Okaloosa County BOCC — November 5, 2013 — Atkins Final Payment SWPPP and SPCC Plan Update — reading text

Liiva POLICY NUMBER paminureryyy iamaisneeery) LIMITS A | GENERAL LIABILITY Y | ¥ |CGG740901602 4/1/2013 14/1/2014 | EACHOCCURRENCE $ 1,000,000 X_| COMMERCIAL GENERAL LIABILITY PREMISES (eee nce) $ 300,000 CLAIMS-MADE OCCUR MED EXP (Any one person) $ 10,000 X_| Contractual Liability PERSONAL & ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OPAGG |§ 2,000,000 poucy | x | FBO | x | Loc $ A | AUTOMOBILE LIABILITY Y¥ | ¥ 1CAH740901702 4/1/2013 (4/1/2014 | GOMBINEDSINGLELIMIT = J 2000, 000 X | ANYAUTO BODILY INJURY(Per person) [$ ly | ~ALLOWNED SCHEDULED ; xX AUTOS |__lautos BODILY INJURY(Per accident) [$ ; X | HIREDAUTOS | X |/NON-QWNED ee eye PAMAGE $ $ ! B |X | umprectacias | X | occur Y AUC924234901 14/1/2013 4/1/2014 |EACHOCCURRENCE $ 1,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 1,000,000 peD | x |RETENTIONSzero $ STATU- OTH- WORKERS COMPENSATION Y 1CWG740901502 4/1/2013 {4/1/2014 |x |W A | AND EMPLOYERS’ LIABILITY YIN /1/ // TORY-LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L. EACH ACCIDENT $ 1,000,000 ? (Mandates ie EXCLUDED? E.L. DISEASE-EAEMPLOYEE |§ 1,000,000 lf yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICYLIMIT {$ 1,000,000 C | Professional B080111209P13 4/1/2013 [4/1/2014 | $1,000,000 Each Claim & Liability-Claims Made $1,000,000 Annual Aggregate 11/11/1961 Retrodate DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additonal Remarks Schedule, if more space Is required) Greenwich Insurance Companies Best Rating A XV American Guarantee and Liability Insurance Company Best Rating A+ XV Underwriters at Lloyd’s London AM Best Rating: A XV. Professional Liability policy written on claims-made basis. There are no Deductiblesa or Self-Insured Retentions on the General Liability, Automobile Liability, Workers Compensation and Umbrella coverages. 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. Okaloosa County Board of County Commissioners AUTHORIZED REPRESENTATIVE Attn: Jack Allen, Purchasing Services Manager t 602-C North Pearl Street Crestview, FL 32536 Coll:4047437 Tp1:1610622 Cert:19543353 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: 33004588 LOCc#: is le ACORD Ce ADDITIONAL REMARKS SCHEDULE Page_2 of 2 AGENCY NAMED INSURED Atkins North America, Inc. Willis of New York, Inc. 2001 NW 107th Avenue POLICY NUMBER Miami, FL 33172-2507 See First Page CARRIER NAIC CODE See First Page EFFECTIVEDATE: See First Page ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORMTITLE; CERTIFICATE OF LIABILITY INSURANCE Re: Professional Architectural, Engineering, and Aviation Planning Services (Contract C08-1684-AP3-153) ; Coverage for Independent Contractors is provided under the General Liability policy. Coverage for Contractual Liability is provided under the Auto Liability policy. - Okaloosa County, its respective agents, consultants, servants and employees of each and all other interests as may be reasonably required by Okaloosa_County, Subcontractor, Sub-subcontractor and any associated or subsidiary companies of the Consultant are included as Additional Insureds as respects to General Liability, Auto Liability and Umbrella Liability policies. General Liability and Auto Liability policies shall be Primary and Non-Contributory with any other insurance in force for or which may be purchased by Additional Insureds. Waiver of Subrogation applies in favor of Additional Insureds with respects to General Liability, Auto Liability and Workers Compensation, as permitted by law. ACORD 101 (2008/01) Coll1:4047437 Tpl:1610622 Cert:19543353 ©2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD