Okaloosa County BOCC — May 6, 2014 — Eglin Main Wastewater Easement — reading text

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PLEzes sagas gate esaue 2228 Ven SOME are PRO ona. too Soavevon Or meeonD TEASER RESON [Pe i I I | esse 8 é 169+00 170400 171+00 172400 / 173+00 174400 175+00 1764/8 aE, Bp -—o - “| ip - | __ - eee} - yt — |e 4. - +} ip +--+ # tt \Cesomn ig 1g | I i 5, Zo8 oo age | 8: ttt Es gis pEenee opeges sige Sigg gee 28 gem ~—— err cee ROUERY fJOFNSON eeeisnatco aurwevon sez SIATE GE ELORIDA MATCH LINE Su ad He i | ut EASED RENEE res i EASEMENT 1 i 1 i} i] a Sbo 177+00 178400 /179+00 180400 181+00 182+00 %, 1 =, _ 3 Sob et Rt - tS pm cael Ei g st \cessawe + w 23 a! gee | as 8 g3¢ | oo I Bae | 3% 238 | $3 1 Som | 2b z 2a eae | 22 ze | 8 5 PLAN ee 8 REET gragee gBeage Hue BEE 23 Fag eenenanorrne VER cane ae Pou, enone = core — 29 Uy 1 i END OF CENTERUNE Pod EASEMENT 2 OF 4° N332801.609 Es323086.455 [~ 2 secBF"e > TORS 186+00 187+09 ee EASEMENT 1 PLAN ET cor osisteea aURvevOR sta STATE OE FLORIO Ex eA EASE eu RESON ee 5 wz | &3 228 | os 28e = $5 | EE Ze z 236 | 32 ie | 22 5 | 58 & $805 Lewis Turner Bld, Suite 300 AF. Walton Beact, FL. 32547 Phone: (850) 609-7079 Fax (850) (51-7550 Okaloosa County ‘Water & Sever Engineering EXHIBIT C —- PHYSICAL CONDITION REPORT DEPARTMENT OF THE AIR FORCE USE OF PROPERTY ON EGLIN AIR FORCE BASE, FLORIDA PHYSICAL CONDITION REPORT (PCR) Date of Report: 5 Sep 13 Instrument Type & No: Easement # USAE- BFMC- ETFA ~ \3- és oF Instrument Start Date: TBD Date Possession Taken: TBD Activity: Okaloosa County Water & Sewer Total Area for New Instrument: +/- 28.60 ACRES DESCRIPTION, LOCATION, AND CONDITION OF PROPERTY: The property consists of +/- 28.60 acres of laid with 6 building(s) which are owned by Eglin Air Force Base. Property is located on Eglin Air Force Base, Okaloosa County, Florida, Said tand/property is in excellent /good/ fair / poor condition. Said building(s) is in excellent/good/fair/poor condition. gecele ecekvarris@ CHALbOW, CAOMOU amas peat CCAS, JOINT AGREEMENT ON CONDITION OF PROPERTY ‘We, the undersigned, surveyed and inspected the condition of the property identified above. We agree that as of the date of survey, the condition of said property is:as described herein, at ae Melinda A. inal 4 Okaloosa County Water & Sewer Realty Specialist, Eglin Un EXHIBIT D —- INSURANCE Policy # PX FL 1 0461046 13-04 dtd 10/1/2013 to 10/1/2014 ~ CERTIFICATE OF COVERAGE “ISSUED ON: 10/8/2013 COVERAGE PROVIDED BY: PREF ERRED ‘GOVERNMENTAL INSURANCE TRUST ‘PACKAGE AGREEMENT NUMBE Px FLI 0461046 13-04 COVERAGE PERIOD: 10/1/2013 TO. 10/1/2014 12:01 AM COVERAGES: This is to certify that t the agreement below has been issued to the designated member for the coverage 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 coverage afforded by the agreement described here Mail to: Certifi icate Holder "| Designated Member 96 CEG/CEAR Okaloosa County BOCC 501 DeLeon St, Suite 500 601-A North Peari Street Eglin AFB, FL 32542 Crestview, FL 32526 LIABILITY COVERAGE WORKERS’ COMPENSATION COVERAGE X Comprehensive General Liability, Bodily Injury, Property Damage and Personal Injury Limit $1,000,000 $100,000 SIR X Self d Workers' Ci fi a *, ga haght e sures orkers mpensation we Officials Liability $500,000 Self Insured Retention imi X Statutory Workers’ Ci ti Employment Practices Liability atutory Nrorkers’ -ompensation Limit X Employers Liability X Employee Benefits Liability $1,000,000 Each Accident Limit $1,000,000 $100,000 SIR $1,000,000 By Disease , X Law Enforcement Liability $1,000,000 Aggregate Disease Limit $1,000,000 $100,000 SIR PROPERTY COVERAGE AUTOMOBILE COVERAGE. Buildings & Personal Property Automobile Liability Limit Limit $1,000,000 $50,000 SIR Note: See coverage agreement for details on wind, flood, and other X All Owned deductibles. Specifically Described Autos Rented, Borrowed and Leased Equipment X Hired Autos Limit X Non-Owned Autos All other Intand Marine Automobile Physical Damage Limit X Comprehensive See Schedule for Deductible X Collision See Schedule for Deductible X Hired Auto with limit of $35,000 Garage Keepers Liability Limit Liability Deductible Comprehensive Deductible Collision Deductible NOTE: The most we will pay is further limited by the limitations set forth in Section 768. 26(5), Florida Statutes {2040} or the equivalent limitations of successor r Tew which are applicable at the time of the loss. Description of ‘Operations! Locations! Vehicles/Special item Evidence of Coverage 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 if SHGULD ANY PART OF THE ABOVE DESCRIBED AGREEMENT BE CANCELED BEFORE THE EXPIRATION DATE. Public Risk Underwriters® ‘THEREOF, PREFERRED GOVERNMENTAL INSURANCE TRUST WiLL ENDEAVOR TO MAIL 60 BAYS WRITIEN P.O. Box 958455 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 MAMI. SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE PROGRAM, ITS AGENTS OR REPRESENTATIVES, Producer oe ~“ - Public Risk Insurance Agency F imental P, O, Box 2416 Daytona Beach, FL 32115 eo aaa == — ee AUTHORIZED REPRESENTATIVE PGIT-CERT (11/09) PRINT FORM 10/8/2013