93-24 Attachment.pdf

GPI —. ACCORD’ CERTIFICATE OF LIABILITY INSURANCE oan 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 GERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER, IMPORTANT: If tho certificaie holder is an ADDITIONAL INSURED, the policy(ies) must have ADDITIONAL INSURED provisions or be endorsed. tf SUBROGATION IS WAIVED, subject to the terms and concitions of the policy, certain pollcios may require an endorsement. A statement on this cartificato does not confer rights to the certificate holder in ligu of such endorsements). FeoouceR SRI ot Rozaray SS: NEW INDE PARK RO [i2Moveny ste-a00-s720 TE nn 516-470-0008 SUITE 409 Abuness. ikozarsky@gerallarp com NEW HYDE PARK NY 11042 INSURER(3) AFFORDING COVERAGE, __ | wes insureR A: XL Spacisty Insurance Company 37886 isURED GREEN ener a Everest Nalional Insurance Comoany __19120 Greenman Pedersen, nc. Moms Plans) ices NO Demdaco Ca 27740 Moris Plains NJ 07980 [isuren 0: OBE Inuanee Coxporaton 99217 [isusene. Stonington Insurance Company —~—SSS*dt tao nausea Allied Wore Assurance Company (J 5) ine 10400 COVERAGES: CERTIFICATE NUMBER: 1051438221 REVISION NUMBER: THiS IS TO GERTIV THAT THE POLICIES OF INSURANGE LISTED BELOW RAVE BEEN ISSUED TO THE INSURED NAMED ASOVE FOR THE POLIGY PERIOD INDICATED. NOTWITHSTANDING ANY R=QUREMENT. TERM OR CONDITION OF ANY CONTRAGT OR OTHER DOCUMENT 'N'TH RESPECT TO WHICH THIS WAY OE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. AIM, OEATIFICA EXCLUSIONS AND CONDITIONS GF SUCH POLIGIES, LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID G ira Rea Souererr | POuGr Exe hia TPE Or NaURANCE ae POLY NUMBER I DX SOMNARCIAL GENERAL UARALTY Tri0eoTss raaianaa | 123ice2 | eaoreconmence cramsane X] oocua, PREMges ee nr NED EXP Ary cre seen [$10,000 AJ PemsovaLangviewuey | $1000.00 (GEN. AGGREGATE UMT APPLIES PER: gexera,acenscare | 940000.000 powcr X SBR |X| Loe. PROOUGTS-coupIEP AGS | $4,000,000 omnes | 3 © _AVTOMORLLELIASRITY TaI0GT TT Taraianes | 1aaweane 37 000.060 X ANeauTo BODILY INNIFY (ai prerp [ 8 aneD Pos EODILY INJURY Par accor | § ines at

|X| Loe. PROOUGTS-coupIEP AGS | $4,000,000 omnes | 3 © _AVTOMORLLELIASRITY TaI0GT TT Taraianes | 1aaweane 37 000.060 X ANeauTo BODILY INNIFY (ai prerp [ 8 aneD Pos EODILY INJURY Par accor | § ines at PROPERTY OAPACE 7 Mreseur a femaae BX WORELAUAS ooo KESCUNOSTA2 TaRi2023 | 12512024 | exci cocunnence 35,600,000 PACES UAB cians made | AGGREGATE 5.00000 ep _™ _seteNTIONS io.om0. | s warmers cournan oH 7 ies | Testes XE ae |S © Wortens eourewsaTe as 52000788 ‘ersirenas | tersimnze [X_] Eure 1_1ee snrpterneroRaAren cHcCUTVE evesstacaoenr [31.900 000 SEERA ISeR SED yes Lan EL EIgEAse -£A euProvet] 91 900 200 obet TBR OPERATIONS boo EL scat .Pouy une [ $1 900 9c0 SP ‘UMpocezzeonnaaa Taare | rasp | vase Papen 3150009 FP Prakaed bet, rere sprairanas | Tereizare | Exh lar oaiero1e aravrenrs | ‘anieaes | penta Bano ‘DESCRIPTION OF OFERATIONS LOCATIONS VEHICLES (ACORD 104, Adaional Remarks Schedule, ay be aachad mere space ms reauled) CERTIFICATE HOLDER, CANCELLATION 20 day notice apples S A M P L E ‘SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Euan eke ne sere FOR INFORMATIONAL ae ae PURPOSES ONLY We ben © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2046/03) The ACORD name and logo are registered marks of ACORD Sample Insurance Certificate | Page 8