On September 12, 2013 a
Exhibit,Appendix
was filed
involving a dispute between
Kevin Mcgonigal,
and
Baring Industries, Inc.,
Nyy Steak Manhattan, Llc,
Plaza Construction Corp.,
for Tort
in the District Court of New York County.
Preview
FILED: NEW YORK COUNTY CLERK 05/12/2023 11:10 AM INDEX NO. 158327/2013
NYSCEF DOC. NO. 616 RECEIVED NYSCEF: 05/12/2023
EXHIBIT C
FILED: NEW YORK COUNTY CLERK 05/12/2023 11:10 AM INDEX NO. 158327/2013
NYSCEF DOC. NO. 616
RECEIVED NYSCEF: 05/12/2023
Harleysville Worcester Insurance Company
355 Maple Avenue
Harleysville, PA 19438-2297
www.harleysvillegroup.com
Insured: B&G Electrical Contractors of NY Inc Policy Number: CMB00000092786K
Agent: USI INSURANCE SERVICES LLC Policy Period: 09/01/2013 to 09/01/2014
DBA AMERISC RENEWAL CERTIFICATE
COMMERCIAL LIABILITY UMBRELLA DECLARATIONS – NEW YORK
Form of Business: Individual Partnership X Corporation Joint Venture Limited Liab. Co. Other
Business Description: Electrical Contractor
IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY,
WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY.
LIMITS OF INSURANCE
EACH OCCURRENCE LIMIT (Liability Coverage) $ 10,000,000
PERSONAL & ADVERTISING INJURY LIMIT $ 10,000,000 Any one person or organization
AGGREGATE LIMIT (Liability Coverage) $ 10,000,000 (except with respect to “covered autos”)
OTHER: $
SELF-INSURED RETENTION: $ 10,000
ALL PREMISES YOU OWN, RENT OR OCCUPY
LOCATION NUMBER: ADDRESS OF ALL PREMISES YOU OWN, RENT OR OCCUPY:
All Underlying Locations
SCHEDULE OF UNDERLYING INSURANCE
Commercial Auto: Commercial Garage Liability:
Company Name: Harleysville Insurance Co of New York Company Name:
Policy Number: BA00000092787K Policy Number:
Policy Period: 09/01/2013 - 09/01/2014 Policy Period:
Policy Limits: $ 2000000 CSL $ occurrence/
$ aggregate
Commercial General Liability: Business Owners Policy:
Company Name: Harleysville Insurance Co of New York Company Name:
Policy Number: MPA00000092785K Policy Number:
Policy Period: 09/01/2013 - 09/01/2014 Policy Period:
General Liability Limits Business Owners Limits
$ 2,000,000 Each Occurrence $ Liability & Medical Expenses
$ 2,000,000 Personal & Adv. Injury $ Products-Completed Ops Aggregate
$ 4,000,000 General Aggregate $ Other than Products-Compl. Ops. Agg.
$ 4,000,000 Products-Completed Ops Aggregate
Employer’s Liability:
Company Name:
Policy Number: Policy Period:
Policy Limits: Bodily injury by accident $ Each Accident
Bodily injury by disease $ Each Employee
Bodily injury by disease $ Policy Limits
PD-0411 (Ed. 10-09) Page 1
Insured Copy Issued: 09/23/2013
Document Filed Date
May 12, 2023
Case Filing Date
September 12, 2013
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FILED: NEW YORK COUNTY CLERK 05/12/2023 11:10 AM INDEX NO. 158327/2013 NYSCEF DOC. NO. 616 RECEIVED NYSCEF: 05/12/2023 EXHIBIT C FILED: NEW YORK COUNTY CLERK 05/12/2023 11:10 AM INDEX NO. 158327/2013 NYSCEF DOC. NO. 616 RECEIVED NYSCEF: 05/12/2023 Harleysville Worcester Insurance Company 355 Maple Avenue Harleysville, PA 19438-2297 www.harleysvillegroup.com Insured: B&G Electrical Contractors of NY Inc Policy Number: CMB00000092786K Agent: USI INSURANCE SERVICES LLC Policy Period: 09/01/2013 to 09/01/2014 DBA AMERISC RENEWAL CERTIFICATE COMMERCIAL LIABILITY UMBRELLA DECLARATIONS – NEW YORK Form of Business: Individual Partnership X Corporation Joint Venture Limited Liab. Co. Other Business Description: Electrical Contractor IN RETURN FOR THE PAYMENT OF THE PREMIUM, AND SUBJECT TO ALL THE TERMS OF THIS POLICY, WE AGREE WITH YOU TO PROVIDE THE INSURANCE AS STATED IN THIS POLICY. LIMITS OF INSURANCE EACH OCCURRENCE LIMIT (Liability Coverage) $ 10,000,000 PERSONAL & ADVERTISING INJURY LIMIT $ 10,000,000 Any one person or organization AGGREGATE LIMIT (Liability Coverage) $ 10,000,000 (except with respect to “covered autos”) OTHER: $ SELF-INSURED RETENTION: $ 10,000 ALL PREMISES YOU OWN, RENT OR OCCUPY LOCATION NUMBER: ADDRESS OF ALL PREMISES YOU OWN, RENT OR OCCUPY: All Underlying Locations SCHEDULE OF UNDERLYING INSURANCE Commercial Auto: Commercial Garage Liability: Company Name: Harleysville Insurance Co of New York Company Name: Policy Number: BA00000092787K Policy Number: Policy Period: 09/01/2013 - 09/01/2014 Policy Period: Policy Limits: $ 2000000 CSL $ occurrence/ $ aggregate Commercial General Liability: Business Owners Policy: Company Name: Harleysville Insurance Co of New York Company Name: Policy Number: MPA00000092785K Policy Number: Policy Period: 09/01/2013 - 09/01/2014 Policy Period: General Liability Limits Business Owners Limits $ 2,000,000 Each Occurrence $ Liability & Medical Expenses $ 2,000,000 Personal & Adv. Injury $ Products-Completed Ops Aggregate $ 4,000,000 General Aggregate $ Other than Products-Compl. Ops. Agg. $ 4,000,000 Products-Completed Ops Aggregate Employer’s Liability: Company Name: Policy Number: Policy Period: Policy Limits: Bodily injury by accident $ Each Accident Bodily injury by disease $ Each Employee Bodily injury by disease $ Policy Limits PD-0411 (Ed. 10-09) Page 1 Insured Copy Issued: 09/23/2013