On July 05, 2016 a
Exhibit,Appendix
was filed
involving a dispute between
Anthony Magni,
and
Clune Construction Company, L.P.,
Concepts For Business, Llc,
G&S Concepts, Inc.,
Polsinelli Pc,
Third Avenue Tower Owner, Llc,
for Torts - Other Negligence (Premises liability)
in the District Court of New York County.
Preview
FILED: NEW YORK COUNTY CLERK 04/15/2019 03:09 PM INDEX NO. 155570/2016
NYSCEF DOC. NO. 137 RECEIVED NYSCEF: 04/15/2019
G&SCO-1 OP ID:JH
ACORD" DATE(MMfDDIYYYY)
CERTIFICATE OF LIABILITY INSURANCE 02,04,201s
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIu¹ATON ONLY AND CONFERS NO RIGHTS UPON THE CERTlFICATE HOLDER. THIS
CERTlFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES
, BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONST1TUTE A CONTRACT BETWEEN THE ISSUlNG INSURER(S), AUTHORiZED
REPRESENTATIVE OR PRODUCER, AND THE CERT1FICATE HOLDER.
IMPORTANT: If the
ced!Seete holder isan ADDITIONAL INSURED, the must
policy(les) be endorsed. IfPJBROCATION IS WAlVED, subjectto
the terms and c:nit!:ns Of the certain
policy, policlesmay require an endorsement. A state-:enton thisCedfeate does not conferrightsto the
cert!Seeteholderin IleuOf suchendorsement(s).
PRODUCER Dennis Rawlins
j
Suburban General InsuranceAgy PHONÊi PAX
21-00 Route 208 SouthSte 105 (AIC.No.Ex8:201 -225-9099 _
| (AJC.No): 201-225-0253
FairLawn, NJ 07410 ¶foARSS•
Dennis Rawilns
AFFORDING
INSURER(S) COVERAGE NAIC8
INSURERA : TheHartford 22357
INSURED G&S Concepts, Inc. INSURERe:Harleysville Insurance Comp±ny 23582
287 Cheesequake Rd Bldg A
*
Sayerville,NJ 08859
INSURERO:
INSURERE:
I INSURERF
:
COVERAGES CERTIFICATE NUMBER: REVISION NUMBER:
THIS IS TO CERTlFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NOTWITHSTANDING ANY REQuiREmEreT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE !MSUPAMCE AFFORuED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
TYPEOF1NSURANCE POLICYNUMBER (I LIMITS
)
A COMMERCIALGENERAL LIABILITY EACHOCCURRENCE $ 2,000,000
CLAIMS-MADE X OCCuR 13SBATQ7814 07/10/2015 07/10/2016 SE E oŠuÎence) $ 1,000,000
X Business Owners | MEDEXP(Anyoneperson)$ 10,000
PERSONAL&ADVINJURY |$ 2,000,000
GEN'LAGGREGATEUMITAPPLIESPER: GENERALAGGREGATE $ 4,000,000
X POUCY LOC PRODUCTS-
|1 COMP/OPAGG $ 4,000,000
OTHER:
AUrOMOBILELIABILITY INGLELIMIT
B Y ANYAUTO -- BA 00000023756X 01/11/2016 01/11/2017 BODILYINJURY(Perperson)
$
NED SC LED BODILYINJURY(Peraccident) $
HIREDAUTOS O Ia c denr
$
X UMBRELLAUAB X OCCUR EACHOCCURRENCE $ 3,000,000
A EXCESSLIAB CLAIMS-MADE 13SBATQ7814 07/10/2015 07/10/20i6 AGGREGATE $ 3,000,000
__
DED | X RETENTION
$ 10000 |$
|
WORKERS COMPENSATION PER OTM.
AND EMPLOYERS'
LIABILITY STATUTE ER
Y IN
A ANYPROPRIETOR/PARTNERESECUTIVE 13WBCBZ5724 07/10/2015 07/10/2016 E.L.EACHACCIDENT |$ 500,000
OFFICER/MEMBER
EXCLUDED? NI A
(MandatoryIn NH) - EAEMPLOYEE$
E.L.DISEASE 500,000
OF PERATloNS
below - POLICYUMIT
E.L.DISEASE $ 500,000
OFOPERATIONS
DESCRIPTION / LOCATONS AdditlanalRemarksSchedule,maybeattachedIf rnorespaceIs required)
!VEl4CLES(ACORD101,
Black Rock Real Advisors Inc. Third Avenue Tower Owner LLC, Third Avenue
Tower Member L C,L&L 600 Third Avenue Promote LLC, Third Avenue Tower LLC,
L&L Holdin~ LLC L&L Acquisitions Mettpo!!tan LifeInsurance
Company LLC,
Com an Ifolsinelli
are included as d'''=2! insürsds under the above
desCrlbe policles(except forworkers Compenation) as respects...
CERTIFICATE HOLDER CANCELLATION __
THIRDAV
SHOULo ANY OF THE ABOVE DESCRIBEDPoLICIES BE CANCELLED BEFORE
THE EXPIRATloN DATE THEREOP, NoT1cE W1LL BE DELIVERED IN
THIRD AVENUE TOWER OWNER, LLC ACCORDANCEWITH THE POLICY PROVisioNS.
