AgdaPkt 2016-04-25 Closed and Joint SA PFA

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(HOFFM64) ,acoR ® CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYYY) L_____. 6.1.C. - Page 16 3/28/2016 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). CONT PRODUCER The Graham Company NAMEACT Joe Holden The Graham Building PHONE FAX (A/C, Ext): 215-701-5225 (NC,No): 215-933-3988 One Penn Square West 25th Floor Philadelphia, PA 19102 ADDRESS: Holden_Unit @grahamco.com INSURER(S)AFFORDING COVERAGE NAIC# www.grahamco.com INSURERA: First Mercury Insurance Company 10657 INSURED INSURER B: Zurich American Insurance Company 16535 Hoffman t Corp. 23311 Madero deco Street INSURERC: Endurance Risk Solutions Assurance Co. 43630 St Mission Viejo CA 92691 INSURERD: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: 29190190 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. INSR ADDL SUBR POLICY NUMBER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE (MM/DD/YYYY) (MM/DD/YYYY) LIMITS A i COMMERCIAL GENERAL LIABILRY / / WACGL000006027901 12/31/2015 12/31/2016 EACH OCCURRENCE $ 1,000,000 DAMAGE TO RENTED CLAIMS-MADE I OCCUR PREMISES(Ea occurrence) $ 100,000 MED EXP(Any one person) $ 10,000 PERSONAL&ADV INJURY $ 1,000,000 GE 'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 2,000,000 POLICY ✓ Tai LOC PRODUCTS-COMP/OP AGG $ 2,000,000 OTHER: $ B AUTOMOBILE LIABILITY ✓ ✓ BAP 017954300 7/13/2015 7/13/2016 (Ee accl ideDt>SINGLE LIMIT $ 2,000,000 `/ ANY AUTO BODILY INJURY(Per person) $ OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS ONLY AUTOS HIRED NON-OWNED PROPERTY DAMAGE $ AUTOS ONLY AUTOS ONLY (Per accident) $ C UMBRELLA LIAB I OCCUR ,/ 1 EXC10004357202 12/31/2015 12/31/2016 EACH OCCURRENCE $ 10,000,000 s/ EXCESS LIAB CLAIMS-MADE AGGREGATE $ 10,000,000 DED RETENTION$ $ B WORKERS COMPENSATION / WC 017954500 7/13/2015 7/13/2016 y/ STATUTE OTH- ER AND EMPLOYERS'LIABILITY Y/N ANYPROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ 1,000,000 OFFICER/MEMBEREXCLUDED? N N/A (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) See Additional Remarks Schedule CERTIFICATE HOLDER CANCELLATION Clt of Redwood City SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Y y THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Engineering DIVISIon ACCORDANCE WITH THE POLICY PROVISIONS. P.O. Box 391 Redwood City CA 94064 AUTHORIZED REPRESENTATIVE t;r.,. William A.Graham IV ©1988-2015 ACORD CORPORATION. All rights reserved. ACORD 25(2016/03) The ACORD name and logo are registered marks of ACORD 29190190 1 HSWHOLD-01 1 15/16 GL AU XS WC 1 Stephanie Hughes 1 3/28/2016 4:42:24 PM (EDT) 1 Page 1 of 12