Okaloosa County BOCC — December 2, 2014 — Ludwig Sub Lease Rigdon 11-18-14 — reading text

M.C. Davis 2006 Trust dated March 15, 2006, who Is personally known to me, or presented as Identification. NOTARY PUBLIC” | TYPED, PRINTED OR STAMPED NAME OF NOTARY MY COMMISSION EXPIRES: Prolaws1 43804 , 2 —— eee emer eee ee ee cee re ee ee me ee aeee sete | a NESS WHEREOF, the parties have executed this Memorandum onthe ____ day of July, ' LANDLORD: Wineas #1 (print name bel LUDWIG LAW FIRM, PLG, an Arkansas reso # (pint nae below ’ professional Ilmited lability company ; By: Witness #2 (print name below) ~ Gone A, Ludwig, as Manager TENANT: ' t\ . + ~ Cena ‘a name BeIOW) | Ve $5 Mf Ay» . ‘pes KN M.C, Davis, as Trustee of the M.C, Davis ess #2 (print namp bala 2006 Trust dated March 16, 2006 one we. Blughes STATE OF COUNTY OF The foregoing was acknowledged before me thle day of July, 2008, by Gene A. Ludwig, as Manager of LUDWIG LAW FIRM, PLC, an | Arkansas professional Umited lability ‘sompany and who Is personally known to me, or ‘presented as identification, 4 ‘ [ dees a wo, 7 _ \ "NOTARY FOBLIC _ TYPED, PRINTED CR STAMPED NAME OF NOTARY MY GOMMISSION EXPIRES: STATE OF FLORID, COUNTY OF a Alenat The foregoing was acknowledged before me this PG day of July, 2008, by M.C, Davis, as Trustee of the M,C, Davis 2008 Trust dated March 16, 2006, who Is personally known to me, or presented as Identification, pomaeresmareas Qed inv Sean one Lf en re cetar2008. NOT PURLIC ‘ ZF Bonded tu (600 MSR4264E TT B PRINTED OR STAMPED laxen OF pee AN ona eaniaan aosrs leet MY COMMISSION EXPIRES: 9-14-O8 Prolaw:145904 2 Lt me ee nen ee a rte a SE ag mn SR re CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number: A (4 dy ~ A Tracking Number: f/ )9~) > Grant Funded: YES. «NO _L¥ Contractor/Lessee Name: loAws & hus bie prong X Purpose Sub lec ae Pips in, + bette f Wy, Deve. 4 “ _R: ches - Feteniley jee Date/Term: 8 - /e-.B 1. LJ] GREATER THAN $50,000 ; li [| Amount: Mf 2, GREATER THAN $25,000 Department:__A{” 3. L] $25,000 or Less N Dept. Monitor Namez_! Vournetien| FV ORO Document has been reviewed and includes any attachments or exhibits. ae. Purchasing Review oo we Procurement requirements are met” i _ oS {a} tf Date: } O° l. ” ly Purchasing Dirdctor 6 * at Joanne Kublik Risk Management Review {| Ap roved as writ : y Kies eC Dek Bey nate: (O- 7-14 RiskIM anager or designee — Kay Godwin or Krystal King \ County Attorney Review —— a q (xy | WAS Date: | Q “1% Cpunty shone ~ ST Gregory T, Stewart or Lynn Hoshihara Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager © ACCORD nee CERTIFICATE OF AIRCRAFT INSURANCE DATE (MM/DDIYYYY) 11/18/2014 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED certificate holder in lieu of such endorsement(s). IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the PRODUCER Bramar Associates 2135 Golden Hill Road CONTACT NAME: {A‘e, No): 805.237.0690 PHONE Ext: 805.237.0666 “MAIL Paso Robles, CA 93446-2285 ADDRESS: | CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE % NAIC # INSURED INSURERA;: StarNet Insurance Company 100} 40045 Rigdon Family Living Trust Hangar INSURER B : dba Rebel Services, LLC 4502 Olde Plantation Place INSURER C : Destin FL 32541 INSURER D: INSURERE: INSURER F : THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICY INFORMATION CERTIFICATE NUMBER: 22396553 REVISION NUMBER: POLICY TYPE LINE OF BUSINESS SUBCODE INDUSTRIAL AID | / | PLEASURE & BUS COMMERCIAL | | AIRPLANE HELICOPTER MIXED FLEET EXCESS QUOTA SHARE NON-OWNED LIABILITY ONLY Y | HULL & LIABILITY HULL ONLY AIRCRAFT INFORMATION YEAR | MAKE MODEL SERIAL NUMBER REGISTRATION NUMBER SEE A/C SCHED TERRITORY: USA, Canada, Mexico, Bahamas Islands, Caribbean Islands and points flown within. AIRCRAFT COVERAGES EXPIRATION DATE ADDITIONAL INSURED? (Y / N) SUBROGATION WAIVED? (Y/N) INSURER LETTER | POLICY NUMBER EFFECTIVE DATE BA-13-12-00092 12/14/2014 12/14/2015 Y N COVERAGE OPTIONS LIMIT APPLIES TO LIMIT APPLIES TO AIRCRAFT HULL Ly | : SEE A/C SCHED $ AIRCRAFT LIABILITY =a L— $ SEE AIC SCHED EAOCC $ EAPER $ EA PASS $ AGGR MEDICAL PAYMENTS |v | INCLUDING CREW $ 5,000 | EAPER EXCLUDING CREW ' COVERAGE CODE DESCRIPTION OPTIONS LIMIT APPLIES TO LIMIT APPLIES TO | | | | $ $ $ $ |_| | | $ $ $ $ | | |_| $ $ $ $ DESCRIPTION OF OPERATIONS / REMARKS (Attach ACORD 101, Additional Remarks Schedule, if more space is required) --See Attached Remarks Schedule-- CERTIFICATE HOLDER CANCELLATION Okaloosa County 602 — C North Pearl Street Crestview FL 32536 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Tony Park AUTHORIZED REPRESENTATIVE ACORD 21 (2009/12) CERT NO,: 22396553 Natalie Strahl 11/18/2014 2:30:29 PM (PST) Page 1 of 3 © 2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE ISSUED CERTIFICATE OF INSURANCE 11/18/2014 ADDENDUM (Schedule of Aircraft) CERTIFICATE HOLDER: NAMED INSURED: Rigdon Family Living Trust Hangar Okaloosa County dba Rebel! Services, LLC 602 — C North Peart Street 4502 Olde Plantation Place Crestview FL 32536 Destin FL 32541 This is to certify that the following policy(s), subject to the terms, conditions, limitations and endorsements contained therein, and during their effective period, have been issued by the company(s) indicated below. In the event of material change or cancellation of said policy(s), the company will endeavor to notify the certificate holder, but failure to do so shall impose no liability or obligation of any kind upon the undersigned or the company(s) involved. N Number Year Make Model Serial No. Crew Pax Hull Value Liability Limit 1 7 $795,000.00 $10,000,000.00 N717TR 1982 Cessna 550 Bramar Associates 2135 Golden Hill Road Paso Robles, CA 93446-2285 805.237.0666 805.237.0690 AVIATION ADDENDUM (Schedule of Aircraft) CERT NO.: 22396553 Natalie Strahl 11/18/2014 2:30:29 PM (PST) Page 2 of 3 AGENCY CUSTOMER ID: LOC #: ¥ mC) ACCORD ADDITIONAL REMARKS SCHEDULE Page of AGENCY NAMED INSURED Berkley Aviation (A Berkley Company) dba Rebel Services, LL Hangar POLICY NUMBER p08 de agntation ace CARRIER NAIC CODE EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 21 FORM TITLE: ACORD 21 ((12/09)) CERTIFICATE HOLDER: Okaloosa County ADDRESS: 602 ~-C North Pearl Street Crestview FL 32536 Additional Insured Provision: Scheduled Person or Organization: It is agreed that the Certificate Holder is included as an Additional Insured under Aircraft Liability Coverages, but only to the extent of liability imposed upon the Additional Insured solely as the result of an act or omission of the Named Insured or its employees in connection with the Named Insured’s Aircraft