Preview
FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018
FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018
STANDARD FORM OF AGREEMENT
BETWEEN
General contractor and Subcontractor
AGREEMENT
Made as of the June Day of 25 In the year of 201_ 16
BETWEEN General Contractor: Cornerstone Builders NY LLC
And the Subcontractor: New York builder of stairs inc
WHEREAS the G. Contractor and subcontractor are desired of enteringinto a business arrangements
directlyor for
indirectly the constructionat thelocation
oiled lyn ny 1124E
The G. Contractorand the Subcontractor agree as set forth
below:
ARTICLE 1.0
INDEMNIFICATION
1.I To the fullestextent permittedby law,the Subcontractor agrees toindemnify, defend and hold
harmlessthe Owner and theContractor,as wellas allpartiestheowner/ contractorare requiredto
indemnify, their officers, directors,agents, employees, members and partners (hereafter
collectively"Indemnitees") from any and allclaims,suits,damages, professional
liabilities, fees,
attorneys'
including fees,costs,courtcosts,expenses and disbursements relatedto death,bodily
injuryor property damage (includinglossof use thereof)brought againstany ofthe Indemnitees
by any person or entity,
arisingor allegedto be arisingoutof or in connectionwith or as a result
or consequence of theperformance ofthe Work ofSubcontractor,as well as anyadditionalwork,
extrawork or add-on work, whether ornot caused inwhole or in partby theSubcontractor orany
person or entityemployed, either directlyor indirectlyby the Subcontractor including any
subcontractorsthereof and theiremployees. The partiesexpresslyagree thatthisindemnification
agreement contemplates 1) full indemnity in the event of liabilityimposed against the
Indemnitees without negligence;and 2) partialindemnity in the event
of any actualnegligence on
the part of the Indemnitees eithercausing or contributing to the underlying claim which
Attorneys'
negligence is expresslyexcepted from the Subcontractor's obligationtoindemnify,
fees, court expenses
costs, and disbursements shallbe definedwithout limitto includethose fees,
costs,etc. incurred in defending the underlying claim and those fees, costs,etc. incurredin
of'
connection with the enforcement of thisAgreement. Indemnificationunder thisAgreement shall
operate whether ornot the Subcontractorhas placed and maintained the insurancerequired under
thisagreement. The Subcontractorshallcause allsubcontract agreements it enters
into toinclude
thisindemnification clause so as toensure that the Indemniteesshall have the same protection
from subcontractorsof alltiersas is afforded
by the Subcontractorhereunder.
1.2 In claims againstany personor entity indemnified under thisagreement by an employee of the
Subcontractor,the Subcontractor'sSub-subcontractors. anyone directlyorindirectlyemployed by
them or anyone forwhose acts they may be liable,the indemnification obligation under this
agreement shall notbe limited by a limitation
on amount or type ofdamages, compensation, or
FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018
benefitspayable by or for the Subcontractor or the Subcontractor's Sub-subcontractors under
Workers'
or Workmen's Compensation Acts or otheremployee benefit acts.
1.3 in claims againstany person orentity indemnified under thisagreement shallnot extend tothe
of
liability the Architect,the Architect'sconsultants,and agents and employees of any of them
arising out of (1) the preparation or approval of maps, drawing, opinions, reports,surveys,
Change Orders, designs,or or
specifications, (2)the givingof or thefailureto givedirectionsor
instructionby theArchitect,the Architect's and
consultants, agents and employees of any of them
provided such giving or failure
to giveis theprimary cause ofthe injuryor damage.
1.4 Subcontractor waives allrights against Contractor, Owner and Architect and their agents,
ol'
officers,directors and employees for recovery of damages that shall be covered by his
Commercial General Umbrella
Liability business
liability, auto or
liability workers compensation
and employers maintained
liability per insurance requirementsstatedin thisagreement.
ARTICLE 2,0
INSURANCE REQUIREMENTS
2.1 Subcontractor specificallyagrees to maintain the following insurance coverages in the limits
provided below:
Commercial General - Contractual and employer's
Liability including Liability liability
(coverage to be issued on a form at leastas broad as ISO form CG001 or equivalentand must
include premises-operations hazard,product completed operations,Broad form damage,
property
Independent contractors.
$1,000,000 Each Occurrence S2,000,000 Aggregate on a PER PROJECT basis.
Workers'
Compensation and Employers Liability: NYS statutory
limits
(il'
Business Automobile (including hired and non-owed auto) $1,000,000 CSL per Accident (if
applicable)
Excess/ Umbrella Insurance$4,000,000 Each Occurrence $4,000,000 Aggregate
The Owner and manager/General Contractor are to be named as an additional insured on a
primary noncontributory basisto the Subcontractor's Comprehensive General Liabilitypolicy
using appropriate ISO forms that includePremises Operations Liability,Contractual Liability,
Advertising and Personal injury Liability,waiver of subrogation endorsement and additional
insured for ongoing and Products/Completed Operations Liability,or by using a company
specificendorsement thatprovideequivalent protection.
2.2 Coverage writtenon an occurrence basis shallbe maintained without interruptionfrom date of
ol'
commencement of the Subcontractor's work until expiration of the applicable statuteof
limitationsrelatingtolatentdefect inconstructionof orimprovement to realproperty ofthe state
in whichthe work is performed.
FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018
2.3 CertificatesofInsurance acceptable to theOwner/General Contractor/manager shallbe filedwith
ol'
the owner/General Contractor prior to commencement of the subcontractor's work. The
certificates
and insurance policiesrequired by Article2 shallcontain thelanguage shown on the
sample certificate
enclosed, and containa provisionthatcoverage affordedunder the policieswill
days'
not be canceled orallowed to expire until
at least30 priorwrittennotice has beengiven to
the owner/General Contractor. Ifany of theforegoing insurancecoverages are requiredto remain
in force afterfinalpayment and are reasonably available,an additional certificate
evidencing
continuation of such coverage shall be submitted with the finalapplication for payment as
required. Ifany information concerning reduction ofcoverage isnot furnishedby the insurer,it
shall be furnished by the Subcontractor with reasonable promptness according to the
Subcontractor's informationand belief.
2.4 Waivers of Subrogation. The Contractorand Subcontractor waive allrightsagainst(1)each other
and any of theirSubcontractors,Sub-subcontractors,agents and employee, each ofthe other,and
(2) theowner, the Architect,the Architect'sconsultants,separatecontractors,and any of their
subcontractors,sub-subcontractors, agents and employees fordamages caused by fireor other
perilsto theextent covered by property insuranceprovided under the Contract or otherproperty
ol'
insurance applicable to the Work except such rightsas they may have to proceeds of such
insurance held by theOwner as fiduciary.The Subcontractor shallrequireof theSubcontractor's
Sub-subcontractors, agents and employees. by appropriate agreements, written where legally
requiredforvalidity,similarwaivers in favorof otherpartiesenumerated herein. lfpossible,the
policiesshallprovide such waivers ofsubrogation by endorsement or otherwise. A waiver of
subrogation shallbe effectiveas to a personor entity even though that person orentity would
otherwise have a duty of indemnification,contractual orotherwise,did not pay the insurance
premium directlyor and
indirectly, whether or notthe personor entityhad an insurableinterest
in
theproperty damaged.
6/25/2016
Joel Banda )JAN I>) g4c'ce gp+/~6
GeneralC tracto am : Date: Subcontractor
Name: Date:
5
Signature:
FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017
NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018
NEWYORK-04 CCOLVER
A CERTIFICATE OF LIABILITY INSURANCE o°",
THIS CERTiFICATE 18 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 CERTlFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUlNG INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER.
IMPORTANT: If the holder
certificate is an ADDITIONAL INSURED, the policy(les)
must be endorsed. If SUBROGATION IS WAIVED, subjectto
the termsand conditionsof the
policy,certainpolicies
may requirean endorsement. A statementon thiscertificate
does not conferrights
to the
certificate
holderinlieu of such
endorsement(s).
PRODUcER CONTACT
NAME:
The B 8 G GroupInc. '
55 West Ames Court,Suite400 Ec..No.Ano•(516)
UVCJ(o..Eat)
576-0400
____ (516)
(Ar+,Jao).'
_Jê/Ali
576-1177
Plainview,NY 11803 aSs:
AFFORDING
INSUREER(S) COVERAGE NAICff
INSURERA:Penn Lumbermens Mutual
INSURl!D gagy B:
New York Builders Inc. & AAMAA
of Stairs Corp. Cr
INSURER
54-05 GrandAvenue o .'
INsURER
Maspoth,NY 11378
F
INSURER
COVERAGES CERTlFICATE NUMBER: REV1SIONNUMBER:
THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD
INDICATED. NO'lWITHSTANDING 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.
EXCLUSIONSAND CONDITIONSOF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS.
