Okaloosa County BOCC — March 18, 2014 — WD Roger COI

ACØRL/ YY) CERTIFICATE OF LIABILITY INSURANCE 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 CONTACT Melanie Johnson, CISR McMahon-Hadder Insurance, Inc. NQ (850)484-7011 EU NoI (850)474-5201 375 North 9th Ave., Suite A E- 55 .melan ie@mcmahonhadder.com INSURER(S) AFFORDING COVERAGE NAIC 8 Pensacola FL 32502 INSURERA:The Charter Oak Fire Insurance 25615 INSURED INSURER B:The Travelers Indemnity Company 25682 WD Rogers Mechanical Contractors, Inc INsuRERCNavigators Specialty Ins Co 36056 P0 Box 9607 INSURER D:Bridgefield Employers Ins, Co 10701 INSURER E:Federal Insurance Company 20281 Pensacola FL 32513-9607 INSURER F:The American Insurance Co I COVERAGES CERTIFICATE NUMBER:2014 Term 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. ABl. U8h POLICY EFF POLICY EXP TYPE OF INSURANCE POLICY NUMBER MM/DD/YYYYI IMMIDD/YYYY' LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 I DAMAGE TO RENTED X I COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $ 300,000 rA ICLAIMS-MADE OCCUR X :00129L297 1/1/2014 1/1/2015 MEOEXP (Any one person) $ 5,000 PERSONAL & ADV INJURY $ 1,000,000 GENE RALAGGREGATE $ 2,000,000 I GENt AGGREGATE LIMIT APPLIES PER: PRODUCTS- COMP/OP AGG $ 2,000,000 - POLICY [1 PER,0T P1 LOC - - COMBINED SINGLE LIMIT $ AUTOMOBILE LIABILITY 1,000,000 (Ea accident) $ ANY AUTO BODILY INJURY (Per person) $ B ALL OWNED SCHEDULED 8100129L297 AUTOS AUTOS x 1/1/2014 1/1/2015 BODILY INJURY (Per accident) $ NON-OWNED PROPERTY (per accident)DAMAGE HIRED AUTOS AUTOS $ PIP-Basic 10 , 000 UMBRELLA LIAB EXCESSLIAB LJ OCCUR - - 14EXC7723131C 1/1/2014 1/1/2015 EACHOCCURRENCE 10,000,000 F X CLAIMS-MADE AGGREGATE $ 10,000,000 r.XO0048751861 2/4/2014 1/1/2015 RETENTIONS $ O WORKERS COMPENSATION - - , WC STATU- 0TH- AND EMPLOYERS LIABILITY TORY LIMITS ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E . L. EACH ACCIDENT $ 1 , 000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) 0830-31070 1 / I / E . L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below - - E . L. DISEASE - POLICY LIMIT $ 1,000,000 E Contrs Equip 1000 ded 4546-55-73 1/1/2014 1/1/2015 Leased/Reeled Equip 100,000 1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Okaloosa County is an additional insured with respect to general liability and automobile liability. Coverage is primary and non-contributory. Should any of the above described policies be cancelled before the expiration date thereof, the producer will endeavor to mail 30 days written notice except 10 days notice for non-payment cancellation to the certificate holder named herein, but failure to do so shall impose no obligation or liability of any kind upon the producer, its agents or representatives. All other terms and conditions of this policy remain unchanged. CERTIFICATE HOLDER CANCELLATION jkublik@co.okaloosa.fl.co 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 602-C Pearl St AUTHORIZED REPRESENTATIVE Crestview, E% 32577 3 ,. J McMahon, CIC, CWCP/ ACORD 25(2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. IPjSfl2 e,r,inrici ru Th. ACCIPfl n,n,w ,.nd Iwnw rwni tr,u.1 wf ftt('Pfl  COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT B. BLANKET ADDITIONAL INSURED I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT C. EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS E. SUPPLEMENTARY PAYMENTS - INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS OR LOSS F. HIRED AUTO - LIMITED WORLDWIDE M. BLANKET WAIVER OF SUBROGATION COVERAGE - INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE - GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED executed by you before the "bodily injury" or The following is added to Paragraph A.1., Who Is "property damage" occurs and that is in effect An Insured, of SECTION II - LIABILITY COV- during the policy period, to be named as an addi- ERAGE: tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance Any organization you newly acquire or form dur- applies and only to the extent that person or or- ing the policy period over which you maintain ganization qualifies as an "insured" under the 50% or more ownership interest and that is not Who Is An Insured provision contained in Section separately insured for Business Auto Coverage. II. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- C. EMPLOYEE HIRED AUTO ganization or the end of the policy period, which- The following is added to Paragraph A.1., ever is earlier. Who Is An Insured, of SECTION II - LI- B. BLANKET ADDITIONAL INSURED ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION II - LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 06 09 © 2009 The Travelers companies, Inc. Page 1 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.5., United States of America applies to and pro- Other Insurance, of SECTION IV - BUSI- hibits the transaction of business with or NESS AUTO CONDITIONS: within such country or jurisdiction, for Liability b. For Hired Auto Physical Damage Cover- Coverage for any covered "auto" that you age, the following are deemed to be cov- lease, hire, rent or borrow without a driver for ered "autos" you own: a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from (1) Any covered "auto" you lease, hire, any of your "employees", partners (if you are rent or borrow; and a partnership), members (if you are a limited (2) Any covered "auto" hired or rented by liability company) or members of their house- your "employee" under a contract in holds. that individual "employee's" name, (1) With respect to any claim made or "suit" with your permission, while perform- brought outside the United States of ing duties related to the conduct of America, the territories and possessions your business. of the United States of America, Puerto However, any "auto" that is leased, hired, Rico and Canada: rented or borrowed with a driver is not a (a) You must arrange to defend the covered "auto". "insured" against, and investigate D. EMPLOYEES AS INSURED or settle any such claim or "suit" and keep us advised of all pro- The following is added to Paragraph A.1., Who Is ceedings and actions. An Insured, of SECTION II - LIABILITY COV- ERAGE: (b) Neither you nor any other in- volved "insured" will make any Any "employee" of yours is an "insured" while us- settlement without our consent. ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. (c) We may, at our discretion, par- ticipate in defending the "insured" E. SUPPLEMENTARY PAYMENTS - INCREASED against, or in the settlement of, LIMITS any claim or "suit". 1. The following replaces Paragraph A.2.a.(2), (d) We will reimburse the "insured": of SECTION II - LIABILITY COVERAGE: (i) For sums that the "insured" (2) Up to $3,000 for cost of bail bonds (in- legally must pay as damages cluding bonds for related traffic law viola- because of "bodily injury" or tions) required because of an "accident" "property damage" to which we cover. We do not have to furnish this insurance applies, that these bonds. the "insured" pays with our 2. The following replaces Paragraph A.2.a.(4), consent, but only up to the of SECTION II— LIABILITY COVERAGE: limit described in Paragraph C., Limit Of Insurance, of (4) All reasonable expenses incurred by the SECTION II - LIABILITY "insured" at our request, including actual COVERAGE; loss of earnings up to $500 a day be- cause of time off from work. (ii) For the reasonable expenses incurred with our consent for F. HIRED AUTO - LIMITED WORLDWIDE COV- your investigation of such ERAGE - INDEMNITY BASIS claims and your defense of The following replaces Subparagraph e. in Para- the "insured" against any graph B.7., Policy Term, Coverage Territory, of such "suit", but only up to and SECTION IV - BUSINESS AUTO CONDITIONS: included within the limit de- e. Anywhere in the world, except any country or scribed in Paragraph C., Limit jurisdiction while any trade sanction, em- Of Insurance, of SECTION II bargo, or similar regulation imposed by the - LIABILITY COVERAGE, Page 2 of 4 © 2009 The Travelers Companies, Inc. CA T3 53 06 09 Includes the copyrighted material of Insurance Services Office, Inc. with its permission.  COMMERCIAL AUTO and not in addition to such 1. PHYSICAL DAMAGE - TRANSPORTATION limit. Our duty to make such EXPENSES - INCREASED LIMIT payments ends when we The following replaces the first sentence in Para- have used up the applicable graph A.4.a., Transportation Expenses, of SEC- limit of insurance in payments TION III - PHYSICAL DAMAGE COVERAGE: for damages, settlements or defense expenses. We will pay up to $50 per day to a maximum of $1,500 for temporary transportation expense in- (2) This insurance is excess over any valid curred by you because of the total theft of a cov- and collectible other insurance available ered "auto" of the private passenger type. to the 'insured" whether primary, excess J. PERSONAL EFFECTS contingent or on any other basis. The following is added to Paragraph A.4., Cover- (3) This insurance is not a substitute for re- age Extensions, of SECTION III - PHYSICAL quired or compulsory insurance in any DAMAGE COVERAGE: country outside the United States, its ter- ritories and possessions, Puerto Rico and Personal Effects Canada. We will pay up to $400 for "loss" to wearing ap- You agree to maintain all required or parel and other personal effects which are: compulsory insurance in any such coun- (1) Owned by an "insured"; and try up to the minimum limits required by (2) In or on your covered "auto". local law. Your failure to comply with compulsory insurance requirements will This coverage applies only in the event of a total not invalidate the coverage afforded by theft of your covered "auto". this policy, but we will only be liable to the No deductibles apply to this Personal Effects same extent we would have been liable coverage. had you complied with the compulsory in- K. AIRBAGS surance requirements. The following is added to Paragraph B.3., Exclu- (4) It is understood that we are not an admit- sions, of SECTION III - PHYSICAL DAMAGE ted or authorized insurer outside the COVERAGE: United States of America, its territories Exclusion 3.a. does not apply to "loss" to one or and possessions, Puerto Rico and Can- more airbags in a covered "auto" you own that in- ada. We assume no responsibility for the flate due to a cause other than a cause of "loss" furnishing of certificates of insurance, or set forth in Paragraphs A.1.b. and A.1.c., but for compliance in any way with the laws only: of other countries relating to insurance. a. If that "auto" is a covered "auto" for Compre- G. WAIVER OF DEDUCTIBLE - GLASS hensive Coverage under this policy; The following is added to Paragraph D., Deducti- b. The airbags are not covered under any war- ble, of SECTION III - PHYSICAL DAMAGE ranty; and COVERAGE: c. The airbags were not intentionally inflated. No deductible for a covered "auto" will apply to We will pay up to a maximum of $1,000 for any glass damage if the glass is repaired rather than one "loss'. replaced. L. NOTICE AND KNOWLEDGE OF ACCIDENT OR H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF LOSS USE - INCREASED LIMIT The following is added to Paragraph A.2.a., of The following replaces the last sentence of Para- SECTION IV - BUSINESS AUTO CONDITIONS: graph A.4.b., Loss Of Use Expenses, of SEC- TION III - PHYSICAL DAMAGE COVERAGE: Your duty to give us or our authorized representa- tive prompt notice of the "accident" or "loss" ap- However, the most we will pay for any expenses plies only when the "accident" or "loss" is known for loss of use is $65 per day, to a maximum of to: $750 for any one "accident". (a) You (if you are an individual); CA T3 53 06 09 © 2009 The Travelers companies, Inc. Page 3 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. COMMERCIAL AUTO (b) A partner (if you are a partnership); tent required of you by a written contract (c) A member (if you are a limited liability com- signed and executed prior to any "accident" pany); or "loss", provided that the "accident" or "loss" arises out of operations contemplated by (d) An executive officer, director or insurance such contract. The waiver applies only to the manager (if you are a corporation or other or- person or organization designated in such ganization); or contract. (e) Any "employee" authorized by you to give no- N. UNINTENTIONAL ERRORS OR OMISSIONS tice of the 'accident" or "loss". The following is added to Paragraph B.2., Con- M. BLANKET WAIVER OF SUBROGATION cealment, Misrepresentation, Or Fraud, of The following replaces Paragraph A.5., Transfer SECTION IV— BUSINESS AUTO CONDITIONS: Of Rights Of Recovery Against Others To Us, The unintentional omission of, or unintentional of SECTION IV - BUSINESS AUTO CONDI- error in, any information given by you shall not TIONS: prejudice your rights under this insurance. How- 5. Transfer Of Rights Of Recovery Against ever this provision does not affect our right to col- Others To Us lect additional premium or exercise our right of We waive any right of recovery we may have cancellation or non-renewal. against any person or organization to the ex- Page 4 of 4 © 2009 The Travelers Companies, Inc. CA T3 53 06 09 Includes the copyrighted material of Insurance Services Office, Inc. with its permission.  COMMERCIAL GENERAL LIABILITY THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY BLANKET ADDITIONAL INSURED (CONTRACTORS) This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART 1. WHO IS AN INSURED - (Section II) is amended c) The insurance provided to the additional in- to include any person or organization that you sured does not apply to "bodily injury" or agree in a "written contract requiring insurance" "property damage" caused by "your work" to include as an additional insured on this Cover- and included in the "products-completed op- age Part, but: erations hazard" unless the "written contract a) Only with respect to liability for "bodily injury", requiring insurance" specifically requires you "property damage" or "personal injury'; and to provide such coverage for that additional insured, and then the insurance provided to b) If, and only to the extent that, the injury or the additional insured applies only to such damage is caused by acts or omissions of "bodily injury" or "property damage" that oc- you or your subcontractor in the performance curs before the end of the period of time for of "your work" to which the "written contract which the "written contract requiring insur- requiring insurance" applies. The person or ance" requires you to provide such coverage organization does not qualify as an additional or the end of the policy period, whichever is insured with respect to the independent acts earlier. or omissions of such person or organization. 