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STANDARD AGENCY AGREEMENT
BETWEEN
BOARD OF PUBLIC WORKS and SAFETY
for the CITY OF JEFFERSONVILLE
(Hereinafter, the Board)
And
EDWARD CULPEPPER COOPER
NEACE LUKENS/MAVERICK INSURANCE LLC
(Hereinafter, Agent of Record)
WITNESSETH:
The Board hereby appoints Edward Culpepper Cooper and Neace Lukens /Maverick Insurance
LLC its Agent of Record to solicit new applications within the State of Indiana for all insurance products
as shown on Schedule A. attached to this Agreement and incorporated herein by reference.
ARTICLE I
DUTIES OF AGENT OF RECORD
A. Agent of Record shall have the power to appoint subagents of record within the
limitations of the terms of this Agreement for the purpose of procuring applications for
insurance coverage and forwarding the same to the Board for action. Within sixty (60)
days of the end of February of each year in which this Agreement is effective, Agent of
Record shall provide a list of the names and addresses of all subagents to whom the
Agent of Record is paying a commission for the Board's business. The Board reserves
the right to require the Agent of Record to sever the relationship with any such subagents
of record upon thirty (30) days written notice to the Agent of Record.
B. Agent of Record will comply and will cause and require his subagents of record to comply
with all the applicable State and Federal laws and with the Regulations of the Indiana
Department of Insurance, including the procurement of prescribed licenses.
C. Agent of Record will comply and will cause and require his subagents of record to comply
with the Board's rules and regulations relating to the completion and submission of
applications.
D. Agent of Record warrants that Agent of Record will, and will cause and require his
subagents of record to, diligently and to the best of their ability insure that the facts set
forth by any applicant in any application they solicit are true and correct. Agent of Record
further warrants that each applicant will be fully informed that the Board will rely solely
upon those representations in rejecting, conditionally accepting or contracting with each
Insurance Company and that the subsequent discovery by the Board of material facts
known by the Insurance Company and either not disclosed or misrepresented on the
application can result in the cancellation of any contract entered into in the reliance
thereon.
E. Agent of Record will, and will cause his subagents of record to, conduct their business so
as to not adversely affect the business, good standing and reputation of the Board of
Public Works and Safety for the City of Jeffersonville.
F. Agent of Record will not hold any monies belonging to the Board; however, in the event
funds are directed to the Agent of Record, Agent of Record will securely hold, for the
benefit of the Board, any monies belonging to the City separate and distinct from other
accounts and in no case make any improper use of such funds. Agent of Record will
remit any such funds to the Board within ten (10) business days of receipt thereof.
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G. Agent of Record agrees not to employ or make use of any advertisement in which the
City of Jeffersonville or names of the Board members will be utilized without tho prior
written approval and consent of the Mayor of the City of Jeffersonville.
H. The Agent of Record, and appointed subagents of record, shall act solely as independent
contractors, and as such, shall control in all matters their time and effort in the placement
of products offered hereunder. Nothing herein contained shall be construed to create the
relationship of employer and employee between the Agent of Record and/or subagents of
record and/or the Board.
Agent of Record shall Indemnify and hold the City of Jeffersonville harmless from all
expense, costs, causes of action and damages resulting from or growing out of any
negligence and/or unauthorized act or transaction by the Agent of Record and any
appointed subagents of record or employees of Agent of Record. The Board shall
indemnify and hold the Agent of Record harmless from all expense, costs, causes of
action and damages resulting from or growing out of any negligence and/or unauthorized
act or transaction by the Board or any employees of the City of Jeffersonville.
J. The Agent of Record has the power on behalf of the City of Jeffersonville to bind
coverage, to make, alter or discharge any contract, or to waive or forfeit the performance
of any of the terms and conditions of any policy or other contract to which the City of
Jeffersonville Is a party as long as he has written permission of at least two Board of
Public Works members or the Mayor of the City of Jeffersonville.
K. The Agent of Record shall prepare specifications for requests for bids or proposals for the
annual insurance coverage for the City of Jeffersonville. The Agent of Record shall
provide to the Board competitive bid submissions or proposals from qualified providers
for each annual renewal of coverage. If requested.
L. The Agent of Record may work with any local servicing agent, if selected by the Board
and shall compensate the local agent from the compensation paid to the Agent of Record
by the Board, as agreed to in writing by all parties.
ARTICLE II
RIGHTS RESERVED TO BOARD OF PUBLIC WORKS
A. The Board reserves the right to reject any and all applications submitted by Agent of
Record or appointed subagents.
B. The Board reserves the right to select what products will be accepted pursuant to this
agreement.
C. The Board reserves the right to discontinue the underwriting or offering of products which
become the subject of this Agreement upon thirty (30) days written notice to the Agent of
Record.
D. All printed material, applications, and sales literature and computer software which the
Agent of Record furnishes to the Board shall remain the property of the Agent of Record
subject at all times to his control, and same shall be returned to the Agent of Record
upon written demand.
ARTICLE III
COMPENSATION
A. Compensation for the Agent of Record shall be based on the terms, conditions, and rates
for each type of product to be offered, which are set gpt hereafter in this Agreement and
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A. Compensation for the Agent of' Record shall be based on the terms, conditions, and rates for
each type of product to be offered, which are set out hereafter in this Agreement and
Schedule A. Any changes In the compensation rates shall be effective only on the renewal
date of an existing account. The accounts subject to this Agreement are set forth in the
Schedule A attached hereto and made a part hereof. The Board of Public Works and the City
of Jeffersonville may add said accounts upon Agent of Record's submission of an account for
acceptance and written acknowledgment of such acceptance.
