Agenda 03/25/2014 Item #16G3 3/25/2014 16.G.3.
EXECUTIVE SUMMARY
Recommendation to approve the attached Commercial Aviation Operations License
Agreement (Licensee) with Van Wagner Aerial Media for banner towing operations at the
Immokalee Regional Airport.
OBJECTIVE: To allow Van Wagner Aerial Media to provide banner towing services at the
Immokalee Regional Airport.
CONSIDERATIONS: Van Wagner Aerial Media has requested permission to provide banner
towing services from the Immokalee Regional Airport.
The operations of Licensee will not interfere with safe, efficient operations at the Immokalee
Regional Airport and will enhance the overall level of services available to airport users.
This license agreement will continue on a month-to-month basis until written notice to terminate
is given by one party to the other. Licensee will pay an annual commercial operating fee as
published in the currently approved rates and charges for the Immokalee Regional Airport, plus
applicable Florida Sales Tax.
Insurance requirements for the Licensee's proposed operations have been reviewed by Collier
County Risk Management.
FISCAL IMPACT: Commercial operating fee in the amount of$200 has been budgeted in the
Airport Authority FYI4 operating Fund 495 related to this agreement.
GROWTH MANAGEMENT IMPACT: There is no Growth Impact associated with this
executive summary.
LEGAL CONSIDERATIONS: The County Attorney has reviewed this item and approved it
as to form and legality. Majority support of the Board is required for approval. -JAK
RECOMMENDATION: That the Board of County Commissioners, in its capacity as the
Collier County Airport Authority, approves and authorizes the Chairman to execute the attached
Commercial Aviation Operations License Agreement with Van Wagner Aerial Media for banner
towing operations at the Immokalee Regional Airport.
Prepared by: Thomas Vergo, Airport Manager, Collier County Airport Authority
Attachments: 1) Van Wagner License Agreement: 2) Van Wagner Commercial Insurance; and
Van Wagner Workers Compensation Insurance Certificate
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3/25/2014 16.G.3.
COLLIER COUNTY
Board of County Commissioners
Item Number: 16.16.G.16.G.3.
Item Summary: Recommendation to approve the attached Commercial Aviation
Operations License Agreement (Licensee) with Van Wagner Aerial Media for banner towing
operations at the Immokalee Regional Airport.
Meeting Date: 3/25/2014
Prepared By
Name: BrueggemanDebra
Title:Operations Coordinator,Airport Authority
3/10/2014 12:23:56 PM
Submitted by
Title:Manager-Airport,Airport Authority
Name: VergoThomas
3/10/2014 12:23:57 PM
Approved By
Name: VergoThomas
Title:Manager-Airport,Airport Authority
Date:3/13/2014 2:56:34 PM
Name: LynchDiane
Title:Supervisor-Operations,Road Maintenance
Date:3/13/2014 4:03:55 PM
Name: LynchDiane
Title:Supervisor-Operations,Road Maintenance
Date:3/13/2014 4:17:26 PM
Name: LynchDiane
Title: Supervisor-Operations,Road Maintenance
Date:3/13/2014 4:19:50 PM
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3/25/2014 16.G.3.
Name: KearnsAllison
Title:Manager Financial & Operational Support, Transportation Administration
Date: 3/17/2014 11:34:30 AM
Name: ShueGene
Title:Director-Operations Support, Transportation Administration
Date: 3/17/2014 12:10:19 PM
Name: CasalanguidaNick
Title:Administrator-Growth Management Div,Business Management&Budget Office
Date: 3/17/2014 12:49:07 PM
Name: KlatzkowJeff
Title:County Attorney,
Date: 3/17/2014 1:40:30 PM
Name: KlatzkowJeff
Title: County Attorney,
Date:3/17/2014 2:01:44 PM
Name: FinnEd
Title:Management/Budget Analyst, Senior,Transportation Engineering&Construction Management
Date: 3/18/2014 9:36:27 AM
Name: OchsLeo
Title:County Manager, County Managers Office
Date: 3/18/2014 10:24:30 AM
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Collier County Airport Authority Commercial Aviation Operations License Agreement 3/25/2014 16.G.3.
COMMERCIAL AVIATION OPERATIONS LICENSE AGREEMENT
4� v 'y COLLIER COUNTY AIRPORT AUTHORITY
2005 MAINSAIL DRIVE, SUITE 1
NAPLES,FLORIDA 34114
(239)642-7878
LICENSEE: Van Wagner Aerial Media LICENSEE'S PHONE NUMBER: 954-989-2086
LICENSEE'S ADDRESS: 1600 East Airport Road,Pembroke Pines, FL 33023
1. Licensee/ Commercial Aviation Operator: The Collier County Airport Authority (Licensor) hereby
licenses Van Wagner Aerial Media (Licensee) to conduct specific and limited commercial aviation
operations at the Immokalee Regional Airport. This bare license with no interest attached, begins on
, 2014 and continues from month to month or until written notice to
terminate is given by one party to the other.
2. PREMISES: Immokalee Regional Airport located at 165 Airpark Boulevard, Immokalee, Florida. The
premises consist of the airport air operations areas, common use areas and other public use areas on
airport specifically designated for aviation use or as approved by the Airport Manager.
3. OPERATIONS:This license agreement allows for the specific commercial aviation operations as listed:
Banner Towing
4. FEE: Licensee shall pay an annual commercial operating license fee of$200 plus applicable Florida
Sales Tax. Any failure to pay the fee when due will result in the termination of this license agreement or
suspension of the ability to conduct commercial aviation activities on or at the Immokalee Regional
Airport.
5. MINIMUM STANDARD REQUIREMENTS: The Collier County Airport Authority Minimum
Standards for Commercial Airport Activity and Service Providers requires for the licensed activities
listed in paragraph 3. Operations (above), a minimum of 300 square feet of office space, restroom
facilities and aircraft tie down or hanger space to accommodate each type of activity. For the terms of
this license, the Licensor is allowing on a temporary basis, the minimum standards be met through use
of the common area and restroom facilities in the airport terminal building. The aircraft tie down
requirements must continue to meet the written requirements independently. The use of the terminal's
common areas and restroom facilities are available to the licensee in the same manner as the general
public and under the same terms and conditions as allowed to the general public and only during normal
operating hours of the terminal building.
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Collier County Airport Authority Commercial Aviation Operations License Agreement
6. LIABILITIES: Licensee hereby waives all future claims against Licensor, its employees, agents and/or
representatives for any and all liability for damage to aircraft and any other property on the premises
except for physical damage caused by movement of aircraft solely by Licensor's employees, agents or
representatives without any participation in such movement (or instructions to move same) from
Licensee or Licensee's agents, employees or any other person with apparent authority on behalf of
Licensee. Any act or use of the premises by Licensee not expressly authorized by this license or which
is deemed unsafe by the airport manager or against the CCAA rules and regulations, policies and
procedures or other regulation is unauthorized.
7. INDEMNIFICATION AND INSURANCE:
a. Licensee agrees to indemnify fully and save and hold harmless Collier County, Authority, and
their officers, agents,and employees from and against all losses,damages,claims,liabilities,and
causes of action of every kind or character and nature as well as costs and fees, including
reasonable attorney's fees connected therewith including any and all appeals, and the expense of
the investigation thereof, based upon or arising out of damages or injuries to any and all third
persons or their property. Authority shall give Licensee prompt and reasonable notice of any
such claim or action. Licensee shall have the right to investigate, compromise, and defend the
same to the extent of its own interest.
b. During the entire term of this agreement, Licensee shall provide,pay for, and maintain the types
of insurance required by the Collier County Risk Management Department as listed in exhibit A
attached and made a part hereof for the commercial aeronautical activities to be conducted as
listed in item 6 of this agreement. All insurance shall be from responsible companies duly
authorized to conduct the respective insurance in the State of Florida and/or responsible risk
retention group insurance companies registered with the State of Florida. All liability policies
shall provide that the Authority and the County of Collier as additional insured as to the uses of
the licensed premises under this agreement and shall also provide the Separation of Insured's
Provision. Prior to the execution of this agreement by licensee,the specified insurance coverage
and limits required must be evidenced by properly executed Certificates of Insurance on the
forms which are deemed acceptable by Authority.
8. USE OF PREMISES: The premises shall be used only for those commercial operations listed in this
agreement for aircraft owned by or leased to Licensee with a valid proof of insurance, in accordance
with the Collier County Contract Insurance Requirements Form-1 attached and made a part hereof, on
file with the CCAA.
