HomeMy WebLinkAbout22-55 Resolution No. 22-55
RESOLUTION
AUTHORIZING EXECUTION OF A PARTIAL MASTER PROOF OF LOSS WITH
ALLIANT PROPERTY INSURANCE PROGRAM (APIP) FOR A BUSINESS
INTERRUPTION CLAIM
BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF ELGIN,ILLINOIS,that
Richard G.Kozal,City Manager,be and is hereby authorized and directed to execute a Partial Master
Proof of Loss on behalf of the City of Elgin with Alliant Property Insurance Program(APIP), for a
business interruption claim in the amount of$54,878,a copy of which is attached hereto and made a
part hereof by reference.
s/David J. Kaptain
David J. Kaptain, Mayor
Presented: March 23, 2022
Adopted: March 23, 2022
Omnibus Vote: Yeas: 9 Nays: 0
Attest:
s/Kimberly Dewis
Kimberly Dewis, City Clerk
PARTIAL MASTER PROOF OF LOSS
TO THE VARIOUS COMPANIES UNDER THEIR RESPECTIVE POLICIES AS INDICATED IN THE ANNEXED SCHEDULE OF INSURANCE AND
APPORTIONMENT OF CLAIM WHICH IS MADE A PART HEREOF
At time of loss, by the annexed indicated policies of insurance you insured City of Elgin
against loss by All Risk of physical loss or damage to the property described
under Schedule annexed according to the terms and conditions of the said policies and all forms, endorsements, transfer and
assignments attached thereto.
1. Time and Origin: A COVID-19 Communicable Disease loss occurred about the hour of
STATE KIND
o'clock M.,on the 12th day of March 20 20 . The
cause and origin of the said loss were: Business interruption
2. Occupancy: The building described,or containing the property described,was occupied at the time of the loss as follows,and
for no other purpose whatever:
3. Title and Interest: At the time of the loss the interest of your insured in the property described therein was sole and
unconditional ownership,and no other person or persons had any interest therein or encumbrance thereon,except: No exceptions
4. Changes: Since the said policies were issued there have been no assignments thereof,or change of interest,use,occupancy,
possession, location or exposure of the property described,except: No exceptions
5. Total Insurance: The total amount of insurance upon the property described by the involved policies was,at the time of the
loss, $ as more particularly specified in the apportionment attached, besides which there was no policy or
other contract of insurance,written or oral,valid or invalid.
6. The Actual Cash Value of said property at the time of loss was $ Not Determined
7. The Whole Loss and Damage was $ TO BE DETERMINED
8. The Amount Claimed under this Master Proof of Loss $ 54,878.00
(Amount claimed is net applicable deductible.)SEE APPORTIONMENT ATTACHED.
The said loss did not originate by any act,design or procurement on the part of your insured,or this affiant;nothing has been done by or
with the privity or consent of your insured or this affiant,to violate the conditions of the policies of insurance or render them void;no articles are
mentioned herein or in annexed schedules but such as were destroyed or damaged at the time of said loss,has in any manner been made. Any other
information that may be required will be furnished and considered a part of this proof. 1
The furnishing of this blank or the preparation of this Master Proof of Loss by a representative of the annexed mentioned insurance
companies is not a waiver of any of their rights.
FOR YOUR PROTECTION,CALIFORNIA LAW REQUIRES THE FOLLOWING TO APPEAR ON THIS FORM:
Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to
fines and confinement in state prison. rd G. l �
State of Illinois
(Insured Signal re)
County of Kane City of Elgin Insured
Subscribed and sworn to(or affirmed)before me on this 23 day of March (month), 2022 (year)by
Richard G. Kozel proved to me on the basis of satisfactory evidence to be
the person(s)who appear before me. JENNIFER J. QUINTON
�C' OFFICIAL SEAL
(signature of Notary) 1' Notary Public,State of Illinois
My Commission Expires
January 10.2024
M arens File No..002.05187 .DEC 1-4 "�"�
SCHEDULE OF APPORTIONMENT
Policy Period:July 1,2019/2020
City of Elgin Elgin, Illinois
COVID-19—MARCH 12,2020
COMPANY POLICY NUMBER PERCENT SHARE
Lexington Insurance Company 38412454 35.0% $19,207.30
Aspen Insurance PRAGET719 2.5% $ 1,371.95
Underwriters at Lloyd's PJ1900131 4.0% $ 2,195.12
Homeland Insurance Company of NY(Intact) 798000248 3.0% $ 1,646.34
Hallmark Specialty Insurance Company 73PRX19A1E9 7.5% $ 4,115.85
Underwriters at Lloyd's PJ193647 38.0% $20,853.64
Aspen Insurance PRAGET719 6.0% $ 3,292.68
Ironshore Specialty Insurance Company 3661401 2.0% $ 1,097.56
Underwriters at Lloyd's-Syndicate 1200 AMA PJ1900124 2.0% $ 1,097.56
TOTAL 100.0% $54,878.00
McLarens File No.:002.051877.DEC 1-4