Backup Documents 10/13/2009 Item #16E 8ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office ]'he completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines # 1 through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exception of the Chairman's signature, draw a line through routing lines # I through 94, complete the checklist, and forward to Sue Filson (line #5).
Route to Addressee(s)
(I ist in routing order)
Office
Initials
Doe
1.
1/� 1
(Initial)
Applicable)
2.
s-
Agenda Item Number
3. �.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
h 1 5 r , _ ,
Number of Original
3
5, Ian Mitchell, BCC Office
Supervisor
Board of County Commissioners
Documents Attached
9
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created/prepared the executive
summary. Primary contact information is needed in the event one of the addressees above, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
,� A
C 14 A-e-Q C) L , ; A 1
`�'
Phone Number
� --7 C /
T
Contact
1/� 1
(Initial)
Applicable)
Agenda Date Item was
10. 1 3 of UU ' J
Agenda Item Number
Approved b the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
h 1 5 r , _ ,
Number of Original
3
Attached
resolutions, etc. signed by the County Attorney's Office and signature pages from
Documents Attached
INSTRUCTIONS & CHECKLIST
is Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1,26.05, Revised 2.24.05, Revised 9,18.09
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
_
1.
Original document has been signed /initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
2.
All handwritten strike - through and revisions have been initialed by the County Attorney's
�
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
vN
document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
W`
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
should be provided to Ian Mithchell in the BCC office within 24 hours of BCC approval.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
w
time frame or the BCC's actions are nullified. Be a are of our deadlines!
6.
The document was approved by the BCC on t a 1 3 d (enter date) and all changes
made during the meeting have been incorporated in the attached document. The
-
County Attorney's Office has reviewed the changes, if applicable.
is Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1,26.05, Revised 2.24.05, Revised 9,18.09
16E g
MEMORANDUM
Date: October 14, 2009
To: Michael Dowling, Property Management Specialist
Real Estate Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: License Agreement
Contractor: Kmart Corporation
Attached for your records is three (3) originals, referenced above (Agenda
Item #16E8) approved by the Board of County Commissioners
on Tuesday, October 13, 2009.
Please forward a fully executed original to the Minutes & Records
Department for the Board's Records.
If you should have any questions, please contact me at 252 -7240.
Thank you.
16E g
LICENSE AGREEMENT
THIS LICENSE AGREEMENT is made this day of , 2009, between
KMART CORPORATION, a Michigan corporation ( "Licensor ") and COLLIER COUNTY, a political
subdivision of the State of Florida, whose mailing address is 3301 East Tamiami Trail, Naples, Florida
34112 ( "Licensee "), on behalf of the Collier County Health Department ( "User "). The parties agree:
1. Premises
Licensor licenses to Licensee the use of the following premises situated in Collier County, in the State
of Florida, more particularly described as:
The certain space consisting of approximately 116,790 square feet, identified as the area cross-
hatched on the Site Plan attached hereto as Exhibit "A" (the "Premises ") located on the property of
Licensor which is outlined in bold lines on the Site Plan (the "Entire Tract ").
2. Use
The Premises may be used by Licensee for seasonal flu inoculations such as H1N1 inoculations
administered to the general public and for no other use. Licensee agrees to secure at Licensee's sole
cost any required permits for the use of the Premises and shall comply with all federal, state and local
governmental laws, rules, regulations and ordinances applicable to Licensee's use of the Premises.
3. Term
Subject to Licensee providing satisfactory evidence to Licensor of the insurance coverage required in
Section 7 hereof, the term of this License Agreement shall commence on November 1, 2009 (the
"Commencement Date ") and terminate on December 31, 2009 (the "Term ") subject to Section 11.
4. Fee
(a) On or before the Commencement Date, and on or before the first day of each month thereafter
during the Term, Licensee shall pay to Licensor for this License Agreement the sum of TWENTY
FIVE THOUSAND AND 00 /100 DOLLARS ($25,000.00) (the "Fee ") per month.
5. Repairs. Maintenance and Utilities
(a) Licensee shall replace light bulbs, replace air conditioning filters, and make any minor repairs
that are deemed necessary by Licensee at its sole cost and expense. Licensee agrees to keep the
Premises in a clean and safe condition, meeting applicable county ordinances. Upon the termination or
expiration of this License, Licensee agrees to deliver the Premises to the Licensor in as good condition
as when received. Licensee shall further keep the Premises and any improvements and fixtures thereon
in good order and repair. Licensor shall maintain the air - conditioning system throughout the term of
this Agreement.
(b) Licensor shall at all times have access to the Premises.
WOMIRO
(c) If Licensee fails to promptly perform the obligations in this Section 5 within ten (10) days after
written notice by Licensor, Licensor shall have the right to make or cure such conditions and to
recover Licensor's cost with interest from Licensee at an annual rate equal to four percentage points
above the prime rate as published in the Money Rates Section of The Wall Street Journal from time to
time (or if such paper is no longer published or no longer publishes the prime rate, then the prime rate
of another financial journal designated by Licensor).
(d) Licensee shall be responsible for the payment of all Florida Sales Tax as required by law during the
Term.
(e) Licensee will be responsible for the special handling and disposal of all hazardous waste materials
generated by Licensee's operations. Licensor shall have no responsibility or liability for any damage
created by hazardous materials generated or used by Licensee's operations, and Licensee, only to the
extent authorized by 768.28, Florida Statutes shall indemnify, defend and hold Licensor, its directors,
officers, employees and agents, harmless from and against all claims, actions, losses, damages, costs,
expenses and liabilities arising out of hazardous materials generated or used by Licensee's operations.
6. Risk of Loss
Licensee shall use the Premises at its own risk. Licensor shall have no responsibility or liability for any
loss of or damage to any property of Licensee, its employees, agents, contractors or invitees. Licensor
shall not be responsible or liable to Licensee or to anyone claiming by, through, or under Licensee for
any loss or damage that may be occasioned by or through the acts or omissions of any person or
occupant of the Entire Tract, from any cause whatsoever. Licensee agrees that it will not do or permit
anything to be done in or about the Premises, or bring anything onto the Premises or keep anything on
the Premises, which shall increase the rate of insurance on the Entire Tract or any portion thereof.
7. Insurance
Licensor requires the User to provide a Certificate of Coverage pertaining to the use of the Premises, at
its sole cost and expense, and shall include Workers' Compensation Insurance, Commercial General
Liability Insurance and All Risk Property Insurance. A copy of the State of Florida's State Risk
Management Trust Fund General Liability Certificate of Coverage is attached hereto and made a part
of this Agreement.
The policy shall expressly provide that it shall not be subject to cancellation or material change
without prior written notice to Licensor.
