Okaloosa County BOCC — July 2, 2013 — Assignment of Lease for Storage Space - Rankin — reading text

logo are registered marks of ACORD © 2008 ACORD CORPORATION. All rights reserved. bealia Riakin 7/12/2013 12:24:10 PM Page 3 of 3 ADDENDUM/DOO StarNet Insurance Company This endorsement changes the policy please review carefully ADDITIONAL INSURED ENDORSEMENT — AIRCRAFT LIABILITY It is hereby understood and agreed that the policy is amended as follows: The following is included as an Additional Insured under Aircraft Liability coverages, but only with respect to the operations of the Named Insured. Schedule: Okaloosa County Airports 602-C N. Pear! Street Crestview, FL 32536 All other terms and conditions remain unchanged. This endorsement is part of your Policy and takes effect on the effective date of your Policy, unless another effective date is shown below. Date Issued: July 12, 2013 Policy Number: BA-12-09-00139 Issued To: Emerald Coast Aero, LLC Effective Date: July 12, 2013 Endorsement No.: 15 eg ae Authorized Signature AL 74 246 04 10 © 2010 StarNet Insurance Company Page 1 of 1 Includes material copyrighted by Insurance Services Office, Inc., with its permission CONTRACT & LEASE INTERNAL COORDINATION SHEET & ~I€-13 Contraci/Lease Number_4 /0- OF 67-44, P Tracking Number 65073 Contractor/Lessee Name: _[Revis_ mM, Renkin Grant Funded: YES... NO_“S purpose: AOL (Stereye Space) to Eyer elf Corsh Arvo, bt Date/ferm: _/~/4= 7% 1, LD GREATER THAN $50,000 Amount: @ 592 .SD_anmretly ples tex 2. [1] GREATER THAN $25,000 Department: Beports 3, BX] $25,000 OR LESS Dept. Monitor Name: dey if Ml ne ye Document has been reviewed and includes any attachments or exhibits, Purchasing Review osu: SLB are met: awa : Za Date: é (ath 5 PurCheging Director or designee Risk Management Review Date: O) f County Afforney Review soiela 6 13 Following Okaloosa County approval: Contract & Grant Document has been received: Date: Contracts & Grants Manager