3. The insurance provided to the additional insured 2. The insurance provided to the additional insured by this endorsement is excess over any valid and by this endorsement is limited as follows: collectible "other insurance", whether primary, a) In the event that the Limits of Insurance of excess, contingent or on any other basis, that is this Coverage Part shown in the Declarations available to the additional Insured for a loss we exceed the limits of liability required by the cover under this endorsement. However, if the "written contract requiring insurance", the in- "written contract requiring insurance" specifically surarjce provided to the additional insured requires that this insurance apply on a primary shall be limited to the limits of liability re- basis or a primary and non-contributory basis, quired by that "written contract requiring in- this insurance is primary to "other insurance" surance". This endorsement shall not in- available to the additional insured which covers crease the limits of insurance described in that person or organization as a named insured Section III - Limits Of Insurance. for such loss, and we will not share with that "other insurance". But the insurance provided to b) The insurance provided to the additional in- the additional insured by this endorsement still is sured does not apply to "bodily injury", "prop- excess over any valid and collectible "other in- erty damage" or "personal injury" arising out surance", whether primary, excess, contingent or of the rendering of, or failure to render, any on any other basis, that is available to the addi- professional architectural, engineering or sur- tional Insured when that person or organization is veying services, including: an additional insured under such "other insur - 1. The preparing, approving, or failing to ance". prepare or approve, maps, shop draw- 4. As a condition of coverage provided to the ings, opinions, reports, surveys, field or- additional insured by this endorsement: ders or change orders, or the preparing, approving, or falling to prepare or ap- a) The additional insured must give us written prove, drawings and specifications; and notice as soon as practicable of an "occur- rence" or an offense which may result in a iii. Supervisory, inspection, architectural or claim. To the extent possible, such notice engineering activities. should include: CG D2 46 08 05 0 2005 The St. Paul Travelers Companies, Inc. Page 1 of 2 COMMERCIAL GENERAL LIABILITY I. How, when and where the "occurrence" any provider of "other insurance" which would or offense took place; cover the additional insured for a loss we II. The names and addresses of any injured cover under this endorsement. However, this persons and witnesses; and condition does not affect whether the insur- ance provided to the additional insured by iii. The nature and location of any injury or this endorsement is primary to "other Insur- damage arising out of the "occurrence" or ance" available to the additional insured offense. which covers that person or organization as a b) If a claim is made or "suit" is brought against named insured as described in paragraph 3. the additional insured, the additional insured above. must: 5. The following definition is added to SECTION V. I. Immediately record the specifics of the - DEFINITIONS: claim or "suit" and the date received; and "Written contract requiring insurance" means ii. Notify us as soon as practicable. that part of any written contract or agreement under which you are required to include a The additional insured must see to it that we person or organization as an additional in- receive written notice of the claim or "suit" as sured on this Coverage Part, provided that soon as practicable. the "bodily injury" and "property damage" oc- c) The additional insured must immediately curs and the "personal injury" is caused by an send us copies of all legal papers received in offense committed: connection with the claim or "suit', cooperate After the signing and execution of the a. with us in the investigation or settlement of contract or agreement by you; the claim or defense against the "suit", and otherwise comply with all policy conditions. b. While that part of the contract or agreement is in effect; and d) The additional insured must tender the de- fense and indemnity of any claim or "suit" to c. Before the end of the policy period. Page 2 of 2 © 2005 The St. Paul Travelers Companies, Inc. CG 02 46 08 05