Okaloosa County BOCC — August 19, 2014 — Certificate of Insurance — reading text

—"—™ ACORP CERTIFICATE OF LIABILITY INSURANCE page 1 ot 1 | ame 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. 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 tothe certificate holder in lieu of such endorsement(s}. PRODUCER GONTACT Willis of Illinois, Inc. PHONE, FAX c/o 26 Century Blvd. {al NO.ExT. 877-945-7378 aic,Noy 888-467-2378 P. 0. Box 305191 lanteess: _ Certificates@willis.com Nashville, TN 37230-5191 INSURER(S)AFFORDING COVERAGE NAIC # (NSURERA: HDI-Gerling America Insurance Company 41343-001 INSURED : Mutual - ThyssenKrupp Airport Systems, Inc. INSURERB: Sentry Insurance a ‘ual Company 24988-001 3201 N. Sylvania Ave. INSURERC; Sentry Casualty Company 28460-001 Suite 117 ' Fort Worth, TX 76111-3117 INSURER D: INSURER E: ! INSURER F: COVERAGES CERTIFICATE NUMBER: 21914202 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. INSR TYPE OF INSURANCE oped Susi POLICY NUMBER inuipna __| | famasarryev LIMITS A [GENERAL LIABILITY Y GLD1108505 10/1/2013 |10/1/2014 | EACH OCCURRENCE $ 5,000,000 X_| COMMERCIAL GENERAL LIABILITY PREMISES es osauronco) s 100,000 ] ciams-maoe|_x | OCCUR MED EXP (Any one person) ¢ 5,000 [| PERSONAL &ADVINJURY [$5,000,000 |_| GENERAL AGGREGATE $_ 10,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OPAGG |$ 10,000,000 [x | POLICY L | BRO- L] Loc ls B | AUTOMOBILE LIABILITY ¥ 90-17698-03 10/1/2013 |10/1/2024 | FOMBINENSINGLELIMIT =|, 2,000,000 B |X | anyauTo Y 90-17698-04 10/1/2013 |10/1/2014 | BODILY INJURY(Perperson) | —_ ALL OWNED SCHEDULED BODILY INJURY{Per accident) |§ [1] uireD AuTos fone NED PROPER pAMAGE s iS A |X} umprevcarias |X | occur CUD1108605 10/1/2013 [10/1/2014 | EACHOCCURRENCE i$ 14,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $ 14,000,000 DED l RETENTION$ $ B_ | WORKERS COMPENSATION vm y [90-17698-01 10/1/2013 |10/1/2014 [x |raevimmsl [oa C | ANY PROPRIETOR/PARTNER/EXECUTIVE nia| Y {99-17698-02 LO/1/2013 |10/1/2014 | EL. EACH ACCIDENT $1,000,000 ilandaory ot EXCLUDED? EL. DISEASE -EAEMPLOYEE |§ 1, 000,000 ee aeectibe unter DESGRIPTION OF OPERATIONS below E.L, DISEASE -POLICYLIMIT |§ 1,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach Acord 101, Additional Remarks Schedule, if more space Is required) Additional insured applies to General Liability per CG2010 04/13, Auto Liability per CA8007 02/06. Umbrella Liability policy is Follow Form. General Liability is Primary and Non-contributory per CG0001 04/13, Waiver of Subrogation applies to Workers Compensation, as permitted by law, pex WC 00 03 13 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Okaloosa County 602-C North Pearl Street Crestview, FL 32536 QO \ ) . Oe Col1:4484313 Tpl:1849275 Cert:21914202 ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25 (2010/05) The ACORD name and logo are registered marks of ACORD POLICY NUMBER:GLO1 1085-05 COMMERCIAL GENERAL LIABILITY CG 20 10 04 13 THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. ADDITIONAL INSURED — OWNERS, LESSEES OR CONTRACTORS — SCHEDULED PERSON OR ORGANIZATION This endorsement modifies insurance provided under the fellowing COMMERCIAL GENERAL LIABILITY COVERAGE PART SCHEDULE Name Of Additional Insured Person(s) Or Organization(s) Location(s) Of Covered Operations As required by a written contract As required by a written contract Infarmation required to complete this Schedule. if not shown above, will be shown in the Declarations. A, Section [| — Who Is An Insured is amended to include as an additional insured the person(s} or organization(s} shown in the Schedule, but only with respect to liability for "bodily injury”, "property damage” or “personal and advertising injury” caused, in whole or in part, by 1. Your acts or omissions; or 2, The acts or omissions of those acting on your behalf, in the performance of your ongoing operations for the additional insured{s) at the locatian(s) designated above, However: 4, The insurance afforded to such additional insured only applies to the extent permilled by law, and If coverage provided to the additional insured is required by @ cantract or agreement, the insurance afforded to such additional insured will not 52 broader than that which you are required by the contract or agreement to provide for such adaitional insured, Ss CG 20100413 © Insurance Services Office, Inc., 2012 B, With respect to the insurance affarded to these additional insureds, the following additional exclusions apply: This insurance does not apply to “bodily injury” or “property Gamage” occurring after 1, All werk. including materials, parts or equipment furnished in connection with such work, on the project (other than service, maintenance or repairs) to be performed by er on behalf of the additional insured{s) at the location of the covered operations has been completed, or That portion of “your wark" out of which the njury or damage arses has been out to its nlended use by any person or organization other than another contractor or subcontractor engaged in performing operations for a principal as a part of the same project, 2 Page 1 of 2 C, With respect to the inaurance afforded to hese addilienal insureds, the following is added to Section IIl— Limits OHnagurance: If coverage provided te the additional insured is required by a caniract of agreement, Ihe most wa will pay on behall of the additional ineutad