4B, Accepting the Liability Coverae Limits from the League of M

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SECTEON 1: LfABILI�'Y COV�RAGE WAIVER �ORM Cities obtaini�g lisbility coverage from the �eague of Minnesota Cities �nsurance Trust must decide whe#her or not to waive the staf�tory fa�t liabifity lit-ni#s to the extent of the coverage purchased. The decision to waive or not io wai�e th� statuiory li�'nits E�as the follawir�g effects: o!f the city does not warve fhe siafufory tar# limits, an �ndivid�al claimant would be a�le fo recover no rnore than $�00,0(}a. on any claim to whici� #he statu#ory #ort iimits app{y. The totaf which aI{ clairnants waulcE be able to recover for a�ingfe accurrenee to whicE� the staiuiory tort limits appty woufd be limited to $�,50Q,000. Thes�: sta#u#ary tort limits would apply regardless of whether or not the city purc�ases the o�tional excess liability co�erage. a!f the city waives the sfafutory torf limits and does not purchase excess liabiliiy coverage, a singie clairnanf coulcE potentiafly recoWer up io $'� ,5QD,�00. oR a single occurrence. The tataf which al1 claimants woulrf be able to r�cover fot a singie occurrer�ce to which �he statutory tort limifs apply would also be lirnited to $1,500,000_, regarclEess o# the number af claiman#s. a� If fhe city waives fhe stafutory iort limiis and purchases excess liabiliiy coverage, a singfe claiman# could poientialiy recover an amounf up to the limit af the coverage p�rchased. The totaf wl�ict� all claimants woulci be able io reco�er for a single occurrence to whFcfi� the statutory tort limits appiy wouid also be limited to the amount of covera�e purchasecf, regardless a� the number of claimants. Claims to which tF�e st,�tu#nry m�nicipal tor� limits do not apP1y are not af�ectec! by this decision. This tiecision must 6e made by the city co�ncil. Cities purchasing coverage must complete and return khis form to �MCIT before the effective date o€ ihe co�erage. For f�rther information, contact �MCIT. You may also wish to discuss #hese issues witf� yo�r c�#y attorney. . C� �� accepts [iability ca�erage iimits of $� i 5� � D� from th� Leaglie af Minnesoia Citie lnsurance �rust {LMCIT). Che�k one_ - F� The city DOES NOT WAIV� the monetary limits or� municipai to[t liabili#y estabGshed by Minnesota Statutes 466.04_ ❑ The city WAl4`�S the monetary lirnits on torE �iabili#y estabiished by Minr�esota Statutes 468.04, to the extent of the limits of the fiabil�ty coverage obtained from LMCIT. Date of city council meeting Sigr�ature ' Pnsiiian ' Reiurn this completed form Co LMCIT, 145 UniversityAve. W., St. Paul, MN. 55iO3 2044 Pa�e. �6