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HomeMy WebLinkAboutC22-016 Travelers1
CLAIM SERVICE AGREEMENT
THIS CLAIM SERVICE AGREEMENT ("Agreement") dated as of 1/1/2021(the “Effective Date”), is
by and between Eagle County, Colorado and each of its predecessors, successors, subsidiaries,
divisions, and affiliates for whom Claim Services are being furnished ("Client"), and The Travelers
Indemnity Company, a Connecticut corporation at 385 Washington Street, St. Paul, Minnesota, 55102,
and its subsidiaries and affiliates ("Travelers").
WHEREAS, Client and Travelers have entered into insurance policy numbers: 810-91N37268
and ZLP-91N37268 (which together with all applicable riders, endorsements, extensions and renewals
are hereinafter referred to as the "Policy") under which Client is responsible for paying a portion of the
damages and/or certain expenses as more fully described in the policy (“Self-Insured Retention”); and
WHEREAS, Client wants Travelers to furnish certain Claim Services to Client with respect to
the Self-Insured Retention and Travelers is willing to provide such services.
NOW, THEREFORE, in consideration of the mutual promises contained in this Agreement,
Client and Travelers hereby agree as follows:
SECTION I - DEFINITIONS
For the purpose of this Agreement, a "Claim(s)" shall be any request or demand for consideration of
payment of a loss or investigation of a loss with respect to the services enumerated in this Agreement,
which is reported to Travelers, and which is within Client's Self-Insured Retention, and which takes
place in the coverage territory as set forth in the Policy.
"Excess Claim(s)" shall be any request or demand for consideration of payment of a loss or
investigation of a loss with respect to the services enumerated in this Agreement which is reported to
Travelers and which exceeds Client's Self-Insured Retention.
The “Discretionary Authority Limit” is the total amount of money which Travelers is authorized to
spend in payment or settlement of any Claim, and, in case of denial, the total Travelers’ projected
money value of a Claim which Travelers is authorized to deny, without first seeking approval from
Client.
SECTION II - DUTIES OF TRAVELERS
A. During the term of this Agreement, Travelers will provide Claim Services to Client ("Claim
Service(s)") with respect to Claims. Such Claim Service shall consist of the following:
1. CLAIMS ADMINISTRATION
(a) Instructions will be provided for the reporting of Claims.
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(b) Claim reports will be accepted from Client or Client’s employee or
representative. Travelers will establish and maintain a separate file on all such
Claims. Travelers will acknowledge receipt of all Claims, identifying each with
a file number for further reference.
(c) Subject to the Termination Section of this Agreement, closed or inactive Claim
files will be stored and maintained in a reasonable manner to protect
confidentiality of records.
2. CLAIMS INVESTIGATION/PREPARATION
(a) Travelers will perform the necessary investigation and documentation upon
which to base a decision regarding liability and damages exposure, and secure
information required for the adjustment of each Claim.
(b) Travelers will provide for investigation by individuals, other than defense
attorneys, in the preparation of the defense for Claims involving litigation.
(c) Loss information on Claims being handled by Travelers will be provided. This
loss information will include suggested reserves, payments and the disposition
of Claims.
(d) A list of outside physicians and other specialists for use as necessary in the
independent examination and evaluation of all Claims will be maintained by
Travelers.
(e) Travelers will analyze each Claim to determine Client's rights against third
parties. When appropriate, Travelers will supervise subrogation of Claims on
behalf of Client.
3. LOSS ADJUSTMENT/NEGOTIATION & SETTLEMENT
(a) Based upon factual investigation and evaluation of Client's liability, Travelers
will compute the amount of Claim payment, if any payment is warranted, issue
such payment and maintain a record of all payments in each file.
(b) Travelers will enter into negotiation and settlement of Claims where appropriate
in Travelers’ judgment and/or consistent with its authority on behalf of Client.
The Discretionary Authority Limit is $50,000 on a per Claim basis. The
Discretionary Authority Limit does not include ALAE (as hereinafter defined).
4. LITIGATION ASSISTANCE
(a) Travelers will maintain a list of recommended attorneys, and at Client's request, will
arrange for such attorneys to be retained on behalf of Client as the need arises for
defense of Claims, subrogation of Claims or when otherwise requested by Client.
When in Travelers’ sole discretion, it determines it is appropriate, Travelers may
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recommend to Client attorneys employed by Travelers or its affiliates. Travelers
may make such recommendation on a case-by-case basis or more generally with
respect to Client's Claims. Client at all times retains the right to reject Travelers'
recommendation of any attorney, including those employed by Travelers or its
affiliates, and to choose other attorneys to defend Claims, handle subrogation of
Claims or as otherwise needed by Client; provided, however, that Travelers shall
solely control the selection of attorneys when the total amount of damages, to which
the Policy applies for any particular Claim, may possibly exceed the Self-Insured
Retention as determined by Travelers in its sole discretion.
(b) Travelers will review attorney activity and assist with discovery as well as pre-
trial preparation of each case, including continued negotiation and settlement
effort where warranted.
(c) Attorney billings will be analyzed for consistency with fee arrangement and
necessity for expenses or time incurred.
(d) Travelers will coordinate and expedite, where necessary, communication
between Client and attorney for, among other things, information subject to
discovery.
5. ESCHEAT
(a) For outstanding checks which become escheatable during the term of this
Agreement, Travelers shall comply with all State required escheat processes in
accordance with Travelers’ standard practices; provided that, if Client is no
longer a customer of Travelers and requires Claim Services for open Claim files
be provided by an entity other than Travelers, Travelers will no longer have any
escheat responsibilities with respect to outstanding checks issued on those Claim
files. .
(b) Travelers shall maintain records of unclaimed property items, the names and
addresses of owners of unclaimed property, if known, and the time period in
which the item was unclaimed.
6. CLAIMS FOR WHICH TRAVELERS PROVIDES CLAIM SERVICES
Travelers will provide Claim Services only for Claims to which the Self-Insured
Retention applies under the terms of the Policy.
7. MMSEA REPORTING
Travelers will assume all reporting obligations as the Client's duly authorized reporting
agent with respect to the data collection and reporting requirements of Section 111 of
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the Medicare, Medicaid and SCHIP Extension Act of 2007, as it may be amended from
time to time ("MMSEA"). Travelers will comply with all MMSEA reporting
requirements for all qualifying payments that Travelers makes on behalf of Client.
Qualifying payments shall include any payment by Travelers under this Agreement to
or on behalf of a Medicare beneficiary that triggers a reporting obligation on behalf of
Client. Qualifying payments do not include payments made as reimbursement to Client
or to any insurer that has paid amounts to or on behalf of a Medicare beneficiary.
Travelers shall have no obligation to report payments made by another entity. Travelers
will establish appropriate safeguards to protect the confidentiality of data collected and
transmitted by Travelers to prevent unauthorized access to that data.
B. In the course of providing Claim Services, expenses will be incurred on behalf of Client for
allocated loss adjustment expenses, defense expenses, or similar expenses as such terms are
defined in the Policy (referred to herein as “ALAE”).
SECTION III - FUNDING ARRANGEMENTS
A. The following is a description of the terms and procedures under which Travelers’ Claim
billing with Client is established and operated.
Travelers will make Claim and ALAE payments on Client's behalf utilizing checks drawn
against a bank account of Travelers. If Client fails to fulfill its funding obligations hereunder,
Travelers may immediately suspend all payments of Claims and ALAE and terminate this
Agreement pursuant to the Effective Dates and Termination Section of this Agreement. Under
no circumstances will Travelers be required to use its own funds to pay Claims and ALAE
hereunder.
In addition, Travelers may pay claim and ALAE amounts in excess of Client's Self-Insured
Retention in order to effect settlements or for any other reason associated with Travelers’
performance of Claim Services. Client agrees to reimburse Travelers for any such payments
pursuant to these funding arrangements and subject to the terms and conditions of this
Agreement. Client's obligation to reimburse Travelers for such payments is an obligation
which is independent of and not contingent upon Client's receipt of payment from any other
source.
B. Client agrees to make funds available to Travelers from which Travelers may draw at its
discretion for payment of all Claims and ALAE which are within the Discretionary Authority
Limit as well as for payments which exceed the Discretionary Authority Limit but which have
been specifically consented to by Client.
1. Client will make a cash payment to Travelers to establish a claim fund:
(a) $5,000 shall be deposited by inception of this Agreement. This amount shall be
the initial minimum claim fund level. Travelers has the right to commingle the
claims fund with its general assets and deposit in its standard banking accounts
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any and all amounts in the claims fund. Travelers shall not be responsible for
allocating any amounts between the entities of Client.
(b) Travelers shall bill Client for paid Claims on a monthly basis. Client shall be
obligated to pay to Travelers any amount billed for Claims within thirty (30) days
of receipt of written notice by Travelers.
