Okaloosa County BOCC — March 1, 2016 — Glazesignedcontrenewal — reading text

CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Okaloosa County ACCORDANCE WITH THE POLICY PROVISIONS. 602-C North Pearl Street Crestview FL 32536 AUTHORIZED REPRESENlATIVE I ~~ © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD ;0  ACORD® CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDDIYYYY) ~ 2/10/2016 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 BE:LOW. 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 I certificate holder in lieu ·of such endorsement(s). . CONTACT PRODUCER NAME' Waldorff Insurance & Bonding 45 Eglin Parkway NE Ste 202 rA~gNJn FYI\- 850-581-4925 r..e~ No" 850-581-4930 I IFort Walton Beach FL 32548 ~~D~~SS ' reception ist@waldorffinsurance .com I INSURER(S) AFFORDING COVERAGE NAJC# INSURER A :Westfield Insurance Company 24112 INSURED GLAZ-0 1 INSURER B :The FCCI Insurance Company 10 17 8 Glaze Communications Services , Inc . INSURER c: 1864 Cowen Road INSURER D: Gulf Breeze FL 32563 INSURER E: INSURER F: - COVERAGES CERTIFICATE NUMBER' 1759949311 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 WH)CH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTA'IN , 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 CLAIM S. INSR LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER I (~~hlgYv~~1 ' (~~~6g~1 LIMITS A COMMERCIAL GENERAL LIABILITY Y CWP0937612 2112/2016 2/12/2017 $1,000,000 rL- :=I EACH OCCURRENCE r-­ CLAIMS-MADE US] OCCUR ~~~~~~~9E~~J~~n~1 S150,OOO MED EXP (Any one person) S1,OOO r-­ PERSONAL & ADV INJURY S1,OOO ,OOO r-­ r:=:jJ'L AGGREGATE LIMIT APPUES PER: POLICY o PRO­ JECT 0 LOC GENERAL AGGREGATE PRODUCTS ­ COMP/OP AGG S2,OOO 000 52,000,000 $ OTHER : A AUTOMOBILE LIABILITY CWP0937612 2/12/2016 2 /12/2017 tEa aCcide~t?' N<"; L'= LlMI $1,000,000 r--, X ANY AUTO BODILY INJURY (Per person) S I - ALL OWNED r - SCHEDULED AUTOS AUTOS BODILY INJURY (Per accidenl) S 7 I--­ HIRED AU TOS 7f - ­ AUTOS NON·OWNED ip~?~';'~d~~t~AMAGE $ S A X I­ UMBRELLA LlAB EXCESS LlAB M OCCUR CLAIMS·MADE CWP0937612 2/1212016 2/12/2017 EACH OCCUR RENCE AGGREGATE S3,000,000 $3, 000 ,000 DED X I I RETENTION $ 0 s B WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 001WC16A67995 2/12/2016 2/12/2017 X I ~f~TUTE I I ~~H- I ANY PROPRIETORiPARTNERiEXECUTIVE YIN E.L. EACH ACCIDENT $1 ,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) 0 NIA E.L. DISEASE ­ EA EMPLOYEE $1,000,000 If yes , describe under DESCRIPTION OF OPERATIONS below E.L. DISEAS E - POLICY LIM IT $1,000,000 A LeasedlRented Equip CWP0937612 2/12/2016 2/12/2017 Limit: $25,000 Oed : 51,000 Installation Floater limit: $280,000 Oed : $1,000 DESCRIPTION OF OPERATIONS I LOCATIONS / VEHICLES (ACORD 101 , Additional Remarks Schedule, may be attached if more space is required) RE: License #ES1200W89 State of FL Low Voltage Contractor It is hereby understood and agreed that the below named certificate holder is added as additional insured as pertains to General Liability only when required by written contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Okaloosa County Dept of Growth Management ACCORDANCE WITH THE POLICY PROVISIONS. 1804 Lewis Turner Blvd #200 Fort Walton Beach FL 32547 I © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD