Okaloosa County BOCC — December 4, 2012 — NLF 2013 GrantofEasement — reading text

law which are applicable at the time of the loss. Description of C Operations/ Locations/ Vehicles/Special items: Auto Liability coverages is provided on an "any auto" basis. Waiver of subrogation is granted with regard to Certificate Holder for the lease agreement. Certificate Holder is Additional Covered party per the attached PGIT 902 as respects to this lease agreement. This section completed by member's agent, who bears complete responsibility and liability for its accuracy. This certificate is issued as a matter of information only and confers no rights upon the certificate holder. This certificate does not amend, extend or alter the coverage afforded by the agreement above. | Administrator CANCELLATIONS j i SHOULD ANY PART OF THE ABOVE DESCRI REEMENT BE CANCELLED BEFORE THE EXPIRATION DATE Public Risk Underwriters EP De leerepeneaterriete trenton .0. Box NOTICE, OR 10 DAYS WRITTEN NOTICE FOR NON-PAYMENT OF PREMIUM, TO THE CERTIFICATE HOLDER, Lake Mary, FL 32795-8455 NAMED ABOVE, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY } KIND UPON THE PROGRAM. ITS AGENTS OR REPRESENTATIVES. | i Producer : - il ~ ~ | Public Risk Insurance Agency PO P. O. Box 2416 | — Daytona Beach, FL 32115 AUTHOR PGIT-CERT (11/09) PRINT FORM EXHIBIT E PUBLIC ENTITY AUTOMATIC ADDITIONAL COVERED PARTIES THIS ENDORSEMENT CHANGES THE AGREEMENT. PLEASE READ IT CAREFULLY. This endorsement modifies coverage provided under the AUTOMOBILE COVERAGE FORM, PGIT 300, the GENERAL LIABILITY COVERAGE FORM, PGIT 200 and the PROPERTY AND INLAND MARINE COVERAGE FORM, PGIT 104 Where indicated by (x) below, coverage applies to the person(s) or organization(s) as their interest may appear. The pro’ visions in this endorsement do not supersede Florida Statute 768.28, Article 10 § 13 of the Florida Constitution, or any other Statute or law limiting whom a Public Entity can indemnify. =. PGIT 902 (10 08) ADDITIONAL COVERED PARTY - BY CONTRACT, AGREEMENT OR PERMIT SECTION | - WHO IS A COVERED PARTY is amended to include any person(s) or organization(s) (hereinafter called Additional Covered Party) with whom you agree in a written “insured contract” to name as a Covered Party, but only with respect to liability arising, in whole or in part, out of your operations, “your work’ or facilities owned or used by you. The coverage afforded to the Additional Covered Party does not apply: (1) Unless the written “insured contract”, agreement or permit was executed prior to the “bodily injury,” “property damage,” “personal injury” or “advertising injury;” (2) To any person(s) or organization(s) included as a Covered Party under this coverage agreement or by an endorsement made part of this coverage agreement. ADDITIONAL COVERED PARTY - OWNERS OF LEASED EQUIPMENT SECTION II - WHO IS A COVERED PARTY is amended to include any person(s) or organization(s) (hereinafter called Additional Covered Party) with whom you agree in a written equipment lease or rental agreement to name as a Covered Party, but only with respect to liability arising out of the sole negligence of the Covered Party, and only while such equipment is in the care, custody or control of the Covered Party, or any employee or agent of the Covered Party. The coverage afforded to the Additional Covered Party does not apply to: (1) “Bodily injury” or “property damage” occurring after you cease to lease or rent the equipment; (2) “Bodily injury” or “property damage” arising out of any negligence of the Additional Covered Party; (3) Structural alterations, new construction or demolition operations performed by or on behalf of the Additional Covered Party; (4) Liability assumed by the Additional Covered Party under any contract or agreement; (5) “Property damage” to: (a) Property owned, used, occupied by, or rented to the Additional Covered Party; (b) Property in the care, custody or control of the Additional Covered Party or its employees or agents, or of which the Additional Covered Party, its employees or agents are for any purpose exercising physical control. Page 1 _X ADDITIONAL COVERED PARTY - MANAGERS OR LESSORS OF PREMISES SECTION Il - WHO IS A COVERED PARTY is amended to include any person(s) or organization(s) (hereinafter called Additional Covered Party) with whom you agree in a written agreement to name as a Covered Party, but only with respect to liability arising, in whole or in part, out of the “premises” leased to you by such person(s) or organization(s). The coverage afforded to the Additional Covered Party does not apply to: (1) “Bodily injury” or “property damage” occurring after you cease to be a tenant in that “premises”; (2) “Bodily injury” or “property damage” arising out of any negligence of the Additional Covered Party; (3) Structural alterations, new construction or demolition operations performed by or on behalf of the Additional Covered Party; (4) Liability assumed by the Additional Covered Party under any contract or agreement; (5) “Property damage” to: (a) Property owned, used, occupied by, or rented to the Additional Covered Party; (b) Property in the care, custody or control of the Additional Covered Party or its employees or agents, or of which the Additional Covered Party, its employees or agents are for any purpose exercising physical control. Notwithstanding any other provision of this agreement, nothing in this agreement shall be construed as a waiver of the Covered Party’s sovereign immunity nor shall any provision of this agreement increase the liability of the covered party, or the sums for which the covered party may be liable, beyond the limits provided in §768.28, Florida Statutes. PGIT 902 (10 12) Page 2 ENVIRONMENTAL USE RESTRICTIONS Due to changing environmental conditions and/or regulations, the assigned Categorical Exclusion (CATEX) 19 for this proposed action will expire 24 September 2017 (five years from the AF Form 813 signature date). If the proposed action is not implemented within five years, a new AF Form 813 must be submitted. Grantee must coordinate with Eglin Natural Resources prior to any ground disturbing activities (i.e. new well) for protected species surveys. Contact Kathy Gault, 96 CEG/CEVSN, (850) 883- 1145 or Bruce Hagedorn, 96 CEG/CEVSN, (850) 882-8421. Grantee must coordinate with Eglin Natural Resources Forestry Section prior to any tree removal as trees may be merchantable. Contact Al Sutsko, 96 CEG/CEVSNF, (850) 883-1129 or Scott Hassell, 96 CEG/CEVSNF, (850) 883-1126. A UXO survey/study is required and must be conducted by active duty EOD or UXO qualified personnel prior to any ground intrusive activity on property known or suspected to contain Munitions and Explosives of Concern (MEC), UXO or Discarded Military Munitions (DMM). Contact 96 TW/SEU (Range Safety), Ronald Cofer, (850) 882-7347 and 96 TW/SEG (Ground Safety), Tommy Salter, (850) 882-7385. Grantee is required to obtain an approved AF IMT 103, Base Civil Engineering Work Clearance Request (also known as a Dig Permit), prior to performing any digging or ground disturbing activities on Eglin AFB. Contact the Civil Engineering Customer Service Desk at (850) 882- 8347. Grantee must coordinate Dig Permit through AAC/SEU, Range Safety, (850) 882-7358. Grantee is required to obtain approval from the Installation Spectrum Manager prior to the installation and use of all remote monitoring equipment or potential sources of radio frequency. Contact Joseph Giangrosso, 96 CS/SCXF, (850) 882-4416. Grantee is required to obtain a Northwest Florida Water Management District permit in the event wells are abandoned and no longer needed for assessment purposes. Grantee is required to repair any damage done in accessing and drilling new wells and maintenance of any infrastructure needed for future access. Grantee is required to contact the Range Operations Control Center at (850) 882-5800 and obtain a Z Number prior to entering Eglin ranges. EXHIBIT F