PROPERTY PROGRAM APPLICATION

Transcription

1 PROPERTY PROGRAM APPLICATION Agency Name: Contra Costa Water District Mailing Address: 1331 Concord Ave., Concord, CA Agency Contact: Sonja Stanchina or Michelle Hulsey Website: Phone Number: or Please select a deductible for each category of covered property: I. BUILDINGS, PERSONAL PROPERTY, AND FIXED EQUIPMENT II. MOBILE EQUIPMENT III. LICENSED VEHICLES Selection ü Premium Discount Percentage $1,000 0% $2,500 10% $5,000 15% $10,000 20% $25,000 X 25% Selection ü Premium Discount Percentage $1,000 0% $2,500 10% $5,000 15% $10,000 25% $25,000 X 35% Selection ü Premium Discount Percentage $500 0% $1,000 10% $2,500 20% $5,000 35% $10,000 X 45%

2 $25,000 60%

3 Buildings, Fixed Equipment, and Personal Property Report all values at "Replacement Cost." Buildings - includes buildings and treatment structures. Fixed Equipment - includes pumps, permanently installed machinery and equipment, and telemetry. Personal Property - includes office furniture & equipment, data processing equipment, supplies and tools. Building Class A Fireproof structural steel frame with reinforced concrete or masonry floor and roof B Reinforced concrete frame and conrete or masonry floor and roof C Masonry or concrete exterior walls, and wood or steel roof D Wood frame, floor, and roof structure S Frame, roof and walls made of incombustible metal

4 Buildings, Fixed Equipment, and Personal Property (continued)

5 Mobile Equipment Report all values at "Actual Cash Value." List each item valued $10,000 or greater. Small items may be lumped together and reported under miscellaneous equipment with an aggregate value. Mobile Equipment - includes backhoes, tractors, loaders, and any unlicensed wheeled machinery, including their attachments. Do not include items which are licensed for road use, including trailers. Actual Description Serial Number Cash Value MISCELLANEOUS EQUIPMENT TOTAL

6

7 Licensed Vehicles (Comprehensive/Collision Coverage)

8 SOURCE OF OPERATING REVENUE For current budget year ending: _06_/_30_/_18 Sale of Water: Meter Installation Fees Sewer Service Charges Sewer Connection Fees Sale of Electricity Stand-by Charges Property Taxes Assessments Rents, License Fees, Admission Fees Investment Income Grant Income Other (Please describe) $_114,495,000 $_8,000 $ $ $ $ $_3,700,000 $ $_1,600,000 $_2,200,000 $_1,310,000 $_5,557,000 Facility Reserve Charges (Water Connection Fees) $5,400,000 Partner reimbursements for operating expenses

9 Boiler & Machinery Specific to pump stations, treatment plants and hydroelectric facilities, describe type of maintenance program currently in place? Preventative and reactive maintenance is performed. The maintenance is tracked in a computerized maintenance management system. Who performs electrical maintenance? Trained District Staff and contractors support on pump/motor rebuilds. Are records maintained? Are there any pressure vessels (e.g. air tanks, boilers)? If yes, do they have current permits? Are there any hydroelectric facilities with a generating capacity 1,000 KW? YES o NO Xo If yes, please provide the following information for each facility (attach separate sheet if necessary): Age: Manufacturer: Installed Capacity (kw): Age: Manufacturer: Installed Capacity (kw): Are replacement parts readily available in the U.S.? Are shutdown procedures in place and followed? Please indicate location and KVA rating of all transformers over 20,000 KVA: 1)Mallard Pump Station 30KV 2)San Miguel Res. & Pump Station 25KV 3)District Center 112/75KV 4) O&M Building 150 KV 5) Engineering Building 150KV 6)Stores Building 75VK 7)Bollman Treatment Plant has 12 transformers over 20,000KV Describe any other electrical power generation facilities (do not include emergency/standby generators): The District owns a 53kW ground-mount solar array, a Hydro generator for energy recovery at our reservoir, and a 900kv Turbine Is electrical power sold on a contract basis and/or is there a power purchase agreement in effect? _No To whom is power sold? Is electrical power sold on a retail basis? YES o NO Xo If yes, how many customers? What is approximate breakdown of retail electric power customer base? Residential % Industrial % Commercial % Agricultural %

10 Public Employee Dishonesty Are bank accounts reconciled by someone not authorized to deposit or withdraw? Is countersignature of checks required? If not, who signs? Are securities subject to joint control of two or more responsible employees? Is there an independent audit by a CPA, public accountant or equivalent? If yes, please provide copy of most recent audit, and auditor s comments, if any. Please indicate number of: Elected or appointed directors 5 Full-time employees 284 Part-time employees 1 Seasonal employees (average) 10 Prior Carrier Information Has any prior coverage been cancelled, declined, or non-renewed? YES o NO Xo If yes, provide a brief explanation: _Current carrier name: Special District Risk Management Authority (SDRMA) _Current annual premium: $515, Supporting Documentation Attach loss history reports for the past five years. Reports must have current as of dates and must include paid amounts and reserve amounts. Attach a complete copy of current property, boiler & machinery, and crime insurance policies. Certification is hereby given that the information contained herein is complete and accurate. Michelle Hulsey Authorized Signature Risk Management Officer Title Date