Okaloosa County BOCC — November 16, 2013 — Sensus COI — reading text

— ® DATE (MMI/DD/YYYY) ACCORD CERTIFICATE OF LIABILITY INSURANCE. .,,..,.5:3| 13/201 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 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 certificate holder in lieu of such endorsement(s). PRODUCER Lockton Companies, LLC-1 Kansas City CONTACT 444 W. 47th Street, Suite 900 PHONE FAX Kansas City MO 641 12-1906 AeA ale, not (816) 960-9000 ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURER A: First Specialty Ins Corp.(Swiss Re) INSURED SENSUS USA, INC. INSURER B : Travelers Property Casualty Co of America 25674 1052642 9601 SIX FORKS ROAD, SUITE 700 isureR c. The Phoenix Insurance Co(Travelers) RALEIGH NC 27615 INSURER D- INSURER E : INSURER F : COVERAGES _SENME01 CERTIFICATE NUMBER: 11399933 REVISION NUMBER: XXXXXXX 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. ADDLISUBR ie TYPE OF INSURANCE INSR| wvD POLICY NUMBER (aDBIVYYY) CAM/DDIVYYY) LIMITS A [GENERAL LIABILITY Y | N | IRG97533 12/17/2012 | 12/17/2013 | EACH OCCURRENCE. $_1,000,000 X_| COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) |$ 500,000 | CLAIMS-MADE Ix loccur MED EXP (Any one person) | $ 5,000 |X | EBL $1MILL/$1000 DED PERSONAL & ADVINJURY |$ 1,000,000 = GENERAL AGGREGATE $ 2.000.000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG | $ 2.000.000 X | POLICY [ | FRO: [| LOC $ B_ | AUTOMOBILE LIABILITY N | N | TC2ICAPI313458ATIL12 12/17/2012 | 12/17/2013 | GOMBRED SINGLET Ty T O00.000 | ALL OWNED | | AUTOS BODILY INJURY (Per accident)| $ XX KX XXX |X | HiRepautos |X| autos | PROPERTY DAMAGE § XXXXXXX $ XXXXXXX UMBRELLALIAB =| | occuR NOT APPLICABLE EACH OCCURRENCE $ XXXXXXX EXCESS LIAB CLAIMS-MADE AGGREGATE $ XXXXXXX DED | RETENTION $ $ XXXXXXX WORKERS COMPENSATION WC STATU- OTH- C AND EMPLOYERS’ LIABILITY IN N TC2NUBI131J453012 AOS) 12/17/2012 12/17/2013 x |toRY LIMIT: | ER B | aNy PROPRIETORIPARTNERIEXECUTIVE [~ TRJUB131J457812(AZ,MA,WI) | 12/17/2012 | 12/17/2013 TET EACH ACCIDENT $ 1.000.000 OFFICER/MEMBER EXCLUDED? NIA — sae (Mandatory in NH) E.L. DISEASE - EAEMPLOYEE! $ 1.000.000 If yes, describe under 2 Z DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | $_ 1.000.000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space is required) RE: THE CERTIFICATE HOLDER IS ADDITIONAL INSURED WITH RESPECT TO THE GENERAL LIABILITY COVERAGE, ONLY AS REQUIRED BY WRITTEN CONTRACT, SUBJECT TO THE TERMS AND CONDITIONS OF THE POLICY. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 11 399933 AUTHORIZED REPRESENTATIVE OKALOOSA COUNTY, PURCHASING DEPARTMENT ATTN: MARK GRIFFIN 1804 LEWIS TURNER BLVD. FORT WALTON BEACH FL 32541 Gori | ostr