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

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.