About this source
Insurance Policy from the Okaloosa County BOCC meeting of October 16, 2012 (IQM2 meeting #1099). Original portal label: Insurance Policy. Preserved as a historical public record; part of the meeting linked as a related source.
- Original publication
- Insurance Policy
- Date
- October 16, 2012
- Reference collection
- Okaloosa County Board of County Commissioners (IQM2 public portal)
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Insurance Policy (PDF)
Original PDF as published on the Okaloosa County IQM2 meeting portal.
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Federated
National
Insurance
C O M P A N Y A fully owned subsidiary of
21* Century Holding Company
P.O. Box 407193
Ft. Lauderdale, FL 33340-7193
Claims or inquiries 1-800-808-1004
Florida
Commercial General Liability
Policy
READ YOUR POLICY CAREFULLY.
This is a legally binding contract between the policy owner and the Company.
This policy consists of:
Policy Declarations
CS
Coverage Forms/Parts (as applicable)
CS
Endorsements (as applicable)
In Witness Whereof, this company has caused this policy to be signed, but if required by state law, this policy shall not
be valid. unless countersigned by a duly authorized representative of the company.
a
FNIC GL4 (06 09) Page 1 of 1
Insurance provided by the Company designated below
FEDERATED NATIONAL INSURANCE COMPANY
COMMERCIAL LIABILITY POLICY
POLICY DECLARATIONS
POLICY NUMBER: GL-0506007066-00
Named Insured and Mailing Address: Producer Name and Address:
SKYETECH, LLC HARRIS INSURANCE INC
123 MIRACLE STRIP PKWY SE
306 SPENCER DR FT WALTON BEACH FL 32548
FORT WALTON BEACH, FL 32547 (850)244-2111 (850)243-5265
(850)218-7221 Producer Code: 13268
Insured is: __¥___ Corporation Parinership Individual Association
Business of Insured: HANDYMAN
Policy Period: This policy is in force from __ 06/16/2012 to _ 06/16/2013 at _12:01:00A.M. at
your mailing address shown above.
These Declarations, together with the Common Policy Conditions, and the Genera! Liability Coverage Part
(which consists of coverages forms and endorsements, if any, issued to form a part of it) complete the policy.
LIMITS OF INSURANCE
General Aggregate Limit (Other Than Products-Completed Operations) ..............:sssesseseeees $600,000
Products-Completed Operations Aggregate Limit................cesssecssssesseescessreresesesstennncecsssesenses $600,000
Personal & Advertising Injury Liability Limit... sscesessercerssessscesseacenseesertersaeeeeseocssateeeees $300,000
Each OGCUmrONCe: LUM ... csvcsscsssseicssssccscccsssvesvavsacssavsveveensswenssisucenssctes noveesesscarevoncteondooneedses sadn $300,000
Fire Damage Limit (Any One Fire) ...0....... ce cesccescessecneecsscencececsecsscssceereccstsenssensersessesensenseenaces $100,000
Medical Expense Limit (Any One Person)..........cssscssscsesscrssessseessesssesssesceseeessseesesssessescaescenees $5,000
Total Provisional Policy Premium.........csescsccscessccsesscecessssssseeseessereseussaesrassersasseansnearsteneaesrenesters $511.00
Fees and Inspection Costs (if applicable) MGA Fee... cssseesseseeneneesoserecsssessnaceasensoneees $25.00
Florida Insurance Guaranty Association 2006 Regular ASSCSSMENE..........:cccssssessserserserererss N/A
Florida Insurance Guaranty Association 2006 Emergency AsseSSMent ............cccceseseeereeeeees N/A
Florida Insurance Guaranty Association Fee 2007 Regular ASSeSSMENt ..............:eceeeeeeereeee N/A
Florida Insurance Guaranty Association Fee 2009 Regular Assessment ...............:cecreeeeeeee N/A
Florida Hurricane Catastrophe Fund Fee.............ccccsscsssccssecssescorsssessrencersnessecsesassesnenrensoenseses $6.97
Total Payable NOW .......:cccsccssssssscssssssscsesssssrssssesssesesessencasnescscssseoseesssesarscssenesesessetseneseeseseaveeseess $542.97
The policy is subject to audit
Forms and endorsements attached to this policy at time of issue:
FNIC 00 01 (05 09); FNIC 2g (10 09); FNIC 4g (05 09); FNIC Sg (05 09); FNIC 6 (05 08); FNIC 6g (05 09); FNIC 71s (05 09); FNIC 83g (05 09); FNIC 84s (05 09); FNIC 901 (04 03); FNIC
952 (05 09); FNIC 964 (05 09); FNIC 973 (05.09); FNIC 974 (05 09); FNIC 975 (05 09); FNIC 981 (05 09); FNIC 982 (05 09); FNIC 990 (02 12); FNIC 991 (01 09);FNIC 992 (01 09); FNIC
993 (01 09); FNIC 1002 (04 03); FNIC 1071 (04 03); FNIC 8000 (05 09), CG 03 00 (01 96); CG 21 36 (03 05); CG 21 37 (10 01); CG 21 39 (10 93); CG 21 46 (07 98); CG 21 47 (12 07);
GG 21 67 (12 04); CG 21 86 (12 04); CG 21 96 (03 05); IL 00 17 (11 98); IL 00 21 (09 08); FNIC GL4 (06 09), CG 02 20 (04 11); CG 21 32 (05 09), CG 21 42 (12 04), ; CG 21 73 (01 08),
FNICFL 995 (07 10);
Countersigned by P, ES 2, at Florida Date:__ 6/15/2012
Authorized Representative
seveyescuvecseceresenecanconnnznne nnsiipavs GixwissWausavsusu ts abusildsGusicetenn uacaveknes eevusunacavuneee rex vaxeuonseneneveesesunecevesstvereeneees FNIC 1071 (04 03)
Insured’s Copy
FEDERATED NATIONAL INSURANCE COMPANY
Named Insured: SKYETECH, LLC
POLICY: GL-0506007066-00
Commercial Liability Declarations Schedule
(Continued)
Hazards
Premium Premium
Classification Code Basis Rate Deposit
HANDYPERSON 95625 46700 30.62 511
FLORIDA HURRICANE CATASTROPHE FUND FEE 1 6.97 6.97
TBD =To be determined at Audit (c) cost (c) per $1,000
(e) each (e) per each
(p) payroll (p) per $1,000
(r) receipients (r) per $1,000
(s) sales , (s) per $1,000
(u) units (u) per each
ea vaccacnccavcccusvncrporceevesepecerseseurecveersresscecsrepessuanssensnanseussescecsenssscssenoueerssenenasecseucerereesrscsereressrssenseses sane eeeee
FNIC 1002 (04 03)
insurance provided by the Company designated below _
FEDERATED NATIONAL INSURANCE COMPANY
COMMERCIAL LIABILITY POLICY
POLICY DECLARATIONS
POLICY NUMBER; GL-0506007066-00
Named Insured and Mailing Address: me ani dress:
SKYETECH, LLC HARRIS INSURANCE INC
123 MIRACLE STRIP PKWY SE
306 SPENCER DR FT WALTON BEACH FL 32548
FORT WALTON BEACH, FL 32547 (850)244-2 144 (850)243-5265
(850)218-7224 Producer Code; 13268
| Insured is: ¥ Corporation Partnership Individual Association
Business of Insured: HANDYMAN
Policy Period: This policy is in force fram __ 06/16/2012 to 06/16/2013 at _12:01:00A.M. at
your mailing address shown above.
These Declarations, together with the Common Policy Conditions, and the General Liability Coverage Part
(which consists of coverages forms and endorsements, if any, issued to form a part of it) complete the policy,
LUMITS OF INSURANCE
General Aggregate Limit (Other Than Products-Completed Operations) .........scccccesesscrsecese $600,000
Products-Completed Operations Aggregate Limit .
Personal & Advertising Injury Liability Limit........... . wa
Each Occurrence LIME sssssicsassocccescssccsssnesncstssosoneosscsenssven vexsessceesusennecs tae ssnanvenesesvees
Fire Damage Limit (Any One Fire) ........... — =
Mecical Expense Limit (Amy One POrson)..........cccsecsesssserssessrenssecsessesvensiserenssesacasenesveensereuanes
Total Provisional Policy Premium........ses
Fees and Inspection Costs (if applicable) MGA Fee... ecscssesesseerrrererees
Florida Insurance Guaranty Association 2006 Regular ASSGSSIMIENE ...,...,...sssecssssrocenrensereveee N/A
Florida Insurance Guaranty Association 2006 Emergency Assessment ..... N/A
Florida Insurance Guaranty Association Fee 2007 Regular Assessment ..., i N/A
Florida Insurance Guaranty Association Fee 2009 Regular Assessment ........-:.sseesecsereeseeees N/A
Florida Hurricane Catastrophe Fund Fee...........sssesssrerssessseersrsvesvesess $6.97
Total Payable NOW ......ssssssssssssssssnnsssesssesessissnesssnesnecssennsssnvessarsvesteessesavenussssienseesseeceees $542.97
The policy is subject to audit
Forms and endorsements attached to this pa at time of issue: ;
FNIG 00 01 (08 09); FNIC 2g (1D 08); FNIC 4g (05 09); FNIC 5g (05 09k FNIC 6 (05 09); FNIC 6g (05 09); FIG 715 (05 09); FNIC 83g (05 09); FINIC 84s (05 09}; FNIC 501 (04 03); FNIC
952 (05 09); FNIC 864 (05 09); FNIG 973 (05 08); FNIC 876 (05 09); FNIC B75 (05 09); FNIG 981 (05 09): FNIC 962 (05:09): FNIC 990 (02 12); PIC 901 (01 O9)-FNIC 992 (01 DB}: FNC
993 (01 09}- FNIG 1002 (04 03); FNIC 4074 (04 03}; FNIC 8000 (05 05}; CG 03 00 {01 98); CG 21 98 (03 05); CG 21 37 (1001); CG 21 39 (10 BS}; CG.21 48 (07 98), CG 21 47 {12 O7F
CG 21 Gea 88 (12 04); CG 21 BG (03 05% LOD 17 (11 98}; 1.00 24 (09 08): FNIC GL4 (06 09): CG 02 20 (04 11); CG 24 32 (05 09), CG 21 42 (12 04 ; CG 21 73 (01 08);
FINICFL 885 (07 10),
Countersigned by y, KS 2) at Florida Date:__ 6/15/2012.
Authorized Representative
er re ee FNIC 1071 (04 03).
Insured’s Copy