is the Amount Of Insurance: 4. Required by the contract or agraament, or % Availabla under the applicable Limits of Insurance shown In the Declarations; whichover is laas, This sndorsement shall not increase the applicahle Limits of Insurance shawn in the Geclarations, Page 2 of 2 @ Insurance Services Office, Inc,, 2012 CG 20 10 04 13 4. Other Insurance If other valid and collectible insurance is available to the insured for a loss we cover under Coverages A or B of this Coverage Part, our obligations are limited as follows: a. Primary Insurance This insurance is primary except when Paragraph b. below applies. If this insurance is primary, our obligations are not affected unless any of the other insurance is also primary. Then, we will share with all that other insurance by the method described in Paragraph ec. below. b. Excess Insurance (1) This insurance is excess over (a) Any of the other insurance, whether primary, excess, contingent or on any other basis: {i) That is Fire, Extended Coverage, Builder's Risk, Installation Risk or similar coverage for "your work", (ii) That is Fire insurance for premises tented to you or temporarily occupied by you with permission of the owner: (iii) That is insurance purchased by you to cover your liability as a tenant for “property damage” to premises rented to you or temporarily occupied by you with permission of the owner; or (iv) If the loss arises out of the maintenance or use of aircraft, “autos” or watercraft to the extent not subject to Exclusion g. of Section | — Coverage A — toby Injury And Property Damage Lial {b) Any other primary insurance 7 to you covering liability for damages arising out of the premises or operations, or the products and completed operations, for which you have been added as an additional insured. (2) When this insurance is excess, we will have no duty under Coverages A or B to defend the insured against any “suit” if any other insurer has a duty to defend the insured against that “suit”. If no other insurer defends, we will undertake to do so, but we will be entitled to the insured’s rights against all those other insurers. (3) When this insurance is excess over other insurance, we will pay only our share of the amount of the loss, if any, that exceeds the sum of: {a) The total amount that all such other insurance would pay for the loss in the absence of this insurance; and (b) The total of all deductible and self- insured amounts under all that other insurance. (4) We will share the remaining loss, if any, with any other insurance that is not described in this Excess Insurance Provision and was not bought specifically to apply in excess of the Limits of Insurance shown in the Declarations of this Coverage Part. c. Method Of Sharing if all of the other insurance permits contribution by equal shares, we will follow this method also. Under this approach each insurer contributes equal amounts until it has paid its applicable limit of insurance or none of the loss remains, whichever comes first. If any of the other insurance does not permit contribution by equal shares, we will contribute by limits. Under this method, each insurer's share is based on the ratio of its applicable limit of insurance to the total applicable limits of insurance of all insurers. 5. Premium Audit a. We will compute all premiums for this Coverage Part in accordance with our rules and rates. b. Premium shown in this Coverage Part as advance premium is a deposit premium only. At the close of each audit period we will compute the eared premium for that period and send notice to the first Named Insured. The due date for audit and retrospective premiums is the date shown as the due date on the bill. If the sum of the advance and audit premiums paid for the policy period is greater than the earned premium, we will retum the excess to the first Named Insured_ c. The first Named Insured must keep records of the information we need for premium computation, and send us copies at such times as we may request. 6. Representations By accepting this policy, you agree: a. The statements in the Declarations are accurate and complete; Page 12 of 16 © Insurance Services Office, Inc., 2012 CG 00 01 04 13 COMMERCIAL AUTO ADDITIONAL INSURED ~ AUTOMATIC STATUS WHEN REQUIRED BY CONTRACT OR AGREEMENT WITH YOU Yhis endorsement modifies insurance providad under the following: BUSINESS AUTO COVERAGE FORM GARAGE COVERAGE FORK TRUCKERS COVERAGE FORM Section I], Liability A. foverage 1. Who Is Av Inaured is amended to incdude as an additional insured any person er organdzstion for whor you are parforning aperations yvhen you and auch parson or argandzetion have agresd in writing in a contract or agraament that such pergon or organization be addad as an additianal insurad on your policy, . The states of on additional insured under this endorsement ends when your operations for that additional ingurad ore completed, Tho mart wea will pay on behalf of the odditdonal insured t6 the dessar of tha amount pevable under Section C. Linit OF Inaurance or the amount of insurance required by the contrect or agreement. Notwithstanding sny reauirement, term or condition of any contract or agreement with respoet te which this andorsamank may ‘pertain, the insurance affordad to the additional inaured is gubjact to all the terns, exclusions and canditiona of the Comaercial Auto Cevarage Form to which this