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

—_—™ —— ACORD’_ CERTIFICATE OF LIABILITY INSURANCE —* 3/3/2022 REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to certificate holder in lieu of si the terms and conditions of the policy, certain Policies may require an endorsement. A statement on this certificate does not confer rights to the uch endorsement(s). — flagh BouTAcr ritton Gallagher 7 One Govaland Center, Floor 30 [ HONE, oxy. 216-658-7100 TIBE, nor 216-658-7104 Street ADDRESS: Cleveland OH 44414 INSURER(S) AFFORDING COVERAGE | nace INSURER A: Everest National Insurance Company [40120 INSURED 8546) a Gar den s = irewo rks Inc. a 8: fiss Surplus Insurance Company _|___ 26620 atiton Roa E _ Millington NJ 07946 INSURER D : INSURER E = 1 INSURER F : i COVERAGES CERTIFICATE NUMBER: 1636441566 REVISION NUMBER: THIS 18 TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD f Lpoucy |_| 589° ea TYPE OF INSURANCE snl ul POLICY NUMBER caMiBBI 9 | cARIDBN TE Lars 7 _ GENERAL LIABILITY i leacHaccurREeNce | {__LeowMeRci. GENERAL ABILITY | H i (PRNBES es cccuoa) i H {MED EXP (Any one person) H PERSONAL & ADV INJURY | Se ee i GENERAL AGGREGATE. | GENL AGGREGATE, LIMIT APPLIES PER: PRODUCTS - COMP/OP AG‘ Loc. > IBINED SINC ‘OMIT ‘SIBCAOD125-221 anie02. ariz023 | FOMBINED SINGLE BODILY INJURY (Per person) | BODILY INJURY (Per accident) | PROPERTY DAMAGE | Peraccident) B P-01-000087442-04 j anveoz2 si2a23 | EACH OCCURRENCE $5,000,000 pas hahaa AGGREGATE $5,000,000 tt DED ¢ | RETENTIONS S$ T WORKERS COMPENSATION T We STAT. | [Or | AND EMPLOYERS’ LIABILITY vin —LTORYIMTSi PERE | ANY PROPRIETORIPARTN! i | EL. EACH ACCIDENT is ICERIMEMBER EXCLUDED? NIA } - i [Menitztony in bn} ; (EL DISEASE -EA EMPLOYEE) § | ltyes, deseribe under i | DESGRIPTION OS OPERATIONS below i | e1 pisease-Poucy unr | § | DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (Attach ACORD 101, Additfonal Remarks Schedule, if mote space Is required) CERTIFICATE HOLDER CANCELLATION Municipal Excess Liability Joint Insurance Fund 9 Campus Drive Suite 16 AUTHORIZED REPRESENTATIVE. Parsippany NJ 07054 vy ‘SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED

e Fund 9 Campus Drive Suite 16 AUTHORIZED REPRESENTATIVE. Parsippany NJ 07054 vy ‘SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANGE WITH THE POLICY PROVISIONS. AGORD 25 (2040/05) © 1988-2010 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD