Okaloosa County BOCC — December 2, 2014 — Cosgrove Lease Renewal 11-17-14 — reading text

UA00147343-08 * Houston, TX 77040 Prior Policy Number: ITEM) NAMED INSURED AND ADDRESS YOUR AGENT'S NAME AND ADDRESS [] Individual | DEWEY COSGROVE DBA COSCO AVIATION FALCON INS. AGENCY OF DALLAS, INC. 215 E. JAMES LEE BLVD. P.O. BOX 706 [] Partnership CRESTVIEW, FL 32539-2841 ADDISON, TX 75001 or Joint Venture Other POLICY PERIOD: 12:01 a.m. standard time at your above address FROM: 01/11/2014 TO: 04/41/2015 BUSINESS OF NAMED INSURED: AIRCRAFT STORAGE PART OCCUPIED BY NAMED INSURED'S LOCATION OF AIRPORT INSURED BY THIS POLICY NAMED INSURED INTEREST BOB SIKES AIRPORT, CRESTVIEW, FL PORTION TENANT LIMITS OF INSURANCE, COVERAGES AND PREMIUMS: This insurance is only with respect to the following coverage(s) for which a premium charge is shown in the premium column. Absence of a premium charge means that no insurance is provided by the policy for that coverage. LIMITS OF INSURANCE COVERAGES PREMIUM $ 100,000 Each Person , AIRPORT $ 1,000,000 Each Occurrence $ 2,000,000 Aggregate BODILY INJURY AND PROPERTY DAMAGE LIABILITY 1,070,00 $ Each Occurrence PRODUCTS COMPLETED OPERATIONS HAZARD | BODILY INJURY AND PROPERTY DAMAGE LIABILITY $ Aggregate | $ Any One Aircraft Each Occurrence HANGARKEEPER’S LIABILITY Deductible : Each Person Each Occurrence MEDICAL PAYMENTS Forms and Endorsements attached: . Premium for Endorsement 0001 20031 20039 20038 20032 20701 20210 20702 Surcharge .$13.91 TOTAL POLICY PREMIUM 1,083.94 PRODUCTS-COMPLETED OPERATIONS PREMIUM RATE (Coverage Applicable Only With Respect To The Following Classification) BASIS (per $1,000) =o rm 2 co 7) ) —{ tO no ond f= |Minimum Premium $ i @ [ar ? Countersigned: ( Gad Mp ee 20002 (08/10) Authorized Represéntative DEWEO006 A10006 15.00 CK-UND ABAV8G 010 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. [ This endorsement is issued by U.S. Specialty Insurance Company Policy number : UA00147343-09 Endorsement number : issued to (first Named Insured) : DEWEY COSGROVE DBA Effective : 01/11/2014 For : premium of $ (The above information is required only when this endorsement is issued subsequent to preparation of the policy.) EXTENSION - LANDLORD ADDITIONAL INSURED SCHEDULE Name of Person or Organization: OKALOOSA COUNTY AIRPORT 5551 JOHN GIVEN ROAD CRESTVIEW, FL 32539 WHO IS AN INSURED (Section II) of this policy is amended to include as an insured the person or organization shown in the Schedule but only with respect to liability arising out of your maintenance or use of the covered premises. In addition to the other exclusions of this policy, this insurance does not apply to: 1. Any occurrence which takes place after you cease to rent or lease that premises; and 2. Structural alterations, new construction or demolition operations performed by or on behalf of the person or organization shown in the Schedule. 20031 (08/10) Page 1 of 1 OP ID: KT DATE (MM/DDIYYYY) ACOR EVIDENCE OF PROPERTY INSURANCE iinaiao4 THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A-MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS EVIDENCE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE ADDITIONAL INTEREST. AGENCY [ PHONE Ext): 850-581-4925 COMPANY Waldorff Ins & Bonding - FWB Amerisure Mutual 45 Eglin Parkway NE, Ste 202 P O Box 33478 Fort Walton Beach, FL 32548 Detroit, MI 48232-5478 Danny Hare FAX E-MAIL (A/C, No):'850-581-4930 ADDRESS: CODE: | SUB CODE: AGENCY CUSTOMER ID #: COSC-01 INSURED LOAN NUMBER POLICY NUMBER CPP2017799110014 . EFFECTIVE DATE EXPIRATION DATE Cosco & Associates, Inc. & Dewey Cosgrove 01/25/14 01/25/15 215 James Lee Blvd., East Crestview, FL 32539 PROPERTY INFORMATION LOCATION/DESCRIPTION John Givens Rd,Bob Sikes Airpo Crestview, FL 32539 CONTINUED UNTIL TERMINATED IF CHECKED THIS REPLACES PRIOR EVIDENCE DATED: Premises: Airport Hangar-Blck 3, Lot 1 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 EVIDENCE OF PROPERTY INSURANCE 