Okaloosa County BOCC — June 3, 2014 — Horizons Certificate Of Liability Insurance 2015 — reading text

—— ACOREDY CERTIFICATE OF LIABILITY INSURANCI HORIZ-2 OP ID: JL DATE (MM/DDIYYYY) 07H 113 THIS CERTIFICATE iS ISSUED AS A MATTER OF INFORMATION GNLY AND CONFERS NO RIGHTS UPON T] CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISS REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, HE CERTIFICATE HOLDER. THIS AFFORDED BY THE POLICIES WING INSURER(S), AUTHORIZED IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBR the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certifi certificate holder in lieu of such endorsement(s). OGATION IS WAIVED, subject to icate does not confer rights to the PRODUCER 850-656-3747| Nae Pe Box (780 ne 850-656-4065) HO ce FE ne Tallahassee, FL 32317 BMA Matt Osiecki ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC = insurer a: Markel Insurance Company 38970 INSURED Horizons of Ckaloosa pounty, insurer 8 : Philadelphia Indemnity 18058 nc.: Horizons Foundation o ; Okaloosa County, Inc. INSURER C: 123 Truxton Ave INSURER D Fort Walton Beach, FL 32547 INSURER E : INSURER F = COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEI INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUME! CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HERE] EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. D ABOVE FOR THE POLICY PERIOD IT WITH RESPECT TO WHICH THIS: IS SUBJECT TO ALL THE TERMS, INSR ADDL [SUBR] POLICY EFF | POLICY EXP LTR TYPE OF INSURANCE INSR Wo POLICY NUMBER (MMB YYY) | (MRE YYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000) DAMAGE TO RENT A |X | commerciAL GENERAL LIABILITY 8502$$3770430 710143 | O7/0414 | PRETO EEO ce) |S 1,000,000] Jccamswape |X | occur MED EXP [Any one person) | $ 19,000) — PERSONAL & ADV INJURY $ 1,000,000) — GENERAU AGGREGATE, $ 3,060,000) GEN'L AGGREGATE LIMIT APPLIES PER PRODUCTS- COMPIOP AGG | & 3,000,000) POLICY FRO. Loc Emp Ben. $ 1,000,000) COMBINED SINGLE LIMIT AUTOMOBILE LIABILITY Ea accidehth $ 1,000,000) B | X | any auto PHPK1044317 O7/0113 | 7/01/14 | BODILY INURY (Perperson) | $ AE OMNED Sutes BODILY INJURY (Par accident | § NON-OWNED PROPERTY DAMAGE $ RIRED AUTOS: AUTOS Per accident) $ 7 X [UMBRELLALAB |X | occu, EACH OCCURRENCE § 1,000,000) A EXCESS LIAB | cLaws.mape 4602883770440 07/0113 | 07/01/14 |accrecdre $ 1,000,000 DED l x] RETENTION § 10000 $ WORKERS COMPENSATION WC $TATU- [ee AND EMPLOYERS’ LIABILITY YIN TORY LIMITS ER ANY PROPRIETORIPARTNERMEXECUTIVE EL. EACH|ACCIDENT $ OFFICER/MEMBER EXCLUDED? | NIA (Mandatory in NH) ELL. DISEASE - EA EMPLOYEE] $ tyes, desoribe under DESCRIPTION OF OPERATIONS below. EL. DISEASE - POLICY LIMIT | $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, if more space Is required) CERTIFICATE HOLDER CANCELLATION OKALOO4 SHOULD ANY OF THE ABOVE DESCRIBE! THE EXPIRATION DATE THEREOF, Okaloosa County Water & Sewer ACCORDANCE WITH THE POLICY PROVIS| D POLICIES BE CANCELLED BEFORE OTICE WiLL BE DELIVERED IN IONS. Mark Griffin 1804 Lewis Turner Blvd., #100 Ft. Walton Beach, FL 32547 AUTHORIZED REPRESENTATIVE © 1988-2010 ACORD CORP ACORD 25 (2010/05) The ACORD name and lago are registered marks of ACORD (ORATION, Ali rights reserved.