Okaloosa County BOCC — March 1, 2016 — NetworkCablingWorker Comp Insurance for Okaloosa County — reading text

Client#: 1009924 ACORD. CERTIFICATE OF LIABILITY INSURANCE NETWOCAB DATE (MM/DD/YYYY) 2/18/2016 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 USI Insurance Sves LLC, CL Deerwood North Building 300 CONTACT Michelle O'Steen PHONE ). 904-450-4716 [TA% noy: 8T7-775-0285 AL ss: Michelle.Osteen@usi.biz 4601 Toutfhton Rd, Suite 3210 INSURER(S) AFFORDING COVERAGE NAIC # Jacksonville, FL 32246 INSURER A : Bridgefield Employers Insurance 10701 INSURED : Network Cabling Services, Inc. :::3::::: 365 College Drive Ste 101 T Middleburg, FL 32068 INSURERE : INSURERF : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR ADDL]SUBR| POLICY EFF_| POLICY EXP LTR| TYPE OF INSURANCE W POLICY NUMBER (MM/DD/YYYY) |(MM/DDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY ‘ EACH OCCURRENCE s AGE TO RENTED J CLAIMS-MADE D OCCUR BRM R I T Rnce) | MED EXP (Any one person) $ PERSONAL & ADV INJURY | § GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY D JECT D Loc PRODUCTS - COMP/OP AGG | § OTHER: $ AUTOMOBILE LIABILITY Efigmfigfismem LIMIT $ | | ANYAUTO BODILY INJURY (Per person) | $ | ALL OWNED SCHEDULED i AUTOS RiTiGE BODILY INJURY (Per accident) | $ | NON-OWNED PROPERTY DAMAGE s HIRED AUTOS AUTOS (Per accident) $ | | UMBRELLALIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ | DED l 1 RETENTION $ $ WORKERS COMPENSATION PER OTH- A | NORIERS OO, L 83030808 12/23/2015(12/23/2016 x_[§5Rure | (o7 L ANY PROPRIETOR/PARTNER/EXECUTIVE i AN BB TR P ARTNE R ECUTVE 1 N Blkt Waiver Subro | E.L. EACH ACCIDENT $1,000,00 (Mandatory in NH) = E.L. DISEASE - EA EMPLOYEE| $1,000,000 If yes, describe under | DESCRIPTION OF OPERATIONS below E.L DISEASE - PoLICY LimiT | 31,000,000 Low Voltage Electrical Contractor DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION Okaloosa County Information SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Systems ACCORDANCE WITH THE POLICY PROVISIONS. 1804 Lews Turner Bivd. suite 402 AUTHORIZED REPRESENTATIVE Fort Walton Beach, FL . . | 32547-0000 GuarTlo_. B sleleA— ACORD 25 (2014/01) 1 of 1 #S16830094/M16829330 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MBDEQ Client#: 1009924 NETWOCAB DATE (MM/DD/YYYY) ACORD. CERTIFICATE OF LIABILITY INSURANCE 211812016 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 SSNEACT Michelle O'Steen USI Insurance Svecs LLC, CL THoNE 904-450-4716 AIC, No, Ext): | {AIS, Noy: 877-775-0285 Deerwood North Building 300 ENAL <. Michelle.Osteen@usi.biz 4601 Touc.hton Rd, su“e 321 0 INSURER(S) AFFORDING COVERAGE NAIC # Jacksonville, FL 32246 INsURER A : Bridgefield Employers Insurance 10701 INSURED . Network Cabling Services, Inc. :::z:::z: 365 College Drive Ste 101 = : INSURER D : Middleburg, FL 32068 e INSURERE : INSURER F : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: 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. INSR LTR POLICY EFF | POLICY EXP ADDI _ TYPE OF INSURANCE msnL %%R POLICY NUMBER (MM/DD/YYYY) |(MM/DD/YYYY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED l CLAIMS-MADE D OCCUR PREMISES (Ea occurrence) $ MED EXP (Any one person) $ i} PERSONAL & ADV INJURY | $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ PRO- POLICY D JECT D Loc PRODUCTS - COMP/OP AGG | § OTHER: $ AUTOMOBILE LIABILITY &g”flmifios"‘em LiMIT s ANY AUTO BODILY INJURY (Per person) | $ ALL OWNED SCHEDULED ; | AUTOS AUTOS BODILY INJURY (Per accident) | $ — NON-OWNED PROPERTY DAMAGE s HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED l [ RETENTION $ $ WORKERS COMPENSATION PER OTH- A [WOREERCOMEATON - 83030808 12/23/2015(12/23/2016 x [SRure | |38 o ANY PROPRIETOR/PARTNER/EXECUTIVE i e Y PROPRIETORIPARTNER/EXECU A Blkt Waiver Subro E.L. EACH ACCIDENT $1,000, (Manda!ory in NH) E L. DISEASE - EA EMPLOYEE| $1,000,000 If yes, describe un DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LiMIT | $1,000,000 | DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Low Voltage Electrical Contractor CERTIFICATE HOLDER CANCELLATION Okaloosa County 602-C North Pearl Street Crestview, FL 32536-0000 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Gurilo_ B oleleAe ACORD 25 (2014/01) 1 of 1 #516830093/M16829330 © 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD MBDEQ