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O® <br />LEAGUE oP <br />MINNESOTA <br />CITIES <br />CONNECTING & INNOVATING <br />SINCE 1913 <br />LIABILITY COVERAGE - WAIVER FORM <br />LMCIT members purchasing coverage must complete and return this form to LMCIT before the effective date of <br />the coverage. Please return the completed form to your underwriter or email to pstech @lmc.org <br />This decision must be made by the member's governing body every year. You may also wish to discuss these issues with <br />your attorney. <br />League of Minnesota Cities Insurance Trust (LMCIT) members that obtain liability coverage from LMCIT must decide <br />whether to waive the statutory tort liability limits to the extent of the coverage purchased. The decision has the following <br />effects: <br />If the member does not waive the statutory tort limits, an individual claimant would be able to recover no more than <br />$500,000 on any claim to which the statutory tort limits apply. The total all claimants would be able to recover for a <br />single occurrence to which the statutory tort limits apply would be limited to $1,500,000. These statutory tort limits <br />apply regardless of whether the city purchases the optional excess liability coverage. <br />If the member waives the statutory tort limits and does not purchase excess liability coverage, a single claimant could <br />potentially recover up to $2,000,000 for a single occurrence. (Under this option, the tort cap liability limits are waived to <br />the extent of the member's liability coverage limits, and the LMCIT per occurrence limit is $2 million.) The total all <br />claimants would be able to recover for a single occurrence to which the statutory tort limits apply would also be limited <br />to $2,000,000, regardless of the number of claimants. <br />If the member waives the statutory tort limits and purchases excess liability coverage, a single claimant could <br />potentially recover an amount up to the limit of the coverage purchased. The total all claimants would be able to <br />recover for a single occurrence to which the statutory tort limits apply would also be limited to the amount of coverage <br />purchased, regardless of the number of claimants. <br />Claims to which the statutory municipal tort limits do not apply are not affected by this decision. <br />City of St. Anthony <br />LMCIT Member Name <br />Ch one: <br />The member DOES NOT WAIVE the monetary limits on municipal tort liability established by Minnesota Statutes, <br />Section 466.04. <br />❑ The member WAIVES the monetary limits on municipal tort liability established by Minnesota Statutes, Section <br />466.04 to the extent of the limits of the liability coverage obtained from LMCIT. <br />Date of city cou ilfgovernin body meeting May 24th, 2016 <br />Signature Position City Clerk <br />145 UNIVERSITY AVE. WEST PHONE: (651) 281 -1200 FAY: (651) 281 -1299 <br />ST. PAUL, MN SS103 -2044 TOLL FREE: (800) 925 -1122 WEB:WWW.LMC.ORG <br />