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. COVERAGE INFORMATION COVERAGE / PERILS / FORMS AMOUNT OF INSURANCE DEDUCTIBLE Premise 002 Building 001 HANGAR CONTENTS Loss Valuation: Replacement Cost Subject to 80% Coinsurance 5% Wind and Hail Deductible Special Form Causes of Loss 150000 1000) 20000) 1000 REMARKS (Including Special Conditions) CANCELLATION DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE ADDITIONAL INTEREST NAME AND ADDRESS Dewey Cosgrove MORTGAGEE ADDITIONAL INSURED LOSS PAYEE X |Owner LOAN # AUTHORIZED REPRESENTATIVE Qa ACORD 27 (2009/12) © 1993-2009 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD CONTRACT & LEASE INTERNAL COORDINATION SHEET Contract/Lease Number:_/{ 9 &-O 3a3.- A P Tracking Number: (f4e-§5 oy Grant Funded: YES NO &# Date/Term: 4 f= 3% 1. [Nb GREATER THAN $50,000 amount: 5, ove | Anvnsall Department: F\ r Dept. Monitor name: TGA [Pees Document has been reviewed and includes any attachments or exhibits. 2. L] GREATER THAN $25,000 3. L] $25,000 OR LESS Purchasing Review Date: 40 -G- | ee vector or BeSignee i Joanne Kublik 7 Risk Management Review vn as written: SC unto DAS a. Date: [(O-)3-[4+ Risk Malpeet or designee SS) Kay Godwin or Krystal King County Attorney Review Approved as written: creeneite Date: ics | ™p | } Mf ~ Greg T. Stewart or Lynn Hoshihara } } Following Okaloosa County approval: Contracts & Grants Document has been received: Date: Contracts & Grants Manager Dave Miner From: Krystal King Sent: Monday, November 17, 2014 7:36 AM To: Dave Miner Subject: RE: Dewey Cosgrove Col The lease requires him to carry property insurance in an amount “not less than full replacement cost of the building”, so if $150,000 is enough to replace the hangar if it was destroyed then this meets our requirements. Kegstal hing Okaloosa County Risk Management (830)689-5977 Fax (o(1)689-5573 Please note: Due to Florida’s very broad public records laws, most written communications to or from County employees regarding County business are public records available to the public and media upon request. Therefore, this written email communication including your email address, may be subject to public disclosure. From: Dave Miner Seat: Friday, November 14, 2014 12:42 PM To: Krystal King Subject: RE: Dewey Cosgrove COI Krystal: Please review the attached COI for Mr. Cosgrove’s hangar and let me know if it is OK to go the Board. Thank you. Dave From: Krystal King Sent: Monday, November 03, 2014 2:20 PM To: Dave Miner Subject: RE: Dewey Cosgrowe COI There is no need to call they just need to provide you with something in writing that shows the coverage, the effective date and the coverage limits. ingstal hing Okaloosa County Risk Management (890)689-5977 Fax (BG())689-5975 Please note: Due to Florida's very broad public records laws, most written communications to or from County employees regarding County business are public records available to the public and media upon request. Therefore, this written email communication including your email address, may be subject to public disclosure. from: Dave Miner Sent: Friday, October 31, 2014 2:54 PM To: Krystal King Importance: High COE Krystal: Mr. Cosgrove’s insurance company called and stated that he has hangar coverage. Please call Waldorf Insurance, Scarlett Doherty @ 850-581-4925 and mention Cosco & Associates because that is the mame the policy is under. If you talk to them you will understand more than me trying to relay the information to you. Thank you and please let me know the outcome. Dave David E. Miner Properties and Leases Okaloosa County Airports (850) 651-7160 Ext. 4 www. flyvps.com “Please note. Due to Florida's very broad public records laws, most written communication to or from County einployees regarding County business are public records, available tm the public wpon request. Therefore, this written e- mail communication, including your e-mail address, may be subject to public disclosure.”