(c) Travelers shall continually review the adequacy of the claim fund and may require
such increases or decreases in the minimum and maximum claim fund level
described above as Travelers in discussion with Client deems necessary to reserve
for payment of present and future Claims and ALAE. In setting the minimum
claim fund level Travelers does not represent or warrant the adequacy thereof.
Whenever the claim fund is less than the then minimum level described in Section
III.B.1(a) or thereafter set by Travelers, Client shall pay an amount sufficient to
Travelers to increase the claim fund within thirty (30) days of receipt of written
notice by Travelers.
(d) Upon termination of this Agreement pursuant to the terms of Section VIII,
Travelers shall return any amount remaining in the claim fund to Client after
deducting the amount of any Claim or ALAE payable by Travelers for the
settlement or adjustment of any Claim that occurred prior to the termination of this
Agreement.
2. Travelers has no duty under any circumstances, including but not limited to the inability
to pay or insolvency of Client, to provide funds to pay any Claims or ALAE with
respect to Claims of Client except to the extent funds are maintained in the claim fund
or as required by state law. Provided however, that Travelers, without waiving its rights
or excusing performance by Client, may from time to time elect to advance its own
funds for the payment of such amounts in which case Client shall immediately
reimburse the claims fund pursuant to Section III.B.1(b) above. If Client fails to make
funds available for Travelers to pay Claims and ALAE under the Self-Insured
Retention, Travelers will have the right to suspend payment of Claims and ALAE
without prior notice to Client until such funds are available and Travelers may refuse to
render any of the services provided for under this Agreement, to the extent permitted by
state law. Travelers may also bring suit against Client seeking specific performance of
Client's obligations or to recover any amount due Travelers under the terms of this
Agreement. Travelers will not be liable for any penalties, fees, assessments or legal
judgments rendered for, or based upon the failure to pay Claims or ALAE when the
necessary funds were not deposited in the claim fund, except to the extent required by
state law. Any election of Travelers to continue to service claims, to advance its own
funds to pay Claims or ALAE, or to pursue a remedy provided for in this section shall
not operate as a waiver or estop Travelers from asserting any right under the terms of
this Agreement or otherwise provided by law.
3. To secure the payment of the Obligations (as defined below), Client grants to Travelers:
(a) a security interest in the moneys on deposit in the claim fund as cash collateral as
that term is defined in Section 363(a) of the U.S. Bankruptcy Code and acknowledges
that the security interest is perfected by Travelers control over the claim fund, and (b)
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the right to set off any of the Obligations against any sums now or at any time owing by
Travelers to Client. Client agrees to execute such documents as Travelers may require
to evidence the attachment or perfection of the security interest granted pursuant hereto,
and further agrees to take such other steps as Travelers may reasonably require to
establish and maintain the first priority of such security interest. "Obligations" shall
mean all present or future indebtedness and obligations of Client to Travelers including,
but not limited to, those arising at any time under this Agreement and any other prior,
present or future agreement and insurance policy between Client and Travelers and any
renewals, restatements or extensions thereof, whether or not such indebtedness or
obligations are matured, contingent, unliquidated or subject to any recoupment or setoff,
as well as any present or future liabilities of Travelers, payment for which Client has
undertaken or is otherwise obligated to Travelers under this Agreement or any other
agreements and insurance policy(s) or otherwise applicable agreements or law. Client
acknowledges and confirms that the Obligations hereunder are obligations secured by
the security interest granted by Client to Travelers under and pursuant to the terms of
any and all past or present agreements or policy(s) between Travelers and Client.
SECTION IV - DUTIES OF CLIENT
A. Client shall pay the charges provided for herein for the Claim Services.
B. Client agrees to cooperate with Travelers in the investigation of any Claim and to provide any
information Travelers shall reasonably request for the purpose of investigating a Claim.
C. Client agrees to indemnify and hold harmless Travelers and its directors, officers, agents,
employees and affiliates providing Claim Services hereunder against any and all claims,
settlements, interest charges, lawsuits, payments, penalties, administrative proceedings,
judgments, costs, damages or expenses, including attorneys' fees, resulting from, or arising out
of or in connection with any Claim or any Excess Claim hereunder, or incurred to enforce this
provision unless it is determined by the final order of a court of competent jurisdiction that a
proportion of the liability therefore was caused by the willful misconduct or negligent activity
of Travelers, its employees or agents, in which case, Travelers shall be responsible for its
proportionate share of the liability. This clause survives termination of this Agreement.
