Okaloosa County BOCC — July 15, 2014 — Change Order #1 - Building & Elevator Funding — reading text

Waldorf insurance and Bonding Device Model: MX-4111N Location: Not Set File Format: POF MMR(G4) Resolution: 200dpi x 200dpi Attached file is scanned image in PDF format. Use Acrobat(R}Reader(R) or Adobe(R)Reader(R) of Adobe Systems Incorporated to view the document. Adobe({R}Reader(R} can be downloaded from the following URL: Adobe, the Adobe logo, Acrobat, the Adobe PDF logo, and Reader are registered trademarks or trademarks of Adobe Systems Incorporated in the United States and other countries. http://www.adobe.com/ Zurich Programs @ Builders Risk and Installation ZURICH Quote Proposal Premium Summary Prepared For tord a Son Construction Ine. PO Box 1808 Fort Walton Beach, FL 92549 Presented By wALDORFF INSURANCE & BONDING, INC. 45 EGLIN PKWY NE STE 202 FORT WALTON BEACH, FL 32548-4955 +1 850 581 4925 Proposed Policy Perlod From 07/1/2014 To 07/01/2015 {12:01 a.m, Standard Time at your address as stated herein) Coverage and premium infonmation meter «| Type of coverage Total Premium (all locations)* ee any of P ‘ coveranes, Builders Risk $6,371.00 senditions, exclusions or provisions: contained in the policy. Proposed Policy Premium* $6,371.00 State Taxes & Surcharges ‘ $91.74 |< Total Proposed Policy Premium* $6,462.74 * Premium quotation valid for 30 days from the date on the first page of this proposal. Policy is fully samed See attached Disclosure of Terrorism Premium. ‘This is a propesel for Insurances. itis not en Inaurance policy. Only the pollcy itself provides coverage. The coverages offered in this proposal are based on information received through the agent and may not Include all avaliable coverages, The cllent and their agent ahould discuss any addiloral or aptional coverages needed. Coverage descriptions are abbreviated and do not Indicate In force coverage. This proposal Is not a part of and Is not Incorporated Into the Insurance policy, If thera Is any confilcl botween the coverage deacdpilone shown In this proposal and the eclval insurance policy, ihe Inaurance policy prevails. The Insuranca policy supercedes this proposal. “if you want to lear more about the compensation Zurich pays agents and brokare vist: hitpivaww.zurichnaproducercompensation.com or call the following toll frea number. (896) 903-1192. Thig Notice of Disclosure Is provided on behalf of Zurich Amarican Inaurante Company and its underwelting subsidiaries.” Dute Generated: 07/01/2014 3:18:42 PM Page 3 of 6 Zurich Programs @ Builders Risk and Installation ZURICH posed Total Linnts | Covaragé Limit al Any One Bullding or Structure 35,000 $4,960,000 All Covered Properly at all Locations $5,000 $1,350,000 Additional Coverages: Back-up or Overflow of Sewer, Oreine or Sumps None $5,000 Debris Removal None $20,000 Fire Department Service Charge None $19,000 ‘Ordinance or few 95,000 $4,000,000 Loss fo the undamaged portion of the bullding $5,000 included Demoiltion cost $5,000 $4,000,000 increaged cost of construction $5,000 $4,000,000 Pollutant Gean-Up and Removal Nore 315,000 Rewards None $10,000 Re-erection of Scaffolding None $10,000 Scaffalding, Construction Forms and Temporary Structures None $20,000 Property at a Temporary Storage Location $5,000 $33,750 Property In Transit $6,000 $67,500 Vaiueble Papers and Records None $20,000 Coverage. i a pee Se Rr Totelimitss Profit ifincluded Contract Change Order Coverage $5,000 $135,000 This le a proposal for insurance. itls not an Insurance policy. Only the policy Itself provides coverage. The coverages offered In this proposal are based on Information received through the agent and may no Include all available coverages. The client and their agent should discuss eny additional or optional coverages nesdad, Coverage daserlpilons are abbreviated and do not Indicate In foree coverage, This proposal la not 2 part of and Is noi incorporated Into the Insurance pollcy. If there Is any confilcl between the coverage descriptions shown in tts proposel and the actual insurarice policy, the Insurance policy prevalis, The insurance policy auparcedes this proposal. "if you want to [sarn more about the compensation Zusich pays agents and brokers visit hifpvAwww.zurichnaproduicarcompansation.com of call the following {oll fras number: (865) 903-1182. This Nollee of Disclosure is provided on behalf-of Zurich American inaurence Company end fis underemiling subsidiaries,” Date Generated: 07/01/2014 3:18:42 PM Page 4 of 8 Zurich Programs Z) Builders Risk and Installation ZURICH Special Condit Named storm deductible Pioposed (otal Simitss 3% Quote Proposal 24-hour Claim Service Our claim representatives understand businesses like yours and recognize how difficult a business shutdown can be for you. So, while they provide service that's fast, responsive and fair, thelr ultimate goal is to minimize your business disruption and get you back to full operation as promptly as possible, tn the event you have a loss, we now offer online loss reporting with immediate acknowledgement. Your claim is assigned to a Jocal claim office, usually within two hours of reporting the loss, but generally no longer than 24 hours. You can also call us toll-free at 1-888- 279-9375. This is a proposal for Insurance. Itis not an Insurance poiley. Only the pollcy itself provides coverage. The coverages offered in Its proposal ara based on Information received through the egant and may not inciude all available coverages. The client and their agent should discuss any sdditional or optional coverages needed. Coverage deacripiione are abbreviated and do nal indicate In foros covarage. This proposal ls not a part of and Is not Incorporated Into the Insurance policy. If thare fs any confiict between the coverage descripliens shown In this proposal and the aciual insurance polley, the insurance pollgy prevails. The insurance policy supercedes this propossl, “Hf you want to laam more about the compensation Zurich pays