8. Subrogation
Notwithstanding any other provisions herein, Licensor and Licensee each releases the other and, on
behalf of its insurers, waives its entire right to recovery against the other for loss or damage to the
waiving party and its property to the extent that the loss or damage is customarily insurable by a fire
and extended coverage insurance policy.
16E g
9. Indemnitv
(a) Licensee and User shall defend Licensor, its directors, officers, employees and agents against all
claims, actions, proceedings and suits arising out of actual or alleged injury to or death of any person or
loss of or damage to property in or upon the Entire Tract, including the person or property of Licensor,
its directors, officers, employees, agents, invitees, licensees or others arising from the acts or omissions
of Licensee, its employees, agents, invitees or guests.
(b) Licensee and User shall indemnify, and hold Licensor, its directors, officers, employees and agents,
harmless from and against all claims, actions, losses, damages, costs, expenses and liabilities (except
those caused by the willful misconduct or negligent acts or omissions of Licensor), arising out of actual
or alleged injury to or death of any person or loss of or damage to property in or upon the Entire Tract,
including the person and property of Licensor, its directors, officers, employees, agents, invitees,
licensees or others, arising from the acts or omissions of Licensee and/or User, its employees, agents,
invitees or guests.
10. Assienment
The Premises shall be occupied by the User and User or Licensee shall not have the right to assign this
License Agreement or further license the use of all or any part of the Premises without Licensor's
consent which may be withheld in its sole and absolute subjective discretion.
11. Revocability
Either party shall have the right to terminate this Lease at any time, with or without cause, by providing
the other party with ten -day written notice of such termination at the address set forth below. This
notice period shall commence upon placement of the written notice in an official depository of the
United States Post Office, Registered or Certified Mail, postage prepaid, or by personal delivery or
overnight delivery service.
12. Notices
All notices herein provided for shall be in writing and shall be sent by (a) registered or certified mail,
postage prepaid, return receipt requested, (b) personal delivery or (c) reputable overnight air courier,
and shall be deemed to have been given (i) five (5) business days after deposit in the mail postage
prepaid if sent via mail, (ii) upon receipt if personally delivered, and (iii) one (1) business day after
being deposited with a reputable overnight air courier for guaranteed next business day delivery.
Notices shall be addressed to:
Licensor:
Kmart Corporation
3333 Beverly Road
Hoffman Estates, Illinois 60179
Attn: Vice President
Real Estate
Department 824RE
Copy to:
Kmart Corporation
3333 Beverly Road
Hoffman Estates, Illinois 60179
Attn: DVP
Real Estate Law
Department 824RE
16E g
Licensee and User:
Collier County
c/o Real Property Management
Building W
3301 Tamiami Trail East
Naples, Florida 34112
cc: Office of the County Manager
Health Department Director
or to any other address furnished in writing by either of the respective parties. However, any change of
address furnished shall comply with the notice requirements of this Section and shall include a
complete outline of all current notice addresses to be used for the party requesting the change.
13. Remedies
If Licensee fails to perform any obligation hereunder or is otherwise in breach of this Agreement,
Licensor shall be entitled to exercise all remedies Licensor has at law or in equity. Licensee shall pay
all costs, fees and expenses incurred by Licensor in pursuit of Licensor's remedies including, but not
limited to, attorneys' fees and court costs.
14. Time of Essence
Time is of the essence in this License Agreement.
15. Entire Agreement
This License constitutes the entire agreement between the parties with respect to the Premises. Neither
this License nor any of its provisions may be changed, waived, discharged or terminated orally, but
only by an instrument in writing signed by the parties, except as provided in Section 11.
16. Choice of Law
This License shall be construed in accordance with and governed by the laws of the state in which the
Entire Tract is located.
17. Third Party Beneficiaries
Except as herein specifically provided, no other person, customer, employee or invitee of Licensee or
any other third party shall be deemed to be a third party beneficiary of any of the provisions herein.
18. Partial Invalidity
If any Section, paragraph, subparagraph, sentence, clause or phrase of this License Agreement shall be
declared or judged invalid or unconstitutional, such adjudication shall not affect the other Sections,
paragraphs, subparagraphs, sentences, clauses or phrases.
19. Headings
The Section headings are for convenience and are not a part of this License Agreement.
IN WITNESS WHEREOF, the parties have caused this License Agreement to be executed:
AS TO LICENSOR:
AS ''O LICENSEE:
DATED:—/ y ' / `3 ' "'� (J'( '
ATTEST:,
DWIGHT E. BROCK,. Clerk
By:
00uty Clerk ;
Att 41 as w
S 1946t* ,two x
Approved as to form and legal sufficiency:
A'Qtiaifer ite, Assistant County Attorney
KMART CORPORATION
(print name and title)
BOARD OF COUNTY COMMISSIONERS
COLLIER CCNNTY, FLORIDA
1
DONNA FIALA, Chairman
16E g
16E g
Exhibit `A'
12713 Tamiami Trail East
Naples, Florida
16E g
Insurance Policy
CHIEF FINANCIAL OFFICER
STATE OF FLORIDA
ALEx SINK
STATE RISK MANAGEMENT
TRUST FUND
Policy Number: GL -09 -8300
Name Insured: DEPARTMENT OF HEALTH
General Liability
Certificate of Coverage
16E $
General Liability Coverage provided pursuant to Chapter 284, Part II, Section 768.28, Florida
Statutes, and any rules promulgated thereunder.
Coverage Limits:
General Liability:
Inception Date:
Expiration Date:
$100.000.00 each person
$200,000.00 each occurrence
7/l/2009
7/1/2010
CHIEF FINANCIAL OFFICER
`A S ll0 -863
(REV. 3/01)
DEPARTMENT of FINANCIAL SERVICES
DIE CAPITC+L, TALLAHASSEE, FLORIDA 32399 -0301 • (850) 413 -2850 • TELEcopmit (850) 413 -2950
16E 8
DEPARTMENT OF F'INANCiAL SERVICES
Division of Risk Management
STATE RISK MANAGEMENT TRUST FUND
GENERAL LIABILITY
CERTIFICATE OF COVERAGE
In consideration of the provlsfons and stipulations contained herein or added hereto and for the premium charged, the State Risk Management Trust
Fund, hereinafter referred to as the "Fund ", certifies that the State department or agency named In this certificate is hereby provided general Hability
coverage. Coverage shall be effective on the Inception date at 12:01 a.m. standard time. .
This certificate is comprised of the foregoing provisions and stipulations, together with such other provlebns and. stipulations as may be added hereto by
the Fund In the future:
COVERAGES
General Liability Coverage»Bodlly and Property Damage
To pay on behalf of the Insured of sums which the Insured shah
became legally obligated to pay as damages for injury or loss of
Property. personal injury, or death caused by the negligent or
wrongful act or omission of any ofticar, employee, agent or
volunteer of the named Insured, as such terms may be further
defined herein or by adminish-Ave rub, while acting within the
scope of his office or empbyntertt, pursuant to the provisions
and limitations of Chapter 284, Part II and Section 76x.28,
Florida Stahrtes.
N. DEFENSE, SETTLEMENT, SUPPLEMENTARY PAYMENTS
With respect to such coverage as le afforded by this oerelicxle,
the Fund shag:
(a) defend any proceeding against the insured seeking such
benefits and any suit against the Insured alleging such
Injury and seeking damages on account thereof, even If
such proceeding or suit is groundless, false, or fraudulent.
The Fund will investigate all Claims Wed against the
Insured in order to determine the legal gability of the
insured and to determine damages sustained by the
claimant. The Fund will negotiate, settle, or deny the claim
based on these findings and appropriate Florida law.
(b) pay all premiums on bonds to release attachments and on
appeal bonds required in any such defended suit for an
amount not In excess of the applicable limit 6f liability
established In this certificate;
(c) pay all expenses incurred by the Fund, all caste taxed
against the insured In any such suit, and all interest
i tendered, deposited Ina�� that tit the Fund has paid,
pad of such judgment
as does not exceed the limit of the Fund's IWAty thereon;
(d) pay expenses Incurred by the Insured for such Immediate
medial relief to others as shall be imperative at the time of
the accident
UL DEFINITIONS
(a) Named Insured - The department or agency named
herein.
(b) Insured - State department or agency named herein. their
officers. employaes, agents or volunteers.
(c) Volunteer - Any person who of his own free will, provides
goods or services to the named Insured, with no monetary
or material compensation as defined in Chapter 110, Part
1V, Florida Statutes.
(d) Agent - Any person not an employee, acting under the
direct oontrd and supervision of a state agency or
department, for the beneta of a state agency or
department
(e) Automobile - A land motor vehicle, trailer, or semi- fraNer
designed and licensed for use on pubic roads (including
machinery or apparatus attached thereto), but does not
Include mobile equipment.
(f) Mobae Equipment - A land vehicle (Including machinery or
apparatus attached thereto), whether or not self - propelled;
(1) not subject to motor vehicle registration, or
DFS- Dl} -863
Reviecd 3V
(2) maintained for use exclusively on premises owned
by or rented to the named insured, including the
ways imnedlately adjob*g, or
(3) designed for use principally off pubic roads, or
(4) designed or maintained for the sole purpose of
alfcrdkV mobility to equipment of the following types
forming an Integral part of or permanently attached
to such vehicle; pourer cranes, shovels. loaders,
diggers and droK concrete nmixere (other than the
mix -fn- transit type); tinders, scrapers, rovers and
other road construction or repair equipment; air -
compressors, pumps and generators. including
spraying, welding, and building cleaning equipment;
and geophysical exploration and wall-servicing
equipment-
IV. EXCLUSIONS
This certificate does not apply
(a) to bodily Injury or property damage arising out of the
ownership, maintenance, operation, use, loading or
unloading of
(1) any automobile owned or operated by or rented or
loaned to arry insured, or
(2) any other automobile operated by any person In the
course of his employment by any Insured, but this
exclusion does not apply to the parking of an
automobile on premises owned by. rented to, or
controlled by the named insured or the ways
irnmedlately adjoining, if such aukmobile Is not
owned by, rented, or loaned to any insured;
(b) to any action which may be brought against the named
Insured by anyone who unlawfully partk3petea in riok
unlawful assembly, public demonstration, mob violence, or
civil disobedience N the claim arises out of such riot,
unlawful assembly, public demonstration, mob violence, or
civil disobedience;
(c) to any obligallam for which the insured or the Fund may be
held liable under any employees lability or workers'
compensation law,
(d) to property damage to property owned or occupied by the
Insured;
(a) to property damage to premises alienated by the insured
arising out of such premises crony part thereof;
M to loss at use of tangible property which has not been
physically Injured or destroyed, resulting frarr.
(1) a delay In or lack of performance by or on behalf of
the named insured of any contract or agreement;
(2) the failure of the named Insured's products, or work
pefionned by or on behalf of the named Insured to
meet the level of performance, quality fitness, or
durability warranted or represented by the named
Insured;
(ti) to property damage to the named insureft products
arising out of such products or any part of such products;
(h) to ply damage to work performed by or on behalf of
the named Insured arising out of the work or any portion
thereof, or out of materials, parts, or equipment furnished
In connection therewith;
16E 8
p)
eminent domain proceedings or damage to persons or
(4)
Action Against the Fund
property of others arising therefrom;
No action shalt lie against the Fund unless, as a
(j)
to punitive damages;
condition precedent thereto, the Insured shall have
(k)
to actions of Insureds committed In bad faith or with
been In fufi compliance with all of the terms of this
malicious purpose or in a manner exhibiting wanton and
certificate and the provisions of applicable Florida
willful disregard of human rights, safety, or property;
Statutes.
(1)
to professional medical liability of the Board of Regents,
(5)
Severability of Interest
the physicians, officers, employees, or agents of the
The term 'the insured' is used severally and not
Board;
collectively, but the inclusion herein of more than
(m)
to liability related in any way with nuclear energy;
one Insured shall riot operate to increase the limits
(n)
to liability assumed by the insured under any contract or
of the Fund's liability.
agreement;
(o)
to final Judgments In which the Insured has been
(6)
Limits of Liability
determined to have caused the harm Intentionally,
The limit of liability expressed as applicable to "each
(p)
to awards for Injunctive, declaratory, or prospective relief
person" Is the limit of the Fund's Willy for all
rendered against an insured by any federal or state court,
damages, Including damages for care and loss of
agency or commission.
services, arising out of personal injury and property
damage sustained by one person as a result of any
V. CONDITIONS
one occurrerne; but the total liability of the Fund for
A.
Premium
all damages sustained by two or more persons as a
Premium charges shall be assessed In accordance with
resuti of any one occurrence shall not exceed the
the provisions of Chapter 284, Part 11, Florida Statutes, and
limit of tiabifity as applicable "each occurrence ",
any rules promulgated thereunder utHtdng a retrospective
(7)
Other Insurance
rating arrangement premium calculation method Whereby
If there Is Insurance applicable to. am claim, the
84% of the premium Is based on losses actually incurred
coverage extended by this certificate sltaJl apply only
by the Insured and 20% is based on the changes In risk
as excess insurance over any and all other
exposures (employees, etc.) of an Insured. The prendum
applicable Insuranc&
must be paid promptly by an insured agency from Is
(6)
Terms of Coverage
operating budget upon receiving the premium bill or
This certificate is Issued for the purpose of
Invoice.
confirming overage as contemplated by Chapter
284, Part Ill, Florida Statutes. In the event of any
B.
Audit
conflict between provisions or coverages in this
The Fund shall be permitted to examine and audit the
certificate and the provisions of any Florida Statutes
insursd's books and records at any time during the term of
or laws Including, but not firtied to the aforesaid,
Ns coverage and any extension thereof, and within three
said statutes and laws shah control.
years after the final termination of this coverage, as far as
(9)
Cancellation
they relate to the premium bases or the subject matter of
Failure of the Fund to receive the amount of
this coverage.
premiums billed to the insured agency within the
time frames allowed by law may result In
C.
InstreWs Dulles in the Event of Occurrence, Ctalm or
cancellatlon of time oartifirarte of coverage.
Suit
Payments must be made promptly from Bile insuy ell's
(1) Event of Occurrence
operating budget upon receipt of the pmmiurm bill as
Written notice containing particulars sufficient to
specified In Section 284.38, Florida Statutes, and
Identify the Insured, along with reasonably
lack of prompt payment will result In a request from
obtainable information with respect to the dime, place
the Fund to the Comptroller to transfer premiums
and circumstances thereof. the- names and
from any available funds of the delinquent agency
addresses of the Injured and all known witnesses,
under the provisions of Section 284.44(7), Florida
shall Immediately be given by or for the insured to
Statutes.
the Fund.
(2) Notice of Clain or Suit
D.
Self - Insurance Coverage
If cfalm Is made by suit brought against the Insured,
Coverage for defending and paying ciairns under this
Me insured shall Immediately forward to the Fund
certificate 13 provided under the authority of Chapter
every demand, notice, summons, or other process
284, Florida Statutes, wherein the state Is authorized
received by him or his representative. Failure by the
to administer a self- insurance program. Provision of
Insured to advise the Fund of a claim or suit prior to
this certificate does not constitute the issuance of
a settlement agreement or the Insured otherwise
insurance other than on a se{f- Insurance basis, and
obligating Itself, shah void coverage by the Fund, for
payment of any covered claim oUlgations is
that claim,
confingent upon availability of legislative funding.
(3) Assistance and Cooperation of the Insured
The insured shalt cooperate with the Fund and, upon
the Fund's request, assist in making settlements, In
the conduct of subs and In enforcing any right of
contribution or Indemnity against any person or
organization who may be liable to the Insured
because of Injury or damage with respell to which
overage Is afforded under this certificate, and the
insured shall upon request, make available all
agency records pertaining to a specific claim, shah
attend hearings and trials and assist In securing and
giving evidence and obtaining the attendance of
witnesses. The Insured shall not except at his own
cost, voluntarily make any payment, assume any
obligation or Incur any expenses other than for first
aid to others at the time of accident.
DFS- DO-863
Revised 3101
State
r r
DOH Contad Person:
Bureau of General Services, lamberly Copeland, Insurance Specialist
4052 Bald Cypress Way, 0-06, Tallahassee, Fkrida 32399 -1734
(850) 245 -4344 - 205 -4344
Coverage Limits:
Declared Value on the Insurance Certificate; Flood Insurance;
Single Family Residence ;250,000; All other buildings $500,000; Single
Family Residence Contents $100,000;
All other Buildings Contents $500,000
Deductible Minimums:
$2,500 per loss for all covered perils, except flood. Flood deductible per
National Flood Insurance Program.
Submit Loss Detalls to:
Department of Health, Bureau of General Services
I(Imberty Copeland, Insurance Support
Email: Kimber ly_copeland @doh.state.fl.us or by
Fax: 850)412 -1434
What is Covered:
Any direct physical loss of or damage to covered property at the premises
listed on the certificate of insurance for that location.
What Is Not Covered:
Loss or damage due to the enibm wnent of any ordinance or law
regulating the cons vOon use or repair of any property; or
requiring the tearing down of any property Including the cost of
removing Its debris.
• Any earth movement other than sinkhole collapse, volcanic eruption,
explosion or effusion.
• Seizure or destruction of property by order of governmental
authority.
• Nuclear reaction or radiation or radioactive contamination however
caused.
• Failure to power or other utility service supplied to the described
premises, however caused, if the failure occurs away from the
described premises. Contents damaged as a resuit of power
failures,,
• Ware, Including undeclared or civil war, warlike action by a military
tome, Including action in hindering or defending against actual or
expected attack, by any government sovereign or other authority
using military personnel or other agency; or Insurrection, rebellion,
revolution, usurped power, or action taken by governmental
authority In hindering or defending against any or these.
• Water that backs up from a sewer or drain; Water under the ground
surface pressing on or flowing or seeping through ftxmdatlons,
walls, floors, paved surfaces, basements (whether paved or not),
doors, windows or other openings
• Water damage meaning accidental discharge or leaking of water or
steam as the direct result of the breaking or cracking of any part of
a systern or appliance containing water or steam.
• Artificially generated electrical current, Including electric arcing.
• Explosion of steam boilers, steam pipes, steam engines or steam
turbines. Refer to Boiler & Machinery Insurance Coverage
• Mechanical breakdown Including rupture or bursting caused by
centrifugal force. Refer to Boiler & Machinery Insurance Coverage
'Leo,
MINE
Department of Insurance
Division of Risk Management
Slabs Risk Management Trust Fund
Certificate of Property Coverage
Various provisions in this certificate restrict coverage. Read the entire certificate carefully to determine
rights, duties and what is and is not covered.
Coverage for defending and paying claims under this certificate is provided under the authority of
Chapter 284, Florida Statutes, wherein the state is authorized to administer a self - insurance program.
Provision of this certificate does not constitute the issuance of insurance other than on a self-insurance
basis, and payment of any covered claim obligations is contingent upon availability of legislative funding.
Throughout this policy the words "you" and "your" refer to the State Agency, Board, Bureau, or other
authorized entity shown in the Declarations. The words "we ", "us" and "our" refer to the State Risk
Management Trust Fund (the. Fund) or any other successor trust fund administered by the Division of
Risk Management for the purposes of providing property loss coverage.
Other words and phrases that appear in "quotation marks" have special meaning. Refer to SECTION H -
DEFINITIONS.
A. COVERAGE
We will pay for direct physical loss of or
damage to Covered Property at the premises
described in the Declarations caused by or
resulting from any Covered Cause of Loss.
1. Covered Property
Covered Property means the following
types of property for which a limit of
Insurance Is shown In the Declarations:
P. Building, meaning the building or
structure described in the Declarations,
including:
(1) Completed additions;
(2) Permanently Installed:
(a) Fixtures;
(b) Machinery; and
(c) Equipment;
(3) Personal property owned by you
that is used to maintain or service the
Wilding or structure or its premises,
including:
(a) Fire extinguishing equipment;
(b) Outdoor furniture;
(c) Floor coverings; and
(d) Appliances used for
refrigerating, ventilating, cooking,
dishwashing or laundering;
(4) If not covered by other insurance:
(a) Additions, alterations and
repairs to the building or structure,
(b) Materials, equipment, supplies
and temporary structures, on or
within 100 feet of the described
premises, used for making
additions, alterations or repairs to
the building or structure.
b. Your Business Personal Property
located in or on the building described in
the Declarations or in the open (or in a
vehicle) within 100 feet of the described
premises, consisting of the following:
(1) Furniture and fixtures;
(2) Machinery and equipment;
(3) "Stock ";
(4) All other personal property owned
by you and used in your agency;
(b) Your improvements and
D14- 852(Re%dsed 3871 Page I of 8
betterments as a tenant.
Improvements and betterments are
fixtures, alterations, installations or
additions:
(a) Made a part of the building or
structure you occupy but do not
own; and
(b) You acquired or made at your
expense but cannot legally
remove.
2. Property Not Covered
Covered Property does not include:
a. Accounts, bills, currency, deeds, food
stamps or other evidences of debt,
money, notes or securities; lottery tickets
.held for sate are not securities;
b. Animals;
c. Bridges, roadways, walks, patios or
other paved surfaces;
d. The cost of excavations, grading,
backfilling or filling;
e. Foundations of buildings, structures,
machinery or boilers if their foundations
are below:
(1) The lowest basement floor, or
(2) The surface of the ground, if there
is no basement;
f. Land (including land on which the
property is located), water, growing crops,
lawns and plants;
g. Business personal property while
airborne or waterbome;
h. Personal property not owned by the
State of Florida;
i. Pilings, piers, wharves or docks;
j. Property that is covered under another
policy, except for the excess of the
amount due (whether you can collect on it
or not) from that other insurance;
k. Retaining walls that are not part of the
building.
I. Underground pipes, flues, drains, or
electrical and communication wiring;
m. The cost to research, replace or
restore the information on valuable
papers and records, including those which
exist on electronic or magnetic media;
n. Vehicles or self - propelled machines
(including aircraft or watercraft) that:
16E 8
(1) Are licensed for use on public
roads; or
(2) Are operated principally away from
the described premises;
o. Grain, hay, straw or other crops;
p. Fences, including attached devices,
unattached radio or television antennas,
including their lead -in wiring, masts or
towers (except for towers insured
separately as a stand alone structure),
signs (other than signs attached to
buildings), trees, shrubs or plants, stand
alone fight poles/fixtures afi except as
provided in the Coverage Extensions.
cl. Fine arts, manuscripts, nitrocellulose
films, museum collections, artifacts,
relics, bullion;
r. Surplus property
Business Personal Property declared
surplus property but stored on the
premises are deemed to have no value
for the purpose of making Balm under
this certificate.
s. Buildings that have been abaridoned or
selected for removal from the premises or
selected for demolition.
3. Additional Coverages
a. Debris Removal
(1) We will pay your expense to
remove debris of Covered Property
caused by or resulting from a Covered
Cause of Loss that occurs during the
policy period. The expenses will be
paid only if they are reported to us in
writing within 94 days of the date of
direct physical loss or damage.
(2) This Additional Coverage does not
apply to costs to extract "pollutants ".
b. Preservation of Property
If It Is necessary to move Covered
Property from the described premises
to preserve it from loss or damage by
a Covered Cause of Loss, we will pay
up to $10,040 for any direct physical
loss or damage to that property:
(1) While it is being moved or while
temporarily stoned at another location;
and
(2) Only if the loss or damage occurs
Di4- 852(Revised 3101 Page 2 of 8
within 10 days after the property is first
moved.
4. Coverage Extensions
Except as otherwise provided, the
following Extensions apply to property
located in or on the building described in
the Declarations or in the open (or In a
vehicle) within 100 feet of the described
premises.
a. Newly Acquired or Constructed
Property
(1) You may extend the insurance that
applies to Building to apply to:
(a) Your new buildings while being
built on the described premises;
and
(b) Buildings you acquire at
locations, other than the described
premises.
(2) You may extend the insurance that
applies to Your Business Personal
Property to apply to that property at
any location you aoquire. The most
we will pay for loss or damage under
this Extension is 10% of the Limit of
insurance for your Business Personal
Property shown in the Declarations,
but not more than $10,000 at each
building.
(3) Coverage under this Extension for
each newly acquired or constructed
property will end when any of the
following first occurs:
(a) This policy expires.
(b) 30 days expire after you
acquire or begin to construct the
property; or
(c) You report values to us.
b. Property Off- Premises
You may extend the insurance
provided by the Fund to apply to your
Covered Property, other than "stock",
that is temporarily at a location you do
not own, lease or operate. The
Extension does not apply to Covered
Property:
(1) In or on a vehicle unless the
16E
vehicle is owned or operated by an
employee of the State of Florida and
the vehicle is being used for .State
business;
(2) In the care, custody or control of
field personnel or anyone not
employed by the State of Florida.
(3) At any fair or exhibition.
The most we will pay for loss or
damage under this Extension Is
$10,000.
c. Trees, Shrubs and Plants
You may extend the coverage
provided by the Fund to apply to trees,
shrubs and plants Including debris
removal expense, caused by or
resulting from any of the following
causes of loss:
(1) Fire;
(2) Lightning;
(3) Explosion;
(4) Riot or Civil Commotion; or
(5) Aircraft.
The most we will pay for loss or
damage under this Extension is
$1,000, but not more than $250 for
any one tree, shrub or plant.
Each of these Extensions Is additional
Insurance. The Additional Condition,
Coinsurance, does not apply to these
Extensions.
B. COVERED CAUSES OF LOSS
1. Fire.
2. Lightning,
3. Explosion, including the explosion of
gases or fuel within the furnace of any fired
vessel or within the flues or passages
through which the gases of combustion pass.
This cause of loss does not Include loss or
damage by:
a. Rupture, bursting or operation of
pressure relief devices; or
b. Rupture or bursting due to expansion
or swelling of the contents of any building
or structure, caused by or resulting from
water, or
C. Any loss which would normally be
covered only under a standard boiler and
machinery policy.
4. lAfindstorm or Hail, but not including:
D14- 852(Revlsed 3101 Page 3 of 8
�016
a. Frost or cold weather;
b. Ice (other than hail), snow or sleet,
whether driven by wind or not; or
c. Loss or damage to the interior of any
building or structure, or the property
inside the building or structure, caused by
rain, snow, sand or dust, whether driven
by wind or not, unless the building or
structure first sustains wind or hail
damage to its roof or walls through which
the rain, snow, sand or dust enters.
5. Smoke causing sudden end accidental
loss or damage. This cause of loss does not
include smoke from agricultural smudging or
Industrial operations.
S. Aircraft or Vehicles, meaning only
physical contact of an aircraft, a spacecraft,
a self - propelled missile, a vehicle or an
object thrown up by a vehicle with the
described property or with the building or
structure containing the described property.
This cause of loss includes loss or damage
by objects failing from aircraft. We will not
pay for loss or damage caused by or
resulting from owned or non -owned vehicles
which are operated by you.
T. Riot or Civil Commotion, including:
a. Acts of striking employees while
occupying the described premises; and
b. Looting occurring at the time and
place of a riot or civil commotion.
8. Sinkhole Collapse, meaning loss or
damage caused by the sudden sinking or
collapse of land into underground empty
spaces created by the action of water on
limestone or dolomite. This cause of loss
does not include:
a. The cost of filling sinkholes; or
b.. Sinking or collapse of land into man-
made underground cavities.
9. Flood
As per Section 284.01, Florida Statutes,
this section incorporates the same
provisions as the NATIONAL FLOOD
INSURANCE PROGRAM. That program
defines "Flood" as:
a. A general and temporary condition of
partial or complete Inundation of normally
dry land areas from:
(1) The overflow of inland or tidal
16E g
waters.
(2) The unusual and rapid
accumulation or runoff of surface
waters from any source.
(3) Mudslides (I.e., mudflows), which
are proximately caused by flooding as
defined in subparagraph a.(2) above
and are akin to a river of liquid and
flowing mud on the surfaces of
normally dry land areas as when earth
Its carried by a current of water and
deposited along the path of the
current.
b. The collapse or subsidence of land
along the shore of a lake or other body of
water as a result of erosion or
undermining caused by waves or currents
of water exceeding the anticipated
cyclical levels which result in flooding as
defined in subparagraph a.(1) above.
THIS SECTION DOES NOT CONSTITUTE THE
ENTIRE FLOOD POLICY. IT IS MERELY
PROVIDED FOR AGENCY GUIDANCE IN THIS
AREA ONLY. PLEASE REFER TO THE
NATIONAL FLOOD INSURANCE PROGRAM
POLICY, WHICH IS ATTACHED TO THIS
CERTIFICATE.
10. Additional Coverages
a. Debris Removal
(1) We will pay your expense to
remove debris of Covered Property
caused by or resulting from a Covered
Cause of Loss that occurs during the
policy period. We will pay 25% of the
loss or $5,000, whichever is greater.
The expenses will be paid only if they
are reported to us in writing within 90
days of the date of direct physical loss
or damage.
(2) This Additional Coverage does not
apply to costs to extract "pollutants".
b. Preservation of Property
If it is necessary to move Covered
Property from the described premises
to preserve it from loss or damage by
a Covered Cause of Loss, we will pay
up to $10,000 for any direct physical
loss or damage to that property:
014- 852(Revised "I Page 4 of 8
(1) While it is being moved or while
temporarily stored at another location;
and
(2) Only if the loss or damage occurs
within 30 days after the property is first
moved.
11. Coverage Extensions
Except as otherwL" provided, the
following Extensions apply to property
located in or on the building described in
the Declarations or in the open (or in a
vehicle) within 100 feet of the described
premises.
a. Newly Acquired or Constructed
Property
(1) You may extend the insurance that
applies to Building to apply to:
(a) Buildings you acquire at
locations, other than the described
premises. The most we will pay for
loss or damage under this
Extension is $250,000 per building.
(2) You may extend the Insurance that
applies to Your Business Personal
Property to apply to that property at
any location you acquire. The most
we will pay for loss or damage under
this Extension is 10% of the Limit of
Insurance for your Business Personal
Property shown in the Declarations,
but not more than $10,000 at each
building.
(3) Coverage under this Extension for
each newly acquired or constructed
property will end when any of the
following first occurs:
(a) This policy expires.
(b) 30 days expire after you
acquire the property; or
(c) You report values to us.
b. Property Off- Premises
You may extend the Insurance
provided by the Fund to apply to your
Covered Property, other than "stock ",
that Is temporarily at a location you do
not own, lease or operate. The
Extension does not apply to Covered
Property:
(1) In or on a vehicle unless the
i
f!
vehicle is owned or operated by an
employee of the State of Florida and
the vehicle is being used for State
business;
(2) in the care, custody or control of
anyone not employed by the State of
Florida.
(3) At any fair or exhibition.
The most we will pay for loss or
damage under this Extension Is
$10,000.
c. Trees, Shrubs and Plants
You may extend the coverage
provided by the Fund to apply to trees,
shrubs and plants including debris
removal expense, caused by or
resulting from any of the following
causes of loss:
(1) Fire;
(2) Lightning;
(3) Explosion;
(4) Mot or Civil Commotion; or
(6) Aircraft.
The most we wlll pay for loss or
damage under this Extension is
$1,000, but not more than $250 for
any one tree, shrub or plant.
Each of these Extensions Is additional
insurance.
C. EXCLUSIONS
1. We will not pay for loss or damage
caused directly or Indirectly by any of the
following. Such loss or damage is excluded
regardless of any other cause or event that
contributes concurrently or in any sequence
to the loss.
a. Ordinance or Law
The enforcement of any ordinance or
law:
(1) Regulating the construction, use or
repair of any property; or
(2) Requiring the tearing down of any
property including the cost of
removing its debris.
b. Earth Movement
(1) Any earth movement (other than
sinkhole collapse), such as an
earthquake, landslide, mine
D14- 852(Revlsed "I Page 5 of 8
subsidence or earth sinking, rising or
shifting. But if loss or damage by fire
or explosion results, we will pay for
that resulting loss or damage.
(2) Volcanic eruption, explosion or
effusion. But if loss or damage by
fire, breakage of glass or volcanic
action results, we will pay for that
resulting loss or damage.
c. Governmental Action
Seizure or destruction of property by
order of governmental authority.
