Okaloosa County BOCC — March 4, 2014 — AOL Williams to Bremfour 2-26-14 — reading text

DESCRIPTION OF PROPERTY (Attach ACORD 101, Additional Remarks Schacdule, if more space la required) Okaloosa County Airport Systems, 1001 Airport Rd, Destin, FL T-Hanger 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 POLICY NUMBER | DATE (MMNGLIYYYY} POLICY EXPIRATION | COVERED PROPERTY Liars x |X | PROPERTY S| BUILDING $35,000 Causes ortoss | neoucraves 2X | PERSONAL PROPERTY | 57 oq) __ BASIC BUILDING | BUSINESS INCOME | x BROAD [1000 we 4 "| EXTRA EXPENSE [S CONTENTS” 4404X1501 12/23/2013 | 42/23/2014 a SPECIAL RENTAL VALUE $ EARTHQUAKE oo |} GLANKET BURDING — | g 7 xX | wine / | BLANKETPERSPROP |g FLOOD “| @LANKETBLDGAPPE fg | | ae a L3 INLAND MARINE TYPE OF POLICY $ CAUSES OF LOSS _ $ | NAMED PERILS POLICY NUMBER 3 i: & | GRIME $ TYPE OF POLICY Sl 3 ’ 7 BOILER E MACHINERY / 1 EQUIPMENT BREAKDOWN ae _ § —_ So i $ . SPECIAL CONDITIONS / OTHER COVERAGES (Attach ACORD 104, Additional Remarks Schedule, If more space Is required) CERTIFICATE HOLDER CANCELLATION Additional Insured: Okaloosa County 602- C North Pearl Street Crestview, FL. 32536 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANGE WITH THE POLICY PROVISIONS. \ \ AUTHOR}ZED REPRESENTATIVE Mj ACORD 24 (2009/09) ‘19963009 REORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD ACCORD all CERTIFICATE OF LIABILITY INSURANCE DATE (MMIDDIVY'Y) 02/03/2014 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. 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 certificate holder in lieu of such endorsement(s). IMPORTANT. If the certificate holder is an ADDITIONAL INSURED, the pollcy(les) 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 CONTACT i Name: Angela Wilson PRODUCER _ Angela Wilson FHON IF extk 885-031-8971 (ale, No, 865-531-8417 Wilson Insurance Agency EMAL. awilsonagercy@gmail.com 104.11 Lovell Center Dr #101 INSURER(S) AFFORDING COVERAGE NAIC # Knoxville, TN 37922 insuRER A; Atnerican National Insurance Cornpany 28401 INSURED INSURERB: eee une eves woot eo wens Bremfour Aviation Group, Inc. INSURER C: 9724 Kingston Pike #406 WOURERD: SSS ee Knoxville, TN 37922 INSURER E : fo : INSURER FE: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER; THIS 18 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 (ADDLISUBR POLICY EFF T POLICY EXP LIR TYPE OF INSURANCE UNSD | Wwvp POLICY NUMBER (MMJODIYYYY) | (MBVDDIYYYY) LIMITS COMMERCIAL GENERAL LIABILITY EAGH OCCURRENCE 3 1,000,000 ES] —_ DAMAGE TO RENTED >% | CLAIMS-MADE |__| occur PREMISES (Ea occurrence) | § 1,000,000 = . MED EXP (Any one person} $ 5,000 : x x 4101G0317 12/23/2013 | 12/23/2014 | persona aapvinwuRY | 5 1,000,000 _GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE 3 2,000,000 ee ee re : Xl poucy) | ABS | | loc PRODUCTS - Comprop AGG | § 2,000,000 OTHER: $ AUTOMOBILE LIABILITY fev aeeken CIMT ANY AUTO BODILY INJURY (Per person) | $ “| ALLOWNED = [| SCHEDULED an! AUTOS a AUTOS BODILY INJURY (Per accident) | § i LOWNEL PROPERTY DAMAGE | HIRED AUTOS |_| AUTOS {Per accident) $ po : $ t I — UMBRELLA LIAB =| | OCCUR EACH OCCURRENCE 3 ee SXCESS LIAB | | CLAIMS-MADE AGGREGATE $ _ veo | | ReTeNTiIONS § WORKERS COMPENSATION | PER POT: AND EMPLOYERS UABILITY YIN [_SIATUTE | OL ER nee ANY PROPRIETOR/PAR TNERVEXECUTIVE E.L. EACH ACCIDE OFFICERIMEMBER EXCLUDED? | | NIA BAGH ACCIOENT 5 (Mandatory in NH} — ' E.L. DISEASE - EA EMPLOYEE § tf Bes describe under : } . . DESCRIPTION OF OPERATIONS below i EL. DISEAGE - POLICY LIMIT | § : Okaloosa County Airport Systerns, 1001 Airport Rd, Destin, FL. T-Hanger DESCRIPTION OF OPERATIONS | LOCATIONS / VEHICLES (ACORD 404, Additional Remarks Schedule, may be attached If more space is required) CERTIFICATE HOLDER CANCELLATION Additional Insured: Okaloosa County 602- © North Peari Street Crestview, FL 32536 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPI ION, DATE THEREOF, NOTICE WILL BE DELIVERED IN ACGORDA CE WITH THE POLICY PROVISIONS, iQ AUTHORIZEp REPRESENTATIVE ACORD 25 (2014/01) 1988-2014 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Dave Miner From: Gary Real Sent: Tuesday, February 11, 2014 3:36 PM To: Dave Miner Subject: RE: Certificate of Insurance That looks fine. Gary R. Real Risk Manager, Okaloosa County Florida 850-689-5979 Please note: Due to Florida's very broad public records laws, most written communications to or from County employees regarding County business are public records, available to the public and media upon request. Therefore, this written e-mail communication, including your e-mail address, may be subject to public disclosure. From: Dave Miner Sent: Tuesday, February 11, 2014 2:53 PM To: Gary Real Cc: Mike Stenson Subject: Certificate of Insurance Mr. Real: Please review the attached COl’s and let me know if they coincide with the requirements of the lease. Thank you. Dave David E. Miner Properties and Leases Okaloosa County Airports (850) 651-7160 Ext. 4 www.flyvps.com "Please note: Due to Florida's very broad public records laws, most written communication to or from County employees regarding County business are public records, available to the public upon request. Therefore, this written e- mail communication, including your e-mail address, may be subject to public disclosure." Dave Miner From: Andy King [andy.king@williamselectric.com] Sent: Wednesday, February 12, 2014 10:51 AM To: Dave Miner Subject: RE: Assignment of Lease Mr. Miner, You have my and Harvey’s permission to change the Chairman’s information and the date on the Destin hanger contract. Thanks, Andy King Office: (850) 862-1171 Fax: (850)862-2629 Email: Andy. king@williamselectric.com -} Williams electric co. “99a? ay Please consider the environment before printing this e-mail From: Dave Miner [mailto:dminer@co.okaloosa.fl.us] Sent: Wednesday, February 12, 2014 10:26 AM To: Robert Devrnja MD (drbob@erxgroup.net); Andy King Subject: Assignment of Lease Importance: High Good Morning: | received all three certificates of insurance form Dr. Devrnja. | sent them to the Risk Management Dept. and they were approved. When | was going through the packet | noticed that the date on page 1 states 2013 and the Chairman’s signature block on page 4 is incorrect for the current year, we have a new Chairman. | am requesting permission from both of you to reprint page 1 and change the Chairman’s signature block on page 4. The other way would be to send the lease to both of you for signature. Please let me know which you would prefer and then | can give you a timeline on when the Assignment of Lease will go to the Board. David E. Miner Properties and Leases Okaloosa County Airports (850) 651-7160 Ext. 4 www.flyvps.com Dave Miner From: Robert Devrnja, MD [drbob@erxgroup.net] Sent: Wednesday, February 12, 2014 11:06 AM To: Dave Miner Cc: Andy King Subject: Re: Assignment of Lease lam ok with you making the change Sent from my iPad On Feb 12, 2014, at 11:25 AM, Dave Miner <dminer@co.okaloosa.fl.us> wrote: Good Morning: | received all three certificates of insurance form Dr. Devrnja. | sent them to the Risk Management Dept. and they were approved. When | was going through the packet | noticed that the date on page 1 states 2013 and the Chairman’s signature block on page 4 is incorrect for the current year, we have a new Chairman. | am requesting permission from both of you to reprint page 1 and change the Chairman’s . signature block on page 4. The other way would be to send the lease to both of you for signature. Please let me know which you would prefer and then | can give you a timeline on when the Assignment of Lease will go to the Board. David E. Miner Properties and Leases Okaloosa County Airports (850) 651-7160 Ext. 4 www. flyvps.com "Please note: Due to Florida's very broad public records laws, most written communication to or from County employees regarding County business are public records, available to the public upon request. Therefore, this written e-mail communication, including your e-mail address, may be subject to public disclosure."