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2009 (13)~RO® CERTIFICATE OF LIABILITY INSURANCE OPiD JH DATE (MM/DD/YYYY) JOHNC-1 10/07 09 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Commercial Coverage - Ballston HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO Box 5060 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Saratoga Springs NY 12866 Phone:518-602-2020. FaX:518-602-0236 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Harle SV111e Insur of NY INSURER B: Tower Insurance Company of t7Y John Conte Electric, Ina. Conte Electric InC& J E Conte INSURER C: The Hartford insurance Company 22357 2111 NASD HaCkAIIS8Ck Rd P hk i NY 12603 INSURER D: oug eeps e INSURER E: COVERAGES 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 MAYBE ISSUED OR MAY PERTAIN; THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MM/DD DATE MM/DD LIMITS GENERAL LIABILITY EACH OCCURRENCE $ lOOOOOO X X COMMERCIAL GENERAL LIABILITY CB 6J7933 PREMISES (Ea occurence) $ 100000 CLAIMS MADE X^ OCCUR MED EXP (Any one person) $ SOOO A X Business OSrners 04/12/09 04/12/10 PERSONALaADVw.IURY $ 1000000 GENERAL AGGREGATE $ 2000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ 2000000 }[ POLICY PRO LOC JECT AU TOMOBILE LU181LITY COMBINED SINGLE LIMIT 1000000 ANY AUTO BAP2650272 03/16/09 03/18/10 (Ea accident) . $ ALL OWNED AUTOS BODILY INJURY B X SCHEDULED AUTOS (Per person) $ X HIRED AUTOS BODILY INJURY X NON-OWNED AUTOS ~ (Per accident) $ PROPERTY DAMAGE (Per accident) $ GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: qGG $ EXCESS /UMBRELLA LU-BILITY EACH OCCURRENCE $ 1 OOOOOO A OCCUR ~ CLAIMSMADE BE6J933 04/12/09 04/12/10 AGGREGATE $ 1000000 DEDUCTIBLE $ X RETENTION $ !DODO $ WOR AND KERS COMPENSATION EMPLOYERS' LIABILITY X TORY LIMITS ER _ C ECUTIV~ E OIWECJU8863 10/16/09 lO/16/lO E.L. EACH ACCIDENT $ lOOOOO OFFICEEMEMBER EXCLUD D? (Mandatory in NH) L1 E.L. DISEASE-EA EMPLOYEE $ lOOOOO If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ SOOOOO OTHER DESCRIPTION OF OPERATIONS /LOCATIONS /VEHICLES /EXCLUSIONS ADDED BY ENDORSEMENT /SPECIAL PROVISIONS /~~+* TT i CERTIFICATE HOLDER IS ADDED AS ADDITIONAL INSURED. ~l.d 6 ~ ~~~ '''~?IrF~„y ~,( ~~ CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Town of Wappinger 20 Middl b h R d REPRESENTATrvES. us e oa PO BOX 324 /`UTHORI7,E=TjEP ESENFA7IVE a in ers Falls NY 12590 i~r~~~~ : 1 ACORD 25 (2009!01) ©1966-2009 ACORD CORPORATION. AI! rights reserved. The ACORD name and logo are registered marks of ACORD COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAM ED 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 RIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH THE INSURANCE AFFORDED BY THE POLICIES DESC MAY PERTAIN , AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. POLICIES . POLICY NUMBER P LI FE T VE P I RA N LIMITS DATE MMIDD/YY DATE MM/DD/YY LTR NSR TYPE OF INSURANCE RENCE $ lOOOOOO EACH OCCUR GENERAL LIABILITY ISIEIL70021309 11/01/09 11/O1/10 FTpllEl PREMISES (Eaoccurence) $ 50000 C }{ X COMMERCIAL GENERAL LIABILITY S MED EXP (Any one person) $ SOOO CLAIMS MADE ~ OCCUR PERSONALSADVINJURY $ lOOOOOO 2000000 GENERAL AGGREGATE $ G $ 2000000 PRODUCTS-COMPlOPAG GEN'L AGGREGATE LIMIT APPLIES PER: POLICY X PRO LOC JECT AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ 1 ~ OOO , OOO 2610390 11 / O 1 / 0 9 11 / O 1 / 10 $ }{ ANY AUTO $Ap ALL OWNED AUTOS BODILY INJURY (Per person) $ SCHEDULED AUTOS I X HIRED AUTOS BODILY INJURY (Per accident) $ X NON-OWNED AUTOS PROPERTY DAMAGE (Per accident) $ EA ACCIDENT $ AUTO ONLY - GA RAGE LIABILITY OTHER THAN EA ACC $ ANY AUTO AUTO ONLY: AGG $ RRENCE $ SOOOOOO EACH OCCU EXCESSIUMBRELLA LIABILITY IXNV71010409 11/01/09 11/01/10 AGGREGATE $ SOOOOOO C X OCCUR ~ CLAIMSMADE SIS DEDUCTIBLE RETENTION $ _ WORKERS COMPENSATION AND TORY LIMITS ER EMPLOYERS' LIABILITY E.L. EACH ACCIDENT $ ANY PROPRIETORIPARTNER/EXECUTIVE DISEASE - EA EMPLOYEE $ E L OFFICER/MEMBER EXCLUDED? . . If yes, describe under E.L. DISEASE -POLICY LIMIT $ SPECIAL PROVISIONS below OTHER A Property Section Mg197063534 11/01/09 11/01/10. C Pollution/Professi SISIEIL70021309 11/01/09 11/O1/10 $1M Ded DESCRIPTION OF OPERATIONS /LOCATIONS / VEHICLES I EXCLUSIONS ADDED BY ENDORSEMENT !SPECIAL PROVISIONS Certificate holder is included as additional insured as respects General ~®~ Q g 2U09 Liability as required by written & executed contract. j T~'llN~ CLEl~~' CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWNW AP DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Town of Wappinger Falls IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 Middlebush Road REPRESENTATIVES. Wappinger Falls NY 12590 AUT REPR Tgy/kE ACORD 25 (2001/08) © ACORD CORPORATION 1988 CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) A~ ~• 11/12/2009 PRODUCER THIS CERTIFICATION IS ISSUED AS A MATTER OF INFORMATION Marsh USA, Inc. ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE 1166 Avenue of the Americas HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR New York, NY 10036 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. 105892-00000-ACO RD-09-10 INSURED KINGSTON OIL SUPPLY CORP. P.O. BOX 760 PORT EWEN, NY 12466 INSURERS AFFORDING COVERAGE NAIC # INSURERA National Union Fire Ins Co Pittsburgh PA 19445 INSURER B: New Hampshire Ins. Co. 23841 INSURER C: N/A N/A INSURER D: INSURER E: 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSFj ~ADD' TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATION LIMITS LTR INSR DATE (MNUDDIYYYY) DATE (MMIDDIYYYYI A GENERAL LIABILITY GL 6505855 11/16/2009 11/01/2010 EACH OCCURRENCE 1.000.000 E 000 $ 100 )( COMMERCIAL GENERAL LIABILITY rence PREM SES(Ea o cu ' CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 10,000 PERSONAL 8 ADV INJURY $ 1,000,000 GENERAL AGGREGATE ~ 1,000,000 GENERAL AGGREGATE LIMIT APPLIES PER PRO PRODUCTS -COMP/OP AG 1,000,QOQ POLICY LOC JEC7 A AUT OMOBILE LIABILITY CA 0948515 11/16/2009 11/01/2010 COMBINED SINGLE LIMIT $ 1 000 000 (Ea accident) , , ANY AUTO ALL OWNED AUTOS BODILY INJURY SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY (Per accident) NON-0WNED AUTOS PROPERTY DAMAGE (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT ANY AUTO OTHER THAN EA ACC AUTO ONLY: AGG EXCESS /UMBRELLA LIABILITY EACH OCCURRENCE OCCUR ~ CLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION $ B WORKER S COMPENSATION AND WC 7209951 11/16/2009 11/01/2010 )( WC STATU- OTH- EMPLOYERS' LIABILITY EACH ACCIDENT L 000 000 $ 1 ANY PROPRIETOR/PARTNER/EXECUTIVE Y / N . . , , OFFICER/MEMBER EXCLUDED? ~ .L. DISEASE - EA EMPLOYE $ 1,000,000 (Mandatory in NH) ff yes, describe under .L. DISEASE -POLICY LIMIT $ 1,000,000 SPECIAL PROVISIONS below OTHER ^ DESCRIPTION OF OPERATIONS/LOCATIONSNEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS RECEIVFry NOV 1 7 2009 CERTIFICATE HOLDER NYC-003295639-27 CANCELLATION ~ vvy~:V CLF~k SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE Town of Wappingers EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 20 Middlebush Rd $O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, Wappingers Falls, NY 12590 BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UHPOi~N p gE THE INSURER, ITS AGENTS OR REPRESENTATNES. Of H eRS ED REPInCSENTATNE ~ ~/ ~ ~~ PauMl MartUellAOni v~v~~ ACORD 25 (2009101) ©1998-2009 ACORD CORPORATION. All Rights Reserved The ACORD name and logo are registered marks of ACORD r IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER This Certificate of Insurance does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon. NOV ~ ~ 2009 T~~ CLER-~ A~Q~ I` CERTIFICATE OF LIABILITY INSURANCE CPHA A f B3A DATE (MM/DD/YYYY) 09 r / r y, /' ZE 12 23 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE Marshall & Sterling, Inc . HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR t i St 110 M ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. ree n a Poughkeepsie NY 12601 Phone:845-454-0800 Fax:845-485-7804 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: 2urioh 7uaerioan Ineuranae Co. 3 7 9 Land Chazen Engineering INSURER B: , st1rV~ i.n & LandSCap@ C ~ ~ INSURER C: . ure Co., P. ec Archi 21 FOX St INSURER D: Poughkeepsie NY 12601 ~ INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. LTR NSR TYPE OF INSURANCE POLICY NUMBER DATE MMIDDIYYYY DATE MMIDD/YYYY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ COMMERCIAL GENERAL LIABILITY PREMISES Ea occurence $ CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ PERSONAL 8 ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG $ POLICY PRO LOC JECT AUT OMOBILE LIABILITY COMBINED SINGLE LIMIT $ ANY AUTO (Ea accident) ALL OWNED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) HIRED AUTOS BODILY INJURY $ (Per accident) NON-OWNED AUTOS PROPERTY DAMAGE $ (Per accident) GARAGE LIABILITY AUTO ONLY - EA ACCIDENT $ ANY AUTO OTHER THAN ~ ACC $ AUTO ONLY: AGG $ EXCESS I UMBRELLA LIABILITY EACH OCCURRENCE $ OCCUR ~ CLAIMS MADE AGGREGATE $ DEDUCTIBLE $ RETENTION $ $ WOR KERS COMPENSATION TORY LIMITS ER AND EMPLOYERS' LIABILITY Y / N ANY PROPRIETOR/PARTNER/EXECUTIV E.L. EACH ACCIDENT $ ~ OFFICER/MEMBER EXCLUDED? (Mandatory in NH) E.L. DISEASE - EA EMPLOYEE $ If yes, describe under SPECIAL PROVISIONS below E.L. DISEASE -POLICY LIMIT $ OTHER A Professional & PEC488298700 12/31/09 12/31/10 Ea. Claim 5000000 Pollution Liab 5000000 DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT 1 SPECIAL PROVISIONS ~~ DEC 2 4 20Ug -'~~nrN C~ Fps ricRr11=1rer1= unl nFR CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION TOWNOF3 DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 O DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR Town of Wappingers REPRESENTATIVES. 20 Middlebush Road AUT ZED RE ENT IVE Wappingers Falls NY 12590 ACORD 25 (2009/01) ©1988-2009 AGVRD CVRPVRATIVrv. Au rlgnts reserves. The ACORD name and logo are registered marks of ACORD ~,! ACORD CERTIFICATE OF LIABIL UR NCE OPID CJEF SWANS-2 DATE IMMIDD/YYYY) 04/10/09 PRODUCER Marshall & Sterling, Inc. Suite 300 103 Executive Drive ~ ~ THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. , New Windsor NY 12553 Phone:845-567-1000 Fax:845-56 ~ ~t i~" INSURERS AFFORDING COVERAGE NAIC# INSURED ~ INSURER A' xartford Casualty insurance Co 084 ~ _ p a~ . INSURER B~. xartford Pire Insurance Co. 1 6 2 Inc lti C aM, ~'~ ~ ~~ INSURER C: - ng onsu Swanson PO BOX 3 95 ,, ~~~ ~ INSURER D: Salisbury Mills NY 12577 ,~~~. INSURER E: COVERAGES 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. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. lA5 LTR NSR TYPE OF INSURANCE POLICY NUMBER P L Y EFFECTIVE DATE MM/DD/YY P LIC E PIR 10 DATE MM/DD/YY LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 10 0 0 0 0 0 0 -- A x X COMMERCIAL GENERAL LIABILITY ~ 165F1ARV1978 05/25/09 05/25/10 AlU7CG?=-TOR _ PR&MISES (Ea occurence) $ 300000 i . CLAIMS MADE ~ OCCUR MED EXP (Any one person) $ 10 0 0 0 PERSONAL&ADVINJURY $ 10000000 GENERAL AGGREGATE $ 20000000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS -COMP/OP AGG 5 2 0 0 0 0 0 0 0 POLICY PRO LOC JECT AUTOMOBILFLIABILITY COM8INEDSINGLELIMIT $ 1000000 B X ANYAUro 16UECAF9634 05/25/09 05/25/10 (Ea accident) ALL OVNWED AUTOS BODILY INJURY $ SCHEDULED AUTOS I ~ (Per person) }[ I HIRED AUTOS ~ BODILY INJURY NON-U\NNED AUTOS X (Per accidznQ __ - ~ -_ I, ' PROPERTY DAMAGE 5 -~ - - - , ~ ~ I (Per accident) GARAGE LIABILITY I AUTO ONLY - EA ACCIDENT 5_ ____ ANY AUTO ~ OTHER THAN EA ACC 5 i AUTO ONLY: qGG $ EXCESSIUMBRELLALIABILITY ~ EACH OCCURRENCE 5 2000000 A X OCCUR ~ CLAIMSMADE j 16SBARV1978 05/25/09 05/25/10 AGGREGATE $ 2000000 5 --- DEDUCTIBLE I $ - X RETENTION $ 10 0 0 0 ~ 5 WORKERS COMPENSATION AND ~ 'i _ _ TORY LIYIITS,__ ER_ _`_^_ __ __ EMPLOYERS' LIABILITY ~ I ~ E.L. LACH ACCIiiENT 5 ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICERIMEMBER EXCLUDED? -' E.L. DISEASE - EA EMPLOYEE $ If yes, describe under DISEASE -POLICY LIMIT E L $ SPECIAL PROVISIONS below . . OTHER ii DESCRIPTION OF OPERATIONS (LOCATIONS /VEHICLES 1 EXCLUSIONS P.DDED BY ENDORSEMENT I SPECIAL PROVISIONS Town of Wappingersis provided additional insured status when required by written contract or agreement with respects to work the insured is_ performing on their behal';: rcorr rrnnTC uni nco CANCELLATION VGr~111 WAPPI - 3 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL Town Of Wappingers IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR 20 Middlebush Rd NY 12590 ll F i REPRESENTATIVES. s ngers a Wapp A VE E S6NT AUTHORIZED REf}$ ~Tl - T1I1 ~1 A~00 ACORD 25 (2001/OE) IINNVr~V vVr~t v~~n~wn ~...,.. IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). 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). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it . affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon., ACORD 25 (2001/08)