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Certificates of Insurance TERRENV-03 KOTHALEV DATE(MMIDDIYYYY) _. CERTIFICATE OF LIABILITY INSURANCE 11/22/2022 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 NAME CT Angie Dail Insurance Office of America PHONE 407 998-5583 15583 FAX 407 788-7933 13361 Overseas Highway (A/C,No,Ext): ( ) (A/C,No):( ) Marathon,FL 33060 E-MAIL angie.dail@ioausa.com INSURERS AFFORDING COVERAGE NAIC# INSURER A:Homeland Insurance Company of New York 34452 INSURED INSURER B: Terramar Environmental Services,Inc. INSURER C: 1241 Crane Blvd. INSURER D: Sugarloaf Key,FL 33042 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 MMIDDIYYYY MMIDDIYYYY A X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 CLAIMS-MADE X OCCUR 793-00-32-85-0007 4/16/2022 4/16/2023 DAMAGE TO RENTED 50,000 X PREMISES Ea occurrence $ MED EXP(Any oneperson) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY❑ PRO- ❑JECT LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: PROFESSIONAL LI $ 1,000,000 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 YIN STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE ❑ E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? NIA (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ A Professional Liabili 793-00-32-85-0007 4/16/2022 4/16/2023 Per Claim 1,000,000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) Monroe County Board of County Commissioners is additional insured with respects to General Liability when required by written contract. APPROVED BY RISK MANAGEMENT gY DATE 12/5/2022 WAIVER N/A_YES_ CERTIFICATE HOLDER CANCELLATION WC and Auto/Ad Insd waived SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REPRESENTATIVE Monroe County Board of County Commissioners �v 1100 Simonton Street , -- ° -A22107 Key West FL 33040 ACORD 25 (2016/03) ©1988-2015 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD Thank you for choosing Allstate Q)Allstate. Proof" "=~"" ~"" " Card Page of For your convenience,two insurance cards have been included for each vehicle.State law requires that one of these cards be kept in each vehicle. Please place them in your vehicles by the effective date. ��_ ��- ��N�*_��*� Allstate.��0��. u��0�� Please use the printed Insurance Cards below. Please use the printed Insurance Cards below. --------------------------------------'--------------------------------------' Florida Automobile Insurance |mr��mtm�mk�|eUmsm��oe ��N�*-��*� Allstate.u��=�� u��0��=��. Identification Card Identification Card Allstate Property and Casualty Insurance Company Allstate Property and Casualty Insurance Company POLICY NUMBERJ COMPANY CODE EFFECTIVE DATE COMPANY CODE EFFECTIVE DATE � POLICY NUMBER W PERSONAL INJURY PROTECTION BENEFITS/ X BODILY INJURY W PERSONAL INJURY PROTECTION BENEFITS/ X BODILY INJURY PROPERTY DAMAGE LIABILITY LIABILITY PROPERTY DAMAGE LIABILITY LIABILITY Philip&Frank,Rowena PGarcia Philip&Frank,Rowena PGarcia YEAR L VEHICLE|0NUMBER YEAR L VEHICLE|0NUMBER amme Toyota Matrix 2MKU4nE99Cn01635 2nn9 Toyota Matrix 2MKU4nE99Cn01635 NOT VALID MORE THAN ONE YEAR FROM EFFECTIVE DATE NOT VALID MORE THAN ONE YEAR FROM EFFECTIVE DATE --------------------------------------'--------------------------------------' Florida Automobile Insurance |mr��mtm�mk�|eUmsm��oe Allstate.Allstate.��=�� u��0��=�� Identification Card Identification Card Allstate Property and Casualty Insurance Company Allstate Property and Casualty Insurance Company POLICY NUMBER] COMPANY CODE EFFECTIVE DATE COMPANY CODE EFFECTIVE DATE POLICY NUMBER W PERSONAL INJURY PROTECTION BENEFITS/ X BODILY INJURY W PERSONAL INJURY PROTECTION BENEFITS/ X BODILY INJURY PROPERTY DAMAGE LIABILITY LIABILITY PROPERTY DAMAGE LIABILITY LIABILITY Philip&Frank,Rowena PGarcia Philip&Frank,Rowena PGarcia YEAR/MAKE/MODEL VEHICLE|0NUMBER YEAR/MAKE/MODEL VEHICLE|0NUMBER 2Oo4 Ford Truck RSn2wd 1F7FXOCT8ENE17539 2Oo4 Ford Truck RSn2wd 1F7FXOCT8ENE17539 NOT VALID MORE THAN ONE YEAR FROM EFFECTIVE DATE NOT VALID MORE THAN ONE YEAR FROM EFFECTIVE DATE --------------------------------------'--------------------------------------' Florida Automobile Insurance |mr��mtm�mk�|eUmsm��oe Allstate.Allstate.��=�� u��0��=�� Identification Card Identification Card Allstate Property and Casualty Insurance Company Allstate Property and Casualty Insurance Company POLICY NUMBER] COMPANY CODE EFFECTIVE DATE COMPANY CODE EFFECTIVE DATE POLICY NUMBER W PERSONAL INJURY PROTECTION BENEFITS/ X BODILY INJURY W PERSONAL INJURY PROTECTION BENEFITS/ X BODILY INJURY PROPERTY DAMAGE LIABILITY LIABILITY PROPERTY DAMAGE LIABILITY LIABILITY Philip&Frank,Rowena PGarcia Philip&Frank,Rowena PGarcia YEAR/MAKE/MODEL VEHICLE|0NUMBER YEAR/MAKE/MODEL VEHICLE|0NUMBER 2014bmu,Rx350 2T2ZH1B&2E«147300 2014bmu,Rx350 2T2ZH1B&2E«147300 Policy number: 1961240 775 Page 2 of 2 Policy effective date: October 10,2022 APPROVED BY RISK MANAGEMENT BY Z., C, DATE 12/5/2022 WAIVER N/A—YES- ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- Please use the printed Insurance Cards below. Please use the printed Insurance Cards below. ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- If you have an accident or loss: If you have an accident or loss: - Get medical attention if needed.Notify the police immediately. - Get medical attention if needed.Notify the police immediately. - Obtain names,addresses,phone numbers(work&home)and license - Obtain names,addresses,phone numbers(work&home)and license plate numbers of all persons involved,including passengers and witnesses. plate numbers of all persons involved,including passengers and witnesses. • Call 1-800-ALLSTATE(1-800-255-7828),logon to allstate.com • Call 1-800-ALLSTATE(1-800-255-7828),logon to allstate.com or contact your agent as soon as possible. or contact your agent as soon as possible. McKnight&Company McKnight&Company (352)371-2204 (352)371-2204 4004 NW 13th St 4004 NW 13th St Gainesville,FL 32609 Gainesville,FL 32609 • If you carry Auto Collision Insurance:Rental car coverage is provided, If you carry Auto Collision Insurance:Rental car coverage is provided, see outline of coverage.(This means Auto Collision Insurance will apply see outline of coverage.(This means Auto Collision Insurance will apply to a vehicle rented on a short-term basis, not that you will be reimbursed to a vehicle rented on a short-term basis, not that you will be reimbursed for the cost of renting a substitute vehicle) for the cost of renting a substitute vehicle) Misrepresentation of insurance is a first degree misdemeanor Misrepresentation of insurance is a first degree misdemeanor ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- If you have an accident or loss: If you have an accident or loss: - Get medical attention if needed.Notify the police immediately. - Get medical attention if needed.Notify the police immediately. . Obtain names,addresses,phone numbers(work&home)and license - Obtain names,addresses,phone numbers(work&home)and license plate numbers of all persons involved,including passengers and witnesses. plate numbers of all persons involved,including passengers and witnesses. - Call 1-800-ALLSTATE(1-800-255-7828),logon to allstate.com - Call 1-800-ALLSTATE(1-800-255-7828),logon to allstate.com or contact your agent as soon as possible. or contact your agent as soon as possible. McKnight&Company McKnight&Company (352)371-2204 (352)371-2204 4004 NW 13th St 4004 NW 13th St Gainesville,FL 32609 Gainesville,FL 32609 • If you carry Auto Collision Insurance:Rental car coverage is provided, If you carry Auto Collision Insurance:Rental car coverage is provided, see outline of coverage.(This means Auto Collision Insurance will apply see outline of coverage.(This means Auto Collision Insurance will apply to a vehicle rented on a short-term basis, not that you will be reimbursed to a vehicle rented on a short-term basis, not that you will be reimbursed o for the cost of renting a substitute vehicle) for the cost of renting a substitute vehicle) o Misrepresentation of insurance is a first degree misdemeanor Misrepresentation of insurance is a first degree misdemeanor 0 ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- If you have an accident or loss: If you have an accident or loss: Get medical attention if needed.Notify the police immediately. - Get medical attention if needed.Notify the police immediately. < • Obtain names,addresses,phone numbers(work&home)and license - Obtain names,addresses,phone numbers(work&home)and license fa plate numbers of all persons involved,including passengers and witnesses. plate numbers of all persons involved,including passengers and witnesses. • Call 1-800-ALLSTATE(1-800-255-7828),logon to allstate.com • Call 1-800-ALLSTATE(1-800-255-7828),logon to allstate.com o or contact your agent as soon as possible. or contact your agent as soon as possible. 0 00 McKnight&Company McKnight&Company 0 0 N (352)371-2204 M (352)371-2204 c S r, 0 4004 NW 13th St 4004 NW 13th St 0 10 0 < LL Gainesville,FL 32609 Gainesville,FL 32609 0 0 00 If you carry Auto Collision Insurance:Rental car coverage is provided, If you carry Auto Collision Insurance:Rental car coverage is provided, 0 10 0 see outline of coverage.(This means Auto Collision Insurance will apply see outline of coverage.(This means Auto Collision Insurance will apply < to a vehicle rented on a short-term basis, not that you will be reimbursed to a vehicle rented on a short-term basis, not that you will be reimbursed N for the cost of renting a substitute vehicle) for the cost of renting a substitute vehicle) Misrepresentation of insurance is a first degree misdemeanor Misrepresentation of insurance is a first degree misdemeanor Renewal auto policy declarations 1 . ' ' Ei) WAllstate. Your policy effective date is October 10,2022 Platinum Gold Standard Page 1 of 7 Information as of August 30,2022 Total Premium for the Policy Period Please review your insured vehicles and verify their VINs are correct. Summary Vehicles covered Identification Number(VIN) Premium Named Insured(s) 2014 Lexus Rx350 2T2ZK1BA2EC147300 $1,625.99 Philip Frank and Rowena Garcia 2014 Ford Truck F150 2wd 1FTFX1CT8EKE17539 908.12 Mailing address 2009 Toyota Matrix 2T1KU40E99C001635 1,751.89 1241 Crane Blvd Additional coverages Sugarloaf Key FL 33042-3160 Total* $4,286.00 P0" number 961240 775 *Your bill will be mailed separately.Before making a payment,please refer to your Your policy provided by latest bill,which includes payment options and installment fee information.If you do Allstate Property and Casualty not pay in full,you will be charged an instalment fee(s).If you do not pay your bill by Insurance Company the due date shown on your billing statement,you may be charged a late fee. Policy period See the Important payment and coverage information section for details about Beginning October 10,2022 through installment fees. April 10,2023 at 12:01 a.m.standard time Your Allstate agency is Discounts (included in your total premium) McKnight&Company Anti-theft $5.16 Passive Restraint $110.93 4004 NW 13th St Antilock Brakes $189.73 Home Ownership $322.00 Gainesville FL 32609 Drivewise® $114.53 Premier Plus $1,910.76 (352)371-2204 Good Student $394.68 teenSMART $175.42 LMCKNIGHTI@ALLSTATE.COM Total discounts $3,223.21 Some or all of the information on your Policy Declarations is used in the rating of your policy or it could affect your eligibility for certain coverages.Please Discounts per vehicle notify us immediately if you believe that 2014 Lexus Rx350 $290,15 any information on your Policy Anti-theft $2.83 Passive Restraint $47.82 Declarations is incorrect.We will make Antilock Brakes $71.97 Home Ownership $123.58 corrections once you have notified us, Drivewise® $43.95 and any resulting rate adjustments,will 2014 Ford Truck F150 2wd $692,94 be made only for the current policy Anti-theft $2.33 Passive Restraint $19.27 period or for future policy periods. Antilock Brakes $34.66 Home Ownership $61.13 Please also notify us immediately if you Premier Plus $553.80 Drivewise® $21.75 believe any coverages are not listed or are inaccurately listed. 2009 Toyota Matrix $2,240,12 Good Student $394.68 Passive Restraint $43.84 Antilock Brakes $83.10 Home Ownership $137.29 teenSMART $175.42 Premier Plus $1,356.96 Drivewise® $48.83 0 0 m 0 0 J LL Renewal auto policy declarations Page 2 of 7 Policy number: 1961240 775 Policy effective date: October 10,2022 Surcharge (included in your total premium) Chargeable Accident $124.29 ■ 2014 Lexus Rx350 Total surcharges $124.29 Listed drivers on your policy* Philip Frank Rowena Garcia Nathaniel Frank *Are there licensed drivers not listed above who either reside in your household(even if temporarily away from home)or are guests staying in your home for an extended period? If so,please contact us so your policy information and coverage is up to date. There are circumstances under which a loss may not be covered by this policy because the auto was being operated by someone residing at your house who is not listed on the policy. Additional detail about how we treat undisclosed drivers can be found in your policy. Excluded drivers from your policy None 0 0 m 0 0 J LL O O O O O 0 O O r O O O Q N m N O m 0co 0 N m N p, 0 O O Q w O_ O d O po10 � O 0 N Q Renewal auto policy declarations Policy number: 1961240 775 Page 3 of 7 WAllstate. Policy effective date: October 10,2022 Coverage detail for 2014 Lexus Rx350 Coverage Limits Deductible Premium Personal Injury Protection $0 $125.54 Death Benefit $5,000 each person Aggregate Medical Expenses $10,000 each person (Emergency or Non-Emergency Medical Condition), Income Loss and Loss of Services Medical Expenses Limit: Medical Expenses- Emergency Medical Condition $10,000 each person OR Medical Expenses- Non-Emergency Medical Condition $2,500 each person The sum of Medical Expenses, Income Loss and Loss of Services benefits cannot exceed the aggregate$10,000 limit. Auto Collision Insurance Actual cash value $500 $252.82 Auto Comprehensive Insurance Actual cash value $500 $62.48 Automobile Liability Insurance ■ Bodily Injury $1,000,000 each person Not applicable $920.79 $1,000,000 each occurrence ■ Property Damage $1,000,000 each occurrence Not applicable $148.57 Collision for Custom Equipment Not purchased* Comprehensive for Custom Not purchased* Equipment Roadside Coverage $100 Not applicable $6.40 Transportation Expense Not purchased* Uninsured Motorists Insurance for Bodily $100,000 each person Not applicable $109.39 Injury $300,000 each accident Uninsured Motorists Insurance limits of insured vehicles may not be stacked. Auto Replacement Protection Not purchased* Automobile Medical Payments Not purchased* Portable Electronics and Media Not purchased* (continued) 0 0 m 0 0 J LL Renewal auto policy declarations Page 4 of 7 Policy number: 1961240 775 Policy effective date: October 10,2022 Coverage Limits Deductible Premium Sound System Not purchased* Total premium for 2014 Lexus Rx350 $1,625.99 *This coverage can provide you with valuable protection. To help you stay current with your insurance needs,contact your Allstate agent to discuss coverage options and other products and services that can help protect you. VIN 2T2ZK1 BA2EC147300 Rating information ■ This vehicle is driven over 7,500 miles per year,for pleasure,adult age 54,with no unmarried driver under 25 Coverage detail for 2014 Ford Truck F150 2wd Coverage Limits Deductible Premium Personal Injury Protection $0 $58.96 Death Benefit $5,000 each person Aggregate Medical Expenses $10,000 each person (Emergency or Non-Emergency Medical Condition), Income Loss and Loss of Services Medical Expenses Limit: Medical Expenses- Emergency Medical Condition $10,000 each person OR Medical Expenses- Non-Emergency Medical Condition $2,500 each person c, 0 The sum of Medical Expenses, Income Loss and Loss of Services benefits cannot exceed the aggregate$10,000 limit. Auto Collision Insurance Actual cash value $500 $124.16 0 Auto Comprehensive Insurance Actual cash value $500 $53.02 LL Automobile Liability Insurance ■ Bodily Injury $1,000,000 each person Not applicable $471.65 $1,000,000 each occurrence ■ Property Damage $1,000,000 each occurrence Not applicable $84.54 o Collision for Custom Equipment Not purchased* o Comprehensive for Custom Not purchased* 0 Equipment o Fz Roadside Coverage $100 Not applicable $6.40 o O Transportation Expense Not purchased* a (continued) £3 m 0 co N O m O N m N p' O O O Q w O_ O : O po10 � O 0 N Q Renewal auto policy declarations Policy number: 1961240 775 Page 5 of 7 WAllstate. Policy effective date: October 10,2022 Coverage Limits Deductible Premium Uninsured Motorists Insurance for Bodily $100,000 each person Not applicable $109.39 Injury $300,000 each accident Uninsured Motorists Insurance limits of insured vehicles may not be stacked. Auto Replacement Protection Not purchased* Automobile Medical Payments Not purchased* Portable Electronics and Media Not purchased* Sound System Not purchased* Total premium for 2014 Ford Truck F150 2wd $908.12 *This coverage can provide you with valuable protection. To help you stay current with your insurance needs,contact your Allstate agent to discuss coverage options and other products and services that can help protect you. VIN 1FTFX1CT8EKE17539 Rating information ■ This vehicle is driven over 7,500 miles per year,for pleasure,adult age 61,with no unmarried driver under 25,good driver rate Coverage detail for 2009 Toyota Matrix Coverage Limits Deductible Premium Personal Injury Protection $0 $116.25 Death Benefit $5,000 each person Aggregate Medical Expenses $10,000 each person (Emergency or Non-Emergency Medical Condition), Income Loss and Loss of Services Medical Expenses Limit: Medical Expenses- Emergency Medical Condition $10,000 each person OR Medical Expenses- Non-Emergency Medical Condition $2,500 each person The sum of Medical Expenses, Income Loss and Loss of Services benefits cannot exceed the aggregate$10,000 limit. Auto Collision Insurance Not purchased* Auto Comprehensive Insurance Not purchased* Automobile Liability Insurance ■ Bodily Injury $1,000,000 each person Not applicable $1,302.72 $1,000,000 each occurrence ■ Property Damage $1,000,000 each occurrence Not applicable $217.13 Collision for Custom Equipment Not purchased* 0 (continued) o J LL Renewal auto policy declarations Page 6 of 7 Policy number: 1961240 775 Policy effective date: October 10,2022 Coverage Limits Deductible Premium Comprehensive for Custom Not purchased* Equipment Roadside Coverage $100 Not applicable $6.40 Transportation Expense Not purchased* Uninsured Motorists Insurance for Bodily $100,000 each person Not applicable $109.39 Injury $300,000 each accident Uninsured Motorists Insurance limits of insured vehicles may not be stacked. Auto Replacement Protection Not purchased* Automobile Medical Payments Not purchased* Portable Electronics and Media Not purchased* Sound System Not purchased* Total premium for 2009 Toyota Matrix $1,751.89 *This coverage can provide you with valuable protection. To help you stay current with your insurance needs,contact your Allstate agent to discuss coverage options and other products and services that can help protect you. VIN 2T1 KU40E99C001635 Rating information ■ This vehicle is driven over 7,500 miles per year, unmarried male age 17,good driver rate Additional coverage The following policy coverage is also provided. Coverage Limits Deductible Premium Automobile Death Indemnity Insurance $10,000 benefit Not applicable Included Identity Theft Expenses Not purchased* 0 Total $0.00 0 m *This coverage can provide you with valuable protection. To help you stay a J current with your insurance needs,contact your Allstate agent to discuss " coverage options and other products and services that can help protect you. Your policy documents Your automobile policy consists of this Policy Declarations and the documents in the following list. Please keep these together. o 0 ■ Allstate Auto Policy-ACR208 Automobile Death Indemnity Insurance-Coverage CM- o ACR211 a O ■ Florida Amendatory Endorsement-ACR339 ■ Bundling Rewards Amendatory Endorsement-ACR213 ■ FL PIP Amendatory Endorsement-ACR209-1 ■ FL Glass Schedule Endorsement-ACR235 o ■ Uninsured Motorists Amendatory Endorsement-ACR210-1 N m N O m 0 co m N p, O O O Q w O_ O : O po10 � O 0 N Q Renewal auto policy declarations Policy number: 1961240 775 Page 7 of 7 WAllstate. Policy effective date: October 10,2022 Important payment and coverage information Here is some additional,helpful information related to your coverage and paying your bill: ►You are earning a discount of$114.53 for participating in Drivewise®. ►You earned$74.57 in cash as of 10/10/2022 from Drivewise®.Continue driving safely to earn more cash every 6 months. ►A$10.00 late fee may be assessed if payment is received after the due date. ►Your rate is lower because you are insuring multiple cars. ►If you decide to pay your premium in installments,there will be a$3.00 installment fee charge for each payment due. If you make 6 installment payments during the policy period,and do not change your payment plan method,then the total amount of installment fees during the policy period will be$18.00. If you are on the Allstate® Easy Pay Plan,there will be a$1.50 installment fee charge for each payment due. If you make 6 installment payments during the policy period,and remain on the Allstate® Easy Pay Plan,then the total amount of installment fees during the policy period will be$9.00. If you change payment plan methods or make additional payments,your installment fee charge for each payment due and the total amount of installment fees during the policy period may change or even increase. Please note that the Allstate® Easy Pay Plan allows you to have your insurance payments automatically deducted from your checking or savings account. Florida required communications ►If You Have a Question About Your Insurance... If you wish to present an inquiry or obtain information about coverage,or if you need assistance in resolving a complaint, please call (352)371-2204. Allstate Property and Casualty Insurance Company's Secretary and President have signed this policy with legal authority at Northbrook, Illinois.This policy is binding with the countersignature of an authorized Allstate Property and Casualty Insurance Company agent. William Hill Susan L. Lees President Secretary Policy countersigned by McKnight&Company '04/ 0 0 m 0 0 J LL Policy Endorsement Page 1 of 10 Policy number: 1961240 775 Policy effective date: October 10,2022 The following endorsement changes your policy. A. Under Additional Payments We Will Make,item 2 is replaced by Please read this document carefully and keep it with your policy, the following: 2. court costs for defense.This section does not include attorney Florida fees,costs or sanctions awarded or assessed against an insured Amendatory Endorsement -ACR339 person except for those that were imposed,in a case in which (Ed.08/22) we provided a defense,by a court for an offer of judgment or proposal for settlement pursuant to section 768.79,Florida I. In the General Provisions section of the policy the following changes are Statutes,or the applicable Florida or federal rule of procedure, made: that was in an amount that did not exceed our limits of A. Under Definitions Used Throughout The Policy,the following liability. In cases involving more than one insured person,the definition is added: total amount of the offers of judgment or proposal for settlement must not exceed our limits of liability.This means Personal Vehicle Sharing Program means an association or that under no circumstances will we pay attorney fees,costs or legal entity engaged in the business or activity of facilitating sanctions awarded where the amount for offers of judgment or the sharing of vehicles for personal transportation use by proposals for settlement exceeds our limit of liability. individuals. B. Under Additional Definitions For Part I,the definition of insured B. The Where Lawsuits May Be Brought provision is replaced by the person is replaced by the following: following: 3. Insured Person means: Where Lawsuits May Be Brought a. While using your insured auto other than a non-owned Subject to the following three paragraphs,any and all lawsuits in any auto: way related to this policy shall be brought,heard,and decided only in (i) you; a state or federal court located in Florida. Any and all lawsuits (ii) any resident;and against persons not parties to this policy but involved in the sale, (iii) any other person using it with your permission; administration,performance,or alleged breach of this policy or involved in any other way with this policy,shall be brought,heard, b. While using anon-owned auto: and decided only in a state or federal court located in Florida, (i) you; provided that such persons are subject to or consent to suit in the (ii) any resident relative using a wheel private courts specified in this paragraph. passenger auto or utility autoo;; r o or If a covered loss to property we insure under this policy,a covered c. Any other person or organization liable for the use of an motor vehicle accident,or any other occurrence for which coverage insured auto if the auto is not owned or hired by that applies under this policy happens outside Florida,lawsuits regarding person or organization,provided the use is by an insured that covered loss to property,covered motor vehicle accident,or person under a.or b.above and then only for that other covered occurrence may also be brought in the judicial district person's acts or omissions. where that covered loss to property,covered motor vehicle accident, C. Under Exclusions—What Is Not Covered,item 3 is replaced by the or other covered occurrence happened. following: Unless we agree otherwise,any legal action against us must be 3. bodily injury or property damage arising out of the use of brought in a court of competent jurisdiction in the county where your insured auto while it is: your covered auto is principally garaged. a. rented to,leased to,or provided in exchange for a charge Nothing in this provision,Where Lawsuits May Be Brought,shall to,any person or organization by or with the permission of impair any party's right to remove a state court lawsuit to a federal an insured person (this exclusion will only apply to o court. damages that are in excess of the minimum limits of o liability coverage required by the financial responsibility II. Part 1—Automobile Liability Insurance,Bodily Injury Liability and laws of the state of Florida);or o Fz Property Damage Liability Coverages AA and BB is amended as b. being used as part of a Personal Vehicle Sharing o follows: Program. o N m N O m 0 co 0 NN m N O,0 O O Q w O_ O d O po10 � O 0 N Q Policy endorsement Policy number: 1961240 775 Policy effective date: October 10,2022 Page 2 of 10 These exclusions do not apply to an insured person using a amount we will pay for such expenses shall,pursuant to the fee schedule non-owned motor vehicle with the permission of the vehicle's limitations under Section 627.736(5)(a)l.of the Florida Statutes,or any owner. other limitations established by Section 627.736 of the Florida Statutes,or III. In Part 2—Automobile Medical Payments Coverage CC,under any other provisions of the Florida Motor Vehicle No-Fault Law,as Exclusions—What Is Not Covered,item 5 is replaced by the following: enacted,amended or otherwise continued in the law,be limited to eighty percent of the following schedule of maximum charges(or any other fee 5. bodily injury arising out of the use of your insured auto while it is: schedule limitation which may be enacted,amended or otherwise a. rented to,leased to,or provided in exchange for a charge to, continued in the law): any person or organization by or with the permission of an a) for emergency transport and treatment by providers licensed under insured person;or chapter 401 of the Florida Statutes,200 percent of Medicare; b. being used as part of a Personal Vehicle Sharing Program. b) for emergency services and care provided by a hospital licensed This exclusion does not apply to an insured person using a under chapter 395 of the Florida Statutes,75 percent of the hospital's non-owned motor vehicle with the permission of the vehicle's usual and customary charges; c) for emergency services and care as defined by Section 395.002 of owner. the Florida Statutes,provided in a facility licensed under chapter 395 IV. In Part 3—Protection Against Loss To The Auto,under rendered by a physician or dentist,and related hospital inpatient Exclusions—What Is Not Covered,item 12 is replaced by the following: services rendered by a physician or dentist,the usual and customary 12. loss arising out of the use of your insured auto,trailer,or charges in the community; travel-trailer while it is: d) for hospital inpatient services,other than emergency services and a. rented to,leased to,or provided in exchange for a charge to, care,200 percent of the Medicare Part A prospective payment any person or organization by or with the permission of an applicable to the specific hospital providing the inpatient services; insured person;or e) for hospital outpatient services,other than emergency services and b. being used as part of a Personal Vehicle Sharing Program. care,200 percent of the Medicare Part A Ambulatory Payment Classification for the specific hospital providing the outpatient This exclusion does not apply to an insured person using a services;and non-owned motor vehicle with the permission of the vehicle's owner. f) for all other medical services,supplies and care,200 percent of the allowable amount under: i) the participating physicians fee schedule of Medicare Part B, All other policy terms and conditions apply. except as provided in subparagraphs(ii)and(iii)below. ii) Medicare Part B,in the case of services,supplies and care provided by ambulatory surgical centers and clinical laboratories. The following endorsement changes your policy, iii) the Durable Medical Equipment Prosthetics/Orthotics and Please read this document carefully and keep it with your policy. Supplies fee schedule of Medicare Part B,in the case of durable Florida Personal Injury Protection Coverage-" medical equipment. If a provider submits a charge for an amount less than the amount -ACR209-1 determined by the fee schedule or other limitations established by Section (Ed.08/22) 627.736 of the Florida Statutes,or any other provisions of the Florida In accordance with the Florida Motor Vehicle No-Fault Law, we will pay to or on Motor Vehicle No-Fault Law as described above, we will pay eighty behalf of the injured person the following benefits.Payments will be made only percent of the charge that was submitted. when bodily injury is caused by an accident arising from the ownership, However,if such services,supplies or care is not reimbursable under maintenance or use of a motor vehicle. Medicare Part B,as provided above,we will limit reimbursement to 80 1. Medical Expenses percent of the maximum reimbursable allowance under workers' Pursuant to the requirements of Section 627.736(1)(a)of the Florida compensation,as determined under Section 440.13 of the Florida Statutes, Statutes:eighty percent of reasonable expenses;for medical,surgical, and rules adopted thereunder which are in effect at the time such services, X-ray,dental,and rehabilitative services,including prosthetic devices,and supplies or care is provided.Services,supplies or care that is not ambulance,hospital and nursing services;which are medically necessary; reimbursable under Medicare or workers'compensation will not be only if the injured person receives initial services and care within 14 days reimbursed by us. after the motor vehicle accident.The methodology for determining the Policy endorsement Page 3 of 10 Policy number: 1961240 775 Policy effective date: October 10,2022 The applicable fee schedule or payment limitation under Medicare is the a) a hospital or ambulatory surgical center licensed under Florida fee schedule or payment limitation in effect on March 1 of the service year Statutes chapter 395; in which the services,supplies or care is rendered and for the area in which b) an entity wholly owned by one or more physicians licensed under such services,supplies or care is rendered,and the applicable fee schedule Florida Statutes chapter 458 or 459,chiropractic physicians licensed or payment limitation applies to services,supplies,or care rendered during under Florida Statutes chapter 460,or dentists licensed under Florida that service year,notwithstanding any subsequent change made to the fee Statutes chapter 466;or by such practitioners and the spouse, schedule or payment limitation,except that it may not be less than the parent,child,or sibling of such practitioners; allowable amount under the applicable schedule of Medicare Part B for c) an entity that owns or is wholly owned,directly or indirectly,by a 2007 for medical services,supplies and care subject to Medicare Part B. hospital or hospitals; For purposes of this subparagraph,the term"service year"means the d) a physical therapist licensed under Florida Statutes chapter 486,but period from March 1 through the end of February of the following year. only upon referral from: Notwithstanding the foregoing,where: i) a physician licensed under Florida Statutes chapter 458 or 459; a) a medical provider has contracted with an organization or network to ii) a dentist licensed under Florida Statutes chapter 466; accept payment for services in an amount that is less than the fee iii) a chiropractic physician licensed under Florida Statutes chapter schedule or other limitations established by Section 627.736 of the 460; Florida Statutes,or any other provisions of the Florida Motor Vehicle iv) a physician assistant licensed under Florida Statutes chapter No-Fault Law as described above;and 458 or 459,to the extent permitted by law and under the b) we contracted with that organization or network or one of its supervision of a provider listed in d.i),d.ii)or d.iii)above;or affiliates,either directly or through one or more medical bill review v) an advanced registered nurse practitioner licensed under companies or third-party administrators,to apply and accept such Florida Statutes chapter 464,to the extent permitted by law contractually agreed amounts; and under the supervision of a provider listed in d.i),d.ii)or d.iii)above;or then we will pay that provider's bills at eighty percent(80%)of the e) a health care clinic licensed under part X of Florida Statutes chapter contractually agreed rate. 400 which is accredited by the Joint Commission on Accreditation of Medical expense benefit provides reimbursement only for initial services Healthcare Organizations,the American Osteopathic Association,the and care: Commission on Accreditation of Rehabilitation Facilities,or the a) that are lawfully provided,supervised, ordered or prescribed by a Accreditation Association for Ambulatory Health Care,Inc.,or: physician licensed under Florida Statutes chapter 458 or 459,a i) has a medical director licensed under Florida Statutes chapter dentist licensed under Florida Statutes chapter 466 or a chiropractic 458,459 or 460; physician licensed under Florida Statutes chapter 460;or ii) has been continuously licensed for more than 3 years or is a b) that are provided in a hospital or in a facility that owns,or is wholly publicly traded corporation that issues securities traded on an owned by,a hospital;or exchange registered with the United States Securities and c) provided by a person or entity licensed under part III of Florida Exchange Commission as a national securities exchange;and Statutes chapter 401 which provides emergency transportation and iii) provides at least four of the following medical specialties: treatment. (a) general medicine; Upon referral from a provider described above,follow up services and care (b) radiography; consistent with the underlying medical diagnosis rendered pursuant to the (c) orthopedic medicine; above which may be provided,supervised,ordered or prescribed only by a (d) physical medicine; physician licensed under Florida Statutes chapter 458 or 459,a (e) physical therapy; chiropractic physician licensed under Florida Statutes chapter 460,a (f) physical rehabilitation; dentist licensed under Florida Statutes chapter 466,or,to the extent (g) prescribing or dispensing outpatient prescription permitted by applicable law and under the supervision of such physician, medication;or o osteopathic physician,chiropractic physician,or dentist,by a physician (h) laboratory services. o O assistant licensed under Florida Statutes chapter 458 or 459,or an However,the licensing requirement under this subparagraph e.does not o advanced registered nurse practitioner licensed under Florida Statutes apply to: q Fz chapter 464. i) an entity wholly owned by a physician licensed under chapter 458 or o chapter 459,or by the physician and the spouse,parent,child,or a Follow up services and care may also be provided by any of the following: sibling of the physician; < m N O m Oco m N p, O O O Q w O_ O d O po10 � O 0 N Q Policy endorsement Policy number: 1961240 775 Q)Allstate. Policy effective date: October 10,2022 Page 4 of 10 ii) an entity wholly owned by a dentist licensed under chapter 466,or The following definitions apply throughout the personal injury by the dentist and the spouse,parent,child,or sibling of the dentist; protection section of the policy. iii) an entity wholly owned by a chiropractic physician licensed under 1. Bodily injury means bodily harm,sickness,disease or death. chapter 460,or by the chiropractic physician and the spouse,parent, child,or sibling of the chiropractic physician; 2. Insured motor vehicle means a motor vehicle: iv) a hospital or ambulatory surgical center licensed under chapter 395; a) you own; v) an entity that wholly owns or is wholly owned,directly or indirectly, b) for which security is required to be maintained under the by a hospital or hospitals licensed under chapter 395; Florida Motor Vehicle No-Fault Law,and vi) an entity that is a clinical facility affiliated with an accredited medical c) i) for which a premium is charged,or school at which training is provided for medical students,residents, ii) is a trailer designed for use primarily with a or fellows;or motor vehicle. vii) an entity that is certified under 42 C.F.R.part 485,subpart H. 3. Injured person means: Medical expense benefits do not include massage as defined in s.480.033 a) Within the State of Florida: of the Florida Statutes or acupuncture as defined in s.457.102 of the i) You or a resident relative while in,on,getting into or out Florida Statutes,regardless of the person,entity or licensee providing the of,or struck while a pedestrian by a motor vehicle. massage or acupuncture.Licensed massage therapists or licensed ii) Any other person while in,on,getting into or out of the acupuncturists will not be reimbursed for medical expense benefits. insured motor vehicle. We will not pay for medical services,supplies or care that is not iii) Any other persons struck by the insured motor vehicle reimbursable under Medicare or under Florida workers'compensation law. while not an occupant of a self-propelled vehicle if that If a healthcare provider takes action against the injured person to recover person is a resident of Florida. for services billed and not paid,we will defend and,if necessary,indemnify b) Outside the State of Florida: the injured person up to the policy limits. i) You or a resident relative while in,on,getting into or out of the insured motor vehicle. 2. Income Loss ii) You while in,on,getting into or out of a motor vehicle Sixty percent of loss of income and earning capacity from inability to work owned by a resident relative for which security is caused directly by the injury sustained in the auto accident.Income loss required to be maintained under the Florida Motor benefits end upon the death of the injured person. Vehicle No-Fault Law. 3. Loss of Services 4. Motor Vehicle means any self-propelled vehicle with four or more All reasonable expenses incurred in obtaining from others ordinary and wheels which is of a type both designed and required to be licensed necessary services usually performed by the injured person without for use on the highways of Florida and any trailer or semi-trailer income for the benefit of the family or family household.Loss of services designed for use with such vehicle. benefits end upon the death of the injured person. A Motor Vehicle does not include: 4. Death Benefits a) any motor vehicle which is used in mass transit,other than Benefits due to the death of an injured person.The death benefit is public school transportation,and designed to transport more $5,000 per deceased injured person.Death benefits are in addition to than five passengers exclusive of the operator of the motor Medical Expenses,Income Loss and Loss of Services benefits.We may pay vehicle and which is owned by a municipality,a transit death benefits to:the executor or administrator of the deceased injured authority,or a political subdivision of the state;or person;to any of the deceased injured person's relatives by blood, b) a mobile home marriage or adoption;or to any person that is entitled to such benefits. 5. Medically necessary means a medical service or supply that a Payments will be made only when bodily injury is caused by an accident prudent physician would provide for the purpose of preventing, arising from the ownership,maintenance or use of a motor vehicle. diagnosing,or treating an illness,injury,disease,or symptom in a We shall create and maintain a log of Personal Injury Protection manner that is: benefits paid by us on behalf of the injured person.If litigation is a) in accordance with generally accepted standards of medical commenced,we shall provide you a copy of the log within 30 days practice; after receiving a request. b) clinically appropriate in terms of type,frequency,extent,site, and duration;and Additional Definitions Under Personal Injury Protection Policy endorsement Page 5 of 10 Policy number: 1961240 775 Policy effective date: October 10,2022 c) not primarily for the convenience of the patient,physician,or SUBJECT TO THAT$10,000 AGGREGATE LIMIT,MEDICAL other health care provider. EXPENSES PER INJURED PERSON FOR ONE ACCIDENT are ALSO 6. Emergency medical condition means a medical condition which subject to EITHER a$10,000 or a$2,500 per injured person limit manifests itself by acute symptoms of sufficient severity,which determined as follows: may include severe pain,such that the absence of immediate A$10,000 coverage limit for Medical Expenses applies to an injured medical attention could reasonably be expected to result in any of person if: the following: 1. a physician licensed under Florida Statutes chapter 458 or 459; a) serious jeopardy to patient health; 2. a dentist licensed under Florida Statutes chapter 466; b) serious impairment to bodily functions;or c) serious dysfunction of any bodily organ or part. 3. a physician assistant licensed under Florida Statutes chapter 458 or Exclusions—What Is Not Covered 459;or This coverage does not apply: 4. an advanced registered nurse practitioner licensed under Florida 1. to you or any resident relative while in,on,getting into or out of a Statutes chapter 464; motor vehicle which you own that is not an insured motor vehicle has determined that the injured person had an emergency medical under this policy. condition. 2. to any person while operating the insured motor vehicle without However,a$2,500 coverage limit for Medical Expenses applies to an your permission. injured person if: 3. to any person whose conduct contributed to a self injury: 1. a physician licensed under Florida Statutes chapter 458 or 459; a) intentionally caused;or 2. a dentist licensed under Florida Statutes chapter 466; b) while committing a felony. 4. to any person,other than you,if that person owns a motor vehicle 3. a chiropractic physician licensed under Florida Statutes chapter 460; for which security is required under the Florida Motor Vehicle 4. a person or entity licensed under part III of Florida Statutes chapter No-Fault Law. 401 which provides emergency transportation and treatment; 5. to any person,other than you or a resident relative,who is entitled 5. a physician assistant licensed under Florida Statutes chapter 458 or to no-fault benefits from the owner or insurer of a motor vehicle 459; which is not an insured motor vehicle under this insurance. 6. an advanced registered nurse practitioner licensed under Florida 6. to any person who sustains bodily injury while in,on,getting into or Statutes chapter 464;or out of a motor vehicle while located for use as a residence or 7. a physical therapist licensed under Florida Statutes chapter 486, premises. based upon a referral by a provider described in(1),(2),(3),(5)or(6) 7. to you or a resident relative for Income Loss if the Policy above; Declarations indicates that Income Loss coverage does not apply. has determined that the injured person did not have an emergency 8. to bodily injury arising out of the use of your insured motor medical condition. vehicle while it is being used as part of a Personal Vehicle Sharing Expenses and losses will be reduced by: Program. 1. amounts paid or payable for the same items of loss and expense This exclusion does not apply to an insured person using a under any workers'compensation law. non-owned motor vehicle with the permission of the vehicle's 2. amounts received from any insurer for the same items of loss and owner. expense for which benefits are available under this policy.This o Limits Of Liability reduction applies only to amounts that are a duplication of payment o The applicable Personal Injury Protection limit(s)shown on the Policy for the same loss or expense.The insurer paying these benefits, q Declarations for Medical Expenses,Income Loss,Loss of Services and however,will be entitled to recover from us an equitable pro rata o Death Benefits is the maximum we will pay per injured person for any share of the benefit paid and expenses incurred in processing 0 one motor vehicle accident,regardless of the number of vehicles insured the claim. o under this or other policies.A$10,000 aggregate per injured person limit a applies to Medical Expenses,Income Loss,and Loss of Services. N O m 00 co ON m N p, 0 O O Q w O_ O d O po10 � O 0 N Q Policy endorsement Policy number: 1961240 775 Q)Allstate. Policy effective date: October 10,2022 Page 6 of 10 3. the amount of any deductible stated on the Policy Declarations.This Action Against Us will not apply to Death Benefits. No one may sue us under this coverage unless: In the event any benefits are paid to the injured person under the 1. there is full compliance with all the terms of this policy; Medicaid program we will repay the full amount to Medicaid within 30 2. a demand letter has been provided pursuant to Florida Statutes days after receiving notice that Medicaid paid the benefits. Section 627.736(10);and 3. such action is commenced within the time limits prescribed by Claims will be paid in the order received except:(1)where otherwise Florida law. provided by the Florida Motor Vehicle No-Fault Law;or(2)where the Proof Of Claim;Medical Reports injury is investigated or disputed by us as not being related to the loss,or As soon as possible,you or any other person making claim must give us treatment is investigated or disputed by us as not being reasonable or written proof of claim including all details reasonably required by us to medically necessary.We can proceed to pay other claims that are later determine the amounts payable. received without incurring any liability for the prior disputed or investigated claim amounts if limits are exhausted after paying later If the mental or physical condition of an injured person is material to any received claims. claim under this coverage,that person may be required to submit to Any amounts payable under this coverage shall be subject to any and all mental or physical examinations by physicians we choose,as often as we limitations,authorized by Section 627.736 of the Florida Statutes,or any reasonably require.The person making the claim or that person's other provisions of the Florida Motor Vehicle No-Fault