Okaloosa County BOCC — March 18, 2014 — reading text

TORY LIMITS ER YIN ANY PROPRIETOR/PARTNER/EXECUTIVE E . L. EACH ACCIDENT $ 1 , 000,000 OFFICER/MEMBER EXCLUDED? N N/A (Mandatory In NH) 0830-31070 1 / I / E . L. DISEASE - EA EMPLOYE $ 1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below - - E . L. DISEASE - POLICY LIMIT $ 1,000,000 E Contrs Equip 1000 ded 4546-55-73 1/1/2014 1/1/2015 Leased/Reeled Equip 100,000 1 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additional Remarks Schedule, If more space Is required) Okaloosa County is an additional insured with respect to general liability and automobile liability. Coverage is primary and non-contributory. Should any of the above described policies be cancelled before the expiration date thereof, the producer will endeavor to mail 30 days written notice except 10 days notice for non-payment cancellation to the certificate holder named herein, but failure to do so shall impose no obligation or liability of any kind upon the producer, its agents or representatives. All other terms and conditions of this policy remain unchanged. CERTIFICATE HOLDER CANCELLATION jkublik@co.okaloosa.fl.co SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Okaloosa County 602-C Pearl St AUTHORIZED REPRESENTATIVE Crestview, E% 32577 3 ,. J McMahon, CIC, CWCP/ ACORD 25(2010/05) © 1988-2010 ACORD CORPORATION. All rights reserved. IPjSfl2 e,r,inrici ru Th. ACCIPfl n,n,w ,.nd Iwnw rwni tr,u.1 wf ftt('Pfl Packet Pg. 425  COMMERCIAL AUTO THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. BUSINESS AUTO EXTENSION ENDORSEMENT This endorsement modifies insurance provided under the following: BUSINESS AUTO COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modi- fied by the endorsement. GENERAL DESCRIPTION OF COVERAGE - This endorsement broadens coverage. However, coverage for any injury, damage or medical expenses described in any of the provisions of this endorsement may be excluded or limited by another endorsement to the Coverage Part, and these coverage broadening provisions do not apply to the extent that coverage is excluded or limited by such an endorsement. The following listing is a general cover- age description only. Limitations and exclusions may apply to these coverages. Read all the provisions of this en- dorsement and the rest of your policy carefully to determine rights, duties, and what is and is not covered. A. BROAD FORM NAMED INSURED H. HIRED AUTO PHYSICAL DAMAGE - LOSS OF USE - INCREASED LIMIT B. BLANKET ADDITIONAL INSURED I. PHYSICAL DAMAGE - TRANSPORTATION EXPENSES - INCREASED LIMIT C. EMPLOYEE HIRED AUTO J. PERSONAL EFFECTS D. EMPLOYEES AS INSURED K. AIRBAGS E. SUPPLEMENTARY PAYMENTS - INCREASED L. NOTICE AND KNOWLEDGE OF ACCIDENT LIMITS OR LOSS F. HIRED AUTO - LIMITED WORLDWIDE M. BLANKET WAIVER OF SUBROGATION COVERAGE - INDEMNITY BASIS G. WAIVER OF DEDUCTIBLE - GLASS N. UNINTENTIONAL ERRORS OR OMISSIONS PROVISIONS A. BROAD FORM NAMED INSURED executed by you before the "bodily injury" or The following is added to Paragraph A.1., Who Is "property damage" occurs and that is in effect An Insured, of SECTION II - LIABILITY COV- during the policy period, to be named as an addi- ERAGE: tional insured is an "insured" for Liability Cover- age, but only for damages to which this insurance Any organization you newly acquire or form dur- applies and only to the extent that person or or- ing the policy period over which you maintain ganization qualifies as an "insured" under the 50% or more ownership interest and that is not Who Is An Insured provision contained in Section separately insured for Business Auto Coverage. II. Coverage under this provision is afforded only un- til the 180th day after you acquire or form the or- C. EMPLOYEE HIRED AUTO ganization or the end of the policy period, which- The following is added to Paragraph A.1., ever is earlier. Who Is An Insured, of SECTION II - LI- B. BLANKET ADDITIONAL INSURED ABILITY COVERAGE: The following is added to Paragraph c. in A.1., An "employee" of yours is an "insured" while Who Is An Insured, of SECTION II - LIABILITY operating an "auto" hired or rented under a COVERAGE: contract or agreement in that "employee's" name, with your permission, while performing Any person or organization who is required under duties related to the conduct of your busi- a written contract or agreement between you and ness. that person or organization, that is signed and CA T3 53 06 09 © 2009 The Travelers companies, Inc. Page 1 of 4 Includes the copyrighted material of Insurance Services Office, Inc. with its permission. Packet Pg. 426 COMMERCIAL AUTO 2. The following replaces Paragraph b. in B.5., United States of America applies to and pro- Other Insurance, of SECTION IV - BUSI- hibits the transaction of business with or NESS AUTO CONDITIONS: within such country or jurisdiction, for Liability b. For Hired Auto Physical Damage Cover- Coverage for any covered "auto" that you age, the following are deemed to be cov- lease, hire, rent or borrow without a driver for ered "autos" you own: a period of 30 days or less and that is not an "auto" you lease, hire, rent or borrow from (1) Any covered "auto" you lease, hire, any of your "employees", partners (if you are rent or borrow; and a partnership), members (if you are a limited (2) Any covered "auto" hired or rented by liability company) or members of their house- your "employee" under a contract in holds. that individual "employee's" name, (1) With respect to any claim made or "suit" with your permission, while perform- brought outside the United States of ing duties related to the conduct of America, the territories and possessions your business. of the United States of America, Puerto However, any "auto" that is leased, hired, Rico and Canada: rented or borrowed with a driver is not a (a) You must arrange to defend the covered "auto". "insured" against, and investigate D. EMPLOYEES AS INSURED or settle any such claim or "suit" and keep us advised of all pro- The following is added to Paragraph A.1., Who Is ceedings and actions. An Insured, of SECTION II - LIABILITY COV- ERAGE: (b) Neither you nor any other in- volved "insured" will make any Any "employee" of yours is an "insured" while us- settlement without our consent. ing a covered "auto" you don't own, hire or borrow in your business or your personal affairs. (c) We may, at our