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HomeMy Public PortalAboutOCSD Shelter Agreement - Crestview Community CenterOKALOOSA COUNTY SCHOOL DISTRICT MIS 6316 REV 05/30/2019 OFFICE OF SAFE SCHOOLS SCHOOL EVACUATION EMERGENCY SHELTER AGREEMENT THIS AGREEMENT, entered into this day of June . 2023 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 2023 / 2024 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 By: Marcus Cjmbe Superintends t of Schools Date: 7/n/ )*3 Shelter Provider. By: Print Name:T‘ >M kcak &-- Title: G Vvl (Lv\et yV Date• L1 Okaloosa County, Florida Shelter Name: Crestview Community Center Address: 1446 Commerce Drive Shelter Name: Address: Okaloosa County Schools District Office of Sa c >ls 1)ea . grans 1) rector !June .2093 City: Crestview , FL Zip: 32536 City: , FL Zip: Send original to: Office of Safe Schools Carver Hill Administrative Complex Aco DATE (MM/DDNYYY) a CERTIFICATE OF LIABILITY INSURANCE I 5/16/2023 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(tes) 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 ENSURED Okaloosa County School District 120 Lowery Place Fort Walton Beach FL 32548 License#: 0C36861 FLORSCH-04 CONTACT NAME: PHONE C, No. Ext): E-MAIL ADDRESS: INSURER(S) AFFORDING COVERAGE INSURER A : Florida School Boards Insuranc INSURER B : INSURER C : INSURER D FAX (A/C. Not: NAIL if 0 INSURER E : INSURER F : COVERAGES CERTIFICATE NUMBER: 281882881 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 A IX j COMMERCIAL GENERAL UABIUTY CLAIMS -MADE X I OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: POLICY PRO. LOC OTHER: A AUTOMOBILE LIABILITY I X ANY AUTO OWNED SCHEDULED AUTOS ONLY AUTOS HIRED y; NON -OWNED AUTOS ONLY ,l AUTOS ONLY UMBRELLA UAB EXCESS UAB DED 1 RETENTION $ A WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANYPROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBEREXCLUDED? (Mandatory In NH) If yes, describe under DESCRIPTION OF OPERATIONS below A Property A Auto Physical Damage OCCUR CLAIMS -MADE IADDL SUER; I rNSD WVD POLICY NUMBER FSBIT23CAS7-1 YIN NIA'II POLICY EFF I POLICY EXP (MWDDIYYYY) (MM/DD/YYYY) 7/1/2023 I 7/1/2024 FSB1T23CAS7-1 7/1/2023 7/1/2024 FSBIT23CAS7-1 FSBIT23PROP FSBIT23PROP 7/1/2023 7/1/2024 5/1/2023 5/1/2024 5/1/2023 5/1/2024 UMITS EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED PREMISES (Ea occurrence) $ Included MED EXP (Any one person) $ Excluded PERSONAL & ADV INJURY $ Included GENERAL AGGREGATE $ Unlimited PRODUCTS - COMP/OP AGG $ Included $ COMBINED SINGLE LIMIT $ 1,000,000 (Ea accident) BODILY INJURY (Per person) $ BODILY INJURY (Per accident) $ (Per accident) $ PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE $ !$ X STATUTE OTH- ER EL. EACH ACCIDENT I $ 2,000,000 E.L. DISEASE - EA EMPLOYEE $ 2,000,000 E.L. DISEASE - POLICY LIMIT $ 2,000,000 See Remarks Actual Cash Value 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. Property Details: Policy Term: 5/1/2023 to 5/1/2024 Limits: Replacement Cost up to $100M/Occurrence See Attached... CERTIFICATE HOLDER Crestview Community Center 1446 Commerce Dr Crestview FL 32539 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. AUTHORIZED REPRESENTATIVE ACORD 25 (2016/03) O 1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD AGENCY CUSTOMER ID: FLORSCH-04 LOC #: ACO AGENCY Aliiant Insurance Services, Inc. POUCY NUMBER CARRIER ADDITIONAL REMARKS ADDITIONAL REMARKS SCHEDULE NAIC CODE NAMED INSURED Okaloosa County School District 120 Lowery Place Fort Walton Beach FL 32548 EFFECTIVE DATE: THIS ADDITIONAL REMARKS FORM IS A SCHEDULE TO ACORD FORM, FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE Property Deductible: $5,000 Wind Deductible: 5% of TIV per unit $100,000 Minimum Flood Deductible: $100,000 except Named Storm; 5% of $100,000,000 Per Occurrence and Annual Aggregate Earth Movement/Earthquake Shock $100,000,000 Per Occurrence and Annual Aggregate Flood TIV per location $100,000 minimum except Flood Zones A & V coverage is excess of the maximum available from NFIP. Re: Crestview Military Ball Army JROTC. Crestview Community Center is included as an Additional Insured as respects to General Liability. Page 1 of 1 ACORD 101 (2008/01) © 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD