Supporting Documentation · Aug 12, 2025
188-25 Exhibit A_GPI_WO Agreement Contract.pdf
c29566122c16f79c08f46bc0d8cb34308d36df25a00ca9218add6c33a8fad493Indexed text · page 68
Show all pagesa) ACORD CERTIFICATE OF LIABILITY INSURANCE seeaanren 8/7/2025 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 Same." Alyson Graziosi Boa NEW ENE PARK RD | fale No, Ext 516-869-8788 TA, no): 516-470-0338 SUITE 409 | RODMESs: agraziosi@erparp.com NEW HYDE PARK NY 11042 | INSURER(S) AFFORDING COVERAGE NACH | __| insurer a: XL Specialty Insurance Company 37885 INSURED GREENMAN) insurer B : Everest National Insurance Company 10120 Seen edema Ine 3 (New Jersey) insurer ¢ : North Pointe Insurance Company 27740 Shelton CT 08484 INsuRERD: QBE Insurance Corporation 39217 INSURER E: Allied World Assurance Company (U.S.) Inc. 19489 insurer F : Praetorian Insurance Company 37257 COVERAGES CERTIFICATE NUMBER: 724096268 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. WHR "ADDL|SUBR| POLICY EFF | POLICY EXP NER ‘TYPE OF INSURANCE INSD | WvD_ POLICY NUMBER (MM/DBIYYYY) | (MMUDDIVYYY) LIMITS: D | X | COMMERCIAL GENERAL LIABILITY y | 175000033 12/91/2024 | 12/31/2025 | cach OCCURRENCE $2,000,000 DAMAGE TO RENTED | | cLaIMs-MADE ‘occur PREMISES (Ea occurence) | $600,000 | MED EXP (Any one person) | $10,000 = ae eee PERSONAL & ADV INJURY _ | § 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE
ENTED | | cLaIMs-MADE ‘occur PREMISES (Ea occurence) | $600,000 | MED EXP (Any one person) | $10,000 = ae eee PERSONAL & ADV INJURY _ | § 1,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $4,000,000 poucy | X | SB% | X | toc PRODUCTS - COMP/OP AGG | $4,000,000 OTHER: $ © | AUTOMOBILE LIABILITY 7 485000040 42rat/2024 | 12/31/2025 | ROMBINEDSINGLELIMIT | $2,000,000 X ] ANY auto BODILY INJURY (Per person) | § / | ownen SCHEDULED SHNED scHen BODILY INJURY (Per accident)| § rx | HIRED | NON-GWNED PROPERTY DAMAGE ' AUTOS ONLY AUTOS ONLY (Por accidont) s B | X | UMBRELLA LIAB X | occur Y XC5CU00324241 12/31/2024 | 12/31/2025 | EACH OCCURRENCE $5,000,000 EXCESS LIAB CLAIMS-MADE: AGGREGATE $5,000,000 ep | X | revenTIONs sono WORKERS COMPENSATION 155000038 r2rav2024 | 127312025 |X [Eure | [eee AND EMPLOYERS’ LIABILITY vin ER ANYPROPRIETOR/PARTNER/EXECUTIVE ELL EACH ACCIDENT $1,000,000 OFFICERIMEMBEREXCLUDED? NIA (Mandatory in NH | EL DISEASE - EA EMPLOYEE! $ 1,000,000 98, describe und | - — a SCRIPTION OF OPERATIONS bolow | E.L. DISEASE - POLICY LIMIT | $ 1,000,000 & | Bepady | uMo0082200MA248 12/31/2024 | 12/31/2028 | Valuable Papers $150,000 2 Prolesonl itty 03141016 12131/2024 | 12/31/2025 | Each Claim $2,000,000 Aggregate $2,000,000 DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES (ACORD 101, Additional Remarks Schedule, may be attached if more space is required) “WORKERS COMPENSATION NOT APPLICABLE IN MONOPOLISTIC STATES - OH, ND, WA, WY* FOREGOING PER POLICY FORM RE: NJX-2400048.00 TAP 2023 Washington Street Corridor Improvement Project Phase 2 West Orange Township, its officers, and employees and the State of New Jersey, Department of Transportation are included as additional insured as required by written contract. 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. West Orange Township als Seng el He 52 "AUTHORIZED REPRESENTATIVE, Whb tan © 1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25 (2016/03) The ACORD name and logo are registered marks of ACORD
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