I R
LYR TYPEOFINSURANCE N DIWVD' PoUCYNUMBER ( M
(ssNDDIYYYY) ) UMITs
A X ! cOMMeRCIAL
GENERALLlAelLITY EACHOCCURRENCE S 1,000,000
X 31-N187 04/11/2015 04/11/2017 GAUGE TORENTE 100,00Ó
. CLAIMS-MADE
~ OCCuR > sES Eao r ance) S
' .MEDEXP ' 5,000
MEO LAnyone
person) S
I
PERSONAL&ADVINJURY $ isÜ00,000
LIMITAPPLIES
N'LAGGREGATE PER: GENERALAGGREGATE s 2,000,000
PouCY A LOC - COMP/OP 00,000
JECT PRODUCTS AGG $
' OTHER $
LIAB1UTY
AUTOMOBILE M l:DnslNuLEUMil 5
(Eea~ant) 000,000
' '
A X ANYAUTO 31-N187-02-16 02/22/2016 04/11/2017 BODILYINJURY(Perperson) $
' L WNED ULED
)( . AUTOS > X,AUTOS
BODILY
INJURY(Peraccident)$
I,'
t NONOWNED I >PPor PTYGAMA 5
X HIREDAUTOS X A O I Pciddont)
X UMBRELLAUAB X OCCu EACHOCCURRENCE S 5,000,000
A ' ExcessuAB CLAIMS-MADE 31-N187-03-16 04/27/201604/11/2017 AGGREGATE '5 6,Ö00,ÖÓO
DED , 5
?RETENTION $
WORMI!RS
COMPl!NSATION PER . OTH.
,'ANDEMPLOYERS*
UABILITY .JTATUTE .
>ITATUTE, ER _ ,
Y/ N
ANY R -EVEAC
E.L EACHACC_1DENI I5
! B D N/ A
in NH) ' E.L.DISEASE
- EAEMPLOYE5
(Mandatory
r
B es.descdt>cond . POUCYUMITI $
ID C I IIF below
PliRATIONS E.L DISEASE
DESCRIPTION f LOCATIONS
OFOPERATIONS f VEHICLEs Remarks
(ACORD101,Additional Schedule, if morespaceIsrequired)
maybeattached
holder is included as additional
Certificate insuredas required
by written with respects to General Liability.
contract Subject to policy terms, conditions,
and
exclusions.
CERTIFICATE HOLDER CANCELLATION
SHOULDANY OF THE ABOVE DESCRIBEDPOLICIESBE CANCELLEDBEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
CornerstoneBuildersNY LLC ACCORDANCEWITH THEPOLICYPROVISIONS.
199 Lee Avenue#884
Brooklyn,NY 11211
AUTHOR1ZED
REPRESliNTATIVE
© 1988-2014 ACORD CORPORATION. All rights
reserved.
ACORD 25 (2014/01) The ACORD name and logo are registered
marks of ACORD
Preview
FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018 FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018 STANDARD FORM OF AGREEMENT BETWEEN General contractor and Subcontractor AGREEMENT Made as of the June Day of 25 In the year of 201_ 16 BETWEEN General Contractor: Cornerstone Builders NY LLC And the Subcontractor: New York builder of stairs inc WHEREAS the G. Contractor and subcontractor are desired of enteringinto a business arrangements directlyor for indirectly the constructionat thelocation oiled lyn ny 1124E The G. Contractorand the Subcontractor agree as set forth below: ARTICLE 1.0 INDEMNIFICATION 1.I To the fullestextent permittedby law,the Subcontractor agrees toindemnify, defend and hold harmlessthe Owner and theContractor,as wellas allpartiestheowner/ contractorare requiredto indemnify, their officers, directors,agents, employees, members and partners (hereafter collectively"Indemnitees") from any and allclaims,suits,damages, professional liabilities, fees, attorneys' including fees,costs,courtcosts,expenses and disbursements relatedto death,bodily injuryor property damage (includinglossof use thereof)brought againstany ofthe Indemnitees by any person or entity, arisingor allegedto be arisingoutof or in connectionwith or as a result or consequence of theperformance ofthe Work ofSubcontractor,as well as anyadditionalwork, extrawork or add-on work, whether ornot caused inwhole or in partby theSubcontractor orany person or entityemployed, either directlyor indirectlyby the Subcontractor including any subcontractorsthereof and theiremployees. The partiesexpresslyagree thatthisindemnification agreement contemplates 1) full indemnity in the event of liabilityimposed against the Indemnitees without negligence;and 2) partialindemnity in the event of any actualnegligence on the part of the Indemnitees eithercausing or contributing to the underlying claim which Attorneys' negligence is expresslyexcepted from the Subcontractor's obligationtoindemnify, fees, court expenses costs, and disbursements shallbe definedwithout limitto includethose fees, costs,etc. incurred in defending the underlying claim and those fees, costs,etc. incurredin of' connection with the enforcement of thisAgreement. Indemnificationunder thisAgreement shall operate whether ornot the Subcontractorhas placed and maintained the insurancerequired under thisagreement. The Subcontractorshallcause allsubcontract agreements it enters into toinclude thisindemnification clause so as toensure that the Indemniteesshall have the same protection from subcontractorsof alltiersas is afforded by the Subcontractorhereunder. 