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2019 CITY SEAWALLS - 19-0021-EN - CERTIFICATE OF LIABILITY INSURANCE (2) CUSTOMER NUMBER: 1462091 RUN DATE: 01-21-20 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 Policy Number 648778492 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. COMMON POLICY CHANGE ENDORSEMENT Endorsement No. 003 Allstate Insurance Company Named Insured WATERFRONT ENGINEERING, INC. Effective Date: 01-17-20 12:01 A.M., Standard Time Agent Name REGINALD G MASON This endorsement will not be used to decrease coverages, increase rates or deductibles or alter any terms or conditions of coverage unless at the sole request of the insured. COVERAGE PART INFORMATION -Coverage parts affected by this change as indicated by E]below. ❑ Commercial Property ❑ Commercial General Liability ❑ Commercial Crime ❑ Commercial Inland Marine ❑ COMMERCIAL AUTOMOBILE NO CHARGE 11 The following item(s): Insured's Name F-1 Insured's Mailing Address Policy Number F-1 Company Effective/Expiration Date FI Insured's Legal Status/Business of Insured Payment Plan F-1 Premium Determination Additional Interested Parties F-1 Coverage Forms and Endorsements Limits/Exposures F-1 Deductibles Covered Property/Location Description F-1 Classification/Class Codes Rates 1:1 Underlying Exposure/Insurance is (are) changed to read (See Additional Page(s)) THE FOLLOWING ADDITIONAL INTEREST (ADDITIONAL INSURED - OTHER) HAS BEEN ADDED TO THE POLICY: CITY OF CLEARWATER, ENGINEERING DEPT. ATTN: CARRIE SZURLY 100 S MYRTLE AVE CLEARWATER FL 33756-5520 The above amendments result in a change in the premium as follows: This premium does not include taxes and surcharges. ❑ No Changes E]To be Adjusted at Audit Additional NO CHARGE Return NO CHARGE Tax and Surcharge Changes Additional Return Countersigned By: REGINALD G MASON AUTHORIZED AGENT DM CW 30 01 10 Allstate Insurance Company Insured Full Copy Policy Number 648778492 COMMON POLICY CHANGE ENDORSEMENT Endorsement No. 003 Allstate Insurance Company Named Insured WATERFRONT ENGINEERING, INC. Effective Date: 01-17-20 12:01 A.M., Standard Time Agent Name REGINALD G MASON POLICY CHANGES ENDORSEMENT DESCRIPTION (CONT'D) ALL OTHER TERMS AND CONDITIONS REMAIN THE SAME REMOVAL PERMIT If this policy includes the Commercial Property Coverage Part, the following applies with respect to the Coverage Part: If Covered Property is removed to a new location that is described on this Policy Change, you may extend this insurance to include that Covered Property at each location during the removal. Coverage at each location will apply in the proportion that the value at each location bears to the value of all Covered Property being removed. This permit applies up to 10 days after the effective date of this Policy Change; after that, this insurance does not apply at the previous location. DM CW 30 01 10 Allstate Insurance Company 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: 01-17-20 12:01 A.M., Standard Time Agent Name REGINALD G MASON COMMON POLICY FORMS AND ENDORSEMENTS DM CW 30 01-10 COMMON POLICY CHANGE ENDORSEMENT DM CW 12 01-10 SCHEDULE OF FORMS AND ENDORSEMENTS AUTOMOBILE FORMS AND ENDORSEMENTS CA 20 48 10-13 DESIGNATED INSURED 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, ENGINEERING DEPT. WATERFRONT ENGINEERING, INC. ATTN: CARRIE SZURLY 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: 01-17-2020 Policy Expiration Date: 01-17-2021 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 THE CITY OF CLEARWATER IS NAMED AS ADDITIONAL INSURED WITH REGARD TO AUTOMOBILE LIABILITY. PROJECT #19-0021-EN 2019 CITY SEAWALLS. Interested Party Type: ADDITIONAL INSURED - OTHER 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: 01-21-20 Includes copyrighted material of Insurance Services Office, Inc., with its permission CI CW A021011 Allstate Insurance Company Page 1 of 1 Insured Full Copy Cl 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, regardless 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, ENGINEERING WATERFRONT ENGINEERING, INC. DEPT. 11705 5TH ST E ATTN: CARRIE SZURLY TREASURE ISLAND FL 33706-2917 100 S MYRTLE AVE CLEARWATER, FL USA 337565520 Automobile Liability Insurer Name:Allstate Insurance Company Polic Number. 648778492 1 --Any Auto 2-Owned Autos Only 3—Owned Priv.Pass.Autos Only 4--Owned Autos Other Than Priv. 5-Owned Autos Subject to 6—Owned Autos Subject to a Compulsory UM Law Pass.Autos Only X No Fault X 7--Specifically Described Autos 8-Hired Autos Only 1 19—Nonowned Autos Only Policy Effective Date: 01-17-2020 1 Policy Expiration Date: 01-17-2021 Limits of $1,000,000 Combined Single Limit(each accident) Insurance: BI Per Person I BI Per Accident I PD Per Accident Description of Operations/Locations/Vehicles/Endorsements/Special Provisions Interested Party Type: Additional Insured - Municipality 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: 01-21-20 Includes copyrighted material of Insurance Services Office, Inc., with its permission Cl CW A021011 Allstate Insurance Company Page 1 of 1 Insured Full Copy POLICY NUMBER: 648778492 COMMERCIAL AUTO CA 20 48 10 13 THIS ENDORSEMENT CHANGES THE POLICY. PLEASE READ IT CAREFULLY. DESIGNATED INSURED FOR COVERED AUTOS LIABILITY COVERAGE This endorsement modifies insurance provided under the following: AUTO DEALERS COVERAGE FORM BUSINESS AUTO COVERAGE FORM MOTOR CARRIER COVERAGE FORM With respect to coverage provided by this endorsement, the provisions of the Coverage Form apply unless modified by this endorsement. This endorsement identifies person(s) or organization(s) who are "insureds"for Covered Autos Liability Coverage under the Who Is An Insured provision of the Coverage Form. This endorsement does not alter coverage provided in the Coverage Form. This endorsement changes the policy effective on the inception date of the policy unless another date is indicated below. Named Insured: WATERFRONT ENGINEERING, INC. Endorsement Effective Date: 01-17-2020 SCHEDULE Name Of Person(s) Or Organization(s): CITY OF CLEARWATER, ENGINEERING DEPT. ATTN: CARRIE SZURLY 100 S MYRTLE AVE CLEARWATER, FL USA 337565520 Information required to complete this Schedule, if not shown above, will be shown in the Declarations. Each person or organization shown in the Schedule is an "insured"for Covered Autos Liability Coverage, but only to the extent that person or organization qualifies as an "insured" under the Who Is An Insured provision contained in Paragraph A.1. of Section II — Covered Autos Liability Coverage in the Business Auto and Motor Carrier Coverage Forms and Paragraph D.2. of Section I — Covered Autos Coverages of the Auto Dealers Coverage Form. CA 20 48 10 13 ©Insurance Services Office, Inc., 2011 Page 1 of 1 Insured Full Copy