Supporting Documentation · Aug 7, 2018
180-18 Exhibit A - Fireworks at Rock Spring at Montclair Golf Club for Labor Day Celebration - 2018.pdf
200fe9186ba996a2ecc3b0e70a8f741c8cf1c52e96a01e7ea4315b2a7d3a3415Indexed text · page 9
Show all pages— Ye ACORD a ‘DATE (MMIODIYYYY) CERTIFICATE OF LIABILITY INSURANCE 610512017 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY ‘AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS THIS CERTIFICATE OF INSUI COVERAGE AFFORDED BY THE POLICIES BELOW, AUTHORIZED EXTEND OR ALTER THE IRANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDE! IMPORTANT: If the certificate holder is ADDITIONAL INSURED, the policy(ies) must be endorsed. terms and conditions of the policy, certain policies may require an endorsement. A statement on Tf SUBROGATION IS WAIVE! ‘subject to the is certificate does not confer rights to the certificate holder in lieu of such endorsement{s). PRODUCER 2. ne" MICHAEL J. POLLER COVER ME INSURANCE AGENCY OF NJ, INC. Ff eu, 908-587-2500 TFBS, ney 908-587-1681 610.618 W. ST. GEORGES AVENUE : LINDEN, NJ 07036 __INSURER(S) AFFORDING COVERAGE 5 NAIC a PH: 908-587~2500 FAX: 908-587-1681 INSURER A: TRAVELERS INSURANCE CO. INSURED INSURER 8: GARDEN STATE FIREWORKS, INC. INSURER © P,O.BOX 403 INSURER 0: MILLINGTON, NJ 07948 INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 771689 REVISION NUMBER; Fis IS TO CERTIFY INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY THAT THE POLICIES OF INSURANCE TISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ‘ABOVE FOR ‘OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH SNSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT HAVE BEEN REDUCED BY PAID CLAIMS. THe POLICY PERIOD RESPECT TO WHICH THIS TO ALL THE TERMS, INR TYPE OF INSURANCE eae POLICY NUMBER Finan LIMITS COMMERCIAL GENERAL LIABILTY EACH OCCURRENCE A |_| _] cuaims.mace occur BES crcatrence) | s |_| MED EXP (Any one person)_| $ |_| PERSONAL & ADV INJURY _|$ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE __|$ poucy |_] SBS mi PRODUCTS - COMPIOP AGG | $ ___|__Lomer: $ AUTOMOBILE LIABILITY Qa ts (| AMY AUTO BODILY INJURY (Per person) | $ |_| AeeyNe? Royegutee BODILY INJURY (Por accident| |_| nireo Autos noregyne? oe ee s 3 UMBRELLA LIAB OocUR EACH OCCURRENCE s |__| excess L1ag CLAIMS-MADE] AGGREGATE. $ ozo] | Retentions: 5 ice gr ee XT Eiiiae 1_TE A | ANY PROPRIETORIPARTNERMEXECUT weal 2£870369UB 6/10/2017 | 6/10/2018 | EL EACH ACCIDENT s
EACH OCCURRENCE s |__| excess L1ag CLAIMS-MADE] AGGREGATE. $ ozo] | Retentions: 5 ice gr ee XT Eiiiae 1_TE A | ANY PROPRIETORIPARTNERMEXECUT weal 2£870369UB 6/10/2017 | 6/10/2018 | EL EACH ACCIDENT s 1,000.000 OFstGSen in Nee ail EL DISEASE - EA EMPLOYEH S 4,000,000 te Gate ade anions blow EL owease-poucyumm [s 1,000,000 SESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, ‘Additional Remarks Schedule, | LONGSHOREMEN'S L&H COVERAGE - ADDED EFFECTIVE: 07/07/2015 Tay be attached If mare spaca Is required) | CANCELLATION CERTIFICATE HOLDER rc MUNICIPAL EXCESS LIABILITY JOINT INSURANCE FUND 9 CAMPUS DR., STE. 16 PARSIPPANY, NJ 07054 1 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 ACORD 25 (2014/01) @ 1588-2014 ACORD CORPORATION. All rights raserved, The AGORD name and logo are registered marks of ACORD
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