CERTIFICATE OF LIABILITY INSURANCE

Transcription

1 ACORdt CERTIFICATE OF LIABILITY INSURANCE 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, ETEND 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(les) must be endorsed. If SUBROGATION IS WAIVED, subjectto the terms and conditions ofthe policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificateholder In Heu of such endorsement(s). PRODUCER Angelo J. DeBellis Agency, LLC INSURED Fairview Owners Corp PA: CONTACT NAME: 5»W address-.&jd6aol. COM Producer customerids: IH8UHER(8) AFFORDMQ COVERAGE DATE(MM/DD/YYYY) 3/6/2015 TEC Ia%W INSURER A STARR INDEMNITY & LIABILITY CO INSURER 8 GREAT AMERICAN INSURANCE CO INSURER C CNA INSURANCE COMPANY INSURER D INSURER E INSURER F COVERAGES CERTIFICATE NUMBER: 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. ECLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. UtSR IDS? POLICY EFF POLICY EP LTR TYPE OF INSURANCE POUCY NUMBER (MM/DDVyYYY) (Mwdd/yyyy) LIMITS GENERAL LIABILITY EACH OCCURRENCE UAMAGb lokfcnibu COMMERCIAL GENERAL LIABILITY PREMISES (Ea occurrence) CLAIMS4MDE OCCUR GBTL AGGREGATE LIMIT APPLIES PER: POLICY I jgct I ILOC AUTOMOBILE LIABILITY ANYAUTO ALLOWNED AUTOS SCHEDULED AUTOS HIRED AUTOS SIKCGF SIKCGFOO MEDEP(Any one person) PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per pereon) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) $ 1,000, ,000 $ 5,000»T7000,000 $ 2r000,000 1,000,000 * 1,000,000 B NON-OWNED AUTOS UMBRELLA LIAB ECESS UAB DEDUCTIBLE OCCUR CLAIMS-MADE UM HIRED/NON-OWN EACH OCCURRENCE AGGREGATE * 1 25tf,000, , ,000,000 RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY YIN ANY PROPRIETOR/PARTNER/EECUTIVE i 1 OFFtCER/UEMBER ECLUDED? (HindttwyfaNH) ' ' Hyes, descr&e under DESCRIPTION OP OPERATIONS below DIRECTORS&OFFICERS LIABILITY WC STATU TORY LIMITS E.L EACH ACCIDENT OTH ER E.L DISEASE-EA EMPLOYEE $ E.L DISEASE - POLICY LIMIT $ $1,000,000./5,000.RET DESCRIPTION OFOPERATIONS / LOCATIONS / VEHICLES (Attach ACORD101. Additional Remarks Schedule, ifmorespace is required) CERTIFICATE HOLDER IS NAMED AS ADDITIONAL INSURED. LOAN #20190, PROPERTY/COLLATERAL ADDRESS UNDER LIABILITY CERTIFICATE TO READ AS: GRAND CENTRAL PKY. FOREST HILLS,NY.WAIVER OF SUBROGATION FORM CG IN FAVOR OF. (CONT.PG2) CERTIFICATE HOLDER CANCELLATION ACORD25 (2009/09) i ITS SUCCESSORS AND/OR ASSIGNS, ATIMA 276 SEVENTH AVENUE,6TH FLOOR NEW YORK,NY SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POUCY PROVISIONS. AUTHORIZED gtyke5enla>ft<e MJ ACORD CORPORATION. All rightsreserved. The ACORD name and logo are registered markswfacord $

2 & AlCOKD CUSTOMER ID: LOC#: ANGELO J POLICY NUMBER VARIOUS CARRIER VARIOUS ADDITIONAL REMARKS DEBELLIS LLC ADDITIONAL REMARKS SCHEDULE Page 2 of 2 NAICCODE THIS ADDITIONAL REMARKS FORM ISA SCHEDULE TO ACORD FORM, NAMED INSURED Fairview Owners Corp FA: EFFECTIVE DATE: -15 FORM NUMBER: 25 FORM TITLE: CERTIFICATE OF LIABILITY INSURANCE CANCELLATION, SHOULD ANY OF THE DESCRIBED POLICIES BE CANCELED BEFORE THE EPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURERS,ITS AGENTS OR REPRESENTATIVES.. I* It' pr ACORD101 (2008/01) 2008 ACORD CORPORATION. All rights reserved. The ACORD name and logo are registered marks of ACORD

3 acord EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DATE(MMTOD/YYYY) 3/6/2015 THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DOES NOT AMEND, ETEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. PRODUCER NAME. COMPANY NAME AND ADDRESS NAICNO: CONTACT PERSON AND ADDRESS Angelo J. DeBellis Agency, LLC.): asss: AJDQAOL. COM TRAVELERS INSURANCE COMPANY 445 SOUTH STREET MORRISTOWN,NJ POLICY TYPE IF MULTIPLECOMPANIES, COMPLETE SEPARATE FORM FOR EACH CUSTOMER ID «: NAMED INSURED AND ADDRESS Fairview Owners Corp.& GRANDWAY ASSOC ADDITIONAL NAMED INSURED(S) COMMERCIAL PROPERTY LOAN NUMBER EFFECTIVE DATE EPIRATION DATE THIS REPLACES PRIOR EVIDENCE DATED: POUCY NUMBER KTQCMB6D CONTINUED UNTIL TfcKMlNATdD IF CHECKED PROPERTY INFORMATION (Use REMARKS on page 2, if more space is required) LOCATION/DESCRIPTION LOC# GRAND CENTRAL PARKWAY, FOREST HILLS, NY SI BUILDING OR CI BUSINESS PERSONAL PROPERTY THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANYREQUIREMENT,TERM OR CONDITIONOF ANY CONTRACT OR OTHER DOCUMENTWITH RESPECT TO WHICH THIS EVIDENCE OF PROPERTY INSURANCEMAY BE ISSUEDOR MAY PERTAIN, THE INSURANCE AFFORDED BYTHE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALLTHE TERMS, ECLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION PERILS INSURED BASIC BROAD SPECIAL COMMERCIAL PROPERTY COVERAGE AMOUNT OF INSURANCE: $ 86,520, DED: $10, YES NO N/A Kl BUSINESS INCOME Q RENTALVALUE IfYES. LIMIT: 6,000,000 ActualLossSuslained;#ofmonths: BLANKET COVERAGE lfyes,indicatevalue(s)reportedonpropertyidentifiedabove:$ TERRORISM COVERAGE Attach Disclosure Notice/DEC IS THERE A TERRORISM-SPECIFIC ECLUSION? IS DOMESTIC TERRORISM ECLUDED? LIMITED FUNGUS COVERAGE IfYES.LIMIT: 15, DED: 10,000. FUNGUSECLUSIONOfYES-.specifyorganization'sformused) REPLACEMENT COST AGREED VALUE COINSURANCE IfYES. % EQUIPMENT BREAKDOWN (IfApplicable) IfYES.LIMIT: 92,600,000 DED: 10,000 ORDINANCE OR LAW -Coverageforlosstoundamagedportionofbtdg -DemolitionCosts IfYES.LIMIT 10,000,000 DED:10,000. -Incr.CostofConstruction IfYES.LIMIT INCLUDED DED: INCLUDED EARTHMOVEMENT(lfApplteabte) IfYES.LIMIT 2,500,000 DED: 100,000 FLOOD (IfApplicaWe) IfYES, LIMIT 2,500,000 DED: 100,000 WIND/HAIL(lfSubjecttoDifferentProvisions) IfYES.LIMIT DED: PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS CANCELLATION SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TOTHEADDITIONAL INTEREST NAMED BELOW. BUT FAILURE TOMAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANYKIND UPONTHE INSURER. ITS AGENTS OR REPRESENTATIVES. ADDITIONAL INTEREST MORTGAGEE LENDERS LOSS PAYABLE CONTRACT OF SALE LOSS PAYEE NAME AND ADDRESS ITS SUCCESSORS AND/OR ASSIGNS,ATIMA 275 SEVENTH AVENUE,6TH FLOOR NEW YORK,NY ACORD28 (2006/07) Pagel of 2 The ACORD name and logo are registered "mark LENDER SERVICING AGENT NAME AND AODRES3 (CORD CORPORATION All rights reserved. ACORD

4 EVIDENCE OF COMMERCIAL PROPERTY INSURANCE REMARKS - Including Special CondiUons (Use only Ifmore spaceis required) #1. ADDITIONAL INTEREST IS NAMED AS MORTGAGEE & LOSS PAYEE. #2. 90 DAY ETENDED PERIOD OF INDEMNITY FOR BUSINESS INCOME. #3. #4. LOAN NUMBER EFFECTIVE 3/16/2015 # DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST PER CANCELLATION CLAUSE SHOWN ON EVIDENCE OF COMMERCIAL PROPERTY INSURANCE. ot\ s ACORD28(2006/07) Page 2 of2

5 acorc? EVIDENCE OF COMMERCIAL PROPERTY INSURANCE PRODUCER NAME, CONTACT PERSON ANDADDRESS DATE(MWDIWYYYY) 3/6/2015 THIS EVIDENCEOF COMMERCIAL PROPERTY INSURANCE IS ISSUED AS A MATTEROF INFORMATION ONLYAND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF COMMERCIAL PROPERTY INSURANCE DOES NOT AMEND, ETEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ^_^_ PHONE WC.No.E»l); COMPANY KAME ANDADDRESS NA1CNO: Angelo J. DeBellis Agency, FA on, -00 eca* (A/C.Noj: ADDRESS; LLC ajdagencyqaol.com TRAVELERS INSURANCE COMPANY 445 SOUTH STREET MORRISTOWN, NJ POLICY TYPE IF MULTIPLE COMPANIES, COMPLETE SEPARATE FORM POR EACH CUSTOMERID ft NAMED INSURED AND ADDRESS Fairview Owners Corp & GRANDWAY ASSOC. ADDITIONAL NAMEDINSURED^) COMMERCIAL PROPERTY LOAN NUMBER EFFECTIVE DATE EPIRATION DATE THIS REPLACES PRIOR EVIDENCE OATED: POLICY NUMBER KTQCMB6D CONTINUED UNTIL TERMINATED IF CHECKED PROPERTY INFORMATION (Use REMARKS on page 2, if more space Is required) IS> BUILDING OR BUSINESS PERSONAL PROPERTY LOCATION/DESCRIPTION LOC #02 CLUB HOUSE GRAND CENTRAL PKWY.FOREST HILLS,NY 11375s THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED. NOTWITHSTANDING ANYREQUIREMENT, TERMOR CONDITION OF ANYCONTRACT OR OTHER DOCUMENT WITHRESPECT TO WHICHTHIS EVIDENCEOF PROPERTY INSURANCE MAY BEISSUED OR MAY PERTAIN, THEINSURANCE AFFORDED BYTHEPOLICIES DESCRIBED HEREIN ISSUBJECTTOALL THETERMS, ECLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COVERAGE INFORMATION PERILS INSURED BASIC BROAD SPECIAL COMMERCIAL PROPERTY COVERAGE AMOUNT OFINSURANCE: $ 1,442, DED: $10, YES NO WA BQ BUSINESSINCOME Q RENTAL VALUE IfYES.LIMIT: 700,000 ActualLossSustained:#ofmonths: BLANKET COVERAGE IfYES, indicatevalue(s)reportedonprop8rty(dentifi8dabove:$ TERRORISM COVERAGE AttachDisclosureNotice/DEC IS THERE A TERRORISM-SPECIFIC ECLUSION? IS DOMESTIC TERRORISM ECLUDED? LIMITED FUNGUS COVERAGE lfyes,limrt: $15, Q DED: $ FUNGUSECLUSION^fYES-.spedfyorganizallon'sformused) REPLACEMENT COST AGREED VALUE COINSURANCE IfYES. % EQUIPMENT BREAKDOWN (IfApplicable) lfyes.limit: 1,442,000 ED: 10,000. ORDINANCEOR LAW - Coverageforlossto undamaged portion of bldg -DemolitionCosts IfYES, LIMIT 1,442,000 DED: io,000. -Incr.CostofConstruction IfYES.LIMIT INCLUDED DED: INCLUDED EARTHMOVEMENT^Applicable) IfYES, LIMIT 2,500,000 ded: 100,000 FLOOD(lfApplicable) IfYES. LIMIT 2,500,000 DED: 100,000 WIND/HAIL(lfSubjecttoDifferentProvislfins) IfYES.LIMIT DED: PERMISSION TO WAIVE SUBROGATION IN FAVOR OF MORTGAGE HOLDER PRIOR TO LOSS CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EPIRATION DATETHEREOF. THE ISSUING INSURER WILLENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST NAMED BELOW, BUT FAILURE TOMAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ADDITIONAL INTEREST MORTGAGEE CONTRACT OF SALE LENDERS LOSS PAYABLE LOSS PAYEE NAME ANDADDRESS LENDER SERVICING AGENT NAME AND ADDRESS ITS SUCCESSORS AND/OR ASSIGNS,ATIMA 275 SEVENTH AVENUE,6TH FLOOR NEW YORK,NY AUTHORIZED REP f*xu&^ ACORD28 (2008/07) Page1of2 A AtfORD CORPORATION All rights reserved. The ACORD name and logo are registered marks of ACORD

6 EVIDENCE OF COMMERCIAL PROPERTY INSURANCE REMARKS - Including Special CondiUons (Use only if more space Is required) #1. ADDITIONAL INTEREST IS NAMED AS MORTGAGEE & LOSS PAYEE. #2. 90 DAY ETENDED PERIOD OF INDEMNITY FOR BUSINESS INCOME. #3. LOAN NUMBER EFFECTIVE 3/16/2015 # #4. 30 DAYS WRITTEN NOTICE TO THE ADDITIONAL INTEREST PER CANCELLATION CLAUSE SHOWN ON EVIDENCE OF COMMERCIAL PROPERTY INSURANCE. ACORD28(2008/07) Page 2 of2

7 ACORCf EVIDENCE OF PROPERTY INSURANCE DATE(MWWVYYYY) THIS EVIDENCE OF PROPERTY INSURANCE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE ADDITIONAL INTEREST NAMED BELOW. THIS EVIDENCE OF PROPERTY INSURANCE DOES NOT AMEND, ETEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ANGELO J PHONE DEBELLIS LLC (201) COMPANY CNA INSURANCE COMPANIES gg.^ (201) gffsjsst a-idaqancy@aol. com Aa&NCY CU8TOMER1DC; Fairview Owners Corp LOAN NUMBER EFFECTIVE DATE EPIRATION DATE THIS REPLACES PRIOR EVIDENCE DATED: POUCY NUMBER CONTINUED UNTIL TERMINATED IF CHECKED PROPERTY INFORMATION LOCATION/DESCRIPTION GRAND CENTRAL PKWY FOREST HILLS, NY 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 EVIDENCE OF PROPERTY INSURANCE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECTTOALL THETERMS, ECLUSIONS AND CONDITIONS OF SUCHPOLICIES. LIMITS SHOWN MAY HAVE BEENREDUCED BYPAID CLAIMS. COVERAGE INFORMATION COVERAGE / PERILS / FORMS EMPLOYEE DISHONESTY / INCLUDING MGT.A6T. /CARLSON REALTY FORGERY OR ALTERATION THEFT, DISAPPEARANCE, & DESTRUCTION COMPUTER FRAUD/WIRE FRAUD AMOUNTOF INSURANCE 1,500, , , ,500, DEDUCTIBLE 10, NONE 10, REMARKS (Including Special Conditions) FAIRVIEW OWNERS CORP GRAND CENTRAL PKWY. FOREST HILLS, NY CANCELLATION SHOULD ANY OF THEABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THEEPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TOTHE ADDITIONAL INTEREST NAMED BELOW, BUT FAILURE TOMAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION ORLIABILITY OFANY KIND UPON THEINSURER, ITSAGENTS OR REPRESENTATIVES. ADDITIONAL INTEREST NAME ANDADDRESS ITS SUCCESSORS AND/OR ASSIGNS,ATIMA 275 SEVENTH AVENUE NEW YORK,NJ ACORD27(2006/07) LOANS MORTGAGEE LOSS PAYEE The ACORD name and logo are registered marks of ACORD ADDITIONAL INSURED S^fr*4%^- ACCORD CORPORATION All rights reserved.