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HomeMy Public PortalAboutOkaloosa County School Evacuation EmergencyOKALOOSA COUNTY SCHOOL DISTRICT OFFICE OF SAFE SCHOOLS SCHOOL EVACUATION EMERGENCY SHELTER AGREEMENT MIS 6316 REV 05/30/2019 THIS AGREEMENT, entered into this day of June , 2022 by and between The School Board of Okaloosa County, Florida as the governmental agency having jurisdiction over Okaloosa County School District School (hereinafter called the "School") and Crestview Community Center _ 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 2022 / 2023 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 Sch Bo fad oosa County, Florida By: Marcus am rs) Superintenlfent f Schools Date: 'nl Shelter Provider: By: Print Name: Title: c: 4-. f ,.0 •tir‘•w..4r Date: /6 11"2. _ s)) 5a -9a30 c ttObt eet,z-tej Shelter Name: crestview Community Center Address: 1446 Commerce Drive Okaloosa County School District Office of Safe Schools Daniny Dean, Safe Schools Specialist (850) 689-7117 City: c;re�tvie�ar�' , FL Zip: 32536 Shelter Name: Address: _ _ City: FL Zip: Send original to: Office of Safe Schools Carver Hill Administrative Complex ACO OR CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) 6/23/2022 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 Alliant Insurance Services, Inc. 101 N. Tryon St, Ste 6000 Charlotte NC 28246 INSURED Okaloosa County School District 120 Lowery Place Fort Walton Beach FL 32548 License#: 0C36861 FLORSCH-04 COVERAGES CERTIFICATE NUMBER: 2116524399 CONTACT NAME: PHONE (AM. No, Eai). E-MAIL ADDRESS: INSURERIS) AFFORDING COVERAGE INSURER A: Florida School Boards Insuranc INSURER B : INSURER C : INSURER D : INSURER E INSURER F : FAX IA/C, No): NAIC # 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 ADDL:SUBR POLICY EFF POLICY EXP LTR INSD I WVD POLICY NUMBER ' IMM/DDIY'YYYI (MMfDDtYYYY) , _ LIMITS A X COMMERCIAL GENERAL CLAIMS -MADE LIABILITY OCCUR PER: I 1 I FSBIT22CAS7-1 i 7/1/2022 7/1/2023 EACH OCCURRENCE $1,000,000 X DAMAGE TO RENTED PREMISES (Ea occurrence; $ Included H'L APPLIES MED EXP (Any one person) $ Excluded AGGREGATE LIMIT PERSONAL & ADV INJURY $ Included GENERAL AGGREGATE j$ Unlimited POLICY PRO - JECT PRODUCTS PRODUCTS - COMP/OP AGG $ Included I OTHER: $ 1 AUTOMOBILE LIABILITY ANY AUTO OWNED SCHEDULED I _ .. AUTOS ONLY _ AUTOS HIRED NON -OWNED AUTOS ONLY ... AUTOS ONLY 1 1 COMBINED SINGLE LIMIT (Ea accident/ $ BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ PROPERTY DAMAGE (Per accident) $ 1 UMBRELLA LIAB EXCESS LIAB O OCCUR CLAIMS -MADE EACH OCCURRENCE $ AGGREGATE $ DED I l RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNERIEXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory in NH) If yes, describe under DESCRIPTION OF OPERATIONS I Y / N I I PER 1 1OTH- STATUTE ER E.L. EACH ACCIDENT $ N /A E.L. DISEASE - EA EMPLOYEE $ below E.L. DISEASE - POLICY LIMIT $ DESCRIPTION OF OPERATIONS / LOCATIONS 1 VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) For the General Liability Policy, General Aggregate is Unlimited. Re: Emergency Evacuation Shelter Crestview Community Center is included as Additional Insured with respect to the General Liability when required by written contract. 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) © 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD