Okaloosa County BOCC — November 5, 2013 — United Airlines Extension & Coord — reading text

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. Limits shown are as requested ER TYPE OF INSURANCE ao Soe POLICY NUMBER an | ony LIMITS GENERAL LIABILITY EACH OCCURRENCE | GAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) CLAJMS-MADE [__Joccur MED EXP (Any one person) PERSONAL & ADV INJURY 19 GENERAL AGGREGATE 5 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG 3 PRO- So _| — [ct CT = 3253803 30 08/01/2013/08/01/2014 E lel iS A | AUTOMOBILE LIABILITY BAP COMBINED SINGLE LIMIT A BAP 5571109 01 08/01/2013|08/01/2014 (Ba accident) $1,000,000 - lx | ANY AUTO BODILY INJURY { Per person) g [| ALL OWNED SCHEDULED BODILY INJURY (Per accident) 2 |__| AuTos . |__| HIRED AUTOS NON-OWNED (Per eccdent) ace = Fi UMBRELLA LIAB OCCUR - EACH OCCURRENCE <) || EXCESS LIAB || cLAIMs-MADE AGGREGATE peED| [RETENTION B | WORKERS COMPENSATION AND wc062 790649 08/01/2013(08/01/2014 x | WG STATU- OTH- EMPLOYERS' LIABILITY YIN AK, GA TORY LIMITS ER B ANY PROPRIETOR / PARTNER / EXECUTIVE NIA wC062790651' 08/01/2013]08/01/2014 E.L. EACH ACCIDENT $1,000,000 (Mandatory in NH) FL E.L. DISEASE-EA EMPLOYEE $1,000,000 HM SCRIPTION OF OPERATIONS velow . 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: Okaloosa Regional Airport, Fort walton, Florida, Airport Code vPs oa a= Okaloosa County is named as an Additional Insured excluding workers' Compensation and Employers’ Liability as required by ort written contract but limited to the operations of the Insured under said contract, and always subject to the policy terms, ia conditions and exclusions. The polici es certified hereon are primary to other insurance available to the certificate holder, [ce but_only to the extent required by written contract with the insured, and always subject to the policy terms, conditions and Pon exclusions. 30 Day Notice of Cancellation in favor of the Certificate Holder. = = CERTIFICATE HOLDER CANCELLATION ms SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE GANCELLED BEFORE THE ne EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE -— POLICY PROVISIONS. a Okaloosa County AUTHORIZED REPRESENTATIVE “= 602 C. North Pearl Street Crestview FL 32536 USA ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD IIE AGENCY CUSTOMER ID: 570000049837 ——, ® Loc #: CORD ——, ADDITIONAL REMARKS SCHEDULE page _ of _ AGENCY NAMED INSURED Aon Risk Services Central, Inc. united Airlines, Inc. and POLICY NUMBER See Certificate Number: 570050947375 CARRIER NAIC CODE See Certificate Number: 570050947375 EFFECTIVE DATE: ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: ACORD 25 FORM TITLE: Certificate of Liability Insurance INSURER(S) AFFORDING COVERAGE NAIC # INSURER INSURER INSURER INSURER ADDITIONAL POLICIES If a policy below does not include limit information, refer to the corresponding policy on the ACORD certificate form for policy limits, INSR APDL|SUBR POLICY roucy LTR TYPE OF INSURANCE INSR | wv POLICY NUMBER mlgeiha AP ATION Limits (MM/DD/YYYY)_|_(MM/DD/YYYY) WORKERS COMPENSATION B N/A WwC062790646 08/01/2013 | 08/01/2014 |. pc, Io B N/A wC062790650 08/01/2013 | 08/01/2014 AZ,NJ,RI,TX B N/A wC062790647 08/01/2013 | 08/01/2014 KY, NC, NH, UT B N/A wc062790653 08/01/2013 | 08/01/2014 ND, WI, WY B N/A WwC062790644 08/01/2013 | 08/01/2014 AOS B N/A wC062790645 08/01/2013 | 08/01/2014 RI, TX B N/A wc062790648 08/01/2013 | 08/01/2014 NIJ B N/A WCO62 790652 08/01/2013] 08701/2014 MN c N/A WC1307549 08/01/2013 | 08/01/2014 Excess WC SIR applies per policy tegms & conditipns c N/A WC1307550 08701/2013 | 0870172014 Excess WC SIR applies per policy tegms & conditijons C WC1307551 08/01/2013 |08/01/2014 Excess wc SIR applies per policy teyms & conditijons ACORD 101 (2008/01) © 2008 ACORD CORPORATION. Alt rights reserved, The ACORD name and Jogo are registered marks of ACORD | ( CERTIFICATE OF INSURANCE Issued on behalf of Insurers by Willis of Texas. — Global Aviation 920 Memorial City Way, Suite 500 Houston, TX 77024 Telephone (713) 961-3800 Fax (713) 961-0069 Okaloosa Regional Airport Attn: Jon Morris 1701 State Road 85 North Eglin Air Force Base, FL 32542 This is to certify to: Sometimes referred to herein as the Certificate Holder(s)) that the Insurers listed below, each for their own part and not one for the other, are providing the following insurance: NAMED INSURED: NAMED INSURED'S ADDRESS: PERIOD OF INSURANCE: GEOGRAPHICAL LIMITS: AIRCRAFT INSURED: DESCRIPTION OF COVERAGE: LIMITS: CONTRACT: COA-0365 ( Okalossa Regional) United Continental Holdings, Inc., United Airlines, Inc, Continental Micronesia, Inc. and all subsidiary, affiliated, managed, owned or controlled companies now in existence or cs hereafter formed or acquired, jointly or severally as_ their 7 respective rights and interests may appear. 