9. TERMINATION FOR CAUSE: Licensor may terminate this license immediately for cause. Any
breach of this agreement by Licensee is cause for such termination.
10. SECURITY AND SAFETY: Licensee agrees to always cooperate with Licensor in every respect to
insure the security and safety on the premises.
11.EMERGENCY SITUATIONS: In the event of an emergency, (e.g. hurricane) access may be denied to
the premises at the discretion of the Airport Manager or designee,provided such denial of access is to
protect the public or airport from potential exposure to loss,damage or safety because of the emergency.
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Collier County Airport Authority Commercial Aviation Operations License Agreement
12. AUTHORIZED AIRCRAFT: Any aircraft owned or leased to the Licensee,or approved by the Airport
Manager or designee. Aircraft I. D.: . Aircraft Color:
Aircraft Mokc: . Aircraft Model: .
LICENSEE:
VAN WAGNER AERIAL MEDIA
By: Date:
Print Name:
Title:
LICENSOR:
A11'EST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E.BROCK, CLERK COLLIER COUNTY, FLORIDA, IN ITS CAPACITY AS
THE COLLIER COUNTY AIRPORT AUTHORITY
By: By:
,Deputy Clerk TOM HENNING,CHAIRMAN
Ap• ove' 1 to f.... d legality
idea
411111
Jeffre ' ow
Coun 1 ' orney
1
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ce3
EXHIBIT A
COLLIER COUNTY AIRPORT AUTHORITY
CONTRACT INSURANCE
REQUIREMENTS
TYPE LIMITS(Check)
X Workers' Compensation Statutory Limits of Florida Statutes 440 and Federal Government
Statutory Limits and Requirements
X Employer's Liability X $500,000 $1,000,000
Commercial General $500,000 per occurrence $1,000,000 per occurrence
Liability(Occurrence Form) bodily injury and property bodily injury and property
patterned after the current damage damage
ISO form with no limiting
endorsements.
Airport Liability Insurance $500,000 per occurrence $1,000,000 per occurrence
bodily injury and property bodily injury and property
damage damage
Hangarkeepers Liability $500,000 per aircraft $1,000,000 per aircraft
X Aircraft Liability Insurance $500,000 per occurrence X $1,000,000 per occurrence
bodily injury and property bodily injury and property
damage damage
Business Automobile $500,000 per occurrence $1,000,000 per occurrence
Insurance bodily injury and property bodily injury and property
damage damage
Pollution Liability Insurance $500,000 per occurrence $1,000,000 per occurrence
bodily injury and property bodily injury and property
damage damage
Property Insurance Replacement Cost-All Risks of Loss
INDEMNIFICATION:To the maximum extent permitted by Florida law, the ContractorNendor/Consultant
shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities,
damages, losses and costs, including, but not limited to, reasonable attorneys'fees and paralegals'fees,
to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the
ContractorNendor/Consultant or anyone employed or utilized by the ContractorNendor/Consultant in the
performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge
or reduce any other rights or remedies which otherwise may be available to an indemnified party or person
described in this paragraph.This section does not pertain to any incident arising from the sole negligence
of Collier County.
Collier County Board of County Commissioners shall be named as the Certificate Holder. NOTE--The
"Certificate Holder"should read as follows:
Collier County
Board of County Commissioners
Naples, Florida
No County Division, Department, or individual name should appear on the Certificate. No other format will
be acceptable.
Thirty(30)Days Cancellation Notice required on Agreements exceeding 6 months. The contract name
and number shall be included on the certificate of insurance.
Collier County shall be shown as an"ADDITIONAL NAMED INSURED"on property policies where an
interest in improvements and betterments is made,as its interests may appear.
Collier County must be named as"ADDITIONAL INSURED"on the Insurance Certificate for Commercial
General Liability and/or Airport Liability where required.
FORM 1- Commercial Activities License/Sublease of Land/Low Hazard or
Short Term/Aviation Related
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ACORD 3/25/2014 16.G.3.
-- CERTIFICATE �� LIABILITY INSURANCE I 1D/aD12D13
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 al:Mortised must be entloroed.if SUBROGATION IS WAIVED,subject to
the terms•and conditions of the policy,certain policies may require an ondofeemant A statement an this certificate does not confer rights to the
certificate holder In lieu of such endorcementts).
PRODUCER r ' Gayle L.Guest,Area Vice President
Arthur dGellagher Risk Management Services,inc.IOC. NANa
AIS Gallagher �o.6m_702-DO&8iY11 Neat
moms; gYla_puesteajgcom
8345 HIIMroed Drive
. INSURER(S)AFFORDING COVERAGE NAIC a
Las Vegas NV 59134 INSURER A: North American EIRE Insurance Company •
Wsunao INSURER En •
Van Wagner Aerial Media,LLC --
INSYI!!n 0:
1600 East Airport Road INSURER D:•
INSUR!!R e:
Pembroke Pines' FL 53023 INSURER F: •
COVERAGES CERTIFICATE NUMBER: 027 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 WTH'RESPECT TO WHICH THIS
• CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO AEI.THE TERMS,
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LASTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
_ T Yes OF INSURANCE ,;f N SI!all POLICY NURSER I AIM airedv i • - WAITS
'AL gym' EACH 6OCCCURRE OCCURRENCE ,a ' 6,000,000
7 COMMERCIAL GENERAL LIABILITY PRfiAB�SC tttNThD
Naha(Ea eeaunerp o 3
IMAMS-MADE Z OCCUR WED ExPSA mere person) ' S 6,000
A On.AirpOT Auto Liability Y FG20000043.01 1113/2013 12131/2014 ,PERSONAL&ADVINJURY $ 1,000,000
• GENERAL AGGREGATE S
GEN%AOGREOATE LIMIT
APPLE S PER;
PRODUCTS•COMP/OR AGO $
' • PoucY f Ep," fl Lcc S
AUTOMOBILE LIASBU Y FgM!INEDHINBLE LIMI I e-1 �
•ANY AUTO EIODILY INJURY Tor person) $ • .
— ALL OwNED ,___ SUEDSULED BODILY INJURY(Par aeel.ent) $
wros HIREDAtrros ■ SON-OWNED (eraTcc DAMRoE $
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USBREIA UAS I OCCUR • EACH OCCURRENCE S
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iYF LIAEa.ITY0 YIN — I I TORY LIMIT$ I ER
ANY PROPRIETOMPARTNER/EXECUTIV<^ E.L.EACH ACCIDENT S
(OFFICERNENSER EXCLUDED? N IA
R�m�sa baNu tlar EL01IMABE•EAEMPLOYEE S '
DEr3CIRI ON OF'OPERATIONS below E.L.DISEASE.POLICY LIMIT $.
$26,000,000 Single Limit Bodily Injury one
• A Alrcreft Liability Y FGZ 000004340 111312013 12/3112014 Property Damage with Passenger Liability
limited to$1,000,000 each passenger.
DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Mach ACORD¶01,Ammonal Remansa Schedule,M more mince M required),
CERTIFICATE HOLDER • CANCELLATION
SHOULD ANY OP THE ABOVE DESCRIBED POUCIEN BE CANCELLED BEFORE
• Collier County Airport Authority A Board of County THE EXPIRATION DA?E THEREOF,NOTICE WILL BE DELIVERED IN
Commissioners ACCORDANCE WITH THE POLICY PROVISIONS.
• 2005 MalnesiL Drive,Suds 1 ACTIUM=REPRSSaNSAnn
• Naples FL 94114 Gayle L.Guest National Producer a684303
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• '01938-2010 ACORD CORPORATION.All rights reserved.
ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD
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Feb 11 2014 14:15 P002/003
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�,,,. CERTIFICATE OF LIABILITY INSURANCE I �1 13 •
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 aertffcato holder Is an ADDITIONAL INSURED,the policy(les)must be endorsed.It 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 endorsementts). •
PlodicSR �— Gayle L.Quest,Area Vice President
Arthur J,Gallagher Risk Management Services,Inc. ' s
AIS Gallagher. L702.888,3011 Nets
9515 HiliwOOd Drive ADo*Dock= Eyla�uestaajfl•oorrt
, INSURER(S)API:0mM comErumn NAV#
Lee Vegas NV 88134 mum A:"North Ametean Elite Insurance Company •
INSURED INSURER B:
Van Wagner Aerial Media,LLC
DVSUrme e:
1500 Earn Airport Road • INSURER D:
Paw=E:
• Pembroke Pines FL 33029 .INSURER Ft
COVERAGES CERTIFICATE NUMBER 025 REVISION NUMBER:
THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE LISTED BELOWHAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED.NOTINITHSTANDINQ ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACTOR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY SE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
NM—
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPE OF INsImANCE rairflaRWO POLICY NUMBER DD ( Y 'rr) LIMITS
EACHOCCURRENCE b 5,000,000
7 COMMERCIAL.GENERAL LIABILITY I E (Ee etsL r,oe7 $
ICLAI6IS-MADE 7 OCCUR MED EXP(My are Paean) 6 6,000
A ve On-Airport Auto Liability Y FCC 0000043-01 11/3/2013 12/31/2014 PERVONAL&ADV INJURY $ 1,000,000
GENERAL AGGREGATE 5
GEM_AGGREGATE LIMIT APPLIES PER: PRODUCTS•COMP/OP AGO• $
'7 POLICY E 7LOC
b
AUTOMOBILE Lamm' . 16L4Wrin Lh LIMIT b
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AUTOS AUTOS BODILY INJURY(Per ecaleent) $
HIRED AUTOS •NON-OWNED
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EXCESS JAR CLAIMS-MADE AGGREGATE 6
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$26,000,000 Single Limit Bodily Injury inc
A Aircraft Liability Y FG2 0000043.01 11/3/2013 12/91/2014 Property Damage with Passenger Liability
limited to$1,000,000 each passenger.
DESORmaciN OF OPERATIONS 1 LOCATIONS/VEHICLES(Mob ACORD 101,AemaerW Remake S hedeM,If mere space Is roesesES
•
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED Poucros BE CANCELLED BsroRE
Collier County Aviation Authority THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
2003 Mainsail Drive ACCORDANCE WITH THE POLICY PROVISIONS,
AUTHORMED RCPREBENTAmre
r Naples FL 34114 Gayle L Guest National Producer#6114203
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M 19B8-2010 ACORD CORPORATION,All tights reserved.
ACORD 26(2010105) The ACORD name and logo are registered marks of ACORD
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Ac 3/25/2014 16.G.3.
60.--- CERTIFICATE OF LIABILITY INSURANCE 013
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 poliey(Ies)must be endorsed.if SUBROGATION IS WAIVED,subject to
the terns and conditions of the policy,certain policies may require an endorsement.A statement on this certtfcats does not confer rights to the
certificate holder In lieu of Such endorsement(s). • '
-Arthur J.Gallagher Risk Management 8ervlcsa,Inc. N�arra /ayes L.Guest,Area Vice President
wr' ' 702-808-3911 Net:
Ala Gallagher ADOResa: • gaYte_•guesta gig•COM ",
0615 11iliwOOd Delve IN0URER(SI'AFFONthNu COVERADE NAJDM
Loa Vegas NV 89134 Newsom North Amehoan Otis Insurance Company
INSURED INSURERS:
Van Wagner Aerial Media,LLC mums e:
lax East Airport Road ..
INSURER D:
INSURER E:
Pembroke Pines • FL 33023 INSURER F:
COVERAGES CERTIFICATE NUMBER: 029 . 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 OP SUCH POtIOIE�S..pLIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
LTR TYPE OF INSURANCE lelak w V POUGY NUMaaR IMMrDpnYYyl OM•c Ai WAITS
OEfIERAL LIABILITY • EACH OCCURRENCE, b •5,000,000
COMMERCIAL GENERAL LIABILITY r« • -j, ��
71"jc kl,�Ee 000,sroneet s
i CLAIMS-MADE ZOCCUR MEDEXP(Any one perseV S 5,000
A V On-Airport Auto Liability • Y • FGZ 0000043-0i • 11/3/2013 12/81/2014 PERSONAL&ADV INJURY S 11000,00o
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GENERAL AGOREGATE S
OEN1 AGGRE GATE LIMIT APPLIES PER PRODUCTS•COMP/OP AGO $
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AUTOMOBILE LIABILITY (Ee d�0601 I�N 1 INULt LAID S
( 7 ANY AUTO . BODILY INJURY(Per person �b
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ANY PROPRIETORiPARTNERIEXECUTIVE EL EACH ACCIDENT S
OFFICERIMEMBER EXCLUDED'? N/A
(Men eatery In MO • EL DISEASE.EA B ULUYEE 3
I}yea,deae,ine under
DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY UNIT 5
$25,000,000 Single LImit Bodily Injury and
• A Airrmft Liability Y FGZ 0000043-01 1113/2013 12/31/2014 Property Damage With passenger Liability
iimtted to 51,000,000 each passenger.