SECTION V - LIMITATION OF LIABILITY
A. Travelers makes no representation that Client is authorized to insure or to self-insure. It is the
responsibility of Client to obtain all necessary authorization from applicable governmental
authorities. Client further agrees that it is its responsibility to fund Claim payments. Client
acknowledges and agrees that this Agreement is not a policy of insurance.
B. In the event Travelers should fail to perform its duties hereunder and if such failure is not
corrected within thirty (30) days after written notice by Client to Travelers of such failure, then
Client may terminate this Agreement upon fifteen (15) days written notice to Travelers. The
foregoing is in lieu of all other warranties, expressed or implied (including warranties of
merchantability and fitness for a particular purpose) and all liability for special, indirect or
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consequential damages, including lost profits, even if Travelers has been advised of the
possibility of such damages.
C. Travelers reserves the right to not provide Claim Services in any state or political jurisdiction if
such services are prohibited by the laws or regulations thereof. Travelers may immediately
discontinue Claim Services and return Claim files in its possession to Client to the extent there
is a change in law or regulation, or a change to how Travelers is required to interpret a law or
regulation, which imposes additional duties, responsibilities or obligations on Travelers. In
such instances, Travelers shall have no further duty to provide such Claim Services.
SECTION VI - CLAIMS SERVICE FEES AND OTHER CHARGES
A. As consideration for the Claims Services provided under this Agreement, Client shall pay to
Travelers a claims service fee, which has been included in the policy premium.
B. 1. In the event that a state or other jurisdiction, in accordance with existing or future law,
determines that Travelers is liable for payment of any taxes, assessments or escheat
obligations (other than taxes solely based upon Travelers’ net income) with respect to
any aspect of this Agreement, Client agrees to reimburse Travelers for the amount of
any such taxes, assessments or escheat obligations, any interest expense assessed
against or incurred by Travelers before or after payment of such amounts, and any other
charges, penalties or fines in connection therewith, including reasonable attorneys' fees,
that Travelers may sustain in connection with such amounts. Any such amount shall be
due and payable upon written notification by Travelers to Client.
2. Travelers shall have sole discretion in determining whether any claim or assessment for
taxes, assessments or escheat obligations shall be paid, compromised, litigated or
appealed and as to all matters of procedure, compromise, defense or appeal or any other
aspects of any claim or assessment concerning its liability.
3. In the event that a state or other jurisdiction, in accordance with existing or future law,
imposes upon Travelers the duty to act as agent for collection of any tax or assessment
obligation imposed on Client with respect to any aspect of the Agreement, Client will
pay over any such amounts to Travelers when requested to do so by Travelers.
C. The claim service fee for each Claim shall cover Claim Services for the lifetime of the claim.
In the event this Agreement is terminated for any reason, these claim service fees will not be
pro-rated and are not refundable.
SECTION VII - EVENTS OF DEFAULT
Each of the following events shall constitute an Event of Default:
A. Client shall fail to make any payment of charges or fees on or before the date due; or
B. Client shall fail to fulfill any of its obligations under the Funding Arrangements; or
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C. Client shall fail to perform or observe any other condition or agreement to be performed or
observed by it under this Agreement or other similar agreement; or
D. Client becomes insolvent or is unable to pay its debts as they become due or Client is declared
bankrupt or insolvent, or if a debtor relief proceeding has been brought by or against it.
SECTION VIII - EFFECTIVE DATES AND TERMINATION
A. This Agreement shall commence on the Effective Date and shall remain continuous until
terminated.
B. 1. This Agreement may be terminated by either Travelers or Client with or without cause
for any reason whatsoever upon sixty (60) days prior written notice.
2. Upon the occurrence of any Event of Default, and if such Event of Default is not
corrected within thirty (30) days after written notice by Travelers to Client of such
Event of Default, then Travelers may terminate this Agreement upon fifteen (15) days
written notice to Client. This Agreement may be terminated by Client as set forth in
Section V.B. or by Travelers as set forth in Section V.C.
3. If none of the events referenced in the preceding subsections take place, this Agreement
will terminate when both parties agree that all the obligations of each hereunder have
been paid or otherwise performed.
C. Notwithstanding the termination of this Agreement, Client shall remain fully liable to Travelers
for all claim service fees, paid Claims, ALAE and all other sums due in accordance with the
terms and provisions of this Agreement with respect to Claims reported before such
termination, and all such obligations of Client shall be deemed to survive any such termination.
D. 1. This Agreement contemplates Travelers providing Claim Services for each Claim
handled pursuant hereto, from the time the Claim is opened until conclusion. Therefore,
in the event of termination, unless there is a default by Client, Travelers will continue to
provide Claim Services for Claims which were reported prior to termination, until all
Claims are concluded.
2. In the event of a termination by Travelers pursuant to this Section because of a default
by Client, or if, after the termination of this Agreement for any other reason pursuant to
this Section, Client fails to fulfill its obligations under the Funding Arrangements or to
pay any other amounts due and owing hereunder, Travelers may immediately
discontinue all Claim Services and return the Claim files in its possession to Client at
Client's expense at the address specified in the "Notices" Section of this Agreement,
without any offset or deduction from any of the Claim Service fees or other charges
paid or payable by Client to Travelers under this Agreement. Travelers shall then have
no further responsibility to provide Claim Services for any Claims of Client other than
as may be required by state law.
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3. Travelers assumes no liability with respect to Claim Services, and the work product
thereof, performed by anyone other than Travelers, either prior to or subsequent to the
Term of this Agreement. To the extent that Travelers incurs any liability as a result of
Claim Services performed by anyone other than Travelers, Client agrees to hold
Travelers harmless for any such liability as set forth in the Duties of Client Section of
this Agreement.
SECTION IX - EXAMINATION OF RECORDS
Client shall have the right to examine any Claim file or time sheets relating to the specific Claim
maintained by Travelers pursuant to this Agreement upon thirty (30) days advance written notice from
Client to Travelers; provided, however, Client agrees that an examination of individual Claim files
shall be carried out in a manner agreed to between Client and Travelers designed to protect the
confidentiality of the individual's medical and professional information and that any examination be
conducted during the normal business hours of Travelers pursuant to reasonable restrictions imposed
by Travelers. If Client retains a third party to perform the examination functions set forth in this
section, Client agrees that the third party will not have access to records until third party signs a Non-
Disclosure Agreement between third party and Travelers.
SECTION X - SOLE BENEFIT
This Agreement is for the sole benefit of the parties hereto and in no event shall this Agreement be
construed to be for the benefit of any third party, and Travelers shall not be liable for any loss, liability,
damages or expense to any person not a party to this Agreement.
SECTION XI - ASSIGNMENT
No assignment by either party of this Agreement shall be valid without the prior written consent of the
other party, which consent shall be reasonably given. Notwithstanding the foregoing, Travelers may at
any time assign its rights and delegate its duties hereunder to any of its affiliated companies. In
addition, Client acknowledges and agrees that all or some of the Claim Services provided hereunder
may be provided by affiliated companies of Travelers.
SECTION XII - FAILURE OF ENFORCEMENT
Travelers' failure to enforce at any time an y of the provisions of this Agreement, or to exercise any
option which is herein provided, or to require at any time performance by Client of any of the
provisions hereof, shall in no way be construed to be a waiver of such provisions, nor in any way to
affect the validity of this Agreement or any part thereof, or Travelers’ right to thereafter enforce each
and every provision of this Agreement or to exercise any right or remedy available to Travelers under
applicable law.
SECTION X III - LEGAL AGREEMENT
Nothing in this Agreement shall be construed to require commission of any act contrary to the law. In
the event of a conflict between any provision of this Agreement and any law or regulation contrary to
which the parties have no legal right to contract, the latter shall prevail; provided however, that in such
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event, the provision so affected shall be limited only to the extent necessary to permit compliance with
the minimum legal requirement, and all such other provisions of this Agreement shall continue in full
force and effect.
The parties have read this Agreement and they have had a full opportunity to evaluate this Agreement
along with all transactions and other matters contemplated by this Agreement. The parties have had
the opportunity to consult with, and have consulted with, business advisors and counselors of their
choice in connection with this Agreement. If any provision of this Agreement is found ambiguous by a
court or arbitration panel, such provision shall not be construed against either party based on the party's
alleged drafting of such provision.
SECTION X IV – AGREEMENT TO ARBITRATE
The parties recognize that disputes may arise between them and in some instances involving non -
parties as well, about the parties' rights and duties relative to reimbursement of Claims and ALAE and
payment of Claim Service charges and other charges under this Agreement. In addition, disputes may
arise regarding whether and how much Travelers’ Claims Services (e.g. investigation, administration,
payments in connection with Claims) may impact the amount of Claims and ALAE payments and
Claims Service Fees charges Client may owe to Travelers under this Agreement. The parties will
attempt to resolve those disputes without resort to formal procedures. However, in the event such a
dispute is not resolved, either party shall submit the matter to arbitration and the other party shall be
bound by such submission, provided that neither party shall submit to arbitration (i) any coverage
dispute which arise under or in connection with Claim Service performed by Travelers under this
Agreement; and/or (ii) any claim which either party purports to arbitrate as a representative or member
of a class or as a private attorney general.
The arbitrator(s) has no authority, and is not empowered, to consolidate or direct class-action
arbitration as to any disputes between the parties to this Agreement with other disputes between
Travelers and any other of its customers or other third parties. Nor shall the arbitrator(s) have
authority or be empowered to consolidate or direct disputes brought by Client as a private attorney
general. Any determination by the arbitrator(s) to so consolidate or direct class-action arbitration or to
consolidate or direct disputes brought by Client as a private attorney general shall be beyond the
arbitrator's authority and jurisdiction and shall accordingly, be void. Any dispute regarding these
prohibitions against consolidation of class-action arbitrations and against disputes brought by Client as
a private attorney general shall be heard and resolved by a court having jurisdiction over the parties as
provided in the Consent to Jurisdiction provision below, not the arbitrator(s).
The parties agree that Client's Claim Services program with Travelers is deemed made in the State of
Connecticut and involves interstate commerce. Accordingly, Travelers and Client agree that any
arbitration proceeding arising out of or related to this Agreement shall be governed by the Federal
Arbitration Act ("FAA") and, to the extent not inconsistent with the FAA, Connecticut arbitration law.
A. All such disputes shall be submitted for decision to a panel of arbitrators composed of two
party-appointed arbitrators and an umpire (the “Arbitration Panel”). Each member of the
Arbitration Panel shall be a disinterested, active or retired judge, or executive officer of a
property-casualty insurance company or claim service provider, or property-casualty broker
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authorized to transact business in the United States. The arbitration proceedings shall take place
in Hartford, Connecticut unless otherwise agreed by the parties.
B. The party demanding arbitration (“Claimant”) shall appoint its arbitrator first. The other party
(“Respondent”) shall appoint its arbitrator no later than two weeks after the date on which
Respondent receives notice from Claimant of Claimant’s appointment of its arbitrator. If the
Respondent fails to appoint its arbitrator within such two week-period, then Claimant shall
appoint the second arbitrator and Respondent shall forfeit any right to name the second
arbitrator. The two arbitrators shall select an umpire within twenty one (21) days after both
arbitrators have been appointed. If the two arbitrators fail to agree on an umpire within the
twenty one (21) day period, each arbitrator shall name three umpire candidates, of whom the
other arbitrator shall strike two and the decision shall be made from the remaining two umpire
candidates by drawing lots.
C. Notwithstanding anything in this 'Agreement to Arbitrate' Section to the contrary, if the amount
claimed by the Claimant in its demand for arbitration is less than $250,000, the parties agree
that an abbreviated, streamlined arbitration procedure (“Streamlined Arbitration”) will be
followed. In such a case, the parties agree to submit the dispute to an Arbitration Panel
comprised of a sole arbitrator. The sole arbitrator shall be a disinterested, active or retired
judge, or executive officer of a property-casualty insurance company or claim service provider,
or property-casualty broker authorized to transact business in the United States. Within
fourteen (14) days of the date the arbitration demand is served on Respondent, Claimant and
Respondent shall each name three candidates. If a candidate appears on both lists of
candidates, then that candidate shall be named the sole arbitrator to resolve the dispute. If there
is no match on the lists, each party shall strike two names from the other’s list and the sole
arbitrator shall be selected from the remaining two candidates by drawing lots.
All Streamlined Arbitration proceedings shall be subject to the following rules:
1. Each party will be permitted a maximum of three depositions.
2. The parties agree that time is of the essence and that the final hearing shall
commence no later than six months from the date of the arbitration demand. The
parties further agree that no continuances or extensions of time with respect to that
six month period shall be granted unless both parties agree.
3. The sole arbitrator shall have the authority, in his/her discretion to decide the case
without a formal hearing and based upon the written materials submitted by the
parties.
D. The Arbitration Panel is relieved from all judicial formalities and may abstain from following
the strict rule of law. At the hearing, evidence may be introduced without following the strict
rules of evidence, but cross examination and rebuttal shall be allowed.
E. The Arbitration Panel shall issue its decision within fourteen (14) days following the
conclusion of the hearings or, if the case is submitted on the briefs, within fourteen (14) days of
the submission of the final briefs.
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F. The Arbitration Panel shall issue its decision in writing, identifying the reasons and rationale
for the decision and, if the arbitration panel feels it is necessary, setting forth the findings of
fact with respect to its decision.
G. The decision of the majority of the Arbitration Panel shall be final and binding upon all parties
to the proceeding. Judgment may be entered upon the award in any court having jurisdiction.
H. The Arbitration Panel shall have authority to award pre-judgment interest, post-judgment
interest, interim relief, pre-hearing security, and summary judgment.
I. Each party shall bear the expense of its own arbitrator and shall jointly and equally bear with
the other party all expenses of the umpire and of the arbitration. Unless otherwise required by
statute, each party shall be responsible for its own attorneys’ fees and costs.
SECTION XV – CONSENT TO JURISDICTION
Subject to the terms and conditions of this Agreement, in the event any suit is commenced to enforce
any right hereunder, the non-suing party hereby irrevocably submits to, consents to and waives any
objection to the exclusive jurisdiction of the courts of the state of Connecticut, including the United
States District Court for the State of Connecticut. In connection with any such action, process may be
served within or outside of the State of Connecticut by personal service or by registered mail, return
receipt requested, addressed to the address set forth in the Notices Section of this Agreement or such
other address as the non-suing party may hereafter designate in writing. The parties agree and consent
that the exclusive venue (subject to the applicable rules of the courts concerning the assignment or
transfer of cases) for any such action shall lie in the County of Hartford in the State of Connecticut.
SECTION XVI - CHOICE OF LAW
This Agreement shall be governed by the internal laws of the State of Connecticut, without regard to
Connecticut's rules regarding conflict of laws. This choice of law provision applies to this Agreement
and not to coverage disputes which may arise in connection with claims or suits brought against
Claims as defined in this Agreement.
SECTION XVII - ENTIRE AGREEMENT
This Agreement, including the Cover Page, its exhibits and any agreement(s) incorporated by reference
constitute the entire agreement between the parties with respect to the subject matter hereof, and all
prior agreements, representations, statements, negotiations and undertaking are superseded hereby.
SECTION XVIII - AMENDMENTS
This Agreement may be amended by the parties at any time so long as each amendment is in writing
and signed by authorized officers of both parties.
DocuSign Envelope ID: 4AEEB7D1-DF21-4CF6-8E15-F354B33D0D72DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2
13
SECTION X IX - NOTICES
All notices, demands or other communications hereunder (excluding Claim notices) shall be in writing
and shall be deemed to have been duly given when sent if delivered by (i) overnight mail via a
commercial courier who will provide evidence of delivery or (ii) electronic mail to the other party at
the address(es) set forth below:
(a) If to Client:
Abby Dallmann
Risk Manager
Eagle County, Colorado
PO Box 850, 500 Broadway
Eagle, CO 81631
E-Mail Address: abby.dallmann@eaglecounty.us
(b) If to Travelers:
The Travelers Indemnity Company
Public Sector Services
385 Washington Street
St. Paul, MN 55102
Attention: Amy Schmidt, Chief Underwriting Officer
E-Mail Address: ASCHMID2@travelers.com
SECTION XX - COUNTERPARTS
This Agreement may be executed in any number of counterparts, each of which when so executed and
delivered shall constitute an original, but such counterparts together shall constitute but one and the
same instrument.
DocuSign Envelope ID: 4AEEB7D1-DF21-4CF6-8E15-F354B33D0D72DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2
14
IN WITNESS WHEREOF, Client and Travelers have caused this Agreement to be executed by
their respective officers duly authorized.
Eagle County, Colorado The Travelers Indemnity Company
("Client") ("Travelers")
By:______________________________ By:___________________________
Print Name: Abby Dallmann Print Name: James M. Petrone
Title: Risk Manager Title: Loss Sensitive Segment Lead
Date: ____________________________ Date: _________________________
DocuSign Envelope ID: 4AEEB7D1-DF21-4CF6-8E15-F354B33D0D72
1/1/2022
DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2
1/6/2022
Certificate Of Completion
Envelope Id: 4AEEB7D1DF214CF68E15F354B33D0D72 Status: Sent
Subject: Please DocuSign: Eagle County Colorado CSA - 2021
SAI Number: 6813X5229
Effective Date (mm/dd/yy): 01/01/2021
NB or RN?: NB
Market: Middle
Source Envelope:
Document Pages: 14 Signatures: 1 Envelope Originator:
Certificate Pages: 5 Initials: 0 Diane Scott
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
One Tower Square
Hartford, CT 06183
DSCOTT5@travelers.com
IP Address: 170.202.22.112
Record Tracking
Status: Original
12/27/2021 3:46:59 PM
Holder: Diane Scott
DSCOTT5@travelers.com
Location: DocuSign
Signer Events Signature Timestamp
James M Petrone
jpetrone@travelers.com
Loss Sensitive Segment Lead PSS
Security Level: Email, Account Authentication
(None)Signature Adoption: Pre-selected Style
Using IP Address: 170.202.222.100
Sent: 12/27/2021 4:18:47 PM
Viewed: 1/1/2022 11:04:50 AM
Signed: 1/1/2022 11:05:50 AM
Electronic Record and Signature Disclosure:
Accepted: 1/1/2022 11:04:50 AM
ID: 45a7ff42-566a-4180-9650-6a5b5cf7180c
Abby Dallmann
abby.dallmann@eaglecounty.us
Security Level: Email, Account Authentication
(None)
Sent: 1/1/2022 11:05:52 AM
Viewed: 1/2/2022 1:22:14 PM
Electronic Record and Signature Disclosure:
Accepted: 1/2/2022 1:22:14 PM
ID: 417e7521-4d00-4f2c-91da-eebb91faaaaa
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Tracy Petterson
tracy_petterson@ajg.com
Security Level: Email, Account Authentication
(None)
Sent: 1/1/2022 11:05:51 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2
Carbon Copy Events Status Timestamp
Tracy Petterson
tracy_petterson@ajg.com
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Mick Petrone
jpetrone@travelers.com
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Accepted: 1/1/2022 11:04:50 AM
ID: 45a7ff42-566a-4180-9650-6a5b5cf7180c
Janet Moody
jlmoody@travelers.com
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 12/27/2021 4:18:47 PM
Certified Delivered Security Checked 1/2/2022 1:22:14 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Travelers – National Accounts - IPA (we, us or Company) may be required
by law to provide to you certain written notices or disclosures. Described below are the terms
and conditions for providing to you such notices and disclosures electronically through the
DocuSign system. Please read the information below carefully and thoroughly, and if you can
access this information electronically to your satisfaction and agree to this Electronic Record and
Signature Disclosure (ERSD), please confirm your agreement by selecting the check-box next to
‘I agree to use electronic records and signatures’ before clicking ‘CONTINUE’ within the
DocuSign system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per-page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
Electronic Record and Signature Disclosure created on: 10/22/2018 7:28:47 AM
Parties agreed to: James M Petrone, Abby Dallmann, Mick Petrone
DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process, please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Travelers – National Accounts - IPA:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: ahwang@travelers.com
To advise Travelers – National Accounts - IPA of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at ahwang@travelers.com and in the
body of such request you must state: your previous email address, your new email address. We
do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from Travelers – National Accounts - IPA
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to ahwang@travelers.com and in the body
of such request you must state your email address, full name, mailing address, and telephone
number. We will bill you for any fees at that time, if any.
To withdraw your consent with Travelers – National Accounts - IPA
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an email to ahwang@travelers.com and in the body of such request you must state
your email, full name, mailing address, and telephone number. We do not need any other
information from you to withdraw consent.. The consequences of your withdrawing consent for
online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-guide-
signing-system-requirements.
Acknowledging your access and consent to receive and sign documents elect ronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you, please confirm that you have
read this ERSD, and (i) that you are able to print on paper or electronically save this ERSD for
your future reference and access; or (ii) that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein, then select the check-box next to ‘I agree to use electronic records and signatures’ before
clicking ‘CONTINUE’ within the DocuSign system.
By selecting the check-box next to ‘I agree to use electronic records and signatures’, you confirm
that:
You can access and read this Electronic Record and Signature Disclosure; and
You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
Until or unless you notify Travelers – National Accounts - IPA as described above, you
consent to receive exclusively through electronic means all notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided
or made available to you by Travelers – National Accounts - IPA during the course of
your relationship with Travelers – National Accounts - IPA.
DocuSign Envelope ID: CADB1771-C7FD-45F8-93E5-B341271F17C2