163-22 Exhibit - Fireworks at Montclair Golf Club - 2022.pdf

4coniy! CERTIFICATE OF LIABILITY INSURANCE yosjez 03/03/22 THIS CERTIFICATE IS ISSUED AS A MATTER CERTIFICATE DOES NOT AFFIRMATIVE! 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 ndorsement(s). PRODUGER Ras DRAYTON INSURANCE BROKERS INC PHONE (205)854-5806 I FAX (205)854-5899 2500 Center Point Rd #301 cuits. Beorgine@draytonins.com Birmingham, AL 35215 INSURER{S) AFFORDING COVERAGE NAICS insurer a: ADMIRAL INSURANCE COMPANY 24856 INSURED —_ Garden State Fireworks, Inc. INSURER 8: New Vernon Fireworks INSURER: P.O, Box 403 INSURER D: Millington, NJ 07946 INSURER E- INSURERE: COVERAGES CERTIFICATE NUMBER: REVISION_NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ASOVE 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. mE PROD POLICY EFF TOV EXE, ue TYPE OF INSURANCE ssp | wo POLICY NUMBER wanvoon vv lanai Luis X | COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s_5,000,000 DAMAGE TO RENTED | camsmace [3X] occur PREMISES (ea aseurence) 18 100,000 MED EXP (Anyone person) |S __ NONE SS 1s 4/2: A cA000016477-11 8/9/22 8/1/23 eensona. aaovnwuey ]s 5,000,000 fe GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $10,000,000 XJ poucy |_] 58 Loc pRooucts-covpror ass | s 6,000,000 OTHER: si "AUTOMOBILE LIABILITY SNBINED SINGLELINIT |g ANYAUTO BODILY INJURY (Perperson) | § f 7] owen. SCHEDULED x fo une ay ‘SCHED BODILY INJURY (Peraccident) | § HIRED NON-OWNED ROPERTY DAMAGE ry foe} AUTOS ONLY ‘AUTOS ONLY [er accident) 5 |__| UMBRELLA LIAB occur EACH OCCURRENCE $ EXCESS LIAB cLams.mape| AGGREGATE s veo | Trerenmiow: = os WORKERS COMPENSATION iN gine ‘AND EMPLOYERS’ LIABILITY iAure |_| es ANY PROPRIETORIPARTNERMEXECUTIVE EL cach accioenr. s aracemrsaaapee= C4, {Mandatory In NH) EL DISEASE - EA

s veo | Trerenmiow: = os WORKERS COMPENSATION iN gine ‘AND EMPLOYERS’ LIABILITY iAure |_| es ANY PROPRIETORIPARTNERMEXECUTIVE EL cach accioenr. s aracemrsaaapee= C4, {Mandatory In NH) EL DISEASE - EA EMPLOYEE | § Iyes, dascrive under DESCRIPTION OF OPERATIONS peloy E.L. DISEASE - POLICY LINIT DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Adcitional Remarks Schedule, may be altachedif more space is required) ERTIFICATE HOLDER CANCELLATION, ‘ij iabilit ‘SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE. Muntelpal Exenss Liability Joint THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Insurance Fund ACCORDANCE WITH THE POLICY PROVISIONS. 9 Campus Drive, Suite 16 Parsippany, NJ 07054 AUTHORIZED REPRESENTATIVE © 1988-21 ‘CORD CORPORATION. All rights 1 ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACGRD