Okaloosa County BOCC — February 21, 2017 — Amendment One to Crystal Beach MT — reading text

Brannen PRODUCER 2551 Geiratarr Do, Cthice (AN, Ext): (850) 257-2995 | TR \o):(850) 387-0935 Destin, FL. 32541 Ml oq. stacey.brannen@acentria.com INSURER(S) AFFORDING COVERAGE NAIC # insurer A : Westfield Insurance Company 24112 INSURED INSURERB : Crystal Beach Development of Destin, 1.td INSURER G : PO Box 1735 INSURER D : Destin, FL 32540 INSURERE : INSURERF : COVERAGES CERTIFICATE NUMBER: 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 GONDITION 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 GONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. R TYPE OF INSURANCE Aok SaR POLICY NUMBER O] | (D) LIMITS A | X | COMMERCIAL GENERAL LIABILITY EACH OGCURRENCE 3 1,000,000 | ctamsmace | X | occur x| [cvmariaseo 03/01/2016 | 03/01/2017 | DAVAGETORENTED Ty 500,000 MED EXP (Any one person) $ 1,000 - PERSONAL & ADVINJURY | § 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 || PoucY D S Loc PRODUCTS - COMP/OP AGG | § 2,000,000 OTHER: s AUTOMOBILE LIABILITY MR NCLEYMT | ANY AUTO BODILY INJURY (Perperson) | $ OWNED SCHEDULED i AUTOS ONLY AUTOS BODILY INJURY (Per accident) | $ PROPERTY DAMAGE I mfi%?a ONLY RSPC-)%\%,\KEQ (Per accident) $ 5 A UMBRELLA LIAB X | occur EACH OCCURRENCE $ 10,000,000 EXGESS LIAB cLamsmae| X | [GMMA714890 03/01/2016 | 03/01/2017 [ o . 10,000,000 pep | X | reventions 0 $ WORKERS COMPENSATION PER OTH- AND ENPLOYERS' LIABILITY viN BRwre | [ 2% ANY PROPRIETOR/PARTNER/EXECUTIVE E.L. EAGH ACCIDENT $ QA GERIME MR EXCLUDED? N/A andatory in NH) E.L. DISEASE - EA EMPLOYEE § If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE - POLICY LIMIT | $ DESCRIPTION OF QPERATIONS / LOCATIONS / VEHICLES (ACORD 104, Additional Remarks Schedule, may be attached if more space is required) RE: 1001 AIRPORT RD., BLOCK 9, LOT 1 & 2, DESTIN, FL 32541 OKALOOSA COUNTY IS ADDITIONAL INSURED LOSS PAYEE WITH REGARD TO THE ABOVE LOCATION. CERTIFICATE HOLDER CANCELLATION Okaloosa County 5749 A Old Bethel Road Crestview, FL 32536 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS, AUTHORIZED REPRESENTATIVE > Gtr—" 1 ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. Allrights reserved. The ACORD name and logo are registered marks of ACORD o~ SBRANNEN ACERP CERTIFICATE OF PROPERTY INSURANCE “rpmots 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. I this certificate is being prepared for a party who has an Insurable interest in the property, do not use this form. Use ACORD 27 or ACORD 28. PRODUCER fimgfiw Acentria, Inc - Destin Office PHONE . o.(B50) 6501950 A o (850} 550-9288 4634 Gulfstarr Drive E‘lfi'\ft’," e (850) ' (G, oy (850) Destin, FL 32541 gggggfiz:a custaMerip, CRYSBEA-03 INSURER(S) AFEORDING COVERAGE NAIG # INSURED wsurer A -Aich Specialty Insurance Company 21199 INSURER B ; Crystal Beach Development of Destin, Lid , PO Box 1735 MERER S Destin, FL 32540 INSURER D INGURER & : INSURERE : COVERAGES CERTIFICATE MUMBER: REVISION NUMBER: LOCATION OF PREMISES 1 DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Rernarits Schedule, if more space Is required) Crystal Beach Development Company of Northw est Florida, etal. Per Scheduled Named Insureds and Locations SEE ATTACHED ACORD 101 THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABQVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM QR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TOWHICH 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. POLICY EFFECTIVE POLICY EXPIRATION TYPE OF POLICY } RONER 8 MACHINERY ( -~ EQUIPMENT BREAKDOWN — e TYPE OF INSURANCE POLICY HUNBER DATE (MRNDDIYY) | BATE Ginbryawy | SOVERED PROPERTY LTS fl PROPERTY X | suiLomG $ 375,000 b |cassesoFloss | oEpucTIBES |ESPO04866104 03012016 | 0304/2017 | X | PERSONAL PROPERTY |3 40,000 BASIC BUILOING | BUSINESSINCOME | ¢ BROAD ORTETE || prrameENsE 5 ¥ | sPECAL 8,000 RENTAL VALLE 5 EARTHQUAKE BLANKET BULDING | ¢ X TN 3.0000% ] BLANKET PERS FROP | ¢ FLOOD | leLankeET BLOG PP | g L 3 5 TNLAND MARINE TYPE OF POLICY 5 | CAUSES OF LOSS o g ] NAvED RERILS POLICY NUMEER I 3 $ CRIVE s v B $ $ $ $ $ $ SPECIAL CONDITIONS | OTHER COVERAGES [Attach AGORD 104, Additioral Remarks Schedule, if more space Is required) PROPERTY POLICIES INCLUDING WIND, Effective 3/1/2018 to 3//2017; 'I{ Arch Specially Insurance Co. - Policy #E5PI048661-04 2} Evanston Insurance Co, - Policy #KLVIIXPO04358 3} Landmark American insurance Co. - Policy #LHD395718 SEE ATTACHED ACORD 461 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE SANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED iN Okaloosa County ACCORDANCE WiTH THE POLICY PROVISIONS. §749 A Old Bethel Road Crastview, FL 32536 AUTHORIZED REPRESENTATIVE G ® 1895-2000 ACORD CORPORATION. All rights reserved. ACORD 24 (2008/08) The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: CRYSBEA-03 SBRANNEN S LOC #: AE_EZRD ADDITIONAL REMARKS SCHEDULE Page 1 of 1 AGENCY NAMED INSURED Acentria, Inc - Destin Office Crygtal Beach Development of Destin, Ltd BOLICY NUMBER Desfin, FL. 32540 lSEE PAGE 1 CARRIER NAIC CORE SEE PAGE 1 SEE P1 | errecivEpATE: SEE PAGE 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM 18 A SCHEDULE TO ACORD FORM, FORM NUMBER: _ACORD 24 FORM TITLE: Certificate of Property Insurance Description of Property: RE: 1001 AIRPORT RD,, BLOCK 8, LOT 1 & 2, DESTIN, FL 32541 OKALOOSA COUNTY IS LISTED AS LOSS PAYEE AS RESPECTS TO THE ABOVE LOCATION, Special Conditions: 4) Aspen Specialty Insurance Co. - Policy 8RNOFPXASSGV1S Valuation = Replacement Cost Coinsurance = Waived Coverage is not blanket, limits are per Schedule on file with Company 30 Days Cancellation Notice DEDUCTIBLES: Named Storm: 3% of affected values (including time element) subject to $50,000 minimum per Occurrence All Other Wind: $25,000 per Occurrance All Other Perils: $5,000 per Occurrence SUBLIMITS: Debris Removal: $100,000 Fire Department Service Charge: $10,000 Lost Key Coverage: $10,000 Property in Transit: $10,0600 Valuable Paper and Records: $100,000 Accounts Receivable: $100,000 Property of Others: $25,000 Utility Services Coverage; $100,000 "Excluding T&D Lines" Law & Ordinance: $2,500,000 (A ,B&C Combined) ACORD 101 (2008/01) @ 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD @ QBE Certificate of Insurance " QBE The Americas This is to certify to Okaloosa County (Certificate Holder}: 5749 A Old:Bethel Road Crestview, -FL. 32536 The following policy(ies) Zeppelin-Holdings, LLC, B&J of Destin, Inc., Crystal Beach have been issued to: Development of Destin, Ltd. and Crestview Hangar 51, LLC 4652 Gulfstarr Drive Destin, FL~32541 [POLICY INFORMATION Aircraft Policy No. QAV0001078 i : Policy Period: This Coverage Is Effective 12:07 AM. From: .. May 4; 2016 To: May 4, 2017 Policy Territory: Worldwide Insurance Company: QBE Insurance Corporation [LIABILITY COVERAGES Limits of Liability Each Person Each Occurrence Bodily injury $ - $ Property Damage $. $ Passenger Bodily Injury $ $ S X Single Limit Including - Pass. $ $ 20,000,000 ‘ Passenger Liability Limited to: $ $ i [ Description of Aircraft Physical Damage Caverage: All Risks Ground and In-Flight FAA Insured Number Year Make & Model Value Deductibles (NIM/IM) N255TC:. . 1990 Citation 550 .0+ - - $1.750,000 o NIL./NIE THE CERTIFICATE HOLDER [S: Included as a Loss Payee for Arcraft Physical Damage Coverage. Breach of Warranty Coverage on Aircraft Physical Damage as thelr interest may appear not to exceed 100% of the insured value X Included as an Additional Instred on Aircraft Liability Coverage but only as respects operations of the Named Insured. Provided a waiver of subrogation on aircraft physical damage coverage but OTHER COVERAGES / CONDITIONS / REMARKS: X This coverage includes War Physical Damage Coverage and TRIA X This coverage includes War Liability Coverage and TRIA REMARKS: Premises Liability Limit: $20,000,000 each occurrence Premises Liability Coverage is included as respects Block 9 Lot 1 & 2 The Aviation Managers have made provision to give the certificate holder prompt notice of canceliation of any policy above; however, the Aviation Managers assume no responsibility for failure to provide such notice. This certificate does not change in any way the actual coverages provided by the policy(ies) specified above. Date of Issue: 02/06/17 @L} %__J By: {Authorized Representative) David Gray QBE North America 175 TownPark Drive Suite 125 Kennesaw, GA 30144 710-794-6400