operations, subject to all policy terms, limits, conditions and exclusions. The Company's rights of recourse: This Certificate does not provide coverage for the Additional Insured with respect to claims arising out of their legal liability as manufacturers, repairers, modification, suppliers or servicing agents and shall not operate to prejudice the Company's rights of recourse against the Additional Insured as manufactures, repairers, modification, suppliers or servicing agents where such rights of recourse would have existed had this Certificate not been affected under this policy. Notice of Cancellation Provision: 30 day's (10 day's for non-payment of premium) prior written notice to the Certificate Holder in the event of material change in the policy or in the event the policy is cancelled by the Company. Notwithstanding any requirements, terms or conditions of any contract or other document with respect to which the Certificate may be issued or may pertain, the Insurance afforded by the policy(ies) described herein is subject to all the terms, conditions, limits and exclusions of such policy. The Company has made the provision to give the Certificate Holder prompt notice of cancellation of any policy above. But, the Company assumes no responsibility for failure to provide such notice. This Certificate does not change in any way the actual coverages provided by the policy(ies) specified above. . ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ADDENDUM/DOCO CERT NO.: 22396553 Natalie Strahl 11/18/2014 2:30:29 PM (PST) Page 3 of 3 — ® ACCORD Ne CERTIFICATE OF AIRCRAFT INSURANCE DATE (MM/DDIYYYY) 11/18/2014 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED the terms and conditions of the policy, certain policies may require an certificate holder in lieu of such endorsement(s). IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to endorsement. A statement on this certificate does not confer rights to the PRODUCER noneect i FAX Bramar Associates d fale No Ext): 805.237.0866 (Ae, No}: 805.237.0690 Paso Robles, CA 93446-2285 ADDRESS: PRODUCER | CUSTOMER ID #: INSURER(S) AFFORDING COVERAGE % NAIC # INSURED INSURER A: StarNet Insurance Company 100) 40045 Rigdon Family Living Trust Hangar INSURER B: dba Rebel Services, LLC 4502 Olde Plantation Place INSURER ¢ : Destin FL 32541 INSURER D : INSURER E; INSURER F : INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR COND THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE ITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, POLICY INFORMATION CERTIFICATE NUMBER: 22396554 REVISION NUMBER: POLICY TYPE LINE OF BUSINESS SUBCODE SEE A/C SCHED INDUSTRIAL AID | 7 | PLEASURE & BUS COMMERCIAL | _// | AIRPLANE HELICOPTER MIXED FLEET EXCESS QUOTA SHARE NON-OWNED LIABILITY ONLY Y | HULL & LIABILITY HULL ONLY AIRCRAFT INFORMATION YEAR | MAKE MODEL SERIAL NUMBER REGISTRATION NUMBER TERRITORY: USA, Canada, Mexico, Bahamas islands, Caribbean Islands and points flown withi n. AIRCRAFT COVERAGES INSURER LETTER | POLICY NUMBER EFFECTIVE DATE | EXPIRATION DATE | ADDITIONAL INSURED? (Y/N) | SUBROGATION WAIVED? (Y/N) BA-13-12-00092 12/14/2014 12/14/2015 Y N COVERAGE OPTIONS LIMIT APPLIES TO ‘| LIMIT APPLIES TO AIRCRAFT HULL Lv | [— $ SEE A/C SCHED $ $ AIRCRAFT LIABILITY Lv | L-— $ SEE AIC SCHED EA OCC $