294-22 Korwell PS-Proposals.pdf

e DATE (MM/DD/YYYY) ACORD CERTIFICATE OF LIABILITY INSURANCE ‘ ' 3/1/2022 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 Names” Tina Taran Dale Group BuO, cx 973-377-7000 _ (6, oy 973-377-4614 Florham Park NJ 07932 RouKess:_tinat@dalegroup.com ; INSURER(S) AFFORDING COVERAGE NAIC # | ee INSURER A: Continental Casualty Company 20443 nee Goneottna Ehasine 71 isurer 8 : National Fire & Marine Insurance Company 20079 96 Hwy RT 206 Suite 101 InsuRER C: Valley Forge Insurance Company 20508 Flanders NJ 07836 ivsureR D : Continental Insurance Company Of New Jersey 42625 | insurer E: HSB Specialty Insurance Company 14438 | INSURER F COVERAGES CERTIFICATE NUMBER: 1784385551 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 [ADDL/SUBR| | POLICY EXP LR TYPE OF INSURANCE INSD | wvD POLICY NUMBER [ian (MMIDDIYYYY) LIMITS ‘A |X | COMMERCIAL GENERAL LIABILITY y | ¥ | 7018338493 | 21242022 | 2/24/2023 | each occURRENCE $1,000,000 x] | DAMAGE TO RENTED ‘CLAIMS-MADE OCCUR | PREMISES (Ea occurrence) _ $ 300,000 Contractual Liab | MED EXP (Any one person) | $ 10,000 | mieiparion) | $10,000_ | | PERSONAL & ADVINJURY | § 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER | | | GENERAL AGGREGATE $2,000,000 pouicy | X | SBS: | Loc |

iab | MED EXP (Any one person) | $ 10,000 | mieiparion) | $10,000_ | | PERSONAL & ADVINJURY | § 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER | | | GENERAL AGGREGATE $2,000,000 pouicy | X | SBS: | Loc | PRODUCTS - COMP/OP AGG _ $ 2,000,000 OTHER: | § B | AUTOMOBILELIABILITY Y | ¥ | 7018333701 | 2124/2022 | 2/24/2023 | COMBINED SINGLE LIMIT” | § 1,000,000 X | ANY AUTO | BODILY INJURY (Per person) | $ OWNED SCHEDULED a AUTOS ONLY AUTOS | BODILY INJURY (Per accident) $ HIRED X | NON-OWNED | PROPERTY DAMAGE 7 ‘AUTOS ONLY AUTOS ONLY | (Per accident) | | 5 & |X| UMBRELLALIA8 | X | occur y | ¥ | 7018338493 | 2reai2022 | 2/24/2023 | Exc OCCURRENCE 3 10,000,000 \*) *| | | LEAGHOGCURRENGE) __| EXCESS LIAB CLAIMS-MADE | AGGREGATE $ 10,000,000 oe0 _X | RETENTIONS 9 | c|WORKERS COMPENSATION 7018333715 | 22022 | weareoza |X [EER ure | | Se AND EMPLOYERS LIABILITY | STATUTE | ER | ANYPROPRIETOR/PARTNERIEXECUTIVE | E.L. EACH ACCIDENT $1,000,000 OFFICERMMEMBEREXCLUDED? = (Mandatory in NH) | ELL. DISEASE - EA EMPLOYEE, $ 1,000,000 tyes, describe und — DESCRIPTION OF OPERATIONS below | EL. DISEASE - POLICY LIMIT _$ 1,000,000 D | Professional Liab ‘AEH004316497 2124/2022 | 2/24/2023 | Claim/Occurence $5,000,000 D | Pollution Liabiity AEHQ04316497 2124/2022 | 2/24/2023 | Aggregate $5,000,000 E | Cyber Liability 660757102 2/24/2022 | 2/24/2023 | Limit $1,000,000 | | DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) Evidence of Insurance 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 POLICY PROVISIONS. Evidence of Insurance AUTHORIZED REPRESENTATIVE © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD