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

= CERTIFICATE OF LIABILITY INSURANCE avats 03/17/2022 , 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 IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED Provisions or be endorsed. If SUBROGATION IS WAIVED, subject to the terms and Conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT COVER ME INS AGcY OF NZ Nae oe 610-618 W ST GEORGE (AIC, No, Ext}: (AIC, No}: ADDRESS: AbD! Zi LINDEN NI 07036 2953M INSURER(S) AFFORDING COVERAGE Nace INSURERAST. PAUL PROTECTIVE INSURANCE COMPANY INSURED INSURER B: GARDEN STATE FIREWORKS Inc : PO BOX 403 INSURER C: MILLINGTON NI 07946 INSURER 0: INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: REDUCED BY PAID CLAIMS. NSA [ADDL] SUBR] POLICY EFF | POLIGY EXP LTR] TYPE OF INSURANCE Insp | wv POLICY NUMBER (MMW/DDIVYYY) |(mMDDIVYYY) LiniTs COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE s DAMAGE TO RENTED |] evams.mape [occur PREMISES (Ea cccurrence) _|S MED EXP (Any one person) |S PERSONAL & ADV INJURY |S GENL AGGREGATE LIMIT APPLIES PER: GENERAL s BEECH | prosecr mr PRODUCTS — COMPIOP AGG |S s COMBINED SINGLE LinTT |AUTOMOBILE LIABILITY ay 5 [Tany auro JBODILY INJURY (Per person)_|s [—Jowneo autos SCHEDULED BODILY INJURY (Per accident) |S [hive auras \UTOS PROPERTY DAMAGE f—jONLY ADTOS ONES (Per accident) Ss is UMBRELLA LIAB ‘occur EACH OCCURRENCE Is EXCESS LIAB CLAIMS-MADE JAGGREGATE Is Deol [RETENTION § - Is WORKERS COMPENSATION PER A] 3 | AND EMPLOYERS LIABILITY (6SPPUB-6R28552-7-22) 03-01-22 |o3-o1-23 |*_[sranre_| [en ANY PROPRIETORIPARTNERIEXECUTIVE 1,000,000 OFFICER/MEMBER EXCLUDED? Yin} E.L. EACH ACCIDENT s 1,000, (Mandatory in NH) [Ly] na} ELDISEASE-EA EMPLOYEE|s 1,000,000 Ityes, déscribe under DESCRIPTION OF OPERATIONS below E.L. DISEASE—POLICy uMiT}s 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is

cribe under DESCRIPTION OF OPERATIONS below E.L. DISEASE—POLICy uMiT}s 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONSIVEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION ‘SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE MUNICIPAL EXCESS LIABILITY POLICY PROVISIONS. JOINT INSURANCE FUND | AUTHORIZED REPRESENTATIVE 9 CAMPUS DR, STE 16 PARSIPPANY Ng 07054 i) i e1988-201fAcoRD CPRPORATION. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD (Rev. 09-18) Allrights reserved.