Okaloosa County BOCC — January 21, 2014 — Skanska Final Payment — reading text

force Base, thence N 87°48'29" W, along the said boundary of said Board of Public Instruction tract which is along the boundary of said United States tract 1150.83 feet to an unnumbered 4"x4" concrete monument; thence S 01°47'58" W, along the boundary of said Board of Public Instruction tract which is along the boundary of said United States tract 1726.18 feet more or less to an unnumbered 4"x4" concrete monument on the northern right-of-way line of the State Road 189 and to the point of beginning; thence S 65°40'01" W along the northern right-of-way line of said road 1718.69 feet to a rod and cap #4167; thence N 01°47'58" E, 882.25 feet; thence N 90°00'00" E, 938.86 feet; thence S 00°00'00" W, 173.65 feet; thence N 90°00'00" E, 599.45 feet more or less to the point of beginning. The parcel described herein contains 16.30 acres, more or less and is a portion of Parcel 1 (Tract 943) and a portion of Parcel 2 (Tract 944) as recorded in the Official Records Book 2663, page 4937, Okaloosa County, Florida. DATED on October 11, 2013. Lienor, Skanska USA Buildin " By: bod Authorized representative DRAIN RRR 4 3 ra . WORTHWEST ily News Published Daily Fort Walton Beach, Florida Distributed in Okaloosa, Santa Rosa & Walton Counties State of Florida, County of Okaloosa Before the undersigned authorized personally appeared M GWA Lin _ WW f | 45t a who on oath says that (s)he is Loge Add ths: a Chak of the Northwest Florida Daily News, a daily newspaper published at Fort Walton Beach, in Okaloosa County, Florida; that the attached copy of advertisement, being a uf ToS in the matter of Ad Vir tst mint of Comp ction Os) oese (: dunks Cowthous: Amney in the beg hoesa Coury ae was published in said newspaper in the issues of August ZU 28 Siykimbur # Ut 2013 Affiant further says that the said Northwest Florida Daily News is a newspaper published at Fort Walton Beach, in said Okaloosa County, Florida, and that the said newspaper has heretofore been continuously published in said Okaloosa County, Florida, each day, and has been entered as second class mail matter at the post office in Fort Walton Beach, in said Okaloosa County, Florida, for a period of one year next preceding the first publication of the attached copy of advertisement; and affiant further says that (s)he has neither paid nor promised any person, firm or corporation any discount, rebate, commission or refund for the purpose of securing this advertisement for publication in the said newspaper. STATE OF FLORIDA COUNTY OF OKALOOSA Subscribed and sworn to (or affirmed) before me this M1 Ne phrmdd O13 Lf (Date) Lhe , who is/are personally known to me or has/have produced frsm Ghky 7 y ow a] as identification. (Type of idéntification) Notary Public, Commission No. (Signatu: (Name of Notary typed, printed or stamped) , fPma st Ma eee a a pews Bucs ® ay v \ Seite, ELEANOR We . - ; 1 SK Ns Notary Public - State of Florida ot )°s My Comm, Expires Ju 130, 2015 { ' RSW YsF Commission # BE 110919 / 2 i ae Bonded Through National Notary Aven. OAS Pe =, J DATE(MM/DD/YYYY) ACORIY : es CERTIFICATE OF LIABILITY INSURANCE t2naz013 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. r =r oer? THT oe 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 2 certificate holder in lieu of such endorsement(s). -_ 2 PRODUCER CONTACT s Aon Risk Services Northeast, Inc. PHONE Bie: Jericho NY Broadway Office (NC. No. Ext): {AiG No.): a 390 North Broadway E-MAIL 2 Jericho NY 11753 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURERA: Zurich American Ins Co 16535 Skanska USA Building, Inc. IWSURERB: American Zurich Ins Co 40142 35 Han) Ven Sr Boulevard INSURER C: Arch Insurance Company 11150 Atlanta GA 30308 USA INSURERD: American Guarantee & Liability Ins Co 26247 INSURER E: _ INSURER F: COVERAGES CERTIFICATE NUMBER: 570052122885 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 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. Limits shown are as requested} TYPE OF INSURANCE POLICY NUMBER FOLEY EFF 7 POvicy EXP LIMITS a Cee aici | A | GENERAL LIABILITY GL 1/2014) Each OCCURRENCE $2,000,000) — | DAMAGE TO RENTED X | COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) $2,000,000 || CLAMS-MADE [x] occuR MED EXP (Any one person) $10,000 rx | xcu PERSONAL & ADV INJURY $2,000,000 3 X | 50 RR Delete GENERAL AGGREGATE $4,000,000 g GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS - COMP/OP AGG $4,000,000 & r | POLICY [x] X | Loc s c AUTOMOBILE LIABILITY 11CAB8907901L 08/31/2013] 08/7 31/7 2014 COMBINED SINGLE LIMIT $2,000,000 oi AOS | (Ea accident) _ : z x ¢ TX ] anyauto 11¢A88908001 08/31/2013] 08/31/2014} BODILY INJURY (Per person) 8 rx | ALLOWNED [1] Sari MA BODILY INJURY (Per accident) 2 | * | AuTos S L—-{ PROPERTY DAMAGE [X_]HIRED AUTOS | x | ees (Per accident) € 6 D Tx] umprewtauas | x | occur AEC489601907 08/31/2013|08/31/2014| EACH OCCURRENCE $10,000,000] © || excess uss || CLAIMS-MADE AGGREGATE $10,000,000 DED | |RETENTION B | WORKERS COMPENSATION AND wc489601709 08731/2013[0873172014] y | WC STATU-| [OTH EMPLOYERS’ LIABILITY YIN TORY LIMITS ANY PROPRIETOR / PARTNER / EXECUTIVE E.L. EACH ACCIDENT $2,000,000 OFFICERVMEMBER EXCLUDED? NIA (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $2,000,000 b SERIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $2,000, 000) of the General Liability, Automobi d Monopolistic States - OH, NO, WA, WY and Puerto Rico. DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, f more space is required) RE: Project No. 219515, Okaloosa County Courthouse Annex Extension, . at . . Okaloosa County Board of County Commissioners and Okaloosa County are included as Additional Insured in accordance with the policy provisions of the General Liability, Automobile Liability and Umbrella Liability policies. granted in favor of Okaloosa County Board of County Commissioners and Okaloosa Count ae Liability and umbrella Liability policies. A waiver of Subrogation is in accordance with the policy provisions workers' Compensation Coverage Not Included in CERTIFICATE HOLDER CANCELLATION Okaloosa County Board of County Commissioners 602-c North Pearl Street Fort Walton Beach, FL 32536 USA POLICY PROVISIONS. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WL BE DELIVERED IN ACCORDANCE WITH THE U AUTHORIZED REPRESENTATIVE Metre boo TRS RS Se Ae I ACORD 25 (2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. CG 02 24 10 93 EARLIER NOTICE OF CANCELLATION PROVIDED BY US This endorsement modifies insurance provided under the following: COMMERCIAL GENERAL LIABILITY COVERAGE PART LIQUOR LIABILITY COVERAGE PART POLLUTION LIABILITY COVERAGE PART PRODUCTS/COMPLETED OPERATIONS LIABILITY COVERAGE PART This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Endorsement effective Policy No. GLO4896018-06 12:01 A.M. standard time Named Insured- Skanska USA Building Inc. Countersigned nay (Authorized Representative) SCHEDULE Number of Days’ Notice 90 (If no entry appears above, information required to complete this Schedule will be shown in the Declarations as applicable to this endorsement.) For any statutorily permitted reason other than nonpayment of premium, the number of days required for notice of cancellation, as provided in paragraph 2. of either the CANCELLATION Common Policy Condition or as amended by an applicable state cancellation endorsement, is increased to the number of days shown in the Schedule above. CL 648 (10-93) CG 02 24 10 93 Copyright, Insurance Services Office, Inc., 1992 Page 1 of 1 . 