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Okaloosa County BOCC — February 17, 2015 — NetworkCablingAndRepairContractRenewals — reading text
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original to Purchasing Services Coordinator.
If you have any questions please contact the Purchasing Director at 850-689-5960, Fax: 850
689-5998.
I
DATE (MMIDD/VYVY)
ACORD-
~ CERTIFICATE OF LIABILITY INSURANCE 1 2/ 1 9 / 20 14
THIS C ERTIFICATE IS ISSUED AS A MAnER OF INFORMATION ONLY AN D CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS
CERTIFICATE DOES NOT AFFI RM ATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE C OVERAGE AFFORDE D BY TH E POLICIES
BEL OW . T HIS CE RTIFICATE OF IN SU RANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S). AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND TH E C ERTIFICATE HOL DER.
IMPORTANT: If the certificate holder is an ADDITIO NAL INSURED, the p ollcy(ies) must be endorsed . If SUBROGATION IS WAIVED. subject to
the terms and conditions of the p olicy, certai n policies may require an endorsement. A statement on thi s certificate does not confer rights to the
certificate holder in lieu of such endorsement(s) .
PRODUCER ~2AA~~CT B ekah E'iclter ing
L a s s i ter -Ware Insurance of Maitland r~gN~n. Fn" (8 0 0) 8 4 5- 8437 IrM . NQ1: (8881 983 - 8680
270 1 Mai tland Cen ter Parkway ~~D~~: B ekahP@lassit er-ware. com
Sui t e 125 INSURER(S) AFFORDING COVERAGE NAlC#
Ma i t l and FL 32 7 51 INSURER A :All i ed Property & casual t y 42579
INSURED INSURER B :Z eni th Insuranc e C o. 13 269
Universal Cabling Sys tems, Inc. INSURER c :
INSURERD :
9 14 Fern Stree t INSURER E:
West Palm Beach FL 33401 INSURER F :
COVERAGES CERTIFICATE NUMBER" 15/16 we 14/15 P&C REVISION NUMBER·
THIS IS TO CERTI FY THAT TriE 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.
INSR
LTR TYPE OF INSURANCE I ~~~~ ~~ POLICYNUMBER 1 (~gMgTY~l ~~E~ LIMITS
GENERAL LIABILITY EACHOCCLRRENCE S 1 ,000,00 0
I-
r1l p 'IMERCIAL GENERAL LIABI LITY =:t;~~ yt.~e) $ 1 00,000
A
I-
CLAIMS-MADE [i] OCCUR X Y ACP592 547 25 66 ~ / 1l / 20H 5 /11/2015 MED EXP (Any ane p"""",) $ 10 , 000
PERSONAL & ADV INJURY $ 1,000,0 0 0
I-
GENERAL AGGREGATE $ 2,000,0 00
I-
n'LAGGREGATE LIMIT
POLICY Ixl ~~g
APFt PER:
LOC
PRODUCTS· COMP/OPAGG $
S
2 ,000, 0 00
AUTOMOBILE LIABILITY ~=~!~IN(jU: LIMI 1, 0 00 0 00
I- S
X ANY AUTO BODILY INJURY (Per perscn) $
A I-- ALl OWNED .- SCHEDULED ACP592 54 72 566 ~ / 1l/2014 ~/11 / 2 015 BODILY NJURY (Per sccidenl) $
I- AUTOS AUTOS
I- NON-OWNED
HIRED AUTOS !;ROPERTYIt?AMAGE S
I- I- AUTOS : Per accldent
$
A
-
X UMEIRELLA LIAB
EXCESSLlAB
P1 OCCUR
CLAIMS-MADE
EACH OCCURRENCE
AGGREGATE
S
$
3,000,00 0
3,000 , 000
I I
OED X RETENTION S 0 l'.CP592 5 4725 6 6 ~ /ll n014 :> /11/ 2 01 5 $
B WORKERS COMPENSATION
AND EMPLOYERS· LiABILITY YIN
X I T~Im!sl I°m-
ANY PROPRIETORIPARTNERlEXECUTIVE ~ EL EACH ACCIDENT S 1, 000 ,00 0
OFFICERIMEMBER EXCLUDED? N/ A
(Mandatary In NH) 070501506 11 / 2015 /1/2016
E.L OISEASE EA EMPLOYEE $ 1 000 , 000
grs'c~rPTr'6~ O~QpERATIONS be!ow EL DISEASE POUCY UMIT $ 1 0 00 , 000
DESCRIPTIONOF OPERATIONS I LOCATIONS I VEHICLES (Attach ACORD 101. Additional Remarks 5<:hedule, If mare space Is required)
Oka~oosa Co unty, and ~t s respec t i v e agents , c o n sul tants, servants, and emp~ oya es of each and a~ ~ other
i n teres ts are named as a d ditional i nsured under t he terms and condi t ions of t h e g e neral liabi l i t y po1 i cy
wi th respec t s to wor k b eing p erformed b y the named insure d as required by wri tten contract . The genera1
liabil i ty p o l icy contain s a Waiver o f Subrogat ion in favor of t he c ert i ficate hOlder providing the
contrac t is executed prior to any loss. Th i s insurance shall b e primary and non-contributory.
CE RTIFICATE HOLPER CANC ELLATION
SHOU LD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCEL LED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WIL L BE DEUVERED IN
ACCORDANC E WITH THE POLICY PROVISIONS.
Okaloo s a Cou nty
602-C N or t h Pearl Street
Cr e stview, FL AUTHORIZED REPRESENIATIVE
32536
-= .,L
Pau l Z i ccardi/REBBKP ~- ::g
ACORD 25 (201010::;) @1988-2010ACORD CORPORATION . All rights reserved.
INS025 (~Ol005).Ol The ACORD name and logo are regIstered maries ofACORD
