Okaloosa County BOCC — December 1, 2015 — 6) Certificates of Insurance — reading text

DATE(MM/DD/YYYY) CERTIFICATE OF LIABILITY INSURANCE 11/17/2015 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. Holder Identifier : 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 certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Aon Risk Services Northeast, Inc. PHONE FAX (A/C. No. Ext): (866) 283-7122 800-363-0105 Boston MA Office (A/C. No.): One Federal Street E-MAIL Boston MA 02110 USA ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC # INSURED INSURER A: Zurich American Ins Co 16535 CDM Constructors Inc INSURER B: Lloyd's Syndicate No. 2623 AA1128623 555 17th Street Denver CO 80202 USA INSURER C: ACE Property & Casualty Insurance Co. 20699 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 570060165406 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 INSR ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY GLO837663219 01/01/2015 01/01/2016 EACH OCCURRENCE $2,000,000 DAMAGE TO RENTED CLAIMS-MADE X OCCUR $300,000 PREMISES (Ea occurrence) MED EXP (Any one person) $10,000 570060165406 PERSONAL & ADV INJURY $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 PRO- POLICY X JECT X LOC PRODUCTS - COMP/OP AGG $4,000,000 OTHER: A AUTOMOBILE LIABILITY BAP 8376631-19 01/01/2015 01/01/2016 COMBINED SINGLE LIMIT $2,000,000 (Ea accident) Certificate No : ANY AUTO BODILY INJURY ( Per person) X ALL OWNED SCHEDULED BODILY INJURY (Per accident) AUTOS AUTOS NON-OWNED PROPERTY DAMAGE X HIRED AUTOS X (Per accident) AUTOS C X UMBRELLA LIAB X OCCUR XOOG27637449 01/01/2015 01/01/2016 EACH OCCURRENCE $13,000,000 EXCESS LIAB CLAIMS-MADE AGGREGATE $13,000,000 DED X RETENTION $25,000 A WORKERS COMPENSATION AND WC837663320 01/01/2015 01/01/2016 X PER STATUTE OTH- EMPLOYERS' LIABILITY ER Y/N ANY PROPRIETOR / PARTNER / EXECUTIVE N N/A E.L. EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE-EA EMPLOYEE $1,000,000 If yes, describe under DESCRIPTION OF OPERATIONS below E.L. DISEASE-POLICY LIMIT $1,000,000 7777777707070700077763616065553330772635664104575707671135462514120071660575166323300776463515027655607726035772076750077404117562747540736203557205453207706211552276530077727252025773110777777707000707007 B Archit&Eng Prof QC1501367 01/01/2015 01/01/2016 per claim $5,000,000 aggregate $5,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Re: Arbennie Pritchett 10 MGD Water Reclamation Facility, RFP No. WS-01-15 The County of Okaloosa and Constantine Engineering and its respective agents, consultants, servants and employees of each and all other interest as may be reasonably required by Okaloosa County are included as Additional Insured in accordance with the policy provisions of the General Liability and Automobile Liability policies. General Liability and Automobile Liability evidenced herein are Primary and Non-Contributory to other insurance available to an Additional Insured, but only in accordance with the policy's provisions. Umbrella Liability Follows Form. 6666666606060600062606466204446200622200604004202006220024262040022062202260622600200622000624006220206222006040260220062220242620422200602220424222260006002246222660062066646062240664440666666606000606006 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. Okaloosa County AUTHORIZED REPRESENTATIVE 602-C North Pearl Street Crestview FL 32536 USA ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD Additional Insured – Automatic – Owners,