Okaloosa County BOCC — August 2, 2016 — CACI International IncCertOfIns- Board of County Commissioners — reading text

DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 07/25/2016 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. Holder Identifier : IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or 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 NAME: Aon Risk Services, Inc. of Washington, D.C. PHONE FAX 1120 20th Street NW (A/C. No. Ext): (866) 283-7122 (A/C. No.): (800) 363-0105 Washington DC 20036 USA E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: National Union Fire Ins Co of Pittsburgh 19445 CACI International, Inc. INSURER B: New Hampshire Ins Co 23841 Attn: Teri Constantian, CPCU 4114 Legato Road INSURER C: The Insurance Co of the State of PA 19429 Fairfax VA 22033 USA INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570063145904 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. Limits shown are as requested INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GL3796685 07/01/2016 07/01/2017 EACH OCCURRENCE $1,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR $1,000,000 PREMISES (Ea occurrence) MED EXP (Any one person) $10,000 570063145904 PERSONAL & ADV INJURY $1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $2,000,000 PRO- X POLICY JECT LOC PRODUCTS - COMP/OP AGG $2,000,000 OTHER: A AUTOMOBILE LIABILITY CA 2935890 07/01/2016 07/01/2017 COMBINED SINGLE LIMIT $1,000,000 (Ea accident) Certificate No : ANY AUTO BODILY INJURY ( Per person) X SCHEDULED BODILY INJURY (Per accident) OWNED AUTOS AUTOS ONLY PROPERTY DAMAGE HIRED AUTOS NON-OWNED AUTOS ONLY (Per accident) ONLY Ded: $2500/$2500 UMBRELLA LIAB OCCUR EACH OCCURRENCE EXCESS LIAB CLAIMS-MADE AGGREGATE DED RETENTION B WORKERS COMPENSATION AND WC023102316 07/01/2016 07/01/2017 X PER STATUTE OTH- EMPLOYERS' LIABILITY ER Y/N Workers Comp - AOS ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? N N/A SIR applies per policy terms & conditions (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000 7777777707070700077761616045571110747536226107744007740314443627133072771576067101020756673717217677407325040121173120072531000736111200771405564327575507237130072140022076727242035772000777777707000707007 A E&O-PL-Primary 015418806 07/01/2016 07/01/2017 Limit (1) $5,000,000 Claims Made SIR applies per policy terms & conditions DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) RE: CACI-NSS, Inc. Prime Contract #C14-2198-IS POP: 8-5-2016 to 8-4-2019. CACI POC: Barbara McAulay. Board of County Commissioners is included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. Carrier to provide 30 Days' Notice of Cancellation to third parties as required by written contract per and subject to policy terms and conditions, and as and to the extent permitted by law. Carrier to provide 30 Days' Notice of Material Change as required by written contract per and subject to the General Liability policy terms and conditions. Reference to contract language from an Agreement or a Term of an Agreement that is outside the insurance policy 7777777707070700073525677115456000767115013523156407433762603127110070366233461371100703327620653304007122237342072111071322373430631110712333734207201007022337242063011077756163351765540777777707000707007 terms or policy period evidenced on this Certificate, is provided for reference purposes only, and any such reference does not CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Board of County Commissioners AUTHORIZED REPRESENTATIVE Okaloosa County Attn: Don Vanderhock 1804 Lewis Turner Boulevard Suite 402 Fort Walton Beach FL 32547 USA