4 "CONSENT OF oanen = : AR SURETY COMPANY conrracTor:C TO FINAL PAYMENT SURETY a) Conforms with the American Institute of OTHER Architects, AlA Document G707 PROJECT: Bond Nos.:105285571; 8937386; 015-029-735; 8192-99-06 (name, address} FL 32547 TO (Owner) ARCHITECT'S PROJECT NO: OKALOOSA COUNTY BOARD OF COMMISSIONERS CONTRACT FOR: 602-C North Pearl St. Courthouse Annex Extension Fort Walton Beach FL 32536 _] CONTRACT DATE: CONTRACTOR: SKANSKA USA BUILDING INC. - GOVT. In accordance with the provisions of the Contract between the Owner and the Contractor as indicated above, the there insert name and address of Surety Company) TRAVELERS CASUALTY AND SURETY LIBERTY MUTUAL INSURANCE COMPANY FIDELITY AND DEPOSIT COMPANY OF COMPANY OF AMERICA 175 Berkeley Street MARYLAND One Tower Square Boston MA 02116 1400 American Lane, Tower |, 18th Floor Hartford, CT 06183 Schaumburg, IL 601 and FEDERAL INSURANCE COMPANY, 15 Mountain View Rd., PO Box 1615, Warren NJ 07061-1615 4 COMPANY on bond of _ {here insert name and address of Contractor) SKANSKA USA BUILDING INC. - GOVT. 55 Ivan Allen Jr. Blvd. Atlanta GA 30308 , CONTRACTOR, hereby approves of the final payment to the Contractor, and agrees that final payment to the Contractor shall not relieve the Surety Company of any of its obligations to there insert name and address of Owner) OKALOOSA COUNTY BOARD OF COMMISSIONERS 602-C North Pear St. Fort Walton Beach FL 32536 , OWNER, and that the Performance and Payment Bonds will remain in effect for at least one (1) year from the date final payment to the Contractor becomes due. as set forth in the said Surety Company's bond. IN WITNESS, WHEREOF, the Surety Company has hereunto set its hand this 18th day of September, 2013 FEDERAL INSURANCE COMPANY TRAVELERS CASUALTY AND Sa rt hi > aidaiatal OF AMERICA LIBERTY MUTUAL INSURANCE COMP FIDELITY AND DEPOSIT COMPANY OF MARYLAND WITNESS: Surety Company , 7. * a Signafire of AuthoriZed Repfésentative Maria Signorile Attorney-in-Fact Title NOTE: This form is to be used as a companior dccument to AIA DOCUMENT G706, CONTRACTOR'S AFFIDAVIT OF PAYMENT OF DEBTS AND CLAIMS, Current Edition ONE PAGE wate ani i bal mpaaiimauteerh ain cna Sonne MAM ee OF Vigilant Insurance Company 15 Mountain View Road x. Chubb POWER Federal Insurance Company Attn: Surety Department Surety ATTORNEY Pacific Indemnity Company Warren, NJ 07059 Know Ail by These Presents, That FEDERAL INSURANCE COMPANY, an indiana corporation, VIGILANT INSURANCE COMPANY, a New York corporation, and PACIFIC INDEMNITY COMPANY, a Wisconsin corporation, do each hereby constitute and Spot James F. Dunn, Beth Marian Kitchens-Harmon, Maria Signorile and Wesley P. Williams of Atlanta, each as their tue and lawful Attorney- in- Fact to execute under such designation in their names and to affix their corporate seals to and deliver for and on their behatf as surety thereon or otherwise, bonds and undertakings and other writings obligatory in the nature thereof (other than bail bonds) given or executed in the course of business, and any instruments amending or altering the same, and consents to the modification or alteration of any instrument referred to in said