Text · page 39 of 201
Read the whole document on one page (all 201 pages, each with its own heading)
Excess Workers Compensation Quotation Sheet Insurer: Midwest Employers Casualty Company Policy Effective Date: 02/01/2026 Insured: Town of West Seneca Quote Date: 11/07/2025 Policy #: EWC010091 Quote Expiration Date: 60 Days QUOTE OPTIONS POLICY TERMS 0259041 0259144 Named States NY NY SPECIFIC: Specific Limit STATUTORY STATUTORY Specific Retention $1,250,000 $1,250,000 EMPLOYERS LIABILITY: Employers Liability Limit $1,000,000 $1,000,000 Employers Liability Retention See Specific See Specific AGGREGATE: Aggregate Limit NA NA Aggregate Retention NA NA Estimated Aggregate Retention NA NA Minimum Aggregate Retention NA NA RATING BASE: Est. Annual Payroll $20,650,972 $20,650,972 Est. Annual Manual Premium $667,977 $667,977 Length of Policy (Years) 1.000000 2.000000 Est. Policy Normal Premium $667,977 $1,335,954 Rate per $100 of Payroll 0.7228 0.7228 PREMIUM: Total Est Policy Prd Premium $149,265 $298,530 (including Flat Charges) Policy Minimum Premium $134,339 $268,677 Deposit Premium $149,265 $149,265 Deposit Flat Charge(s) NA NA Total Deposit Due $149,265 $149,265 Terrorism Risk Ins Act of 2002 $4,478 $4,478 (incl in Total Deposit Due above) CONDITIONS / COMMENTS: * MECC must be notified of any aircraft changes occurring during the policy period. Page 1 of 1 Date Printed: 11/07/2025 Page 39 of 201