B. Payments to the Agent of Record shall consist of the percentages of earned premiums paid
and factors by the account as set forth on Schedule A. Earned premlums are defined as
premiums due and paid pursuant to the contract of insurance between the Board and the
account. The Agent of Record shall be paid no later than the twentieth (20th) day of the
month following the month of premium application by the Insurance Company or the City of
Jeffersonville.
C. If the Board recalls or rescinds a policy or contract written by the Agent of Record or
appointed subagents and receives the premium paid thereon, the Agent of Record shall not
be required to repay the Board or the City of Jeffersonville the amount of commission
payment received on premiums returned.
D. The Board shall have the right to offset amounts overpaid by the Board to the Agent of
Record against compensation due to Agent of Record by the Insurance Company.
ARTICLE IV
TERM
This Agreement shall continue in full force and effect for a term of twenty-four (24) months from the
date of its execution by the parries and, unless terminated as provided herein.
ARTICLE V
TERMINATION
A. Except as otherwise provided, this Agreement and the agency created hereunder shall not
terminate before December 31, 2013. The parties expressly agree that subject to provisions
of paragraph B of this Article, any termination of this Agreement will not in any fashion
terminate the obligations of the parties with respect to such business which shall remain In
force and effect until the cancellation or termination date of any such policy or contract of
insurance.
Written notice, as provided herein, to be sent to:
Neace Lukens /Maverick Insurance LLC City of Jeffersonville
Agent of Record Office of the Mayor and
c/o Edward Culpepper Cooper Board of Public Works
1994 Charlestown -New Albany Pk.#202 500 Quartermaster Station
Jeffersonville, Indiana 47130 Jeffersonville, Indiana 47130
B. This Agreement will terminate automatically upon the occurrence of any of the following
events, and upon such occurrence, any payments owing by the Board and the City of
Jeffersonville to the Agent of Record hereunder shall be forfeited:
1. Loss or suspension of Agent of Record's license(s) or Corporate license;
2. The death or total disability of Agent of Record, if Agent of Record is an individual;
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ARTICLE VI
NON - WAIVER
Failure of the Board and the City of Jeffersonville to insist upon the performance of any of the
terms of this Agreement or to declare a forfeiture or termination in the event of nonperformance by the
Agent of Record shall not constitute a waiver by the Board and the City of Jeffersonville of performance
required hereunder.
ARTICLE VII
ASSIGNMENT
No assignment. transfer or disposal of any interest that Agent of Record may have pursuant to
this Agreement shall be made at any time without prior written approval of the Board.
ARTICLE VIII
BINDING AGREEMENT
This Agreement shall be binding upon the administrators and executors, successors and
permitted assignees of the parties hereto.
ARTICLE IX
AMENDMENT
No Amendment or modification of this Agreement shall be valid, or of any force or effect, unless
the same be in writing and acknowledged and signed by the Board and the Agent of Record, except as
set out in Article II, Paragraph C and Article III, Paragraph A herein.
ARTICLE X
ENTIRE AGREEMENT
This Agreement constitutes tho entire agreement between the parties with respect to this subject
matter. Neither party has relied on any oral representations by the other party outside of the written terms
of this Agreement.
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ARTICLE XI
EXECUTION OF THE AGREEMENT
The parties acknowledge their agreement to be bound by all the terms and conditions contained
in this Agreement and Schedule A attached hereto, as evidenced by their respective signatures below:
Neace Luke erickInsu L
By: �,.•� Date:
Title: Vice President of Sales
Board of Public Works and Safety for
the City of Je rsonville
Date: 21 z 3- if
Title: oard Member
By. Date: / -//
Title: Boa Member
By: •■ C Date: /1
Title: ''. Member
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STANDARD AGENCY AGREEMENT
BETWEEN
BOARD OF PUBLIC WORKS and SAFETY
CITY OF JEFFERSONVILLE
and
EDWARD CULPEPPER COOPER
NEACE LUKENS/MAVERICK INSURANCE LLC.
SCHEDULE A
Plan of Insurance and factors
Medical Health Benefits Major Medical Benefits
Comprehensive Major Medical Benefits Dental Benefits
Vision Benefits Presaiption Drugs
Group Life Group Accidental Death/ Dismemberment
Group Dependent Life Group Weekly or Monthly Disability
Group Long Term Disability Section 125 Plans and AFLAC
Property & Casualty Workers Compensation
Loss Funding Partial Self- Funded Accounts
II. Payments to Agent of Record by Insurance companies and/or Third Party Administrators.
A. Health Coverage/Fee Based Accounts
This commission scale shall become effective for each account on its effective date. On each
renewal date of an account, calculation of commission payment shall begin again. Single
employers, which have multiple account numbers, will be counted as one account for the purpose
of earned premium and charges calculation. This will be set by the Insurance Carriers.
B. Health Coverage/Cost Plus Accounts/Partial Self-Funded Accounts
Flat five per cent (5 %) of all expected costs for panialty self- funded accounts. Commissions can be
reduced by ten per cent (10 %) for annualization at Agent's action and approved by the Mayor.
The number of covered employees shall be those existing on the monthly run date (between the l
and the 1 D" day of the month) for the commission calculation system.
C. Other Coverage underwritten and placed by the Agent of Record
Insurance Commissions will be set by the Insurance Carrier for eamed premiums as provided by
insurance company or as agreed to by writing company.
0. Property and Casualty/Loss FundingNVorkers Compensation
Insurance & Risk Management fee will be set by the Insurance Carrier or by the employer and
insurance agent of record for property and casualty premiums and loss funding estimated costs.
All workers compensation will be set by the Insurance Carrier or company's filed schedule with the
Department of Insurance.
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