DESCRIPTON OF OPERATIONS/LOCATIONS I VEHICLES(Allen SCORE 101,AdMIUonM Rella a Schedule,k mere awe Is required) ^�
+CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICES BE CANCELLED BEFORE
Collier County Board of County Commissioners THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN
Attn: Bob TWOIdIC ACCORDANCE WITH THE POLICY PROVISIONS.
650 E.C.Airport Road AUTICRIEED REPRESENTAnve
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ACORD is(2010105) The ACORD name and logo are reg)eterea marks of ACORD
•
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,�....41 VAN) 3/25/2014 16.G.3.
Atc-c:R° CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY)
2/11/2014
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 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:
Masters Coverage Corp. PHONE 845 352-9100 FAX 845 3
747 Chestnut Ridge Road
E-MAIL No,Ext):( ) I(A/C,No): ( ) 52-9104
Chestnut Ridge,NY 10977 ADDRESS:
INSURER(S)AFFORDING COVERAGE NAIC#
INSURER A:Commerce and Industry
INSURED INSURER B:
Van Wagner Aerial Media,LLC INSURER C:
1600 E.Airport Road INSURER D:
Pembroke Pines,FL 33023 INSURER E
INSURER F:
COVERAGES CERTIFICATE NUMBER: 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.
INSR1 IADDLISUBR I POLICY EFF I POLICY EXP
LTR 1 TYPE OF INSURANCE I INSR I WVD POLICY NUMBER I IMMIDDIYYYY)I(MM/DD/YYYY) LIMITS
GENERAL LIABILITY EACH OCCURRENCE $
COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED
I PREMISES(Ea occurrence) ,$
CLAIMS-MADE OCCUR MED EXP(Any one person) $
I it
PERSONAL&ADV INJURY $
GENERAL AGGREGATE I$
GEN'L AGGREGATE LIMIT APPLIES PER: ICI PRODUCTS-COMP/OP AGG I$
PRO-
POLICY JECT 1 LOC $
AUTOMOBILE LIABILITY j i COMBINED SINGLE LIMIT
(Ea accident) $
7 ANY AUTO BODILY INJURY(Per person) $
ALL OWNED 1 I SCHEDULED I BODILY INJURY Per accident) -$
AUTOS ' 1 NON-OWNED INJURY(Per !
HIRED AUTOS I PROPERTY DAMAGE $
AUTOS (PER ACCIDENT)
I $
UMBRELLA LIAB I OCCUR EACH OCCURRENCE $
EXCESS LIAB
CLAIMS-MADE AGGREGATE $
DED I I RETENTION$ $
WORKERS COMPENSATION WC STATU- I 1°U.AND EMPLOYERS'LIABILITY Y/N TORY LIMITS
A ANY PROPRIETOR/PARTNER/EXECUTIVE IWCO25072098 05/05/2013 05/05/2014 I E.L.EACH ACCIDENT I$ 1,000,000
OFFICER/MEMBER EXCLUDED? N 1 A
(Mandatory in NH) E.L.DISEASE-EA EMPLOYEE$ 1,000,000
' If yes,describe under
DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT I$ 1,000,000
I I
I
DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more space is required)
Evidence of Insurance
Certificate Holder is listed as an additional insured
CERTIFICATE HOLDER CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
Collier County THE EXPIRATION DATE. THEREOF, NOTICE WILL BE DELIVERED IN
ACCORDANCE WITH THE POLICY PROVISIONS.
Board of County Commissioners
Naples,FL
AUTHORIZED REPRESENTATIVE
I
- I
'7 1988-2010 ACORD CORPORATION. All rights reserved.
ACORD 25(2010/05) The ACORD name Packet Page 4514- marks of ACORD