1.2 In claims againstany personor entity indemnified under thisagreement by an employee of the Subcontractor,the Subcontractor'sSub-subcontractors. anyone directlyorindirectlyemployed by them or anyone forwhose acts they may be liable,the indemnification obligation under this agreement shall notbe limited by a limitation on amount or type ofdamages, compensation, or FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018 benefitspayable by or for the Subcontractor or the Subcontractor's Sub-subcontractors under Workers' or Workmen's Compensation Acts or otheremployee benefit acts. 1.3 in claims againstany person orentity indemnified under thisagreement shallnot extend tothe of liability the Architect,the Architect'sconsultants,and agents and employees of any of them arising out of (1) the preparation or approval of maps, drawing, opinions, reports,surveys, Change Orders, designs,or or specifications, (2)the givingof or thefailureto givedirectionsor instructionby theArchitect,the Architect's and consultants, agents and employees of any of them provided such giving or failure to giveis theprimary cause ofthe injuryor damage. 1.4 Subcontractor waives allrights against Contractor, Owner and Architect and their agents, ol' officers,directors and employees for recovery of damages that shall be covered by his Commercial General Umbrella Liability business liability, auto or liability workers compensation and employers maintained liability per insurance requirementsstatedin thisagreement. ARTICLE 2,0 INSURANCE REQUIREMENTS 2.1 Subcontractor specificallyagrees to maintain the following insurance coverages in the limits provided below: Commercial General - Contractual and employer's Liability including Liability liability (coverage to be issued on a form at leastas broad as ISO form CG001 or equivalentand must include premises-operations hazard,product completed operations,Broad form damage, property Independent contractors. $1,000,000 Each Occurrence S2,000,000 Aggregate on a PER PROJECT basis. Workers' Compensation and Employers Liability: NYS statutory limits (il' Business Automobile (including hired and non-owed auto) $1,000,000 CSL per Accident (if applicable) Excess/ Umbrella Insurance$4,000,000 Each Occurrence $4,000,000 Aggregate The Owner and manager/General Contractor are to be named as an additional insured on a primary noncontributory basisto the Subcontractor's Comprehensive General Liabilitypolicy using appropriate ISO forms that includePremises Operations Liability,Contractual Liability, Advertising and Personal injury Liability,waiver of subrogation endorsement and additional insured for ongoing and Products/Completed Operations Liability,or by using a company specificendorsement thatprovideequivalent protection. 2.2 Coverage writtenon an occurrence basis shallbe maintained without interruptionfrom date of ol' commencement of the Subcontractor's work until expiration of the applicable statuteof limitationsrelatingtolatentdefect inconstructionof orimprovement to realproperty ofthe state in whichthe work is performed. FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018 2.3 CertificatesofInsurance acceptable to theOwner/General Contractor/manager shallbe filedwith ol' the owner/General Contractor prior to commencement of the subcontractor's work. The certificates and insurance policiesrequired by Article2 shallcontain thelanguage shown on the sample certificate enclosed, and containa provisionthatcoverage affordedunder the policieswill days' not be canceled orallowed to expire until at least30 priorwrittennotice has beengiven to the owner/General Contractor. Ifany of theforegoing insurancecoverages are requiredto remain in force afterfinalpayment and are reasonably available,an additional certificate evidencing continuation of such coverage shall be submitted with the finalapplication for payment as required. Ifany information concerning reduction ofcoverage isnot furnishedby the insurer,it shall be furnished by the Subcontractor with reasonable promptness according to the Subcontractor's informationand belief. 2.4 Waivers of Subrogation. The Contractorand Subcontractor waive allrightsagainst(1)each other and any of theirSubcontractors,Sub-subcontractors,agents and employee, each ofthe other,and (2) theowner, the Architect,the Architect'sconsultants,separatecontractors,and any of their subcontractors,sub-subcontractors, agents and employees fordamages caused by fireor other perilsto theextent covered by property insuranceprovided under the Contract or otherproperty ol' insurance applicable to the Work except such rightsas they may have to proceeds of such insurance held by theOwner as fiduciary.The Subcontractor shallrequireof theSubcontractor's Sub-subcontractors, agents and employees. by appropriate agreements, written where legally requiredforvalidity,similarwaivers in favorof otherpartiesenumerated herein. lfpossible,the policiesshallprovide such waivers ofsubrogation by endorsement or otherwise. A waiver of subrogation shallbe effectiveas to a personor entity even though that person orentity would otherwise have a duty of indemnification,contractual orotherwise,did not pay the insurance premium directlyor and indirectly, whether or notthe personor entityhad an insurableinterest in theproperty damaged. 6/25/2016 Joel Banda )JAN I>) g4c'ce gp+/~6 GeneralC tracto am : Date: Subcontractor Name: Date: 5 Signature: FILED: KINGS COUNTY CLERK 06/14/2018 04:34 PM INDEX NO. 504273/2017 NYSCEF DOC. NO. 24 RECEIVED NYSCEF: 06/14/2018 NEWYORK-04 CCOLVER A CERTIFICATE OF LIABILITY INSURANCE o°", THIS CERTiFICATE 18 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 CERTlFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUlNG INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the holder certificate is an ADDITIONAL INSURED, the policy(les) must be endorsed. If SUBROGATION IS WAIVED, subjectto the termsand conditionsof the policy,certainpolicies may requirean endorsement. A statementon thiscertificate does not conferrights to the certificate holderinlieu of such endorsement(s). PRODUcER CONTACT NAME: The B 8 G GroupInc. ' 55 West Ames Court,Suite400 Ec..No.Ano•(516) UVCJ(o..Eat) 576-0400 ____ (516) (Ar+,Jao).' _Jê/Ali 576-1177 Plainview,NY 11803 aSs: AFFORDING INSUREER(S) COVERAGE NAICff INSURERA:Penn Lumbermens Mutual INSURl!D gagy B: New York Builders Inc. & AAMAA of Stairs Corp. Cr INSURER 54-05 GrandAvenue o .' INsURER Maspoth,NY 11378 F INSURER COVERAGES CERTlFICATE NUMBER: REV1SIONNUMBER: THIS IS TO CERTIFYTHAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NO'lWITHSTANDING 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. EXCLUSIONSAND CONDITIONSOF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I R LYR TYPEOFINSURANCE N DIWVD' PoUCYNUMBER ( M (ssNDDIYYYY) ) UMITs A X ! cOMMeRCIAL GENERALLlAelLITY EACHOCCURRENCE S 1,000,000 X 31-N187 04/11/2015 04/11/2017 GAUGE TORENTE 100,00Ó . CLAIMS-MADE ~ OCCuR > sES Eao r ance) S ' .MEDEXP ' 5,000 MEO LAnyone person) S I PERSONAL&ADVINJURY $ isÜ00,000 LIMITAPPLIES N'LAGGREGATE PER: GENERALAGGREGATE s 2,000,000 PouCY A LOC - COMP/OP 00,000 JECT PRODUCTS AGG $ ' OTHER $ LIAB1UTY AUTOMOBILE M l:DnslNuLEUMil 5 (Eea~ant) 000,000 ' ' A X ANYAUTO 31-N187-02-16 02/22/2016 04/11/2017 BODILYINJURY(Perperson) $ ' L WNED ULED )( . AUTOS > X,AUTOS BODILY INJURY(Peraccident)$ I,' t NONOWNED I >PPor PTYGAMA 5 X HIREDAUTOS X A O I Pciddont) X UMBRELLAUAB X OCCu EACHOCCURRENCE S 5,000,000 A ' ExcessuAB CLAIMS-MADE 31-N187-03-16 04/27/201604/11/2017 AGGREGATE '5 6,Ö00,ÖÓO DED , 5 ?RETENTION $ WORMI!RS COMPl!NSATION PER . OTH. ,'ANDEMPLOYERS* UABILITY .JTATUTE . >ITATUTE, ER _ , Y/ N ANY R -EVEAC E.L EACHACC_1DENI I5 ! B D N/ A in NH) ' E.L.DISEASE - EAEMPLOYE5 (Mandatory r B es.descdt>cond . POUCYUMITI $ ID C I IIF below PliRATIONS E.L DISEASE DESCRIPTION f LOCATIONS OFOPERATIONS f VEHICLEs Remarks (ACORD101,Additional Schedule, if morespaceIsrequired) maybeattached holder is included as additional Certificate insuredas required by written with respects to General Liability. contract Subject to policy terms, conditions, and exclusions. CERTIFICATE HOLDER CANCELLATION SHOULDANY OF THE ABOVE DESCRIBEDPOLICIESBE CANCELLEDBEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN CornerstoneBuildersNY LLC ACCORDANCEWITH THEPOLICYPROVISIONS. 199 Lee Avenue#884 Brooklyn,NY 11211 AUTHOR1ZED REPRESliNTATIVE © 1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25 (2014/01) The ACORD name and logo are registered marks of ACORD