But we will pay for acts of destruction
ordered by governmental authority
and taken at the time of a fire to
prevent its spread, if the property
would normally be covered under this
certificate.
d. Nuclear Hazard
Nuclear reactors or the use, storage,
or processing of nuclear fissionable
materials. This exclusion as to
nuclear properties or related reactors
shall not be construed to eliminate the
necessity of coverage on medical
facilities, particle accelerators,
cyclotrons, Van de Graff machines, or
any properties associated therewith. If
loss or damage by fire results, we will
pay for that resulting loss or damage.
e. Off - Promises Services
The failure of power or other utility
service supplied to the described
premises, however caused, If the
failure occurs away from the described
premises.
f. War and Military Action
(1) War, including undeclared or civil
.war,
(2) Warlike action by a military force,
including action in hindering or
defending against actual or expected
attack, by any government, sovereign
or other authority using military
personnel or other agents; or
(3) Insurrection, rebellion, revolution,
usurped power, or action taken by
governmentai authority in hindering or
defending against any of these.
g. Water
16E
(1) Water that backs up from a sewer,
drain, or sump
(2) Water under the ground surface
pressing on, or flowing or seeping
through:
(a) Foundations, walls, floors or
paved surfaces;
(b) Basements, whether paved or
not; or
(c) Doors, windows or other
openings.
But if loss or damage by fire or
explosion results, we will pay for that
resulting loss or damage.
(3) Water damage meaning accidental
discharge or leaking of water or steam
as the direct result of the breaking or
cracking of any part of a system or
appliance containing water or steam.
2. We will not pay for loss or damage
caused by or resulting from:
a. Artificially generated electrical current,
Including electric arcing, that disturbs
electrical devices, appliances or wires.
butBut if loss or damage by fire results,
we will pay for that resulting loss or
damage.
b. Explosion of steam boilers, steam
pipes, steam engines or steam turbines
owned or leased by you, or operated
under your control: But if loss or damage
by fire or combustion explosion results,
we will pay for that resulting loss or
damage.
c. Mechanical breakdown, including
rupture or bursting caused by centrifugal
force. But if loss or damage by a
Covered Cause of Loss results, we will
pay for that resulting loss or damage.
D. LIMITS OF COVERAGE
Coverage is not limited in any one
occurrence or to the reported values shown
in the Declarations, except for flood.
1. For loss or damage sustained due to
FLOOD the following special limits apply in
accordance with the NATIONAL FLOOD
INSURANCE PROGRAM:
a. Building:
(1) Residential $250,000
D14- 852(Revised 3/01 Page 6 of 8
Felo�
(2) Non - Residential $500,080
b. Contents:
a. Residential $100,000
b. Non - Residential $500,000
2. The limits applicable to the following
Coverage Extensions are in addition to the
Limits of Coverage.
a. Newly Acquired or Constructed
Property
b. Property Off - Premises
c. Trees, Shrubs and Plants
3. Payments under the following Additional
Coverages will not increase the applicable.
Limit of Insurance:
a. Preservation of Property; or
b. Debris Removal.
E. DEDUCTIBLE
We will not pay for loss or damage in any
one occurrence, except flood, until the
amount of loss or damage exceeds
$2500.00:
For loss or damage due to Flood, the
applicable deductible applies per location in
accordance with the NFIP.
We will then pay the 'Actual Cash Value'
amount of loss or damage in excess of the
Deductible.,
F. LOSS CONDITIONS
The following conditions apply in addition to
the Certificate of Coverage General
Conditions.
1. Abandonment
There can be no abandonment of any
property to us.
In the event the building is not replaced
nor alternate space constructed, the Fund
will not make a payment on the loss other
than to pay for demolition and clean up
from the loss. The alternate space to be
constructed must house the functions
originally housed. in the destroyed building
and it is to be constrUcted in the local
vicinity of the original structure.
2. Duties In The Event Or Loss Or
16E
Damage
a. You must see that the following are
done In the event of loss or damage to
Covered Property.
(1) Immediately notify the State Fire
Marshal and the Division of Risk
Management, Property Section, In the
event of a fire or damage resulting in
failure of the fire alarm system.
(2) Give prompt notice, by telephone,
of the loss or damage to us so we may
Inspect the damage prior to
commencing with repairs and then
follow up with a written Notice of Loss
Form,
ANY LOSS NOT REPORTED IN
WRITING TO THE DIVISION WITHIN
NINE'T'Y (90) DAYS FROM THE
DATE OF THE LOSS, WILL NOT 13E
PAID UNLESS:
(a) OUR ABILITY TO ASSESS
THE LOSS HAS NOT BEEN
IMPAIRED BY THE DELAY
AND,
(b)THE DOLLAR ($) AMOUNT
OF THE LOSS HAS NOT
INCREASED DUE TO THE
DELAY.
(3) As soon as possible, give us a
description of how, when and where
the loss or damage occurred.
(4) Take all reasonable steps to
protect the Covered Property from
further damage by a Covered Cause
of Loss. If feasible, set the damaged
property aside and in the best possible
order for examination. Also keep, a
record of your expenses for
emergency and temporary repairs, for
consideration in the settlement of the
claim. This will not increase the Limit
of Coverage.
(5) In the event of a lightning claim,
complete the Lightning Statement
Form in its entirety. Make sure the
description of damage as well as the
evidence of a direct strike is detailed.
(6) At our request, give us complete
inventories of the damaged and
undamaged property. Include
D14- 852 {Revised "f Page 7 of 8
quantities, original purchase dates,
costs, values, current replacement
costs and amount of loss claimed.
(7) As often as may be reasonably
required, permit us to inspect the
property proving the loss or damage.
(S) Cooperate with us in the
investigation or settlement of the
claim. This includes providing us with
detailed invoices and payment
evidence to document claim
expenses.
(9) Send us a signed proof of loss
within 30 days of receipt. We will
supply you with the necessary forms.
3. Loss Payment
a. In the event of loss or damage
covered by this Coverage Certificate, at
our option, we will either.
(1) Pay the Actual Cash Value`Actuai
Cash Value" of damaged property;
which has been replaced with property
of like kind and quality; or
(2) Pay the cost of repairing;
whichever is less.
b. If funds are available wWe will pay for
covered loss or damage within 30 days
after we receive the signed proof of loss.
4. Vacancy
Permission is granted for all buildings to
be "vacant' or 'unoccupied' on the
condition that the premises shall be kept
locked and secured to prevent
trespassing or the entrance of
unauthorized persons during the term of
vacancy or unoccupancy.
The Division . must be notified
immediately when a building becomes
'vacant' or `unoccupied.' Should the
'vacant' or "unoccupied' building later
become occupied, the Division must also
be notified.
5. Valuation
We will determine the value of Covered
Property in the event of loss or damage
at "actual cash value" at the time of loss
or damage.
16E g
G. GENERAL CONDITIONS
1. Other Insurance
If there is other insurance covering the
same loss or damage, we will pay only for
the amount of covered loss or damage in
excess of the amount due from that other
insurance, whether you can collect on it
or not. But we will not pay more than the
applicable Limit of Coverage.
