315-24 Attachment.pdf

12/19/2023 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. —_ ACORD CERTIFICATE OF LIABILITY INSURANCE oe wunon 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 endorsementis). PRODUCER Satie" Jeff Kozarsky PG Genatt Group LLC PHONE Fax 3333 NEW HYDE PARK RD AGH ext): 516-869-8788 (AC, No): 516-470-0338 SUITE 409 AovREss: jkozarsky@genattgrp.com NEW HYDE PARK NY 11042 INSURER(S) AFFORDING COVERAGE Nace insurer A - XL Specialty Insurance Company 37885 WEURED CREEXWAN] wsurer 8: Everest National Insurance Company 40120 Sueenman Pedersen, inc. (Morris Plains) isurcr c: North Pointe Insurance Company 27740 Morris Plains Nu 07950 insurer o: QBE Insurance Corporation 30217 suger € : Stonington Insurance Compan 10340 nsuRER Fr: Allied World Assurance Company (U.S. Inc. 19489 COVERAGES: CERTIFICATE NUMBER: 1051436221 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLIGY 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 EFF | POLIGY EXP. ri TYPE OF INSURANCE (NSD. WD POLICY NUMBER (mMODNYYY) Mao LMT DX | COMMERCIAL GENERAL LIABILITY 1771000795 12/91/2023 | 12/91/2024 | eAGH OOGURRENGE $2,000,000 DAMAGE TO RENTEI cLamsvape _% | occur PREM ng $500,000 MED EXP (Any one person) $10,000) PERSONAL &ADVINJURY $1,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE __ $4,000,000 poucy LX fee; LX] Loc PRODUCTS.

cLamsvape _% | occur PREM ng $500,000 MED EXP (Any one person) $10,000) PERSONAL &ADVINJURY $1,000,000 GENL AGGREGATE LIMIT APPLIES PER GENERAL AGGREGATE __ $4,000,000 poucy LX fee; LX] Loc PRODUCTS. COMPIOP AGG _$ 4,000,000 OTHER, s (© AUTOMOBILE LIABILITY 161001112 i2rai2023 | 1212024 | COMBINED SING-E LIMIT $2,000,000 X | ANvauro BODILY INJURY (Per pewson) OWNED SCHEDULED AUTOS ONLY Auros BODILY INJURY (Por accion) x | hReD. X | NON-OWNED PROPERTY DAMAGE + AUTOS ONLY AUTOS ONLY {Per asautent $ BX | UMBRELLALIAB XJ occur XC5CU00324231 7273172023 | 1279712024 | eacM OCCURRENCE $5,000,000 EXCESS LIAB CCLAIMS- MADE! AGGREGATE $5,000,000 ep | X | aetewTions 10.000 [WORKERS COMPENSATION 715200076: yarsi2023 | 121372024 |X Sen rr AND EMPLOYERS’ LIABILITY vin 7000785 fouiza2s | 1210 stature __Ler. ANYPROPRIETORIPARTNERIEXECUTIVE EL EACH ACCIDENT $4,000,000 OrFICcENMEMBEREXCLUDED? NIA {Mandatory in NH) EL DISEASE FA EMPLOYEE § 1,000,000 If yee, doseribo uncer DESCRIPTION OF OPERATIONS below LL DISEASE -POLIGY UMIT_$ 1,000,000 A Proserty UMOG082200NAZ3A 7213112023 | 1273112024 | Valuable Paoers $150,000 FPlessional Uebity 03141018 12/31/2023 | 12/31/2024 | Lac Cian $2,000,000 Aagregste $200,000 DESCRIPTION OF OPERATIONS / LOCATIONS | VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) CERTIFICATE HOLDER CANCELLATION 30 day notice applies SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. FOR INFORMATIONAL TT PURPOSES ONLY Wl. la— ‘© 1988-2015 ACORD CORPORATION. Ail rights reserved. CORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD