ADVANCED RISK MANAGEMENT TECHNIQUES, INC, 200 E. RANDOLPH CHICAGO. IL 60601 COM~ANY AMERICAN CASUALTY COMPANY OF READING. PA COMPANY D wt THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUBED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED B YTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ~ POLICY EFFECTIVE POLICY EXPIRATION TYPE OF INSURANCE I POLICY NUMBER DATE (MM/DDIYY) DATE (MM/DDIYY) CO LTR LIMITS A GENERAL LIABILITY GL2091214146 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE 00 OCCUR OWNER'S & CONTRACTOR'S PROT 06/01/2007 06/01/2008 GENERAL AGGREGATE $ PRODUCTS - COMP/OP AGG $ PERSONAL & ADV INJURY $ EACH OCCURRENCE $ FIRE DAMAGE (Anyone fire) $ MED EXP (Anyone person) $ A AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS 06/01/2007 06/01/2008 BUA2091214065 COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE $ GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT $ OTHER THAN AUTO ONLY: EACH ACCIDENT $ AGGREGATE $ EACH OCCURRENCE $ AGGREGATE $ $ EXCESS LIABILITY UMBRELLA FORM 0610112007 06/01/2008 OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND : EMPLOYERS' UABIL.rlV WC2091213935(AZ.CO,NV.OR.WI) WC2091214020(AOS) WC2091213983 (CA) EL EACH ACCIDENT $ EL DISEASE - POLICY LIMIT $ E - EA EMPLOYEE $ THE PROPRIETOR! PARTNERS/EXECUTIVE OFFICERS ARE: INCL EXCL OTHER !:!:!?~c'>?r ,(/)"- L _l~.-UJ DESCRIPTION OF OPERA TIONS/LOCA TIONSNEHICLES/SPECIAL ITEMS . ., ., I' I t L. (-' A. I. [ 0 r '; c V RE: CLIENT #002, ADVANCED RISK MANAGEMENT TECHNIQUES, INC., 1901 MAIN STREET, 4TH FLOOR, SUITE 420. IRVINE. CA 92614-0513. THE CITY OF SANTA ANA IS ADDITIONAL INSURED ON THE GENERAL LIABILITY POLICY. $ 2,000.000 1,000,000 1.000,000 1,000,000 1,000,000 10,000 1.000,000 $ $ 1,000,000 1,000,000 1,000,000 CITY OF SANTA ANA ATTN: JEFF STEVENS 20 CIVIC CENTER PLAZA SANTA ANA. CA 92702 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE T:\DOCUMENT PRODUCTIONICHOICES\AON GLALWCEX 06-07.FP5 Serial # 06796 DATE (MM/DDIYY) 07/19/2007 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANy LEXINGTON INSURANCE COMPANY A AON RISK SERVICES, INC. OF ILLINOIS 1000 N. MILWAUKEE AVENUE GLENVIEW, IL 60025 PHONE -1-866-283-7122 FAX - 847-953-5390 INSURED AON CORPORATION AND ARM TECH 200 E, RANDOLPH DRIVE CHICAGO, IL 60601 COMPANY B COMPANY C COMPANY D THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, co TYPE OF INSURANCE POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR POLICY NUMBER DATE (MM/DDIYY) DATE (MM/DDIYY) GENERAL LIABILITY GENERAL AGGREGATE COMMERCIAL GENERAL LIABILITY PRODUCTS - COMP/OP AGG CLAIMS MADE OCCUR PERSONAL & ADV INJURY OWNER'S & CONTRACTOR'S PROT EACH OCCURRENCE FIRE DAMAGE (Anyone fire) : MED EXP (Anyone person) AUTOMOBILE LIABILITY ANY AUTO COMBINED SINGLE LIMIT ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY NON,OWNED AUTOS (Per accident) PROPERTY DAMAGE GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLy: EACH ACCIDENT AGGREGATE EXCESS LIABILITY : EACH OCCURRENCE >----- UMBRELLA FORM AGGREGATE OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND OTH- ER EMPLOYERS' LIABILITY , ! EL EACH ACCIDENT THE PROPRIETOR! I INCL I EL DISEASE - POLICY LIMIT PARTNERS/EXECUTIVE OFFICERS ARE EXCL I EL DISEASE - EA EMPLOYEE OTHER A ERRORS & OMISSIONS 7113473 4/17/2007 4/17/2011 EACH CLAIM: $1,000,000 SEE ATTACHED ADDENDUM DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/SPECIAL ITEMS CITY OF SANTA ANA ATTN: BRIZA MIRANDA 7 20 CIVIC CENTER PLAZA jV\ . SANTA ANA, CA 92702-1988 ~~kj SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO DBLlGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE OF AON RISK SERVICES, INC. OF IL Aon Risk &rvice\; me of 6linois T'lDOl,UMENT PRODUCTIONICHOICESAON E&O 2007 -2011.FP5 Page 1 E&O Coverage Insurer: Lexington Insurance Company Policy number: 7113473 Policy term: 4/17/2007 - 4/17/2011 (a) This certificate of insurance contains a summary of the policy coverage and does not include all terms, conditions and exclusions of the policy. The policy contains the full and complete agreement with regard to coverage. In the event of any inconsistency between this certificate of insurance and the policy, the policy language shall control. (b) The insured has a retention on each and every claim under the policy. The retention has a minimum amount of $500,000 on each and every claim and may increase based upon the amount of the loss. (c) The insured has the right of the policy effective date. the policy for non-payment of to cancel the policy within 10 days The insurer has the right to cancel premium. (d) This is a claims made and reported policy of indemnity. (e) After an aggregate $103,500,000 in claims has been paid under the policy, no additional claims will be paid by the policy. However, the Insured, in its sole discretion, may specify an amount less than $103,500,000 on any certificate of insurance. (f) The limits of liability may be reduced in the event of non-payment of premium. Serial #: 06796 Page 2