2. Statutory Control
In the event of any conflict between the
provisions or coverages in this certificate
and the provisions of any Florida Statutes
or law including but not limited to the
aforesaid, said laws and statutes shall
control
3. Fire Protection
In consideration of the rate at which this
certificate Is written R is stipulated that
you shall exercise due diligence In
maintaining In complete working order all
equipment and services, installed for the
detection, prevention, and extinguishment
of fire in the property covered by this
certificate and-under your control. It Is
further stipulated that if changes are
made to any sprinkler system, its
water or chemical. supplies, or to any
watchman service you must notify us
immediately in writing.
4. Natural Disaster
In the event of a natural disaster, whether
or not officially declared, of such
magnitude that our self retained limit of
liability plus the available excess
insurance Is exhausted:
a. We shall only be liable to pay the
amount of our self retained limit of liability
and any excess insurance applicable to
the occurrence; and
b. We shall pay properly documented
claims as they are presented for
payment.
Unpaid claims shall be classified as
uninsured and shall constitute a general
unfunded liability to the State. We may
assist you In determining the number and
D14- 852(Revfsed 3101 Page 8 of 8
16E 8
amount of individual uninsured 'covered
claims ".
5. Transfer of Rights of Recovery Against
Others to Us
We may require you to transfer all rights
of recovery against any party for loss to
the extent of our payment. You must do
everything necessary to secure our rights
and must do nothing after loss to impair
them.
6. Leased Buildings
We will cover leased buildings only when
coverage is required by the terms of a
valid written lease agreement,; when
such lease agreement has been accepted
in writing by the Division.
H. DEFINITIONS
1. "Actual Cash Value" Replacement cost
less depreciation.
2. "Pollutants" means any solid, liquid,
gaseous or thermal irritant or contaminant,
Including smoke, vapor, soot, fumes, acids,
alkalis, chemicals and waste. Waste
Includes materials to be recycled,
reconditioned or reclaimed.
3. "Stock" means merchandise held in
storage for sale, raw materials and in
process or finished goods, including supplies
used in their packing or shipping.
4. "Unoccupied" means containing contents
pertaining to the occupancy of the building
while operations or other customary activities
are suspended.
5. "Vacant" means containing no contents
pertaining to operations or activities
customary to occupancy of the building.
D14- 852(Revised 3171 Page 9 of 8
16E 8
Department of Insurance
Division of Risk Management
State Risk Management Trust Fund
Certificate of Rental Value Coverage
Various provisions in this certificate restrict coverage. Read the entire certificate carefully to determine rights,
duties and what is and is not covered.
Coverage for defending and paying claims under this certificate is provided under the authority of Chapter
284, Florida Statutes, wherein the state is authorized to administer a self- insurance program. Provision of
this certificate does not constitute the issuance of insurance other than on a self-insurance basis, and
payment of any covered claim obligations is contingent upon availability of legislative funding.
Throughout this policy the words "you" and "your' refer to the State Agency, Board, Bureau, or other
authorized entity shown in the Declarations. The words "we ", "us" and "our" refer to the State Risk
Management Trust Fund (the Fund).
Other words and phrases that appear in "quotation marks" have special meaning. Refer to SECTION E -
DEFINITIONS.
A. COVERAGE
We will pay for the actual loss of Rental Value
you sustain due to necessary suspension of
your 'operations" during the "period of
restoration ". The suspension must be caused
by direct physical loss of or damage to
property at the premises described in the
Declarations, caused by or resulting from any
Covered Cause of Loss.
1. Rental Value
Rental value means the:
a. Total anticipated rental income from
tenant occupancy of the premises
described in the Declarations as furnished
and equipped by you; and
b. Amount of all charges which are the
legal obligation of the tenant(s) and which
would otherwise be your obligations, and
c. Fair rental value of any portion of the
described premises which is occupied by
you.
2. Covered Causes Of Loss
See applicable Causes of Loss as shown in
DI4- 853(Rev. 6100)
your Certificate of Property Coverage.
3. Additional Coverages
a. Expenses to Reduce Loss. We will
pay any necessary expenses you incur,
except the cost of extinguishing a fire, to
reduce the amount of loss under this
Certificate. We will pay for such expenses
to the extent that they do not exceed the
amount of loss that otherwise would have
been payable under this Certificate.
b. Civil Authority. We will pay for the
actual loss of Rental Value you sustain
caused by action of civil authority that
prohibits access to the described premises
due to direct physical loss of or damage to
property, other than at the described
premises, caused by or resulting from any
Covered Cause of Loss. This coverage will
apply for a period of up to two consecutive
weeks from the date of that action.
c. Alterations and New Buildings. We
will pay for the actual loss of Rental Value
you sustain due to direct physical loss or
vaee 1 oft
damage at the described premises caused
by or resulting from any Covered Cause of
Loss to:
(1) New buildings or structures, whether
complete or under construction;
(2) Alterations or additions to existing
buildings or structures; and
(3) Machinery, equipment, supplies or
building materials located on or within 100
feet of the described premises and:
(a) Used in the construction, alterations
or additions; or
(b) Incidental to the occupancy of new
buildings.
If such direct physical loss or damage
delays the start of "operations," the "period
of restoration" will begin on the date
"operations" would have begun if the direct
physical loss or damage had not occurred.
B. EXCLUSIONS
See applicable Exclusions as shown in your
Certificate of Property Coverage.
C. LIMITS OF INSURANCE
The most we will pay for loss in any one
occurrence is the applicable Limit of Coverage
shown in the Declarations.
Payments under the Additional Coverages will
not increase the applicable Limit of Coverage.
D. LOSS CONDITIONS
See applicable Loss Conditions as shown in
your Certificate of Property Coverage except:
1. The coinsurance condition does not apply
to Rental Value Coverage.
DI4- 853(Rev. 6100)
16E 8
E. DEFINITIONS
1. "Operations" means the tenantability of
the described premises.
2. "Period of Restoration" means the period
of time that:
a. Begins with the date of direct physical
loss or damage caused by or resulting from
any Covered Cause of loss at the
described premises; and
b. Ends on the date when the property at
the described premises should be repaired,
rebuilt or replaced with reasonable speed
and similar quality.
"Period of restoration" does not include any
increased period required due to the
enforcement of any ordinance or law that
(1) Regulates the. construction, use or
repair, or requires the tearing down of
any property; or
(2) Requires any insured or others to
test for, monitor, clean up, remove,
contain, treat, detoxify, or neutralize, or
in any way respond to, or assess the
effects of "pollutants ".
The expiration date of this policy will not
cut short the "period of restoration ".
3. " Pollutants" means any solid, liquid,
gaseous or thermal irritant or
contaminant, including smoke, vapor,
soot, fumes, acids, alkalis, chemicals,
and waste. Waste includes materials to
be recycled, reconditioned or reclaimed.
Daze 2 of 2