233 South Wacker Drive a Chicago, IL 60606 “y December 31, 2012 to December 31, 2013 (12:01 A.M. C.S.T.) fh Worldwide 2 Any aircraft owned or leased to and operated by the Named O Insured. (A) AIRCRAFT HULL ALL RISKS INSURANCE, covering all aircraft owned or leased to and operated by the Named Insured. (B) AIRLINE LIABILITY INSURANCE, including Aircraft Liability and General Liability. Note: Aggregate Limits may be reduced due to paid claims (A) Agreed Value (B) Combined Single Limit Bodily Injury (including Passengers) and Property Damage Liability $1,000,000. Each Occurrence/Aircraft VPS Airport Lease Agreement Willis PAGE TWO SPECIAL PROVISION(S) Subject always to the scope of the policies noted above and the policies’ declarations, insuring agreements, terms, conditions, limitations, exclusions, deductibles warranties and endorsements remaining paramount: Solely as respects: (i) the Coverage(s) noted above; (ii) the Contract(s) (and then only to the extent of the Named Insured’s obligation to provide insurance under the terms of the Contract(s)); and (iii) the operations of the Named Insured; the following provision(s) apply(ies): The use of the terms “Additional Insured” / “Additional Insureds”, when used in the context of coverages other than Liability Coverage(s), are solely for the purpose of identifying parties and does not, by virtue of the use of these terms convey any benefits or rights not provided for under the policies. Solely as respects Liability Coverage: Okaloosa Regional Airport is included as an Additional Insured as required by written agreement as respects operations of the Named Insured. Solely as respects Liability Coverage: Such insurance as is afforded the Named Insured under the policies applies to liability assumed by the Named Insured under the Contract, but only to the extent of coverage otherwise afforded under the policies. Solely as respects All Coverages: Insurers waive their rights of subrogation against the Additional insureds but only to the same extent that the Named Insured has waived its rights of recovery against and/or indemnified the Additional Insureds in the Contract. Solely as respects All Coverages: In the event of cancellation or adverse material change of the policies by Insurers, Insurers agree that such cancellation or change shall not be effective as to the Additional Insured uniil thirty (30) days / ten days in the event of cancellation due to non-payment of premium) after issuance of notice by the Insurers to the Certificate Holder. As respects each Certificate Holder(s) respective interests, this Certificate of Insurance shall automatically terminate upon the earlier of: (i} Policy expiration; (ii) Cancellation of the policies prior to policy expiration, as notified to the Certificate Holder(s) as required herein; (iii) termination of the Contract(s); and/or in the case of physical damage insurance relating to those Certificate Holder(s) who have an insurable interest in the Equipment as of the date of issuance of this Certificate of Insurance: Termination of the Named Insured's and/or the Certificate Holder(s) insurable interest in the Equipment. This Certificate of Insurance is issued as a summary of the insurances under the policies noted above and confers no rights upon the Certificate Holder(s) as regards those insurances other than those provided by the policies. The undersigned has been authorized by the above insurers to issue this certificate on their behalf and is not an insurer and has no liability of any sort under the above policies as an insurer as a result of this certification. DATE: March 31, 2013 WILLIS OF TEXAS, INC. Global Aviation VAN ba, Authorized Representative Willis COA-0365 ( Okalossa Regional) SECURITY (the “Insurers”) for Policy Period: December 31, 2012 to December 31, 2013 Insurer Policy No One or more of the Member Companies of Global 281129/12 Aerospace Underwriting Managers 51 John F, Kennedy Parkway Short Hills, NJ 07078 Underwriters at Lloyd’s & certain Insurance Companies, 12771A12 London, England through Willis Limited Ten Trinity Square London, EC3P 3AX England Century Casualty Insurance Company RI 12272A12 c/o Willis Global Aviation Ten Trinity Square London, EC3P 3AX England Commerce and industry Company HL3387447-15 through Chartis Aerospace, Inc. 100 Colony Square, Suite 1000 Atlanta, GA 30361 National Fire & Marine Insurance Company Through Starr Aviation Agency, Inc. 12AL 100046 3353 Peachtree Road, NE, Suite 1000 Atlanta, GA 30326 lronshore Specialty Insurance Company IHM100019-03 through Starr Aviation Agency, Inc. 3353 Peachtree Road, NE, Suite 1000 Atlanta, GA 30326 Starnet Insurance Company through Berkley Aviation BA-12-12-00160 1101 Anacapa Street, Suite 200 Santa Barbara, CA 93101 XL Insurance UA0007987AV12A One World Financial Center, 200 Liberty Street, 3° F] New York, NY 10281 Allianz A1AL000573212AM Member Companies of United States Aviation Underwriters, Inc. One Seaport Plaza SIHL1-778T New York, NY 10038 Several Liability Notice The subscribing insurers’ obligations under contracts of insurance to which they subscribe are several and not joint and are limited solely to the extent of their individual subscriptions. The subscribing insurers are not responsible for the subscription of any co-subscribing insurer who for any reason does not satisfy ail or part of its obligations. LSW 1001 (insurance) United Continental Holdings 12-13