agents and brokers visit: hitovAnww.zurichnaproducsrcompensation.cem or call the foliawing loli (ree number: (866) 803-1182. This Notice of Disclosure is provided on behalf of Zurich American Inaurance Company and its underwriting subsidiaries.” Oata Generated: 07/01/2014 3:19:42 PM Page & of 6 Zurich Programs @ Builders Risk and Installation ZURICH Quote Proposal GING end eee Named insured: Lord & Son Construction Inc. Agency Name: WALDORFF INSURANCE & BONDING, INC. Cusiomer ob hatortation Location Addreas: Protection Class: 4 50 2nd Strest Gonstruction: Non-Combustible Shalimar, FL 32579 # of Stories: 2 Primary occupancy: Other Additonal interest ‘This is & proposal for Ineurance. it Is not ani Inaurance policy. Only the policy itself provides coverage. The coverages offered in this proposal ara based on Information received through the agent and may not Include all avatlable coverages. ‘The client and thelr agent should discuss any additional or optional coverages needed. Coverage descriptions are abbreviated and do not indicals In force coverage. This proposal Is not a perl of and le not incorporated Into the Insurance pollcy. If there Is any conflict between the coverage descriptions shown In this proposal and the actual Insurance policy, the Insurance policy prevalis. Tha Insurance policy supercedes thls proposal, “tf you want to lea more about the compensation Zurich pays agents and broker: visit hitp:fivww.zurichnaproducersompensation.com or call the following toll frea number, (866) 903-1192, This Notica of Disclosure ie provided on behalf of Zurich American Insurance Company and ite underwriting subsidiaries.” Date Generated: 07/01/2014 3:18:42 PM Page Sof G Zurich Programs @ Builders Risk and Installation ZURICH Our Builders Risk Pian offers world-class coverages, flexibility and service fo agents and bullders nationwide. For more than 30 years, we've been pioneering the development of insurance solutions for construction professionals and have protected the property interests of builders and developers on aven the most Intricate residential and commercial construction projects. The Builders Risk product offers a wide spectrum of property coverage. Here are few highlights of the coverage offered: Construction Forms, Scaffolding and Ternporary Structures up to $20,006 Re-erection of scaffolding if caused by or results from a covered cause of loss up to $10,000 Valuable Papers and Records — Coat of Research up t6 $20,006 Outdoor Tress, Shrubs, Plants and Lawns Additional Debris Ramoval expense Is covered up to but nat exceading $20,000 Coverage for Pollutant Clean-up and Removal of land and water for up to $18,000 for each 12 manth petiod of the policy. Fire Department Service Charge up to $10,000 Reward up to $10,000 Walver of Coinsurancs clause if loss is less than or equal to $25,000 Foundations Our valuation can Include profit up to 20% for new structures only if included fn the Limit of Insurance you selected Broad Collapse coverage Back-up or overflow of sewers, drains or surmps up to $6,000 Paving, Curbing, Fences and Outdoor Fixtures Ordinance or Law demolition and increased cost Coverage up to $1,000,000 limit for construction of new structures only Inadvertent omission in reporting on @ monthly reporting form policy Model Homes and Model Home Contents coverage can be added on a reporting form policy eeeen eeoee @ ee Strong, reflable insurance protection Is available from Zurich Programs. Zurich Programs is an integral part of Zurich North America. Zurich Financial Services (www.zurich.com) is an insurance-based financial services provider with a global network that focuses its activities on its key markets In North America and Europe. Founded in 1872, Zurich is headquartered in Zurich, Switzerland. Through Its offices in more than 50 countries, 57,000 Zurich employees serve clients in more than 120 countries. In North America, Zurich (www.zurichna.com) is a leading commercial property-casualty insurance provider serving the global corporate, large corporate, middle market, specialties and programs sectors. This is 2 proposal for Insurance. it is not an insurance policy. Only the policy tlself provides covetaga. The coverages offered In this proposal are based on information received through the agent and may not Include all avaliable coverages, The client and thelr Bgent should discues any additional or optional coverages nesded, Coveraga descriptions are abbraviated and de not Indicate In force coverage. This proposal fs not a part of and ls not incorporated into the Ineurancs policy. If there Is any contlict between the coverage deecriptlone shown inthis proposal and the actual insurance policy, tie Insurancs policy prevalls. The Inaurance poticy supersedes this proposal. . “If you went to learn more about the compensation Zurich pays agents and brokers visit: hitpdAwwew.zurichnaproducercompensation.cont or call the following toll ree number: {B65} 809-1192. This Notice of Disclosure is provided on behall cf Zurich Amaricun insurance Company and lis underwilling subsidiaries." Data Generated: 07/01/2044 3:18:42 PM Page 2 of 6 @ ' ZURICH THIS NOTICE DOES NOT GRANT ANY COVERAGE OR CHANGE THE TERMS AND CONDITIONS OF ANY COVERAGE UNDER THE POLICY. DISCLOSURE OF PREMIUM (RELATING TO DISPOSITION OF TRIA) SCHEDULE Premium atiributable fo risk of loss from a certified act of terrorism through the end of the policy period bused on the extension of the Terrorism Risk Insurance Act of 2002, as amended by the Terrorism Risk Insurance Extension Act of 2005, (TRIA") for lines subject to TRIA and the Terroriem Risk Insurance Program Reauthorization Act of 2007 (TRIPRA): Additional information, ifany, concerning the terrorism premiom: INCLUDED A Disclosure of Preminm In accordance with the federal TRIA, we are required to provide you with a notice disclosing the portion of the premium, if any, attributable to the risk of loss from terrorist acts certified under that Act for lines subject