Law,as enacted, representative must authorize us to obtain medical reports and copies of amended or otherwise continued in the law,including,but not limited to, medical and other records related to the claim.If an injured person all fee schedules. unreasonably refuses to submit to an examination or fails to appear at an examination,we are not required to pay any subsequent Personal Injury If we pay a portion of a claim or reject a claim due to an alleged error in Protection benefits.Under Florida law,an insured's refusal to submit to or the claim,we shall provide an itemized specification or explanation of failure to appear at two examinations raises a rebuttable presumption that benefits due to the specified error at the time of the partial payment or the refusal or failure was unreasonable.We will pay the expense of any rejection.Upon receiving the specification or explanation,the person examinations we request. making the claim,at his or her option and without waiving any other legal Such examination shall be conducted within the municipality of residence remedy for payment,has 15 days to submit a revised claim,which shall be of the injured person or in the municipality where the injured person is considered a timely submission of written notice of claim. receiving treatment.If there is no qualified physician to conduct the In the event of a dispute between you and us,or your assignee and us, examination within such municipality,then such examination shall be upon your or your assignee's request,we must notify you or your conducted in an area of the closest proximity to the injured person's assignee that your Personal Injury Protection policy limits have been residence. reached within 15 days after the policy limits have been reached. If we have a reasonable belief that a fraudulent insurance act,for the Once aggregate payments for Medical Expenses,Income Loss and Loss of purposes of s.626.989 of the Florida Statutes or s.817.234 of the Florida Services benefits equal to the limit of liability have been made,no further Statutes,has been committed,we will notify the claimant,in writing, obligation to pay benefits remains,regardless of when claims for such within 30 days after submission of the claim that the claim is being benefits were submitted or received. investigated for suspected fraud.No later than 90 days after the Unreasonable Or Unnecessary Medical Expenses submission of the claim,we will deny or pay the claim. If an injured person incurs medical expenses which we deem to be Notwithstanding the foregoing,if we make a written request for unreasonable or unnecessary,we may refuse to pay for those medical documentation or information in accordance with s.627.736(6)(b)of the expenses and contest them. Florida Statutes within 30 days after having received notice of the amount If the injured person is sued by a medical services provider because we of a covered loss under s.627.736(4)(a)of the Florida Statutes,the refuse to pay medical expenses which we deem to be unreasonable or amount or the partial amount that is the subject of our inquiry shall unnecessary,we will pay resulting defense costs and any resulting become overdue if we do not pay in accordance with s.627.736(4)(b)of judgment against the insured person.We will choose the counsel.The the Florida Statutes or within 10 days after our receipt of the requested insured person must cooperate with us in the defense of any claim or documentation or information,whichever occurs later. lawsuit.If we ask an injured person to attend hearings or trials,we will Assistance And Cooperation pay up to$100 per day for loss of wages or salary. We will pay other We will require you and any injured person making a claim to cooperate reasonable expenses incurred at our request. with us in the investigation,settlement or defense of any claim or suit. This includes,but is not limited to;assisting us in making settlements, Policy endorsement Page 7 of 10 Policy number: 1961240 775 Policy effective date: October 10,2022 securing evidence,obtaining evidence,and in conducting suits;disclosing damages consisting of pain,suffering,mental anguish,or inconvenience unless all facts;attending hearings and trials;helping us recover from anyone the injury or disease consists in whole or in part of: who may be jointly responsible;giving us a recorded statement,a written 1. significant and permanent loss of an important bodily function; statement,a video-recorded statement,records and/or documents;when 2. permanent injury within a reasonable degree of medical probability,other requested by us,as often as we reasonably require.You and any injured than scarring or disfigurement; person making a claim shall be required,at our option,to submit to an 3. significant and permanent scarring or disfigurement;or examination under oath,separately and apart from others,and to sign the 4. death. transcript.The person submitting to the examination under oath may be The bodily injury must be caused by accident and arise out of the ownership, represented by counsel at their own expense.The scope of questioning maintenance or use of an uninsured auto.We will not pay any punitive or during the examination under oath is limited to relevant information or exemplary damages. information that could reasonably be expected to lead to relevant information.Compliance with a request for examination under oath is a If an insured person sues a person believed to be responsible for the accident condition precedent to receiving benefits under this coverage.If you or without our written consent,we are not bound by any resulting judgment. any injured person making a claim does not comply with the terms of this Additional Definitions For Uninsured Motorists Insurance provision we are not required to pay any benefits under this coverage. 1. Bodily injury means bodily harm,sickness,disease or death,but does not Reimbursement And Subrogation include: Unless prohibited by the Florida Motor Vehicle No-Fault Law,as amended, a) any venereal disease; and in the event of payment to or for the benefit of any injured person b) herpes; under this insurance: or any resulting symptom,effect,condition,disease or illness related to a) 1. If the accident occurs outside the state of Florida,we are subrogated or b)listed above unless there is a causal connection or relation between to the rights of the person to whom or for whose benefit such an accident arising from the ownership,maintenance or use of a motor payments were made to the extent of such payments.Such person vehicle and the transmission of the venereal disease or herpes. shall execute and deliver the instruments and papers and do 2. Insured Auto means an auto you own which is described on the Policy whatever else is necessary to secure such rights.Such person shall do Declarations and for which a premium is shown for Uninsured Motorists nothing after loss to prejudice such rights;and Insurance.This also includes: 2. We shall be entitled to reimbursement to the extent of the payment a) its replacement auto; of Personal Injury Protection benefits made under this insurance b) an additional auto; from the owner or insurer of the owner of a commercial motor c) a substitute auto;or vehicle,other than a taxi cab,as defined by the Florida Motor d) a non-owned auto;or Vehicle No-Fault Law,if such injured person sustained the injury e) a trailer or travel-trailer. while in,on,getting into or out of,or while a pedestrian through 3. Insured Person(s)means: being struck by,such commercial motor vehicle. a) you and any resident relative. b) any person while in,on,getting into or out of,or getting on or off of, All other policy terms and conditions apply. an insured auto with your permission. c) any other person who is legally entitled to recover because of bodily injury to you,a resident relative,or an occupant of your insured auto with your permission. 4. Motor vehicle means a land motor vehicle,trailer or travel-trailer The following endorsement changes your policy, other than Please read this document carefully and keep it with your policy, a) a vehicle or other equipment designed for use principally off public roads,while not upon public roads; o Florida Uninsured Motorists Insurance— b) a vehicle operated on rails or crawler-treads;or Coverage ST-ACR210-1 c) a vehicle when used as a residence or premises. s (Ed.08/22) 5. Uninsured auto means: 0 We will pay only those damages which an insured person is legally entitled to a) a motor vehicle which has no bodily injury liability bond or insurance o recover from the owner or operator of an uninsured auto because of bodily policy in effect at the time of the accident; a injury sustained by an insured person,except that we will not pay for N O m 00 co ON m N p, O O O Q w O_ O d O po10 � O 0 N Q Policy endorsement Policy number: 1961240 775 Q)Allstate. Policy effective date: October 10,2022 Page 8 of 10 b) a motor vehicle,other than a motor vehicle insured under the subrogation against the underinsured motorist and the liability insurer for liability portion of this policy,for which the insurer denies coverage; the amounts paid to the injured person. c) a motor vehicle for which the insurer becomes insolvent within four 2 the direct or indirect benefit of workers'compensation or disability years from the date of the accident.This coverage will be excess over benefits insurer,including a self-insurer. any obligations assumed by the Florida Insurance Gua ranty Association to pay claims,but not contingent upon payment of such 3. any person arising out of the insured person(s active participation in any obligations; prearranged,organized,or spontaneous: d) a hit-and-run motor vehicle which causes bodily injury to an a) racing contest; insured person as the result of a motor vehicle accident.The b) speed contest;or identity of either the operator or owner of the vehicle must be c) use of an auto at a track or course designed or used for racing or unknown.The accident must be reported within 24 hours,or as soon high performance driving; as practicable,to the police.We must be notified within 30 days,or or in practice or preparation for any contest or use of this type. as soon as practicable.If the hit-and-run motor vehicle caused the injury without physical contact with the insured person or the 4. bodily injury arising out of the use of an insured auto while used by an vehicle the insured person was occupying,the facts of the accident insured person to carry persons,products or property for any form of must be proved.If the insured person was occupying the insured compensation,including but not limited to fees,delivery charges or wages auto at the time of the accident,we have a right to inspect it; generally. e) a motor vehicle insured under the liability portion of this motor This exclusion does not apply to shared-expense car pools. vehicle insurance policy which causes bodily injury to you or a resident relative while being operated by a person other than you or 5. bodily injury arising out of the use of your insured auto while it is a resident relative and which is excluded under the liability portion being used as part of a Personal Vehicle Sharing Program. of this policy;or This exclusion does not apply to an insured person using a non-owned f) an underinsured motor vehicle.An underinsured motor vehicle is motor vehicle with the permission of the vehicle's owner. one which has liability protection in effect and applicable at the time If the Policy Declarations indicates that under the Uninsured Motorists of the accident but in an amount less than the damages the insured Insurance provision,the limits of two or more insured autos may not be person is legally entitled to recover. stacked together,the following Exclusions also apply: An uninsured auto is not a vehicle insured under the liability portion of 6. any person while in,on,getting into or out of a vehicle you own which is this motor vehicle insurance policy,unless that auto causes bodily injury insured for this coverage under another policy. to you or a resident relative while being operated by a person other than you or a resident relative and which is excluded under the liability portion 7. you or a resident relative while in,on,getting into or out of a vehicle of this policy. owned by you or a relative who resides in your household which is not Exclusions—What Is Not Covered insured for this coverage under this policy. Regardless of the type of coverage under Uninsured Motorists Insurance,this Limits Of Liability coverage does not apply to: 1. When limits of two or more insured autos may be stacked: 1. any person who makes a settlement without our written consent and that If the Policy Declarations indicates that,under the Uninsured Motorist settlement is prejudicial to our company.However this does not apply if Insurance provision,the limits of two or more insured autos may be an injured person or,in the case of death,the personal representative of stacked together,the Uninsured Motorists Insurance limit shown on the such person agrees to settle a claim with a liability insurer and its insured, Policy Declarations for: and such settlement does not fully satisfy the claim so as to create an a) "each person"is the maximum that we will pay for all damages underinsured motorist claim.Written notice of the proposed settlement arising out of bodily injury to one person in any one motor vehicle must be submitted to us by certified or registered mail. We shall then have accident,including damages sustained by anyone else as a result of thirty(30)days after receipt thereof to consider authorization of the that bodily injury. settlement or retention of our subrogation rights.If we choose to preserve When the limits of two or more insured autos are stacked,our our subrogation rights,we shall refuse permission to settle the claim and maximum limit of liability for all damages to you or a resident shall then,within thirty(30)days after receipt of notice of the proposed relative in any one accident is the sum of the"each person"limits for settlement,pay to the injured person(s)the amount of the written offer each insured auto shown on the Policy Declarations. from the liability insurer and/or insured.We shall then,upon final resolution of the underinsured motorist claim,be entitled to seek b) "each accident"is the maximum that we will pay for all damages arising out of bodily injury to two or more persons in any one motor Policy endorsement Page 9 of 10 Policy number: 1961240 775 Policy effective date: October 10,2022 vehicle accident.This"each accident"limit is subject to the"each b) all amounts payable under any workers'compensation law,disability person"limit. benefits law,or similar law,Automobile Medical Payments,or any When the limits of two or more insured autos are stacked,subject similar automobile medical payments coverage, Personal Injury to the limit for"each person,"our maximum limit of liability for all Protection benefits provided under this policy or any no-fault damages to two or more persons in any one accident is the sum of benefits provided under any other auto policy. the"each accident"limits for each insured auto shown on the Policy If There Is Other Insurance Declarations. 1. When limits of two or more insured autos may be stacked: 2. When limits of two or more insured autos may not be stacked: If the injured person was struck as a pedestrian or in,on,getting into or If the Policy Declarations indicates that,under the Uninsured Motorists out of a vehicle which is insured for this coverage under another policy, Insurance coverage,the limits of two or more insured autos may not be this coverage will be excess. stacked together,the Uninsured Motorists Insurance limit shown on the If more than one policy applies to the accident on a primary basis, we will Policy Declarations for: bear our proportionate share of the damages payable. a) "each person"is the maximum that we will pay for all damages 2 When limits of two or more insured autos may not be stacked: arising out of bodily injury to one person in any one motor vehicle If the injured person was struck as a pedestrian or in,on,getting into or accident,including damages sustained by anyone else as a result of out of a vehicle you do not own which is insured for this coverage under that bodily injury. another policy,this coverage will be excess.This means that when the b) "each accident"is the maximum that we will pay for all damages injured person is legally entitled to recover damages in excess of the other arising out of bodily injury to two or more persons in any one motor policy limit,we will a u to our policy limit,except that we will not a vehicle accident.This"each accident"limit is subject to the"each p y pay p y p y p pay person"limit. for damages consisting of pain,suffering,mental anguish,or inconvenience unless the injury or disease consists in whole or in part of: These limits are the maximum we will pay for anyone motor vehicle a) significant and permanent loss of an important bodily function; accident regardless of the number of: b) permanent injury within a reasonable degree of medical probability, a) claims made; other than scarring or disfigurement; b) insured persons; c) significant and permanent scarring or disfigurement;or c) vehicles stated on the Policy Declarations;or d) death. d) vehicles involved in the accident. This applies only after all other collectible insurance has been exhausted. The Uninsured Motorists Insurance limits apply to each insured motor If more than one policy applies to the accident on a primary basis,the total vehicle as stated on the Policy Declarations.If you are struck as a benefits payable to any one person will not exceed the maximum benefits pedestrian or are a passenger in a non-owned auto,you are entitled to payable by the policy with the highest limit for uninsured motorists select the highest limits of Uninsured Motorists Insurance available on benefits.We will bear our proportionate share.This applies no matter how any one motor vehicle for you or a resident relative. many autos or auto policies may be involved whether written by us or 3. Regardless of whether the Policy Declarations indicates that the limits of another company. two or more insured autos may be stacked,or may not be stacked Assistance And Cooperation:Additional Duties together for Uninsured Motorists Insurance,if bodily injury is We will require you and any insured person making a claim to cooperate with sustained in a motor vehicle accident by any person other than you or a us in the investigation,settlement or defense of any claim or suit.This includes, resident relative,our maximum limit of liability for all damages arising but is not limited to;assisting us in making settlements,securing evidence, out of bodily injury to any person other than you or a resident relative is obtaining evidence,and in conducting suits;disclosing all facts;attending the limit of liability shown on the Policy Declarations applicable to the hearings and trials;helping us recover from anyone who may be jointly vehicle the insured person was occupying at the time of the motor responsible;giving us a recorded statement,a written statement,a vehicle accident.This is the most we will pay regardless of the number of: video-recorded statement,records and/or documents;when requested by us,as o a) claims made; often as we reasonably require.You and any insured person making a claim o b) vehicles or persons stated on the Policy Declarations;or shall be required,at our option,to submit to an examination under oath, o c) vehicles involved in the accident. separately and apart from others,and to sign the transcript.The person o 4. Damages payable will be reduced by: submitting to examination under oath may be represented by counsel at their o a) all amounts paid by the owner or operator of the uninsured auto or own expense.We may require you and any insured person to take appropriate a anyone else responsible,including all sums paid or payable under the action to preserve all rights to recover damages from anyone responsible for the N bodily injury liability coverage of this or any other auto policy;and bodily injury.If you or any insured person making a claim does not comply N 0 m 0 co m (N p, O O O Q w O_ O d O po10 � O 0 N Q Policy endorsement Policy number: 1961240 775 Q)Allstate. Policy effective date: October 10,2022 Page 70 of 10 with the terms of this provision we are not required to pay an y benefits under If We Cannot Agree this coverage. If the insured person and we do not agree on that person's right to receive any Proof Of Claim;Medical Reports damages or the amount of that person's damages,then the disagreement will be If the mental or physical condition of an insured person is material to any claim resolved in a court of competent jurisdiction. under this coverage,that person may be required to submit to mental or Notwithstanding this provision,should the insured person and we mutually physical examinations by physicians we choose,as often as we reasonably agree to arbitrate the disagreement,the Florida Arbitration Code will not apply require.The person making the claim or that person's representative must unless the insured person and we mutually agree to apply that code. authorize us to obtain medical reports and copies of medical and other records related to the claim.If an insured person unreasonably refuses to submit to an examination or fails to appear at an examination, we are not required to pay any All other policy terms and conditions apply. subsequent Uninsured Motorists Insurance benefits.We will pay the expense of any examinations we request. Such examination shall be conducted within the municipality of residence of the insured person or in the municipality where the insured person is receiving treatment.If there is no qualified physician to conduct the examination within such municipality,then such examination shall be conducted in an area of the closest proximity to the insured person's residence. Action Against Us No one may bring an action against us in any way related to the existence or amount of coverage,or the amount of loss for which coverage is sought,under Uninsured Motorists Insurance,unless there is full compliance with all policy terms and the action is commenced within 5 years or the time limits prescribed by Florida law. If any insured person sues a person believed responsible for the accident without our written consent,we aren't bound by any resulting judgment. Trust Agreement When we pay any person under this coverage: 1. We are entitled to repayment of amounts paid by us and related collection expenses out of the proceeds of any settlement or judgment that person recovers from any responsible party or insurer. We are not entitled to repayment until after the person we have paid under this coverage has been compensated for all damages that person was legally entitled to recover. 2. All rights of recovery against any responsible party or insurer must be maintained and preserved for our benefit. 3. If we ask,insured person(s)must take appropriate action in their name to recover damages from any responsible party or insurer. We will select the attorney and we will pay all related costs and fees.We will not ask the insured person to sue the insured of an insolvent insurer. Payment Of Loss By Us Any amount due is payable to the insured person,to the parent or guardian of an injured minor,or to the spouse of any insured person who dies.However, we may pay any person lawfully entitled to recover the damages. Important notices Page 1 of 13 Policy number: 1961240 775 Policy effective date: October 10,2022 Important Information Concerning Your ' Under Additional Payments We Will Make,we have revised item 2 to give additional details regarding the Personal Injury Protection Insurance court costs for defense payments. For personal injury protection insurance,the named insured ' Under Additional Definitions For Part I,we have may elect a deductible and to exclude coverage for loss of revised the definition of'insured person'to include gross income and loss of earning capacity("lost wages"). any resident relative using a four-wheel private These elections apply to the named insured alone or to the passenger auto or utility auto. named insured and all dependent resident relatives.A . Under Exclusions—What Is Not Covered,we have premium reduction will result from these elections.The named replaced item 3 to exclude bodily injury or property insured is hereby advised not to elect the lost wage exclusion if damage arising out of the use of your insured auto the named insured or dependent resident relatives are while it is rented to, leased to,or provided in exchange employed,since lost wages will not be payable in the event of for a charge to,any person or organization by or with an accident. the permission of an insured person (only if damages X7137 are in excess of the minimum limits of lability coverage required by the state),or being used as part of a Notice Of Changes To Your Policy Personal Vehicle Sharing Program. 0 In Part 2—Automobile Medical Payments Coverage CC, From time to time Allstate will revise your coverage.We've under Exclusions—What Is Not Covered,we have replaced included an Amendatory Endorsement in this mailing package item 5 to exclude bodily injury arising out of the use of your that changes parts of your contract. Please read this insured auto while it is rented to, leased to,or provided in endorsement and keep it with your policy. exchange for a charge to,any person or organization by or with the permission of an insured person,or being used as We're also providing you with the following summary.We part of a Personal Vehicle Sharing Program. hope you find it informative and useful, but keep in mind that it's not part of your contract.Always reference your policy ' In Part 3—Protection Against Loss To The Auto, under documents for your exact coverage details. Exclusions—What Is Not Covered,we have replaced item 12 to exclude any loss arising out of the use of your insured If you have any questions,we're here to help.Visit our Help auto while it is rented to, leased to,or provided in Center in the Allstate® mobile app or allstate.com/help. exchange for a charge to,any person or organization by or with the permission of an insured person,or being used as part of a Personal Vehicle Sharing Program. Summary of Changes 0 In Florida Personal Injury Protection Coverage-VA and Florida Uninsured Motorists Insurance-Coverage ST, • In the General Provisions,we have made the following under Exclusions—What Is Not Covered,we have added changes: an item to exclude bodily injury arising out of the use of your insured auto while it is being used as part of a • We have revised the Where Lawsuits May Be Brought Personal Vehicle Sharing Program. provision to specify that unless we agree otherwise, XC7336 legal action against us must be brought in a court of competent jurisdiction in the county where the covered auto is principally garaged. An Outline to the Major Coverages in o • Under Definitions Used Throughout The Policy,we Your Allstate Auto Policy 0 have added a definition for Personal Vehicle Sharing q N Program. We are providing you with this outline which highlights the • In Part I—Automobile Liability Insurance, Bodily Injury principal coverages,optional coverages, limitations and o Liability and Property Damage Liability Coverages AA and exclusions of your auto policy,and provides information on N BB,we have made the following changes: policy cancellation, non-renewal,deductibles and the £� discounts that we offer and the surcharges that may be applied N 0 m 0co 0 N m N p, O O O Q w O_ O d O po10 � O 0 N Q Important notices Policy number: 1961240 775 WAllstate. Policy effective date: October 10,2022 Page 2 of 13 to your policy. Please be aware, however, this is just a guide require the Attorney General of the United States to and not a legal contract,and that all coverages are subject to defend that person in any civil action or proceeding. policy terms and conditions.Please read your auto policy, Item 2-we revised this exclusion to state that we do not endorsements and Policy Declarations for complete cover loss arising out of the use of an insured auto to carry descriptions and details. persons or property for any form of compensation.This TO THE EXTENT THERE IS ANY DIFFERENCE BETWEEN THE item now uses the defined term"shared-expense car INFORMATION CONTAINED IN THIS NOTICE AND THE pool." TERMS AND CONDITIONS OF YOUR POLICY,THE POLICY ' Item 3-we added an exclusion which specifically excludes TERMS AND CONDITIONS SHALL GOVERN. coverage for bodily injury or property damage arising out of the use of your insured auto while it is rented to,leased For your convenience,we have listed all of the principal to,or loaned for a charge to,any person or organization by coverages,limits,deductibles and the itemized premiums or with the permission of an insured person,with some which apply to each specific coverage that your policy provides exceptions. on the enclosed Policy Declarations. Please note that your 0 Item 4-we added"leasing"to the list of examples of current policy provides only those coverages which are excluded motor vehicle business operations. indicated on your Policy Declarations. If you have any 0 Item 6-with this item,we exclude coverage for bodily questions,please do not hesitate to call your Allstate Agent. injury or property damage arising out of the ownership, NOTE:The following outline of coverage is for informational maintenance or use of a motor vehicle with less than four purposes only.Florida law prohibits this outline from wheels. changing any of the provisions of the insurance contract ' Item 11 has been revised this exclusion to more broadly which is the subject of this outline.Any endorsement state that loss which would also be covered under nuclear regarding changes in types of coverage,exclusions, energy liability insurance is excluded. limitations,reductions,deductibles,coinsurance,renewal ' Item 13-we added a new exclusion which specifically provisions,cancellation provisions,surcharges or credits will excludes coverage for bodily injury or property damage be mailed separately. arising out of the use of a trailer or travel-trailer that is not attached to an auto which is an insured auto. Note: The Automobile Liability Insurance Bodily exclusion does not apply if the trailer or travel-trailer Injury-Coverage AA,and Property suddenly and accidentally becomes detached from the Damage-Coverage BB auto immediately before the accident. Item 14-we added a new exclusion which specifically These coverages pay for all damages that an insured person is excludes coverage for any liability an insured person legally obligated to pay because of bodily injury or property assumes arising out of any contract or agreement other damage.Your policy also protects an insured person from than a rental or leasing agreement. claims for accidents arising out of the ownership, maintenance, . Item 15-we added a new exclusion which specifically use, loading or unloading of an insured auto. Bodily Injury excludes coverage for bodily injury or property damage Liability-Coverage AA is an optional coverage that can be arising out of the use of a trailer or travel-trailer while it is added to your policy for an additional premium. parked for use as a residence,or as an office,display This coverage is subject to the exclusions,terms and space,or storage space. conditions described in the policy. Automobile Medical Payments-Coverage CC • Under Exclusions—What Is Not Covered,we have made If a premium is shown on the Policy Declarations for several changes. In some cases,we have revised Automobile Medical Payments-Coverage CC,Allstate will pay exclusions that were already a part of your policy; in other to or on behalf of an insured person for medically necessary cases,we have renumbered exclusions and added new treatment actually provided to the insured person within 3 exclusions.All item numbers below refer to the items as years of a covered auto accident because of bodily injury. reflected in the revised policy forms: Payments will be made only:when bodily injury is caused by a • Item 1 is added. It excludes coverage while the insured motor vehicle accident;for medical,surgical,X ray,dental,and auto is used by any person as an employee of the United rehabilitative services, including prosthetic devices,and States government.This exclusion applies only if the ambulance, hospital and nursing services;which are medically provisions of the Federal Tort Claims Act,as amended, necessary;only if the insured person receives initial services and care within 14 days after the motor vehicle accident.The Important notices Page 3 of 13 Policy number: 1961240 775 Policy effective date: October 10,2022 methodology for determining the amount we will pay for such Organizations,the American Osteopathic Association,the expenses shall be pursuant to the fee schedule limitations Commission on Accreditation of Rehabilitation Facilities, under the Florida Motor Vehicle No-Fault Law,and shall be or the Accreditation Association for Ambulatory Health limited to the schedule of maximum charges set forth in the Care, Inc.,or: policy. a) has a licensed medical director; Where a medical provider has contracted with an organization b) has been continuously licensed for more than 3 years or network to accept payment for services in an amount that is or is a publicly traded corporation;and less than the fee schedule or other limitations established by c) provides at least four of the following medical the Florida Motor Vehicle No-Fault Law;and Allstate specialties:general medicine; radiography;orthopedic contracted with that organization or network or one of its medicine; physical medicine; physical therapy; affiliates,either directly or through one or more medical bill physical rehabilitation; prescribing or dispensing review companies or third-party administrators,to apply and outpatient prescription medication;or laboratory accept such contractually agreed amounts;then Allstate will services. pay that provider's bills at the contractually agreed rate. Automobile Medical Payments coverage does not include Automobile Medical Payments provides reimbursement only massage or acupuncture. for initial services and care: (i)that are lawfully provided, We will not pay for medical services,supplies or care that is ordered or prescribed by a licensed physician,dentist or not reimbursable under Medicare or workers'compensation chiropractic physician;or(ii)that are provided in a hospital or law. If a healthcare provider takes action against the insured in a facility that owns,or is wholly owned by,a hospital;or(iii) person to recover for services billed and not paid,we will provided by a licensed person or entity which provides defend and,if necessary, indemnify them up to the policy emergency transportation and treatment. limits. Upon referral from a provider described in (i)through (iii) Notwithstanding the above limitation,we will pay:expenses above,follow up services and care consistent with the not paid under Part III of the policy because of the eighty underlying medical diagnosis rendered may be provided, percent limitation for medical expense benefits;expenses not supervised,ordered or prescribed only by a licensed physician, paid under Part III of the policy or under any no-fault benefits in chiropractic physician or dentist,or to the extent permitted by any other motor vehicle policy because all available medical applicable law and under the supervision of such physician, expense benefits have been exhausted;or expenses for bodily osteopathic physician,chiropractic physician or dentist, by a injury sustained outside the state of Florida through being licensed physician assistant or a licensed advanced registered struck while in,on,getting into or out of,or struck while a nurse practitioner. pedestrian by a motor vehicle. Follow up services and care may also be provided by any of the There is no coverage under Automobile Medical Payments for following: mileage costs for use of a personal vehicle. 1. a licensed hospital or ambulatory surgical center; 2. an entity wholly owned by one or more licensed physicians, This coverage is subject to the exclusions,terms and chiropractic physicians,or dentists;or by such conditions described in the policy. practitioners and the spouse, parent,child,or sibling of . Under Exclusions—What Is Not Covered,we have made such practitioners; several changes. In some cases,we have revised 3. an entity that owns or is wholly owned,directly or exclusions that were already a part of your policy; in other indirectly, by a hospital or hospitals; cases,we have renumbered exclusions and added new 4. a licensed physical therapist, but only upon referral from:a exclusions.All item numbers below refer to the items as licensed physician,dentist,or chiropractic physician;a reflected in the revised policy forms: o licensed physician assistant,to the extent permitted by • Item 2-we added wording to indicate that the o law and under the supervision of a licensed physician, exclusion applies to you or a resident relative while in, o dentist,or chiropractic physician;a licensed advanced on,getting into or out of,or getting on or off of,an auto 0 registered nurse practitioner,to the extent permitted by available or furnished for the regular use of you or a law and under the supervision of a licensed physician, resident relative,which is not insured for this o dentist,or chiropractic physician;or coverage. N 5. a licensed healthcare clinic which is accredited by the • Item 4-we revised this exclusion to state that we do Joint Commission on Accreditation of Healthcare not cover bodily injury to any person arising out of the o m 0 co m (N p, O O O Q w O_ O d O po10 � O 0 N Q Important notices Policy number: 1961240 775 WAllstate. Policy effective date: October 10,2022 Page 4 of 13 use of an insured auto while used by an insured person arising from the ownership, maintenance or use of a"motor to carry persons or property for any form of vehicle"(as defined under this coverage). compensation,or the use of any auto an insured For medical expenses,Allstate will pay eighty percent of person is driving while available for hire by the public. reasonable expenses;for medical,surgical,X-ray,dental,and The exclusion does not apply to shared-expense car rehabilitative services, including prosthetic devices,and pools. ambulance, hospital and nursing services;which are medically • Item 5 is added. It excludes coverage for bodily injury necessary;only if the injured person receives initial services to any person arising out of the use of your insured and care within 14 days after the motor vehicle accident.The auto while it is rented to, leased to,or loaned for a methodology for determining the amount we will pay for such charge to,any person or organization by or with the expenses shall,pursuant to the Florida Motor Vehicle No-Fault permission of an insured person,with some Law, be limited to eighty percent of the schedule of maximum exceptions. charges set forth in the policy AND SHALL BE SUBJECT TO • Item 6 is added. It excludes coverage for bodily injury ANY AND ALL LIMITATIONS,AUTHORIZED BY SECTION to any person arising out of the ownership, 627.736 OF THE FLORIDA STATUTES,OR ANY OTHER maintenance,or use of a motor vehicle with less than PROVISIONS OF THE FLORIDA MOTOR VEHICLE NO-FAULT four wheels. LAW,AS ENACTED,AMENDED OR OTHERWISE • Item 7-we added"leasing"to the list of examples of CONTINUED IN THE LAW, INCLUDING, BUT NOT LIMITED motor vehicle business operations. We have also TO,ALL FEE SCHEDULES. eliminated certain language in light of the changes we made to item 4(see above)and revised language Where a medical provider has contracted with an organization pertaining to private chauffeurs and domestic or network to accept payment for services in an amount that is servants while using an insured auto. less than the fee schedule or other limitations established by • Item 8-we revised the exclusion pertaining to loss the Florida Motor Vehicle No-Fault Law;and Allstate resulting from acts of war, insurrection, rebellion or contracted with that organization or network or one of its revolution, providing an expanded list of excluded affiliates,either directly or through one or more medical bill causes of loss. review companies or third-party administrators,to apply and • Item 10-we revised this exclusion to provide that we accept such contractually agreed amounts;then Allstate will will reimburse the U.S.government when an insured pay that provider's bills at eighty percent(80%)of the receives medical treatment for the same cause of loss contractually agreed rate. through a facility of the uniformed services. Medical expense benefits provides reimbursement only for • Item 11 -we added a new exclusion which specifically initial services and care: (i)that are lawfully provided,ordered excludes coverage for bodily injury to any person while or prescribed by a licensed physician,dentist or chiropractic in,on,getting into or out of,or getting on or off of,a trailer or travel-trailer while it is parked for use as a Physician;or(ii)that are provided in a hospital or in a facility residence,or as an office,display space,or storage that owns,or is wholly owned by,a hospital;or(iii) provided by a licensed person or entity which provides emergency space. transportation and treatment. • Item 12-we added a new exclusion which specifically excludes coverage for bodily injury to any person while Upon referral from a provider described in (i)through (iii) in,on,getting into or out of,or getting on or off of,a above,follow up services and care consistent with the trailer or travel-trailer that is not attached to an auto underlying medical diagnosis rendered may be provided, which is an insured auto. Note:The exclusion does not supervised,ordered or prescribed only by a licensed physician, apply if the trailer or travel-trailer suddenly and chiropractic physician or dentist,or to the extent permitted by accidentally becomes detached from the auto applicable law and under the supervision of such physician, immediately before the accident. osteopathic physician,chiropractic physician or dentist, by a Personal Injury Protection—Coverage VA licensed physician assistant or a licensed advanced registered nurse practitioner. Personal Injury Protection pays for certain medical expenses, income loss, loss of services and death benefits for bodily Follow up services and care may also be provided by any of the harm,sickness,disease or death if it is the result of an accident following: 1. a licensed hospital or ambulatory surgical center; Important notices Page 5 of 13 Policy number: 1961240 775 Policy effective date: October 10,2022 2. an entity wholly owned by one or more licensed physicians, A$10,000 coverage limit for Medical Expenses applies to an chiropractic physicians,or dentists;or by such injured person if: practitioners and the spouse, parent,child,or sibling of (a) a licensed physician; such practitioners; (b) a licensed dentist; 3. an entity that owns or is wholly owned,directly or (c) a licensed physician assistant;or indirectly, by a hospital or hospitals; (d) a licensed advanced registered nurse practitioner; 4. a licensed physical therapist, but only upon referral from:a has determined that the injured person had an emergency licensed physician,dentist,or chiropractic physician;a medical condition. licensed physician assistant,to the extent permitted by law and under the supervision of a licensed physician, However,a$2,500 coverage limit for Medical Expenses dentist,or chiropractic physician;a licensed advanced applies to an injured person if: registered nurse practitioner,to the extent permitted by (1) a licensed physician; law and under the supervision of a licensed physician, (2) a licensed dentist; dentist,or chiropractic physician;or (3) a licensed chiropractic physician; 5. a licensed health care clinic which is accredited by the (4) a person or entity under part III of Florida Statutes Joint Commission on Accreditation of Healthcare Chapter 401 which provides emergency transportation Organizations,the American Osteopathic Association,the and treatment; Commission on Accreditation of Rehabilitation Facilities, (5) a licensed physician assistant; or the Accreditation Association for Ambulatory Health (6) a licensed advanced registered nurse practitioner;or Care, Inc.,or: (7) a licensed physical therapist, based upon a referral by a) has a licensed medical director; a provider described in (1),(2), (3),(5)or(6)above; b) has been continuously licensed for more than 3 years has determined that the injured person did not have an or is a publicly traded corporation;and c) provides at least four of the following medical emergency medical condition. specialties:general medicine; radiography;orthopedic There is a separate$5,000 per injured person limit on death medicine; physical medicine; physical therapy; benefits. physical rehabilitation; prescribing or dispensing This coverage is subject to the exclusions,terms and outpatient prescription medication;or laboratory conditions described in the policy. services. Medical expense benefits do not include massage or Deductibles acupuncture. Deductibles may apply under Personal Injury Protection. Please check the enclosed Policy Declarations for specific We will not pay for medical services,supplies or care that is information on any deductibles which may apply to Personal not reimbursable under Medicare or under Florida workers' Injury Protection-Coverage VA. compensation law. If a healthcare provider takes action against Uninsured Motorists Insurance-Coverage ST the injured person to recover for services billed and not paid, Uninsured Motorists Insurance is provided if a premium is we will defend and, if necessary,indemnify the injured person shown on the Policy Declarations for this coverage.Under this up to the policy limits. coverage,Allstate will pay only those damages which an The applicable Personal Injury Protection limit(s)shown on the insured person is legally entitled to recover from the owner or Policy Declarations for Medical Expenses, Income Loss, Loss of operator of an uninsured auto because of bodily injury Services and Death Benefits is the maximum we will pay per sustained by an insured person caused by an accident and injured person for any one motor vehicle accident, regardless arising out of the ownership, maintenance or use of an o of the number of vehicles insured under this or other policies.A uninsured auto.We will not pay any punitive or exemplary o $10,000 aggregate per injured person limit applies to Medical damages under this coverage. In addition, in order for us to pay o Expenses, Income Loss and Loss of Services. for pain,suffering, mental anguish or inconvenience,the injury o SUBJECT TO THAT$10,000 AGGREGATE LIMIT,MEDICAL or disease must be described in one or more of paragraphs(a) o EXPENSES PER INJURED PERSON FOR ONE ACCIDENT are through (d)of Florida Statute 627.737(2). o ALSO subject to EITHER a$10,000 or a$2,500 per injured This coverage is subject to the exclusions,terms and £� person limit determined as follows: conditions described in the policy. N 0 m 0 co m (N p, O O O Q w O_ O d O po10 � O 0 N Q Important notices Policy number: 1961240 775 WAllstate. Policy effective date: October 10,2022 Page 6 of 13 Protection Against Loss to the Auto This exclusion does not apply to shared-expense car The following coverages are two of the optional coverages pools. which can be added to your policy for an additional premium. 0 Item 3-we added"leasing"to the list of examples of Your current policy provides only those coverages which are excluded motor vehicle business operations. indicated on the enclosed Policy Declarations. 0 Item 4-we revised the exclusion pertaining to loss • Auto Collision Insurance-Coverage DD resulting from acts of war, insurrection, rebellion or Auto Collision Insurance pays for loss to your insured auto revolution, providing an expanded list of excluded or a non-owned auto,including loss to an attached trailer, causes of loss. which results from a collision with another object,or by an 0 Item 5-we revised the radioactive contamination upset of that auto or trailer. exclusion, providing an expanded listing of nuclear, • Auto Comprehensive Insurance-Coverage HH radiation and radioactive contamination losses not Auto Comprehensive Insurance pays for direct and covered. accidental loss to your insured auto or non-owned auto 0 Item 6-we will not cover loss caused by and confined which does not result from a collision. Here are some of to wear and tear,freezing,mechanical or electrical the hazards covered:glass breakage, missiles,falling breakdown,or mold,fungus,or bacteria.We have also objects,fire,theft or larceny,explosion,earthquake, rewritten the list of losses to which the exclusion will windstorm,hail,water,flood,malicious mischief or not apply. vandalism, riot,civil commotion,and collision with a bird Item 9-we will not cover loss to any personal or animal. electronic devices or recording media. The exclusion The deductible amount will not be subtracted from the loss will not apply when you have purchased Portable payment for loss to the windshield of your insured auto or Electronics and Media Coverage and the loss is a non-owned auto. covered under that coverage. Item 11 -we will not cover loss to appliances,furniture, There are several other optional coverages you may purchase, equipment and accessories in or on a travel-trailer. including: The exclusion will not apply when you have purchased • Roadside Coverage-Coverage JJ Contents Coverage and the loss to the item is covered • Transportation Expense-Coverage UU under that coverage. • Sound System Coverage-Coverage ZA Item 12-we will not cover an insured auto,trailer or • Portable Electronics and Media Coverage-Coverage ZZ travel-trailer while it is rented to, leased to,or loaned for a charge to,any person or organization by or with Please read your policy for a full description of these the permission of an insured person. coverages. Item 13-we will not cover loss arising out of a racing This coverage is subject to the exclusions,terms and contest,speed contest,or use of an auto at a track or conditions described in the policy. course designed or uses for racing or high-performance driving. Under Exclusions—What Is Not Covered,we have Item 15-this item has been added. It specifies loss amended the introductory language to say"We will not due to conversion or embezzlement by any person cover"losses described in the exclusions that follow. who has the vehicle due to any lien or sales agreement Additionally,in several of the exclusions that follow,we is not covered. have used the broader term"loss"instead of words that Item 16-this item has been added. Loss to home, might be interpreted more narrowly(such as"property office,store,display or passenger trailers or damage,""any damage,"etc.). Note:All item numbers travel-trailers will only be covered if Auto Collision below refer to the items as reflected in the revised policy Insurance or Auto Comprehensive Insurance is listed forms: on the Policy Declarations for the trailer or Item 2-we revised this exclusion to state that we will travel-trailer and the loss is covered under the listed not cover loss arising out of the use of an insured auto coverage. while used to carry persons or property for any form of Item 17-this item has been added. Loss to devices compensation,or the use of any auto an insured designed for the detection of radar or laser that can be person is driving while available for hire by the public. used to evade law enforcement is not covered. Important notices Page 7 of 13 Policy number: 1961240 775 Policy effective date: October 10,2022 Item 19-We will not cover loss to your insured auto, 0 after the purchase of another policy or binder covering the trailer or travel-trailer from a collision with another auto which was covered under your policy;or object or by upset of that auto,trailer or travel-trailer 0 in the event of a military assignment. if,at the time of the loss,the auto was being operated If your original policy has been in effect for 60 days or less,we by a licensed driver who was not listed on your Policy may cancel for reasons other than non-payment of premium. Declarations as a driver and who was either a resident However,during the first 60 days of your original policy,we of your household or a guest temporarily staying in may cancel for non-payment of premium if the reason for the your home.A person who joins your household or gets cancellation is the issuance of a check,draft,electronic a driver's license must be listed on the Policy transaction,credit card or any remittance other than cash for Declarations within 185 days.We will not apply this the premium which is dishonored upon presentation,or exclusion under certain circumstances described in honored and later reversed or dishonored,for any reason. the exclusion. Deductibles If you make an initial premium payment on your original policy Deductibles may apply under some of the coverages listed that is dishonored upon presentation,or honored and later under Protection Against Loss To The Auto. Please check the reversed or dishonored for any reason,we may deny any claim enclosed Policy Declarations for a listing of any of the above and we may void this entire policy, including any and all coverages your policy provides,and for information about any coverages hereunder. If we void the policy from its inception applicable deductibles. we will not be liable for any claims or damages that would have otherwise been covered in the absence of the non-payment of Additional Optional Coverages Allstate Offers premium. The following is a list of the optional coverages which can be After your original or renewal policy has been in effect for 60 added to your policy if you choose to do so. Please note that days,you may cancel your policy by notifying us what future adding any of these optional coverages to your policy requires date you wish to stop coverage. an additional premium.Your current policy provides only those optional coverages which are indicated on your Policy After your original policy has been in effect for 60 days,or if it Declarations. Please note that certain exclusions and is a renewal policy,Allstate will not cancel your coverage limitations may apply to each specific coverage. Deductibles during the policy period unless: may also apply to these coverages. 0 the premium is not paid when due; • Collision for Custom Equipment-Coverage CD* . there is material misrepresentation,fraud or concealment • Comprehensive for Custom Equipement-Coverage CH* of material facts; Camper Unit Coverage—We will provide coverage for your . you or any member of your household has had a driver's camper unit which is designed for use as a temporary license suspended or revoked;or living quarters.You must pay an additional premium for we have mailed you notice within the first 60 days that the this coverage,depending on which coverages are provided original policy has been in effect that we do not intend to by the policy which insures the auto on which the camper continue the policy. unit is mounted. • Lease or Loan Gap Coverage-Coverage LG We may cancel the policy for non-payment of premium when • Repair or Replacement Cost Coverage-Coverage RC due if the reason for cancellation is the issuance of a check, draft,electronic transaction,credit card or any remittance • Auto Replacement Protection-Coverage NC* other than cash for the premium which is dishonored upon • Identity Theft Coverage-Coverage IT presentation,or honored and later reversed or dishonored for • Contents Coverage-Coverage HC* any reason. o 0 *not available for Allstate Indemnity policies After your original policy has been in effect for 60 days,or if it o The Cancellation And Non-Renewal Provision of Your Auto is a renewal policy,we will give you notice as follows: • If we cancel because you did not pay the premium,we will Policy give you at least ten days notice. o During the first two months following the date of issuance or o renewal,you may not cancel your policy except: If we cancel for any reason other than non-payment of a • upon total destruction of the insured auto; premium,we will give you at least 45 days notice. £� m • upon transfer of ownership of the insured auto; o m 00 co ON m (N p, O O O Q w O_ O d O po10 � O 0 N Q Important notices Policy number: 1961240 775 WAllstate. Policy effective date: October 10,2022 Page 8 of 13 Upon expiration of the policy period,we may transfer the In the event we determine that you have been charged an policy to another insurer under the same ownership or incorrect premium for coverage requested in your application management as Allstate.We will mail you notice at least 45 for insurance,we shall immediately mail you notice of any days before the end of the policy period of our intent to additional premium due us. If within 15 days of the notice of transfer the policy and of the premium,and the specific additional premium due(or a longer time period as specified in reasons for any increase in the premium. the notice),you fail to either: If we do not intend to continue the policy beyond the current 0 pay the additional premium and maintain this policy in full policy period,we will give you notice at least 45 days before force under its original terms;or the end of the policy period. 0 cancel this policy and demand a refund of any unearned premium; We will not refuse to renew or continue this policy solely then this policy shall be cancelled effective 15 days from the because: date of the notice(or a longer time period as specified in the • You were convicted of one or more traffic violations which notice). did not involve an accident or cause revocation or How Auto Policies Are Surcharged suspension of your driving privilege unless you have been Listed below are the different surcharges we use to calculate convicted of,or plead guilty to:two such traffic violations your auto insurance premium in certain special cases: within an 18-month period;three or more such traffic Certified Risk Surcharge—We will apply a surcharge to violations within a 36-month period;or exceeding the • Bodily Injury Liability, Property Damage Liability,and lawful speed limit by more than 15 miles per hour. Personal Injury Protection coverages because of certain • You have had only one accident if we have insured the risks,for which an insured person is required to complete auto for a period of at least five years immediately and file either an"Owner's Certificate to Cover the preceding the renewal date. Described Automobile Only"or an"Operator's Certificate We will mail any cancellation or non-renewal notice to you at to Cover the Operation of Any Automobile." your address shown on the Policy Declarations.Our mailing the These certificates are usually required for risks such as notice of cancellation or non-renewal to you will be deemed past convictions of driving under the influence of drugs or proof of notice.A refund, if due,will be proportional to the time alcohol, leaving the scene of an accident, homicide or your policy has been in effect, but cancellation will be effective assault with an auto,speeding,or reckless driving. even though the refund is not made immediately. If you have any question about whether your policy has been • If you cancel,we will mail the unearned portion of any surcharged,or about any surcharges made to your policy, premium paid within 30 days after the effective date of please contact your Allstate Agent. cancellation or receipt of notice or request for cancellation, whichever is later. Discounts Available With Auto Policies • If we cancel,we will mail the unearned portion of any The following are brief descriptions of the discounts we offer if premium paid within 15 days after the effective date of you qualify and they are available for your Allstate policy.The cancellation. enclosed Policy Declarations provides a listing of all the If we mail a cancellation notice,after your policy has been in discounts which have been applied to your policy. effect for 60 days, because you did not pay the required When you originally applied for your policy,your Allstate premium when due and you then tender payment by check, Agent took the necessary information from you to give you draft,electronic transaction,credit card or other remittance both the correct rate and all of the discounts you qualified for. which is not honored upon presentation,your policy will However,your situation may have changed since then,so you terminate on the date and time shown on the cancellation may want to contact your Allstate Agent to confirm that he or notice and any notice we issue which waives the cancellation she has all the correct, updated information concerning you or reinstates coverage is void.This means that Allstate will not and your family.This way you can be sure that you are be liable under this policy for claims or damages after the date receiving all of the discounts for which you are eligible. and time indicated on the cancellation notice. Passive Restraint Discount—You may be eligible for this Any unearned premium under$5.00 will be refunded only discount if you insure an auto with airbags or factory upon your request. installed automatic motorized seatbelts. Important notices Page 9 of 13 Policy number: 1961240 775 Policy effective date: October 10,2022 0 Defensive Driver Discount—You may be eligible for this have a Renters policy with Castle Key or another Allstate discount for any auto insured under your policy,as long as affiliate. the principal operator of that auto: 0 Preferred Package Discount—You may qualify for this is at least 55 years of age;and discount if you own a residential property and insure more has voluntarily attended and successfully completed a than one auto on this policy. motor vehicle accident prevention course which is 0 Allstate Auto/Life Discounts"—You may qualify for this approved by the Florida Department of Highway discount if you are the owner, insured or payor of a Safety and Motor Vehicles;and qualifying individual life insurance policy written prior to has not had a chargeable accident in the preceding October 11,2021,or mortgage term life insurance three years.(not applicable for Allstate Property and certificate written by an Allstate Agent prior to October 11, Casualty policies) 2021. 0 Anti-Lock Brake Discount—You may be eligible for this 0 Electronic Stability Control Discount—This discount discount if you own and insure an auto which is equipped applies to vehicles equipped with electronic stability with a factory installed anti-lock braking system for control. Allstate Fire and Casualty and Allstate Property and 0 Safe Driving Club Discount—This discount is available to Casualty policies. customers who have not been in an at-fault accident for a For Allstate Indemnity policies—You may be eligible for specific period of time. this discount if you own and insure an auto which is 0 Homeowner Discount—This discount is available to our equipped with either: customers who currently own a home,townhouse, • a factory installed anti-lock brake system on all four condominium,mobile home or manufactured home for wheels,or Allstate Fire and Casualty policies. • a non-factory installed anti-lock brake system on two 0 Homeownership Discount—You may be eligible for this or four wheels. discount if you own a home,townhome,condominium or 0 Anti-Theft Discount—If you own and insure an auto which mobile home in which you reside for Allstate Property and is equipped with a qualifying anti-theft device that is Casualty policies. properly installed and maintained in working condition, For Allstate Indemnity policies—We offer a discount to you may be eligible for this discount. policies in which the insured and/or spouse is able to 0 55 and Retired Discount—This discount is offered to provide sufficient proof that he/she owns a home, drivers who are at least 55 years of age,are not presently townhome,condominium,or mobile home. gainfully employed full time or seeking full time • Smart Student Discount—This discount applies to young employment,and who meet other specifications. drivers who are unmarried, under the age of 25 and meet 0 Farm Discount—You may be eligible for this discount if certain academic and other conditions. you are a farmer. • Responsible Payer Discount—You may be eligible to 0 New Car Discount—You may qualify for this discount if receive this discount simply by paying your premium on your vehicle is a current,first prior,or next subsequent time.* model year and has not been previously titled. 0 FuIlPays""Discount—This discount is offered if you pay ' Early Signing Discount—You may be eligible for this your entire policy premium by your renewal effective discount if the application for your policy is completed date.* seven or more days before the policy effective date,and if Allstate®Easy Pay Plan Discount—This discount applies your policy has prior insurance with no lapse in coverage at when the policy premium is paid through the Allstate® New Business for Allstate Fire and Casualty and Allstate Property and Casualty policies. Easy Pay Plan.* 0 Multiple Policy Discount—You may qualify for this For Allstate Indemnity policies—You may be eligible for o discount if you currently have a Homeowners, this discount if the application for your policy is completed o Condominium Owners, Renters or Personal Umbrella three or more days before the policy effective date at New (PUP)policy with Castle Key or another Allstate affiliate Business,and if you have maintained at least six for Allstate Fire and Casualty policies. continuous months of liability insurance with no lapse in o For Allstate Property and Casualty and Allstate Indemnity coverage at New Business. a policies—You may qualify for this discount if you currently m N O m 0 co 0 NN m N p, O O O Q w O_ O d O po10 � O 0 N Q Important notices Policy number: 1961240 775 Policy effective date: October 10,2022 Page 70 of 13 • Alert Driving Discount—This discount is available to requisite proof that they are a qualified member of an customers who have not been in a non-at-fault accident for approved group. a required period of time. *This discount does NOT apply to the Allstate Fire and • Risk Avoidance Discount—Customers who have not had a Casualty Insurance Company pay as you go telematics Policy. claim under Comprehensive Coverage for a required period of time are eligible to receive this discount. Please remember that this outline contains just a brief • Drivewise*—This discount is available to customers who summary of many of the provisions of your auto policy and that participate in the Allstate Drivewise* Program. For more all coverages are subject to policy terms,conditions, information regarding the program, please contact your limitations and availability. Please consult your policy for Allstate Agent.* complete descriptions and details. If you have any questions • eSmart Discount—This discount is available to customers regarding this outline of coverage,your auto policy or your who participate in the ePolicy program.* other insurance needs,please contact your Allstate Agent. • Resident Student Discount—You may be eligible to XC7087-3 receive a discount on certain coverages if a student insured by your policy lives away at school while the car he or she drives remains at home.The Resident Student Are You Eligible for New Discounts? Discount will be applied to the car insured under your policy that is driven by a student under the age of 25 who Did you know that you may now qualify for discounts that you lives at a school,college,or other educational institution previously were not eligible to receive?For instance,in many located more than 100 miles from where the car is states,Allstate offers discounts for: garaged. • Drivers who are age 55 and older who are no longer TM • teenSMART Discount—You may qualify for this working; discount if an operator insured on your policy is under the age of 21 and has successfully completed the 0Young drivers,including students under the age of 25; teenSMARTT""program. 0 Drivers who have completed approved driver training • Good Student Discount—You may be eligible for this courses;and discount if the rated vehicle operator is unmarried, less . Drivers who also insure their homes with Allstate. than age 25,and meets certain academic requirements and other qualifications. Please contact your Allstate representative for additional • Premier Discount—This discount applies to drivers who information about discount qualifications,as well as other have been accident and violation free for 3 years and meet discounts that may be available. other qualifications. X67094-1 • Premier Plus Discount—This discount applies to drivers who have been accident and violation free for 5 years and meet other qualifications. Other Allstate Companies also offer • Utility Discount—This discount is available for most automobile insurance—giving you pick-up trucks. • Performance Discount—You may be eligible to receive a additional protection options discount on certain coverages such as Bodily Injury, Personal Property Damage Liability Insurance,Automobile We want to make sure you know that automobile insurance is Medical Payments,Auto Collision Insurance,Auto available from different Allstate-branded companies—each Comprehensive Insurance,and Personal Injury Protection with its own mix of price and coverage options.Although your if you meet the eligibility requirements. Please contact current policy is with Allstate Property and Casualty Insurance your agent for more details on how you may qualify. Company,automobile coverage from another Allstate-branded • Loyalty Discount—You will be eligible for this discount if company can differ from your current policy in a number of your policy remains active with Allstate Indemnity ways, including: Company with no lapse in coverage during the preceding . Price policy term. 0 Coverage • The Good Hands People*Discount—This discount . Features applies when the named insured or spouse provides 0 Discounts Important notices Page 77 of 13 Policy number: 1961240 775 Policy effective date: October 10,2022 Things TO Consider When Comparing Insurance member of your family whose operation of an insured Policies vehicle results in injuries to you or a resident relative,and When comparing different policies,you may want to consider ' An underinsured motor vehicle which includes a motor the following: vehicle whose liability limits are less than the amount of ' Price-While another company may offer a lower premium the damages the insured person is legally entitled torecover. today,the premium could change in the future. Be sure to consider this. What Are Your Available Uninsured Motorists ' Policy Features and Benefits -Some of the policy features Insurance Options? and benefits that your current policy has may not be 1. You may select Uninsured Motorists Insurance in an available or carry over to the new company.Also,the new amount equal to your limits for bodily injury liability. policy might not provide the same level of benefits as your 2. You may select Uninsured Motorists limits which are lower current policy.And if you leave Allstate Property and than your bodily injury liability limits. Casualty Insurance Company,you will not be able to return 3. Or,you may reject Uninsured Motorists Insurance. to that company or get the same rate. Your Allstate Agent Can Help Non-Stacked and Stacked Coverage Options Your Allstate Agent is here and can discuss any options you Your Policy Declarations show whether you have non-stacked might be interested in.We want to thank you again for or stacked Uninsured Motorists Insurance. choosing Allstate to protect what's important to you. With non-stacked coverage,your Uninsured Motorists X73000v2 Insurance limits(if any)will not be added together to pay for damages you sustain in an accident.Therefore, if you are injured in a vehicle insured under your policy, Uninsured Important Information About Uninsured Motorists Insurance provides you with protection only to the Motorists Insurance extent of your coverage limits shown on your Policy Declarations for that vehicle. If you are injured in someone Please refer to the Uninsured Motorists Insurance limits on the else's vehicle,or you are struck as a pedestrian,you may select attached Policy Declarations.And please read the information the highest limits for Uninsured Motorists Insurance available below regarding Uninsured Motorists Insurance to determine if on any one vehicle insured under your policy.You pay a you have the type of coverage you want. reduced rate for non-stacked coverage compared to stacked coverage. What Does Uninsured Motorists Insurance Offer? With stacked coverage,your Uninsured Motorists Insurance Uninsured Motorists Insurance provides protection,subject to limits for each vehicle insured under your policy are added the terms and conditions of your policy,for bodily injury together(stacked)to pay for damages you sustain in an sustained in an accident caused by the driver of an uninsured accident.Thus,the Uninsured Motorists Insurance limits motor vehicle which includes: available to you would automatically change during the policy ' Motor Vehicles with no liability insurance in effect at the period if you increase or decrease the number of vehicles time of the accident, insured under your policy. ' Hit-and-run motor vehicles, Please contact your Allstate agent or contact us at 1-800 ' Motor vehicles insured by insurance companies that deny Allstate® (1-800-255-7828)if you would like to change any of your coverage options or if you have any questions about o coverage, Uninsured Motorists Insurance.We can help you determine o ' Motor vehicles insured by insurance companies that what coverages are available so you can select the coverage of o become insolvent within 4 years from the date of the your choice. o accident(this coverage is excess over any obligations (ed.06/2022) assumed by the Florida Insurance Guaranty Association to X5402-2 0 pay claims), a N ' An insured motor vehicle when the liability insurer thereof m excludes liability coverage to a person who is not a o m 0 co 0 NN m N p, O O O Q w O_ O d O po10 � O 0 N Q Important notices Policy number: 1961240 775 Q)Allstate. Policy effective date: October 10,2022 Page 72 of 13 State-Required Information Regarding factors,including any policy changes you might make,can also Mandatory Insurance Coverage affect the amount of your premium. You can learn more by visiting allstate.com. If you'd like us to This notice is being provided for your information only. It's use updated credit information to determine your premium, important that you understand what will happen if your auto please call your agent. policy is cancelled or non-renewed,or if you let your coverage X67520-2 lapse. If you have any questions after reading this notice, please do not hesitate to contact your agent. We are obligated by law to report the cancellation or non-renewal of any auto policy which provides personal injury protection benefits to the Florida Department of Highway Safety and Motor Vehicles. If you fail to maintain personal injury protection and property damage liability insurance on a motor vehicle when required by law,you may lose your registration and driving privileges in the state. If your registration and driving privileges are suspended,you may reinstate them by obtaining an auto insurance policy which includes personal injury protection coverage and property damage liability insurance,as required by law,and paying a nonrefundable reinstatement fee of$150.00.This fee will increase to$250.00 for a second reinstatement,and to $500.00 for each reinstatement after the second during the three years following the first reinstatement. The coverages and the coverage limits currently provided by your policy are listed on the enclosed Policy Declarations. Please review your coverage information,and if you have any questions about your policy or your insurance coverage in general, please contact your agent. X6988 You May Request That We Reorder Your Credit Report Like many insurance companies,when we consider your eligibility for coverage,we review your credit report and base your premium partly on this information. We reorder your credit report(s)every two years, but if you would like us to use updated credit information to determine your premium,you can request that we order it sooner. The rate for your premium will only decrease or remain the same if we reorder your credit report. If your credit history has improved,we will adjust your premium. Please be aware that, depending on when you request a credit reorder,we may not be able to apply any premium change to this policy renewal; if so, it will take effect at your next policy renewal.Several 0 0 0 0 0 0 0 0 0 N m N O m O00 � m N p0 O O O Q w O_ O d O 00 10 10 O O N Q 2021 Edition MONROE COUNTY, FLORIDA REQUEST FOR WAIVER OF INSURANCE REQUIREMENTS It is requested that the insurance requirements, as specified in the County's Schedule of Insurance Requirements,be waived or modified on the following contract. Contractor/Vendor: Terramar Environmental Services,inc. Project or Service: Updates of 2009 Geospatial Land Cover Dataset and Tier Overlay District Maps for the Florida Keys Contractor/Vendor Address&Phone#: 1241 Crane Blvd., Sugarloaf key, FI 33042 General Scope of Work: Support County efforts to update LULC mapping over the Keys. Support re-mapping of Tier designations,and support public review of proposed tier changes through participation in the Tier Development Review Committee(TDRC). Reason for Waiver or Commercial auto insurance is not available. Instead,vendor has provided a Business Modification: Automobile Policy with$1,000,000 per occurrence, meeting or exceeding the auto insurance requirements of the contract. Policies Waiver or Modification will apply to: The requirement for Commercial Auto Liability Insurance. Signature of Contractor/Vendor: �j ;A.,�Q, �� Vice President Date: Approved Not Approved Risk Management Signature._ Date: 12/�,/2t129. County Administrator appeal: Approved: Not Approved: Date: Board of County Commissioners appeal: Approved: Not Approved: Meeting Date: Administrative Instruction 7500.9 104 O� � a JIMMY PATRONIS CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION ** CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW NON-CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 3/4/2021 EXPIRATION DATE: 3/4/2023 PERSON: PHILIP A FRANK EMAIL: TERRAMAR.ENV@GMAIL.COM FEIN: 201899329 BUSINESS NAME AND ADDRESS: TERRAMAR ENVIRONMENTAL SERVICES, INC. 1241 CRANE BOULEVARD SUMMERLAND KEY, FL 33042 SCOPE OF BUSINESS OR TRADE: Architectural or Engineering Firm-Including Salespersons &Drivers IMPORTANT:Pursuant to subsection 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to subsection 440.05(12),F.S.,Certificates of election to be exempt issued under subsection(3)shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to subsection 440.05(13),F.S.,notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01309540 QUESTIONS?(850)413-1609 O� � a JIMMY PATRONIS CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS' COMPENSATION ** CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS' COMPENSATION LAW NON-CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers' Compensation law. EFFECTIVE DATE: 4/29/2021 EXPIRATION DATE: 4/29/2023 PERSON: ROWENA P GARCIA EMAIL: ROWENAFRANK@GMAIL.COM FEIN: 201899329 BUSINESS NAME AND ADDRESS: TERRAMAR ENVIRONMENTAL SERVICES, INC. 1241 CRANE BOULEVARD SUMMERLAND KEY, FL 33042 SCOPE OF BUSINESS OR TRADE: Architectural or Engineering Firm-Including Salespersons &Drivers IMPORTANT:Pursuant to subsection 440.05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to subsection 440.05(12),F.S.,Certificates of election to be exempt issued under subsection(3)shall apply only to the corporate officer named on the notice of election to be exempt and apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to subsection 440.05(13),F.S.,notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section. DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 E01300441 QUESTIONS?(850)413-1609