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HomeMy Public PortalAboutCrestview High School- Shelter AgreementOKALOOSA COUNTY SCHOOL DISTRICT STUDENT INTERVENTION SERVICES SCHOOL EVACUATION EMERGENCY SHELTER AGREEMENT MIS 6316 REV. 7/29/15 THIS AGREEMENT, entered into this 6th day of June , 20 17 by and between The School Board of Okaloosa County, Florida as the governmental agency having jurisdiction over Crestview High School (hereinafter called the "School") and City of Crestview is for the purpose of setting forth the terms and conditions under which the School will be allowed to utilize the facilities of Crestview Community Center in the event of an emergency at the School during the 20 17 / 20 18 school year. The parties do agree as follows: 1. In the event of an emergency and/or crisis situation at the School then the students, faculty and staff of the School may be relocated to the facilities of Crestview Community Center which shall serve as a temporary shelter. 2. The administrators of the School shall be responsible for the supervision of students while they are at the temporary shelter facility. 3. The School District shall issue a certificate of insurance to the owner of the shelter facility for the use as outlined in the Agreement. The School Board of Okaloosa County, Florida By: Mary Beth Jackson Superintendent of Schools Date: She ovid School Principal: By: By: Print Name: 642,16,m Print name: Dexter Day Title: Obtzt Date: 6/6/2017 Date: - - /7 Shelter Name & Address: Crestview Community Center, 1446 Commerce Drive City: Crestview , FL Zip: 32539 Shelter Name & Address: City: , FL Zip: Shelter Name & Address: City: , FL Zip: The extra address lines are for those who use the multiple shelters approved by one source (like the city ). OKALOOSA COUNTY SCHOOL DISTRICT STUDENT INTERVENTION SERVICES SCHOOL EVACUATION EMERGENCY SHELTER AGREEMENT MIS 6316 REV. 6/6/17 THIS AGREEMENT, entered into this 1 day of August , 20 17 by and between The School Board of Okaloosa County, Florida as the governmental agency having jurisdiction over Crestview High School School (hereinafter called the "School') and City of Crestview is for the purpose of setting forth the terms and conditions under which the School will be allowed to utilize the facilities of Crestview Community Center 1446 Commerce Dr in the event of an emergency at the School during the 20 17 / 20 18 school year. The parties do agree as follows: 1. In the event of an emergency and/or crisis situation at the School then the students, faculty and staff of the School may be relocated to the facilities of Crestview Community Center 144.6 Commerce Dr which shall serve as a temporary shelter. 2. The administrators of the School shall be responsible for the supervision of students while they are at the temporary shelter facility. 3. The School District shall issue a certificate of insurance to the owner of the shelter facility for the use as outlined in the Agreement The School Board of Olcaloosa County, Florida By: Mary Beth Jackson Superintendent of Schools Date: Shelte Provi )2? i2 School- P incipal: By: By: -- --- Print Name: k."1, r ALA Print name: 7 Title: Oc"-r-A Date: Date: el3 / i 7 Shelter Name: Crestview Community Center Address: 1448 Commerce Dr City: Crestview , FL Zip: 32838 Shelter Name: Address. City: FL Zip: Shelter Name: Address: City: , FL Zip: The extra address lines are for those who use the multiple shelters approved by one source (like the city ). Page 1 of 2 A14'o� CERTIFICATE OFLIABILITY INSURANCE DATE {MMIDDtYYYY}09/12/2017 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 have ADDITIONAL INSURED provisions or 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 Willis Administrative Services Corporation DBA Willis Pooling c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA CONTACT NAME: PHONE 1-877-945_7378 FAX 1-888-467-2378 (NCNa ExU (A/C. No). E-M E-MAIL certificates8xillis.com ADDRESS: INSURER(S) AFFORDING COVERAGE NAICS INSURER A: Florida School Boards Insurance Trust D2772 INSURED Okaloosa County School District Attn: Russ &rakes 120 Lowery Place SE Fort Walton Beach, FL 32548 USA INSURER B : INSURER C : INSURER 0 : INSURER E . INSURER F : COVERAGES CERTIFICATE NUM ER: W3487804 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY FSBITI7CAS7-1 07/01/2017 07/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) $ Included CLAIMS -MADE X OCCUR MED EXP (Any one person) S Excluded PERSONAL & ADV INJURY S Included GENERAL AGGREGATE S 1lnl mated GENII AGGREGATE LIMIT APPLIES PRO JECT PER LOC PRODUCTS - COMP/OP AGG $ Included $ AUTOMOBILE _ LIABILITY ANY AUTO — SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE S AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED (Mandatory In NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below Y / N N /A PER STATUTE OTH- ER E L EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT S DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) This Voids and Replaces Previously Issued Certificate Dated 09/12/2017 WITH ID: W3486400. For the General Liability policy, General Aggregate is Unlimited. Shelter Name and Address: Crestview Community Center, 1446 Commerce Dr., Crestview, FL 32539 CERTIFICATE HOLDER CANCELLATION City of Crestview and Crestview Community Center 198 North Wilson Street Crestview, FL 32536 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI2EDREPRESEN7A71VE �(,"M' 1SSLNe ACORD 25 (2016/03) 001988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR In: 15045453 HATCH: 442714 AC RE" AGENCY CUSTOMER ID: LOC #: ADDITIONAL REMARKS SCHEDULE Page 2 of 2 AGENCY Willis Administrative Services Corporation DBA Willis Pooling NAMED INSURED Okaloose County School District Attn: Russ Frakes 120 Lowery Place SE Fort Walton Beach, FL 32548 USA POLICY NUMBER See Page 1 CARRIER See Page 1 NAIC CODE See Page 1 EFFECTIVE DATE: See Page 1 ADDITIONAL REMARKS THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE• Certificate of Liability Insurance Liability subject to FS 768.28. Certificate is issued with respects to the School evacuation emergency shelter agreement between Crestview High School and City of Crestview during the 2017-2018 school year. ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR ID: 15045453 BATCH. 442714 CERT: w3487804 Page 1 of 1 D® AL..., ---CERTIFICATE OF LIABILITY INSURANCE DATE(MM/D2017 ) o$�15�2017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW, THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Willis Administrata.ve Services Corporation DBA Willis Pooling c/o 26 Century Blvd P.O. Box 305141 Nashville, TN 372305191 USA CONTACT NAME: PHONE 1-8??-945-737$ FAX 1-$$$-46?-2378 Est}; (A/C. No): E-MAILNo. E-MCertifi.Catesewillis. con ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC1f INSURER A: Florida School Boards Insurance Trust D2772 INSURED Okaloosa County School District Attn: Russ Frakes 120 Lowery Place SE Fort Walton Beach, FL 32545 USA INSURER B : INSURER C : INSURER D : INSURER E : INSURER F : VERAGES CERTIFICATE NUMBER: w32 630 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 LTR TYPE OF INSURANCE ADDL INSD SUER WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP D/ (MM/DYYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY FSBITI7CAS7-1 07/01/2017 07/01/2018 EACH OCCURRENCE $ 1,000,000 oAmAGE TO RENTED PREMISES Ea occurrence) $ Included CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY 5 Included GENERAL AGGREGATE $ Unlimited GEN% AGGREGATE LIMIT APPLIES JET PER: LOC PRODUCTS - COMP/OP AGG $ Included $ AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) S BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ S UMBRELLA LIAB EXCESS LIAB O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? (Mandatory In NH) If yes, descnbe under DESCRIPTION OF OPERATIONS below Y / N N/ A RER STATUTE EH R E L EACH ACCIDENT $ E L DISEASE - EA EMPLOYEE $ E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For the General Liability policy, General Aggregate is Unlimited. Liability subject to FS 768.28. Certificate is issued with respects to the School evacuation emergency shelter agreement between Crestview High School and City of Crestview during the 2017-2018 school year. CERTIFICATE HOLDER CANCELLATION Crestview Community Center 1446 Commerce Drive Crestview, FL 32539 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORI2EDREPRESENTA7IVE �(�"M' _ wtl ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD BR ID: 14950653 BATCH: 415794 OKALOOSA COUNTY SCHOOL DISTRICT STUDENT INTERVENTION SERVICES SCHOOL EVACUATION EMERGENCY SHELTER AGREEMENT MIS 6316 REV. 7/29/15 THIS AGREEMENT, entered into this 6th day of June , 20 17 by and between The School Board of Okaloosa County, Florida as the governmental agency having jurisdiction over Davidson Middle School School (hereinafter called the "School") and City of Crestview is for the purpose of setting forth the terms and conditions under which the School will be allowed to utilize the facilities of Spanish Trail Park and Twin Hill Park in the event of an emergency at the School during the 20 17 / 20 18 school year. The parties do agree as follows: 1. In the event of an emergency and/or crisis situation at the School then the students, faculty and staff of the School may be relocated to the facilities of Spanish Trail Park and Twin Hill Park which shall serve as a temporary shelter. 2. The administrators of the School shall be responsible for the supervision of students while they are at the temporary shelter facility. 3. The School District shall issue a certificate of insurance to the owner of the shelter facility for the use as outlined in the Agreement. The School Board of Okaloosa County, Florida By: Mary Beth Jackson Superintendent of Schools Date: Shel vide SchoolPrincipal: By: //) Print Na 67.74,teik : Jayson Sanders Title: Date: 7-(0 -/ Shelter Name & Address: City: Crestview , FL Zip: 32539 Shelter Name & Address: Twin Hill Park IX neflu wfiti s City: Crestview , FL zip: 32539 Shelter Name &Address: City: , FL Zip: The extra address lines are for those who use the multiple shelters approved by one source (like the city ). By: C._ At, Date: June 6, 2017 Spanish Trail Park 610 Page 1 of 1 a� D) CERTIFICATE OF LIABILITY INSURANCE 8j1;2/ 17'' 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 have ADDITIONAL INSURED provisions or 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 Willis Administrative Services Corporation DEA Willis Pooling c/o 26 Century Blvd P.O. Sox 305191 Nashville, TN 372305191 USA CONTACT NAME: PHONE 1-877-945-7378 FAX 1-888-467-2378 INC. No. Ext) {NC, Na}: E-MAIL certificates@willis.coat ADDRESS: INSURER(S) AFFORDING COVERAGE NAIC S INSURER A• Florida School Boards Insurance Trust D2772 INSURED Okaloosa County School District Attn: Russ Frakes 120 Lowery Place SE Fort Walton Beach, FL 32548 USA INSURER B INSURER C : INSURER D : INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 283641 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DD/YYYY) POLICY EXP (MM/DD/YYYY) LIMITS A X COMMERCIAL GENERAL LIABILITY FSBITI7CAS7-1 07/01/2017 07/01/2018 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES Ea occurrence) $ included CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded PERSONAL dADVINJURY $ Included GENERAL AGGREGATE $ Unlimited GEM_ AGGREGATE LIMIT APPLIES JEC07 PER LOC PRODUCTS - COMP/OP AGG $ Included $ AUTOMOBILELIABILITY ANY AUTO OWNED SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accdent $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ $ UMBRELLA LIAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If Yes, descnbe under DESCRIPTION OF OPERATIONS below Y / N N/A PER STATUTE ERH E.L. EACH ACCIDENT $ E.L DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For the General Liability policy, General Aggregate is Unlimited. Liability subject to FS 768.28. Certificate is issued with respects to the School evacuation emergency shelter agreement between Davidson Middle School and City of Crestview during the 2017-2018 school year. CERTIFICATE HOLDER CANCEL TION Twin Bill Park 100 Hathaway St. S. Crestview, FL 32539 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 t 6-15tSS ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD sa ID: 14950653 BATCH: 415794 Page 1 of 1 .a► >Q� CERTIFICATE OF LIABILITY INSURANCE Dos/l%2o ) 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 have ADDITIONAL INSURED provisions or 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 Willis Administrative Services Corporation DBA Willis Pooling c/o 26 Century Blvd P.O. Box 305191 Nashville, TN 372305191 USA CONTACT NAME: PHONE 1-877-945-7378 FAX 1-88$-467-2378 Ex*{AlC, Na}: E4dAi`o. ADDRESS certificates@xillis.com INSURER(S) AFFORDING COVERAGE NAIC 8 INSURER A: Florida School Boards Insurance Trust D2772 INSURED Okaloosa County School District Attn: Russ Frakes 120 Lowery Place SE Fort Walton Beach, FL 32548 USA INSURER 0 INSURER C: INSURER D : INSURER E INSURER F : RTIFICATE NUMBER. W3283637 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 LTR TYPE OF INSURANCE ADDL INSD SUBR WVD POLICY NUMBER POLICY EFF (MM/DDIYYYY) POLICY EXP (MM/DDPNYY) LIMITS A X COMMERCIAL GENERAL LIABILITY FSBITI7CAS7-1 07/01/2017 07/01/2018 EACH OCCURRENCE $ 1, 000 , 000 DAMAGE l'O RENTED PREMISES Ea occurrence) $ Included CLAIMS -MADE X OCCUR MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ Included GENERAL AGGREGATE $ Unlimited GEN'L AGGREGATE LIMIT APPLIES PRO JECT PER LBC PRODUCTS - COMP/OP AGG $ Included $ AUTOMOBILE _ LIABILITY ANY AUTO OWNED SCHEDULED AUTOS NON -OWNED AUTOS ONLY COMBINED SINGLE LIMIT (Ea accident) $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per acodent) $ $ UMBRELLA LAB EXCESS LIAB OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ $ DED RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPRBPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If Yes, describe under DESCRIPTION OF OPERATIONS below Y / N N / A PER STATUTE OTH- ER E L EACH ACCIDENT $ El, DISEASE - EA EMPLOYEE $ E L DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For the General Liability policy, General Aggregate is Unlimited. Liability subject to FS 768.28. Certificate is issued with respects to the School evacuation emergency shelter agreement between Davidson Middle School and City of Crestview during the 2017-2018 school year. CANCELLATION Spanish Trail Park Stillwell Blvd. Crestview, FL 32539 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 t1�� 63�M' ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD SR Inc 14950653 BATCH: 415794