600 THIRD AVENUE
NEW YORK, NY 10016 REPRESENTATIVE
-AUrHORIZED
© 1988-2014 ACORD CORPORATION. Allrightsreserved.
ACORD 25 (2014/01) The ACORD name and IOgo are registeredmarks Of ACORD
Document Filed Date
April 15, 2019
Case Filing Date
July 05, 2016
Category
Torts - Other Negligence (Premises liability)
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FILED: NEW YORK COUNTY CLERK 04/15/2019 03:09 PM INDEX NO. 155570/2016 NYSCEF DOC. NO. 137 RECEIVED NYSCEF: 04/15/2019 G&SCO-1 OP ID:JH ACORD" DATE(MMfDDIYYYY) CERTIFICATE OF LIABILITY INSURANCE 02,04,201s THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORIu¹ATON ONLY AND CONFERS NO RIGHTS UPON THE CERTlFICATE HOLDER. THIS CERTlFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES , BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONST1TUTE A CONTRACT BETWEEN THE ISSUlNG INSURER(S), AUTHORiZED REPRESENTATIVE OR PRODUCER, AND THE CERT1FICATE HOLDER. IMPORTANT: If the ced!Seete holder isan ADDITIONAL INSURED, the must policy(les) be endorsed. IfPJBROCATION IS WAlVED, subjectto the terms and c:nit!:ns Of the certain policy, policlesmay require an endorsement. A state-:enton thisCedfeate does not conferrightsto the cert!Seeteholderin IleuOf suchendorsement(s). PRODUCER Dennis Rawlins j Suburban General InsuranceAgy PHONÊi PAX 21-00 Route 208 SouthSte 105 (AIC.No.Ex8:201 -225-9099 _ | (AJC.No): 201-225-0253 FairLawn, NJ 07410 ¶foARSS• Dennis Rawilns AFFORDING INSURER(S) COVERAGE NAIC8 INSURERA : TheHartford 22357 INSURED G&S Concepts, Inc. INSURERe:Harleysville Insurance Comp±ny 23582 287 Cheesequake Rd Bldg A * Sayerville,NJ 08859 INSURERO: INSURERE: I INSURERF : COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTlFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQuiREmEreT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE !MSUPAMCE AFFORuED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONSAND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPEOF1NSURANCE POLICYNUMBER (I LIMITS ) A COMMERCIALGENERAL LIABILITY EACHOCCURRENCE $ 2,000,000 CLAIMS-MADE X OCCuR 13SBATQ7814 07/10/2015 07/10/2016 SE E oŠuÎence) $ 1,000,000 X Business Owners | MEDEXP(Anyoneperson)$ 10,000 PERSONAL&ADVINJURY |$ 2,000,000 GEN'LAGGREGATEUMITAPPLIESPER: GENERALAGGREGATE $ 4,000,000 X POUCY LOC PRODUCTS- |1 COMP/OPAGG $ 4,000,000 OTHER: AUrOMOBILELIABILITY INGLELIMIT B Y ANYAUTO -- BA 00000023756X 01/11/2016 01/11/2017 BODILYINJURY(Perperson) $ NED SC LED BODILYINJURY(Peraccident) $ HIREDAUTOS O Ia c denr $ X UMBRELLAUAB X OCCUR EACHOCCURRENCE $ 3,000,000 A EXCESSLIAB CLAIMS-MADE 13SBATQ7814 07/10/2015 07/10/20i6 AGGREGATE $ 3,000,000 __ DED | X RETENTION $ 10000 |$ | WORKERS COMPENSATION PER OTM. AND EMPLOYERS' LIABILITY STATUTE ER Y IN A ANYPROPRIETOR/PARTNERESECUTIVE 13WBCBZ5724 07/10/2015 07/10/2016 E.L.EACHACCIDENT |$ 500,000 OFFICER/MEMBER EXCLUDED? NI A (MandatoryIn NH) - EAEMPLOYEE$ E.L.DISEASE 500,000 OF PERATloNS below - POLICYUMIT E.L.DISEASE $ 500,000 OFOPERATIONS DESCRIPTION / LOCATONS AdditlanalRemarksSchedule,maybeattachedIf rnorespaceIs required) !VEl4CLES(ACORD101, Black Rock Real Advisors Inc. Third Avenue Tower Owner LLC, Third Avenue Tower Member L C,L&L 600 Third Avenue Promote LLC, Third Avenue Tower LLC, L&L Holdin~ LLC L&L Acquisitions Mettpo!!tan LifeInsurance Company LLC, Com an Ifolsinelli are included as d'''=2! insürsds under the above desCrlbe policles(except forworkers Compenation) as respects... CERTIFICATE HOLDER CANCELLATION __ THIRDAV SHOULo ANY OF THE ABOVE DESCRIBEDPoLICIES BE CANCELLED BEFORE THE EXPIRATloN DATE THEREOP, NoT1cE W1LL BE DELIVERED IN THIRD AVENUE TOWER OWNER, LLC ACCORDANCEWITH THE POLICY PROVisioNS. 600 THIRD AVENUE NEW YORK, NY 10016 REPRESENTATIVE -AUrHORIZED © 1988-2014 ACORD CORPORATION. Allrightsreserved. ACORD 25 (2014/01) The ACORD name and IOgo are registeredmarks Of ACORD