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LEAGUE OF MINNESOTA CITIES INSURANCE TRUST <br />LMCIT EXCESS LIABILITY COVERAGE <br />Cities obtaining excess coverage from the League of Minnesota Cities Insurance Trust must decide whether or <br />not to waive the statutory liability limits to the extent of the excess coverage purchased. This decision must be <br />made by the city council. CITIES PURCHASING EXCESS COVERAGE MUST COMPLETE AND <br />RETURN THIS FORM TO LMCIT BEFORE THE EFFECTIVE DATE OF THE COVERAGE. <br />For further information, refer to the accompanying memo. City officials may also want to discuss these issues <br />with the city attorney. <br />The City of <br />limits of S <br />Check one: <br />accepts excess liability coverage <br />from the League of Minnesota Cities Insurance Trust. <br />The city DOES NOT WAIVE the monetary limits on tort liability established by Minnesota Statutes <br />466.04. <br />-OR- <br />The city WAIVES the monetary limits on tort liability established by Minnesota Statutes 466.04, to the <br />extent of the limits of the excess liability coverage obtained from the League of Minnesota Cities <br />Insurance Trust. <br />Date of city council meeting: <br />Signature: <br />Position: <br />Return this completed form to: <br />Berkley Risk Services, Inc. <br />145 University Avenue West <br />St. Paul, MN 55103-2044 <br />LMCTTAPP.31 (1/96) PAGE 2 OF 2 <br />