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2019 CITY SEAWALLS - 19-0021-EN - CERTIFICATE OF LIABILITY INSURANCE WATEENG-01 CSTICKELS ACORO CERTIFICATE OF LIABILITY INSURANCE DATE(M/201YYY) 9/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: The Hilb Group of Florida,LLC-Clearwater PHONE 446-5721 FAX 727 443-2479 DBA All Lines Insurance (A/C,No,Ext): (727) (A/C,No):( ) 1345 S Missouri Ave E-MAIL SS: certificatesfl@hilbgroup.com Clearwater,FL 33756-6533 INSURERS AFFORDING COVERAGE NAIC# INSURERA:United Specialty Insurance Company 12537 INSURED INSURER B: Waterfront Engineering,Inc. INSURER C 7 3940 Foutainebleau Dr. INSURER D: Tampa,FL 33634 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. INSR TYPE OF INSURANCE ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LIMITS LTR INSD WVD MM/DD/YYYY MM/DD/YYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 2,000,000 CLAIMS-MADEOCCUR USA4238176 12/10/2018 12/10/2019 DAMAGE TO RENTED Aj PREMISES Ea ccurrence $ 50,000 o MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000 X POLICYEl PELT1:1 LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT Ea accident $ ANY AUTO BODILY INJURY Perperson) $ OWNED SCHEDULED AUTOS ONLY AUTOS BODILY INJURY Per accident $ HIRED NON-OWNED PROPERTY DAMAGE AUTOS ONLY AUTOS ONLY Per accident $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION PER OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CG2033-Additional Insured,CG2404-Waiver of subrogation,CG2001 Primary and Non contributory as required by written insurance contract. CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Ci of Clearwater THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Department Attn:Jillian Prieto 100 S. Myrtle Ave. AUTHORIZED REPRESENTATIVE Clearwater,FL 33756 ACORD 25(2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD DATE(MM/DD/YYYY) A�" CERTIFICATE OF LIABILITY INSURANCE 9/25/2019 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies)must have ADDITIONAL INSURED provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Laura M Lockhart Wallace Welch &Willingham, Inc. P HONE FAx 300 1 st Ave. So., 5th Floor A/c No Ext): 727-522-7777 A/C,No):727-521-2902 Saint Petersburg FL 33701 E-MAIL DD SS: certificates@w3ins.com INSURER(S)AFFORDING COVERAGE NAIC# INSURERA:American Interstate Ins Co. 31895 INSURED WATEENG-01 INSURER B: Waterfront Engineering, Inc. 3940 Fontainebleau Dr INSURERC: Tampa FL 33634-7421 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:442308489 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUBR POLICY EFF POLICY EXP LIMITS LTR INSD WVD POLICY NUMBER MWDD/YYY MWDD/YYY COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE 1:1PREMISES OCCUR DAMAGETOEaRENTEDoccurrence $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY❑ PRO- ❑ JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ Ea accident ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY Per accident UMBRELLA LAB OCCUR EACH OCCURRENCE $ EXCESS LAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ A WORKERS COMPENSATION AVWCFL2737372019 9/22/2019 9/22/2020 X PERX OTH- AND EMPLOYERS'LIABILITY Y/N STATUTE ER USL&H ANYPROPRIETOR/PARTNER/EXECUTIVEE.L.EACH ACCIDENT $1,000,000 OFFICER/MEMBER EXCLUDED? ❑ N/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 $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,maybe attached if more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN City of Clearwater ACCORDANCE WITH THE POLICY PROVISIONS. Engineering Department Attn: Jillian Prieto AUTHORIZED REPRESENTATIVE 100 S Myrtle Avenue ;; Clearwater FL 33756 '" @ 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD CUSTOMER NUMBER: 1462091 RUN DATE: 09-26-19 REGINALD G MASON 8370 W HILLSBORO#204 TAMPA, FL 33615 WATERFRONT ENGINEERING, INC. 11705 5TH ST E TREASURE ISLAND, FL 33706-2917 Go green . Go paperless . Switch to Paperless Delivery* and help reduce your carbon footprint. View your policy and billing documents, notifications and confirmations of payments online. Register now through Commercial My Account on All'state.com *State exceptions may apply Insured Full Copy DM CW 12 01 10 Policy Number 648778492 SCHEDULE OF FORMS AND ENDORSEMENTS Allstate Insurance Company Named Insured WATERFRONT ENGINEERING, INC. Effective Date: 08-13-19 12:01 A.M., Standard Time Agent Name REGINALD G MASON COMMON POLICY FORMS AND ENDORSEMENTS DM CW 12 01-10 SCHEDULE OF FORMS AND ENDORSEMENTS DM CW 12 0110 Allstate Insurance Company Insured Full Copy CI CW A021011 CERTIFICATE OF INSURANCE This certificate is issued for informational purposes only. It certifies that the policies listed in this document have been issued to the Named Insured. It does not grant any rights to any party nor can it be used, in any way, to modify coverage provided by such policies. Alteration of this certificate does not change the terms, exclusions or conditions of such policies. Coverage is subject to the provisions of the policies, including any exclusions or conditions, regard- less of the provisions of any other contract, such as between the certificate holder and the Named Insured. The limits shown below are the limits provided at the policy inception.Subsequent paid claims may reduce these limits. Certificate Holder: Named Insured: CITY OF CLEARWATER WATERFRONT ENGINEERING, INC. ENGINEERING DEPARTMENT 11705 5TH ST E 100 S MYRTLE AVE TREASURE ISLAND FL 33706-2917 CLEARWATER, FL 33756-5520 Automobile Liability Insurer Name: Allstate Insurance Company Po icy Number. 648778492 1-Any Auto 2-Owned Autos Only 3-Owned Priv.Pass.Autos Only 4-Owned Autos Other Than Priv. X 5-Owned Autos Subject to No 6-Owned Autos Subject to a Compulsory UM Law Pass.Autos Only Fault X 7-Specifically Described Autos 8-Hired Autos Only 9-Non-owned Autos Only Policy Effective Date: 01-17-2019 Policy Expiration Date: 01-17-2020 Limits Of $ 1,000,000 Combined Single Limit(each accident) Insurance: BI Per Person BI Per Accident PD Per Accident Description of Operations/Locations/Vehicles/Endorsements/Special Provisions Interested Party Type: CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT GRANT ANY COVERAGE OR RIGHTS TO THE CERTIFICATE HOLDER. IF THIS CERTIFICATE INDICATES THAT THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED, THE POLICY(IES) MUST EITHER BE ENDORSED OR CONTAIN SPECIFIC LANGUAGE PROVIDING THE CERTIFICATE HOLDER WITH ADDITIONAL INSURED STATUS.THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED ONLY TO THE EXTENT INDICATED IN SUCH POLICY LANGUAGE OR ENDORSEMENT. Producer. REGINALD G MASON Authorized Representative: Date: 09-26-19 Includes copyrighted material of Insurance Services Office, Inc., with its permission CI CW A021011 Allstate Insurance Company Page 1 of 1 Insured Full Copy